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PubMedDate not supplied

Myelopathy due to ossification or calcification of the ligamentum flavum: radiologic and histologic evaluations.

The clinical, radiologic, and histologic features of ossification and calcification of the ligamentum flavum were studied in 18 patients. Ossification (15 patients) usually occurred in the lower thoracic spine in men of various ages, while calcification (three patients) was found exclusively in the cervical region of older women. Histologic examinations of ossification showed mature lamellar bone associated with proliferated cartilage replacing the ligamentum flavum (endochondral ossification). This corresponded well with radiographic and computed tomographic (CT) appearances. In the cases with calcification of the ligamentum flavum, calcification within the degenerated ligamentous fibers was observed on histologic examination, and correlated well with an oval nodular density on radiographs and CT. The two conditions differ in clinical, radiologic, and histologic considerations. Pathomechanisms in the development of these lesions and clinical significance are also discussed.

Adult↗
PubMed1983

Extension of calcific deposits in the anterior mitral valve leaflet and mitral valve stenosis severity. Use of 2D Echo parasternal long-axis view.

To evaluate the role of the extent of calcific deposits on the anterior mitral leaflet in predicting the severity of mitral valve stenosis, two-dimensional echocardiography (2D Echo) and heart catheterization data were analysed in 62 patients with mitral valve stenosis, pure or associated with trivial valve regurgitation. 50 patients had technically adequate 2D Echo. Of these, 28 had pure mitral valve stenosis. The mitral valve area was estimated from the parasternal short-axis 2D Echo projection. Using the parasternal long-axis projection, calcium deposits location and extension on the anterior mitral leaflet was examined. Patients were subdivided into the following groups: Group 0 (absence of calcium deposits = 19 patients), Group 1 (calcium on distal third of the leaflet = 19 patients), Group 2 (calcium on mid and distal segments = 11 patients), Group 3 (calcium on the entire leaflet = one patient). The extension of calcium deposits in long-axis projection was contrasted with 2D Echo mitral valve area in the 50 mitral valve patients. 2D Echo and heart catheterization derived mitral valve area were compared to each other in the 28 patients with pure mitral valve stenosis. 2D Echo mitral valve area was greater in Group 0 patients (1.8 +/- 0.4 cm2) than in Group 1 (1.4 +/- 0.4 cm2) and in Group 2 (1.1 +/- 0.3 cm2) (p less than 0.001 between the three groups). Calcific deposits were present on the anterior mitral leaflet in 30/31 patients with 2D Echo mitral valve area less than or equal to 2 cm2. However, of the 19 patients of Group 0, 13 had moderate and one severe mitral valve stenosis. In the 28 patients with pure mitral valve stenosis, 2D Echo mitral valve area was excellently correlated with Gorlin's derived mitral valve area (r = 0.90). However, in patients with extensive calcification of the anterior mitral valve leaflet (Group 2), 2D Echo mitral valve area was significantly greater than the Gorlin's derived area (1.08 +/- 0.20 cm2 versus 0.68 +/- 0.17 cm2; p less than 0.001). In four patients of Group 2, the mitral valve stenosis was moderate by 2D Echo grading and severe by heart catheterization data. Our data suggest that the study of extension of calcific deposits on the anterior mitral valve leaflet may be a complementary aid in quantifying mitral valve stenosis to the 2D Echo mitral valve area estimate, especially when the valve is severely calcified.

Calcinosis↗
PubMed1983

Lipid matrix of dystrophic calcification and urinary stone.

The concept that phospholipids, phosphatidyl serine (PS) in particular, play a role in tissue calcification has emerged recently and progressed rapidly. Membranous cellular degradation products upon various tissue injuries apparently serve as nidi of calcium apatite nucleation. In view of the strong affinity of calcium for PS, and the frequent occurrence of calcification in apposition to the inner surface of membrane where PS resides, it is concluded that exposure of PS to the extracellular fluid with a high calcium concentration upon cell injury is largely responsible for the dystrophic calcification. An abundance of membranous vesicles and other unidentified organic matrices were visualized in decalcified urinary stones. The findings also indicate the prospect of the role of degenerate cell membrane in stone formation as well. Furthermore, red cells adherent to bipyramid calcium oxalate dihydrate crystals apparently enhance crystal growth by mechanism analogous to the kink site formation. Lipid matrix in the form of membrane plays an important role in dystrophic calcification as well as calcium containing stone formation.

