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At least 1,279 records · Page 71Linked to original sources
PubMed2005

Tumor necrosis factor alpha promotes an osteoblast-like phenotype in human aortic valve myofibroblasts: a potential regulatory mechanism of valvular calcification.

Valvular calcification during calcific aortic stenosis is associated with morphological features of bone formation and expression of various bone-associated proteins, which are both associated with marked leukocyte infiltration of the calcified valve areas. The pro-inflammatory cytokine tumor necrosis factor alpha (TNF-alpha) is abundantly present in areas of leukocyte infiltration in stenotic aortic valves. We therefore hypothesized that valvular calcification might be actively regulated by an inflammatory process involving TNF-alpha. Upon stimulation with TNF-alpha, human aortic valve myofibroblasts cultured under mineralizing conditions showed an increased formation of calcified, alkaline phosphatase (ALP)-enriched cell nodules, ALP activity, concentration of the bone-type ALP isoenzyme, and concentration of osteocalcin, all of which are markers of an osteoblast-like cellular phenotype. By electrophoretic mobility shift assay, DNA binding of the essential osteoblastic transcription factor Cbfa-1 was increased compared to untreated controls. These results support the concept that aortic valve calcification is associated with an osteoblast-like phenotype of local myofibroblasts. In addition, the data demonstrate direct mechanistic evidence that aortic valve calcification may be actively regulated by an inflammatory process involving TNF-alpha.

Aortic Valve↗
PubMedDate not supplied

Brain calcification due to secondary hyperparathyroidism in a child with chronic renal failure.

Secondary hyperparathyroidism (SHPT) has been better treated over the last decades, but the rate of metastatic calcifications, which were rarely seen before, was significantly increased in dialysis patients. The presence of uncontrolled SHPT, disorders of calcium (Ca) and phosphorus homeostasis and the common usage of large doses of vitamin D and Ca- containing phosphate binders may all contribute to the metastatic calcifications of soft tissues and vasculature leading to some life-threatening complications. Although the metastatic lung, heart, kidney, intestinal wall, skin, eye and soft tissue calcifications have been commonly reported in adults and also in children undergoing dialysis, the central nervous system calcification is a very rare condition. We report here a pediatric hemodialysis patient who presented with severe neurological findings due to the metastatic brain calcification secondary to his uncontrolled hyperparathyroidism.

Adolescent↗
PubMed2006

[The role of statins in vascular and valvular calcification].

Vascular calcification, such as coronary and aortic calcification, is a significant feature of vascular pathology, since this lesion is associated with cardiovascular disease. Statins are potent serum cholesterol-reducing drugs, which decrease the risk of cardiovascular diseases. Besides reducing serum cholesterol levels, statins are shown to decrease the rate of coronary artery calcification by unidentified mechanism. Though previous observational studies have shown that statins decrease the rate of calcific aortic valve stenosis, recent prospective study have revealed that statins are not effective against the progression of calcific aortic stenosis. We need to establish the role of statins in the prevention of aortic valve stenosis with long-term, large-scale, randomized controlled study.

Animals↗
PubMedDate not supplied

Algorithm for the treatment of calcific tendinitis in the rotator cuff: indications for arthroscopy and results in our experience.

Calcific tendinitis of the rotator cuff is a relatively frequent pathology and at times, in some phases, it is a disabling one: for this reason, numerous therapeutic options have been proposed. The authors propose an algorithm for the classification and treatment of calcific tendinitis and report their experience with arthroscopic treatment over a three-year period from 2001 to 2004. Based on the algorithm proposed, out of a total of 126 shoulders affected with calcific tendinitis of the rotator cuff for which debridement was indicated, 106 us-guided percutaneous surgeries (EPT), and only 20 arthroscopies were performed. Arthroscopy is indicated, on the basis of the algorithm that we followed, in patients affected by chronic and persistent calcific tendinitis who did not benefit from the execution of previous types of non-surgical treatment for a period of at least 6 to 12 months. Shoulder instability was found to be present in 8 patients out of 20 treated arthroscopically. After arthroscopy, short- and medium-term results were always positive with the exception of one case that evolved into adhesive capsulitis. Based on an analysis of this series, we were able to confirm the usefulness and clinical applicability of an algorithm to classify and treat calcific tendinitis of the rotator cuff; we also confirmed the role of arthroscopic treatment that in cases which did not respond to conservative procedures proved to be effective in resolving symptoms.

Adult↗
PubMed1992

Idiopathic multifocal calcification of the ovarian stroma.

