Winterthur Museum, Garden and Library

About: Winterthur Museum, Garden and Library is a archive organization based out in Wilmington, Delaware, United States. It is known for research contribution in the topics: Bobbin & Piston. The organization has 5740 authors who have published 7489 publications receiving 97728 citations. The organization is also known as: Henry Francis du Pont Winterthur Museum & Henry Francis Du Pont Winterthur Museum.

Clinical Features and Outcomes of Takotsubo (Stress) Cardiomyopathy

Abstract: BackgroundThe natural history, management, and outcome of takotsubo (stress) cardiomyopathy are incompletely understood. MethodsThe International Takotsubo Registry, a consortium of 26 centers in Europe and the United States, was established to investigate clinical features, prognostic predictors, and outcome of takotsubo cardiomyopathy. Patients were compared with age- and sex-matched patients who had an acute coronary syndrome. ResultsOf 1750 patients with takotsubo cardiomyopathy, 89.8% were women (mean age, 66.8 years). Emotional triggers were not as common as physical triggers (27.7% vs. 36.0%), and 28.5% of patients had no evident trigger. Among patients with takotsubo cardiomyopathy, as compared with an acute coronary syndrome, rates of neurologic or psychiatric disorders were higher (55.8% vs. 25.7%) and the mean left ventricular ejection fraction was markedly lower (40.7±11.2% vs. 51.5±12.3%) (P<0.001 for both comparisons). Rates of severe in-hospital complications including shock and death were ...

Variation in FTO contributes to childhood obesity and severe adult obesity

Abstract: The authors identified a set of SNPs in the first intron of the FTO (fat mass and obesity associated) gene on chromosome 16q12.2 that is consistently strongly associated with early-onset and severe obesity in both adults and children of European ancestry with an experiment-wise P value of 1.67 x 10(-26) in 2,900 affected individuals and 5,100 controls. The at-risk haplotype yields a proportion of attributable risk of 22% for common obesity. They conclude that FTO contributes to human obesity and hence may be a target for subsequent functional analyses.

Metal-on-metal bearings and hypersensitivity in patients with artificial hip joints. A clinical and histomorphological study.

Abstract: Background: Some patients who have a total hip replacement with a second-generation metal-on-metal articulation have persistent or early recurrence of preoperative symptoms. Characteristic histological changes in the periprosthetic tissues suggested the development of an immunological response. Therefore, in order to determine the relevance of these symptoms, we performed a study of the clinical data and periprosthetic tissues associated with endoprostheses with a metal-on metal articulation that had been retrieved at revision. Methods: Periprosthetic tissues as well as the clinical data on the patients were obtained from the first nineteen consecutive revisions performed at the treating hospitals. At the time of the revision, fourteen patients had the metal-on-metal articulation exchanged for either an alumina-ceramic or a metal-on-polyethylene articulation. Five patients received another second-generation metal-on-metal total joint replacement. Five-micrometer sections were prepared from the tissue samples, were stained with routine and immunohistochemical methods, and were examined histologically. Histological specimens from three groups of patients, two of which were treated with non-metal-on-metal implants, served as controls. Results: The majority of patients had persistence of their preoperative pain or early recurrence of the pain after the original total hip replacement, and often a pronounced hip joint effusion had developed after the original replacement. Radiographic follow-up showed the development of radiolucent lines in five hips and of osteolysis in another seven hips. At the revision surgery, both the cup and the stem were found to be well fixed in nine patients. The characteristic histological features were diffuse and perivascular infiltrates of T and B lymphocytes and plasma cells, high endothelial venules, massive fibrin exudation, accumulation of macrophages with droplike inclusions, and infiltrates of eosinophilic granulocytes and necrosis. Only a few metal particles were detected. Immunohistochemical analysis demonstrated that the cellular reaction was still active. The patients who received another second-generation metal-on-metal articulation at the time of the revision had no decrease in symptoms. In the control group of tissues obtained at revisions of endoprostheses without cobalt, chromium, or nickel articulations, there were no similar signs of immune reactions. Conclusions: These histological findings support the possibility of a lymphocyte-dominated immunological response. Although the prevalence of this reaction is low, the persistence or early reappearance of symptoms, including a marked joint effusion and the development of osteolysis, after primary implantation may suggest the possibility of such a reaction.

Reactions of the articular capsule to wear products of artificial joint prostheses.

Abstract: Examination of a great number of tissue samples taken from the newly formed capsules surrounding artificial joints reveals small particles of prosthetic material. Abraded from the joint by wear and tear, these particles of plastic, metal, and acrylic cement initiate a foreign-body reaction and result in the formation of granulation tissue, including macrophages and foreign-body giant cells. Typical features of tissue reactions exist for each of the materials from which prostheses are made. The consequent formation of scar tissue produces a thickening of the capsule, which, in turn, may cause a reduction in the mobility of the joint. In small amounts, the foreign-body particles are eliminated via the perivascular lymph spaces. Where this transport system is insufficient to handle the volume, however, the foreign-body response may extend to the whole environment surrounding the joint. In such cases, there may be loosening of the cemented prosthetic parts because of deterioration of contiguous bone anchors by the tissue membrane lining the bone cement.