Animals↗
PubMed1983

[Calcification of the tricuspid annulus in association with pulmonary stenosis: report of a case].

A 51-year-old woman was admitted to our hospital because of palpitation, dyspnea and anterior chest discomfort. She had had a heart murmur since childhood. On physical examination, a rough grade 6/6 ejection systolic murmur was maximally audible at the second left intercostal space with a systolic thrill. The chest X-ray film showed the cardiothoracic ratio of 54% and the electrocardiogram demonstrated right ventricular hypertrophy. Calcification of the tricuspid annulus was recognized by chest X-ray films (anteroposterior and lateral views), M-mode and cross-sectional echocardiograms and the computed tomogram (CT) of the chest. Cardiac catheterization revealed the presence of valvular pulmonary stenosis and atrial septal defect. These findings were confirmed by surgical operation. Since the first description of Paktovskii in 1960, nine cases of calcification of the tricuspid annulus were reported, but no case has been described in the Japanese literature. Contrary to the mitral annulus, the echocardiographic and computed tomographic features of the calcification of the tricuspid annulus has not been reported previously. In this paper, we reported a middle aged patient with circumferential calcification of the tricuspid annulus in association with severe pulmonary stenosis and atrial septal defect, and the features of the echocardiogram and CT images were illustrated.

Calcinosis↗
PubMed1983

[Case of multiple calcifications of the cerebellar hemisphere].

A 38-year-old woman with three intracerebellar calcifications visible in roentgenogram was reported. She had not suffered from any disease that should induce intracranial calcification. Plain x-ray films of the skull showed three small calcifications in the posterior fossa. The laboratory study and neurological examination revealed no abnormality. Computerized tomography showed no abnormal findings either. Histological examination was carried out. The tissue surrounding the calcification seemed to be gliosis.

Adult↗
PubMed1981

[Coronary artery calcification fluoroscopy. A report on procedure of detection and clinical significance (author's transl)].

The methodology of cardiac fluoroscopy and the clinical significance of the coronary artery calcification are judged on the basis of a study on the group of 396 normal persons, 22.72% of whom resulted to suffer from it, while the report says that 46.80% of a group of 94 patients with coronary artery disease suffer from the same. In normal people the coronary artery calcification has practically the same frequency in both sexes and increases with the age, while in patients with coronary artery diseases there is a higher frequency in the fifth decade and in male sex. The discovery of calcification in all cases always shows an advanced coronary atherosclerosis. In the patients with clinical coronary artery diseases, there are also evidence of significative obstructive lesion. The fluoroscopy of the heart is the most powerful tool for the diagnosis of coronary artery calcification in vivo, it is easy to be used and gives diagnostic information of great value in the study of a coronary artery disease.

Adult↗
PubMed1978

[Symmetric cerebral calcification associated with disturbed parathyroid function (author's transl)].

Alteration of the metabolism of calcium and phosphate may be associated with symmetric cerebral calcification. Detailed investigations of the function of parathyroid glands including computer tomography of the brain are so far missing. In 6 patients with clinical and biochemical signs of altered function of the parathyroid glands symmetric cerebral calcification could be demonstrated by computer tomography. They are also visible by X-ray examination in one patient. Consequently, functional disturbances of the brain, cerebellum and of the extrapyramidal system may occur. Moreover, the combination of hypoparathyroidism and hypothyroidism also appears to result in the development of symmetric cerebral calcification. The pathogenesis of the calcification as well as therapeutic approaches will be discussed.

Adult↗
PubMed1982

Calcification of the basal ganglia on computed tomography.

A review of computed tomograms (CT) of 7,120 patients demonstrated bilateral basal ganglia calcifications in 17. Skull roentgenograms were normal in all patients. Seven patients (41%) were older than 50 years of age with no basal ganglia dysfunction and metabolic abnormalities. Therefore it was thought that they may represent the senescent calcification. The second largest group was idiopathic hypoparathyroidism. These five patients (29%) were 16 to 32 years of age, had convulsive seizures and widespread calcifications. The other five patients had various symptomatology. Hypoparathyroidism should be investigated in young patients, if they have convulsive seizures and widespread basal ganglia calcifications on CT.