We report an apparently unique case of extensive, bilateral, multifocal calcification of the ovarian stroma. The lesion was an incidental finding in a 50-year-old gravida 5, para 5 woman who underwent a hysterectomy and a bilateral salpingo-oophorectomy. Gross inspection revealed ovaries that were of normal size but stony hard. On microscopic examination, the ovarian stroma was extensively replaced by uniformly distributed, spherical foci of calcification that were focally psammomatous. No underlying cause for the calcification, which probably represents an unusual form of dystrophic calcification, could be identified. The differential diagnosis of ovarian calcification, which may arise in diverse conditions, is discussed.

Calcinosis↗
PubMed1991

[A case of idiopathic, symmetrical non-arteriosclerotic, intracerebral calcification (Fahr's disease) associated with M-proteinemia, followed by multiple myeloma].

We described a 41-year-old woman with idiopathic, symmetrical, non-arteriosclerotic, intracerebral calcification (Fahr's disease), associated with multiple myeloma. CT scans revealed severe calcification in the basal ganglia, floors of cortices, subcortical white matter, brainstem and cerebellum without calcification in the spinal cord. Cerebral angiography showed no evidence of arteriosclerosis. The cerebral blood flow measured by SPECT, parathyroid function and calcium metabolism were within normal range. The initial symptom was dystonia and spasticity in the left leg, when she was 30 years old, followed by gait disturbance, speech impairment, micrographia and dementia. M-proteinemia was pointed out when she 32 years old. M-proteinemia, which was due to primary benign monoclonal immunoglobulinemia (PBMI), made progress slowly, followed by multiple myeloma when she was 40 years old. Periodical CT scans revealed that the intracerebral calcification had worsened gradually through 8 years. Neurological abnormality had also progressed slowly. In literature, there has not been any report about Fahr's disease associated with PBMI and multiple myeloma. Our present study is the first to radiologically prove that the intracerebral calcification in Fahr's disease progresses gradually through its course.

Adult↗
PubMed1991

Clinical, histological, and chemical characterization of ectopic calcification in dialyzed and non-dialyzed patients.

In a review of 11 cases of ectopic calcification (5 of which in dialyzed patients and one in a paraplegic), the authors attempt to characterize this disorder in all its various forms using histological, clinical, and chemical methods. In dialyzed patients, two contributing factors were identified: hyperphosphatemia (plus hypercalcemia) and secondary hyperparathyroidism. In hyperphosphatemic patients the calcifications are multiple, paraarticular, labile, and have a fluid-viscous consistency. In secondary hyperparathyroidism, in addition to the above metastatic calcification there is dystrophic calcification typically localized in the anterior muscles of the hip and thigh. The ectopic calcification of the non-dialyzed patients is true ossification. The precise moment of the onset of the lesion is not always discernable, but its evolution points to primary or secondary local irritation as the trigger. Ossification is the predominant phenomenon in the paraplegic as well, while the triggering mechanism is still unknown.

Adult↗
PubMed1991

Pulmonary calcification caused by Pneumocystis carinii pneumonia. A clinicopathological study of 13 cases in acquired immune deficiency syndrome patients.

Pulmonary microcalcifications were identified in 13 patients with Pneumocystis carinii pneumonia (PCP) and acquired immune deficiency syndrome (AIDS). Several patterns of calcification were noted including bubbly, plate-like, elongate, and conchoidal forms. All calcifications contained P. carinii cysts within them as demonstrated by Grocott's methenamine silver stain. In eight of the 13 cases, the typical intra-alveolar exudate of P. carinii was absent. Therefore, the calcifications were the only histopathologic indication of prior P. carinii infection. The above-mentioned calcifications are important because in five cases they occurred without a prior diagnosis of PCP, subsequent therapy, or prophylaxis. This indicates that in some patients there is destruction of P. carinii organisms with subsequent calcification, and this can occur without therapy.

Acquired Immunodeficiency Syndrome↗
PubMed1991

Clinical importance of coronary calcification detected by CT.

Coronary calcifications appear in advanced atheromatous lesions therefore fluoroscopy is useful for the detection of the atherosclerotic coronary artery disease (Aldrich et al., 1979). However, the detection of coronary calcification by fluoroscopy is difficult in the case of obesity or thick chest wall and also impaired by the background structures including bone and other intrathoracic calcifications. X-ray CT is more advantageous than fluoroscopy in the detection of coronary calcification. It can eliminate the interference from background structures and clearly demonstrates calcified sites of the coronary artery. Therefore, we investigated the clinical usefulness in the detection of coronary calcification with X-ray CT.

Adult↗
PubMed1990

Calcospherite (calcification nodule) size in the short rib polydactyly syndromes.

The short rib polydactyly syndromes (SRP) are lethal neonatal skeletal dysplasias with a narrow chest, short limbs, and other abnormalities. Type II (Majewski) short rib polydactyly can be distinguished from the Type I/III (Saldino-Noonan) type on the basis of radiographic and histologic changes. Our previous transmission electron microscopic studies suggested unusual patterns of cartilage calcification in these syndromes. We evaluate calcification in the present study using scanning electron microscopy and quantitative morphometry of calcification regions digested to expose calcospherite nodules (calcification nodules), distinctive morphologic structures which form during cartilage calcification. Mean calcospherite area of the Majewski Type II SRP (3.5 +/- 0.24 x 10(-6) mm2 (3) (mean +/- sem (n) did not differ from normal control means (3.1 +/- 0.5 x 10(-6) mm2, (3)). The mean area for Type I/III, however, was significantly larger than both the control and Type II means (8.9 +/- 1.16 x 10(-6) mm2 (7), p = .001). This difference in calcospherite size adds a further differentiating feature between these two dysplasias.

Calcinosis↗
PubMed1990

[Echocardiographic evaluation of mitral valve calcification].

Preoperative assessment of calcifications is important in order to choose the correct surgical approach for mitral valve disease. To test the accuracy of echocardiography (ECHO) in the semiquantitative analysis of mitral valve (MV) calcifications we preoperatively echo-studied 66 patients, who were to undergo MV replacement of rheumatic disease. Echocardiograms were performed using a standardized method, recorded on videotape and analyzed by two independent observers. Areas of calcification were identified as dense conglomerate echoes which were brighter than those of adjacent internal structures. After removal, the MVs were evaluated by means of inspection (I), direct radiography (X-ray) and quantitative calcium extraction--EDTA spectrophotometry--(QCa). In the three methods ECHO, I and X-ray, MV calcifications were graded as absent (group 1), mild (group 2) nodular (group 3) and diffuse (group 4). Using the chi square test, no significant differences were found between the three methods, or between ECHO and X-ray, or between ECHO and I, while I grading was slightly lower than X-ray grading (P less than 0.002). Using variance analysis, no significant differences were found in QCa in the three methods within group 1 and 4, whereas significant differences were present within group 2 (P less than 0.002) and group 3 (P less than 0.001), due to the lower sensitivity of I. On the base of the observed distribution of QCa in the removed MVs, the following QCa values: a) less than 20 mg, b) 20-80 mg, c) greater than 80 mg, were considered as the selection criteria for a) absent or mild, b) nodular and c) diffuse calcifications respectively.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1990

Lipid extraction attenuates the calcific degeneration of bovine pericardium used in cardiac valve bioprostheses.

Bovine pericardial bioprostheses frequently fail due to dystrophic calcification. Since (a) recent studies indicate that membrane-associated complexed acidic phospholipids play an important role in the process of both physiologic and pathologic calcification, and (b) cytoplasmic organelles and plasma membrane of interstitial cells seem to serve as initial sites of calcific degeneration of bioprosthetic bovine pericardial tissue, this investigation was undertaken to evaluate whether, and if so, to what extent, the mineralization of valve tissue could be attenuated by previous lipid extraction. Pretreatment of glutaraldehyde-preserved bovine pericardium with acidified sulphuric ether (pH 3.0-4.0) attenuated calcification significantly: 28 days after subcutaneous implantation in young rats the degree of mineral deposition was approximately equal to typical 7 days implants in this model. The mechanism of this beneficial effect is suggested to be due to partial extraction of tissue phospholipids, as demonstrated by electron microscopy, thus reducing the number of available sites for deposition of hydroxyapatite crystals. In addition, and importantly, the present results indicate that any attempt to reduce cardiac valve bioprosthesis mineralization will have to take into account the role of lipids and, particularly, the membranous phospholipids in the calcification mechanism.

Animals↗
PubMed1990

[CT findings of the benign tracheobronchial lesions with calcification].

In the benign tracheobronchial lesions with calcification, tracheobronchopathia osteochondroplastica, relapsing polychondritis and tracheobronchial amyloidosis were considered. CT demonstrated small nodules with calcifications at the trachea with or without deformity of tracheal wall in the case of tracheobronchopathia osteochondroplastica, swelling of tracheal cartilage with diffuse and multiple calcifications in the case of relapsing polychondritis and calcifications in the deep parts of tracheobronchial amyloid nodules. CT findings were able to differentiate those benign lesions. High-resolution CT is more useful in the distribution of abnormal calcification of these diseases.

Aged↗
PubMed1989

[The importance of magnesium in orthopedics. VI. The importance of magnesium in the treatment of ectopic calcification and ossification].