Adolescent↗
PubMed1981

[Atheromatous coronary artery disease: value of a study of calcification during assessment (author's transl)].

Correlations between calcifications and stenoses observed on coronarography were studied in 200 patients with coronary heart disease and calcifications in the coronary arteries. There was a very close relationship (p less than 0.0005) between the number of calcified and stenosed main coronary vessels. Calcification in the circumflex and right coronary vessels is a specific sign of stenosis. There was a high frequency of poor arterial beds distal to the stenoses when these were calcified. It is considered that the detection of coronary calcification by means of a brilliance amplifier constitutes one of the most effective non-invasive methods for assessing coronary artery disease.

Adult↗
PubMed1981

Rapidly progressing, massive mitral annular calcification. Occurrence in a patient with chronic renal failure.

Calcification of the mitral annulus developed in a patient while undergoing dialysis. The rapid onset of events corresponded to the onset of end-stage renal failure and uncontrolled secondary hyperparathyroidism. Sequential echocardiograms verified the progression of calcification of the annulus as well as the valve. A new systolic and diastolic murmur and reduced valve orifice on two-dimensional echocardiography suggested acquired nonrheumatic mitral stenosis and insufficiency. We propose that metastatic calcium deposition rather than long-term hypertensive and degenerative effects was the predominant mechanism for massive calcification of the annulus and valve. It is suggested that M-mode echocardiography be used sequentially to follow both the occurrence and progression of calcification of the mitral annulus or valve in patients with chronic renal failure, secondary hyperparathyroidism, or both.

Calcinosis↗
PubMed1980

[Cardiac findings and vascular calcification in arteriosclerotic obstructive disease in the pelvis and leg region. I].

In 117 patients with angiographically ascertained arteriosclerotic obstructive disease in the region of pelvis and leg the smoking of cigarettes in a high degree confirmed itself as atherogenic factor of risk. The rate of hypertension of patients with vascular disease was increased in comparison with the average population. In contrast to a control group of test persons who after clinical angiological examination did not give a clue to a vascular disease the patients with vascular diseases shows a significantly higher percentage of radiologically visible calcifications in the region of the abdominal aorta, the iliacal and the peripheral arteries of the legs. The calcification of the vessels were generalized in 85%. Apart from the calcification of the abdominal aorta the sclerosis was visible above all in the vascular are switched after the obstruction. There were no differences between normotonic and hypertonic patients with vascular diseases concerning the state of sclerosis. Clear correlations between the proof of sclerosations of the vessels and the apparative angiologically measurable narrowing of the vascular system are not known. Nevertheless in our opinion the calcification of the arteries of the legs in younger patients may be regarded as a reference to a disturbance of the arterial blood supply which must be clarified. The densitometrically established content of calcium salt in the calcaneus showed a dependance on the formation of collaterals and the state of sclerosis in the corresponding type of obstruction and may give a quantitative measure for the degree of severity of an ischaemic osteoporosis.

Age Factors↗
PubMed1995

Calcific myonecrosis. A late sequela to compartment syndrome of the leg.

The clinicopathologic features of calcific myonecrosis are presented from results of an examination of 3 cases of this rare syndrome and review of the literature. Calcific myonecrosis is a painful, expansile, calcified mass that develops in muscle several decades after lower extremity trauma that typically has been associated with vascular injury. Plain radiographs show a well-defined and heavily calcified mass replacing the leg musculature. The calcifications are present in a thin, linear pattern and are organized around the periphery of the lesion. Smooth erosion of the adjacent bone may be present, whereas magnetic resonance imaging shows a heterogeneous signal with enhancement limited to the periphery of the mass. Pathologic features consist of a centrally cystic mass arising in muscle filled with friable, tan to dark red, soft debris. The cyst walls are firm and fibrous and contain many needle-like, elongated, calcified shards of necrotic tissue composed of hypocellular fibrous tissue with focal aggregates of hemosiderin-laden macrophages. The cyst contents are composed of necrotic skeletal muscle and acellular amorphous debris containing many cholesterol crystals, fibrin, and recent hemorrhage, including focal aggregates of organizing thrombus. The pathologic findings suggest that calcific myonecrosis might expand with time by virtue of recurrent intralesional hemorrhage into a chronic calcified mass that eventually becomes symptomatic. Surgical intervention is associated with a high rate of complication, particularly in cases in which intralesional procedures have been done.