In a five-year investigation the authors demonstrate their results with Mg treatment in 54 patients with ectopic calcifications and ossifications. Based on the results of experimental work, where the inhibiting action of Mg ions on calcium phosphate precipitation was proved in vitro as well as in vivo, the authors treated by means of local MgSO4 injections and oral administration of Mg lactate 17 patients with ossifying myositis, 16 with calcareal bursitis, 4 patients with paraosteoarthropathy of the elbow after craniocerebral injuries, 6 calcifications of the hip joint after operations and 5 calcifications in the insertions of tendons and ligaments. In all instances diminution to complete disappearance of the calcificates and ossificates was observed. The authors achieved also very favourable functional results. In the majority of patients the mobility in adjacent joints was restored. Clinical experience indicates that Mg prevents the development or suppresses further growth of ectopic calcifications and ossifications. During the formation of the ossificate, which is still immature, Mg causes diminution and sometimes complete absorption of the immature bone.

Adolescent↗
PubMed1989

[Thoracic calcification in the elderly--frequency and clinical value].

Chest X-ray films of 200 patients, aged between 90 and 102 years, were analysed for frequency of distribution and varying degrees of thoracic calcification. Calcification was found within the aortic wall in 89%, costal cartilage 79%, lung parenchyma 65%, lung hilum and/or mediastinum 64%, and tracheobronchial cartilages 55%. The degree of calcification was dependent on the tissue and sex involved (significant p less than 0.001). Calcification is of clinical value more often in younger patients than in the elderly. The classification, pathogenesis and differential diagnosis of thoracic calcifications are discussed.

Aged↗
PubMed1989

Hepatic calcification in proliferated bile ductules in a uremic patient.

Hepatic calcification in uremia is rare and, to our knowledge, only two cases have been reported in the English literature. In both previous reports, calcification was found in the damaged hepatocytes in the centrilobular to midzonal area of the hepatic lobules. The patient, a 61-year-old man, was uremic due to diabetic nephropathy. He had suffered posttransfusion hepatitis just before his death. Antemortem radiographic examination of the abdomen failed to visualize the calcification in the liver. At autopsy, microscopic examination of the liver revealed bile ductular proliferation and calcification mainly in the ductular epithelial cells. We suggest that calcification could occur preferentially in abnormally proliferated ductules when the serum calcium and serum phosphorus products are elevated.

Bile Ducts, Intrahepatic↗
PubMed1985

Effect of warfarin on calcification of spontaneously degenerated porcine bioprosthetic valves.

Synthesis of a calcium-binding amino acid, gamma-carboxyglutamic acid, is a vitamin K-dependent enzymatic process. Warfarin inhibits gamma-carboxyglutamic acid synthesis and, therefore, might diminish the calcification of porcine bioprosthetic valves. To evaluate this, we studied 40 porcine bioprosthetic valves removed because of spontaneous degeneration; 17 patients were treated with warfarin (prothrombin time greater than or equal to 1.5 control) and 23 were untreated. Gross visualization of calcification corresponded closely to x-ray visualization of calcification in explanted valves. No grossly visible calcification or only a single localized nodule was shown in 11 of 17 valves (65%) in treated patients and in only five of 23 valves (22%) in untreated patients (p less than 0.02). Histologic examination showed no calcium or only fine specks of calcium in nine of 13 valves (69%) among warfarin-treated patients and three of 19 valves (16%) from untreated patients. Warfarin, therefore, administered in usual clinical doses, appeared to diminish calcification in spontaneously degenerated porcine bioprosthetic valves.

1-Carboxyglutamic Acid↗
PubMed1986

[Pituitary adenoma calcification].

Three hundred and eighteen cases of functioning and non-functioning pituitary adenoma were examined by histological, immunocytochemical and electronmicroscopic technique. Fourty-four of them (13.8%) showed evidence of calcospherites in the tumor tissues. A high incidence of calcospherite is found in functioning adenoma, but not in non-functioning adenoma. Calcification was seen most frequently in cases of prolactinoma (23), GH secreting (7), or GH + PRL tumor (2) and less in adrenocorticotropic hormone secreting adenoma (2) and follicle stimulating hormone secreting adenoma (1). Prolactin and growth hormone might be involved in the control of calcium metabolism. This is because, following adenomectomy in patients with prolactinoma or GH-secreting adenoma with hypercalcemia, there is normalization of serum PRL and GH with reduction in serum calcium. Calcospherite is produced in all of metastatic calcification, arterial calcification, dystrophic calcification and calcinosis. In cases of non-functioning adenoma however, the mechanism is believed to by dystrophic calcification.

Adenoma↗