Aged↗
PubMed1994

Clinical significance of coronary artery calcification.

Coronary artery calcification (CAC) was easily demonstrated by plain CT-scan. The aim of this study was to clarify the clinical significance of CAC in cardiovascular diseases. The subjects were 90 patients with ischemic heart disease (30 myocardial infarction, 50 exertional angina pectoris and 10 variant form of angina pectoris; 46 males and 44 females, 68 +/- 10 y/o) and 50 patients without ischemic heart diseases (30 hypertension, 10 arrhythmia, 3 valvular disease, 2 cardiomyopathy, 2 congenital heart disease and 3 others; 25 males and 25 females 65 +/- 9 y/o). CAC and calcification of thoracic aorta were evaluated by plain CT-scan (1 second scan time and 5 mm slice). The relationship between CAC and other clinical features (age, sex, hypertension, diabetes mellitus, hyperlipidemia, smoking, resting ECG, exercise stress ECG, aortic calcification and optic fundi) were studied. CAC were seen more frequently in patients with ischemic heart disease (63%), old age (67%), aortic calcification (70%) and positive exercise testing (64%). On the other hand, CAC were rare in variant angina (30%). In younger patients (under 70 y/o), CAC were seen more frequently in diabetic patients. But, in older patients, CAC were frequently in those with hyperlipidemia. These results suggested that CAC was associated with not only systemic arteriosclerosis, but also ischemic heart disease, except vasospastic angina. The prognostic value of CAC would be studied later.

Age Factors↗
PubMed1994

[Scrotal calcification associated with hydrocele testis in a child: a case report].

Scrotal calcification is a rare complication of childhood hydrocele testis. Herein, a 12-year-old boy who suffered from left hydrocele testis with intrascrotal calcification is reported. The boy had experienced scrotal pain about 6 months prior to the first visit to our hospital, and gradually noted scrotal swelling. Physical examination revealed left scrotal enlargement with transillumination. Sonographic examination revealed a left hydrocele testis, and a 1.5 cm discrete focus of calcification was found immediate cranio-lateral to the left testis, contour, size and consistency of which were palpated normally. In left hydrocelectomy, no appendix epididymidis was found. A smooth, white, spherical, firm body connecting to the head of the epididymidis was removed. A microscopic examination revealed multiple layers of collagenous tissue with the necrotic tissue in the core. We concluded that this case presented with hydrocele testis secondary to a growing calcification reacting to the infarction due to the repeated torsion of the appendix epididymidis.

Calcinosis↗
PubMedDate not supplied

Intracranial calcification in children on computed tomography.

Pathological intracranial calcifications detected on computed tomography of 83 children during a six-year period were reviewed. The common causes in our series were tuberous sclerosis and intracranial tumors. Other conditions associated with calcification were Sturge-Weber syndrome, neurofibromatosis, Cockayne's syndrome, hypoparathyroidism, arteriovenous malformations, vein of Galen aneurysm, encephalomalacia, cerebral infarcts, subdural hematoma, cerebral infections, birth asphyxia and dihydropteridine reductase deficiency. In two cases (2%), calcifications were idiopathic. The distribution and location of the calcifications in these conditions are discussed.

Adolescent↗
PubMedDate not supplied

[Calcification of the basal nuclei in hypoparathyroidism. The computed and magnetic resonance tomographic aspects].

Six female patients with hypoparathyroidism (2 idiopathic and 4 postoperative cases following total thyroidectomy) were examined with brain CT scans; 4 of them underwent MR exams too. Two patients presented with no symptoms, 4 exhibited extrapyramidal syndrome, tetany, fainting seizures or ischemic attacks and only 2 presented with abnormal calcium-phosphorus balance. CT showed calcifications of the basal nuclei in 5 patients. The caudate nucleus was always affected (100%). The calcifications were in the putamen, globus pallidus and thalamus in 4 cases (80%), in the dentate nuclei, centrum semiovale and cerebral cortex in 2 cases (40%) and in the mesencephalic gray matter in 1 case (20%). In one case only CT failed to detect the abnormalities, which were nevertheless depicted by MRI. In the other 3 patients who underwent MRI, CT findings were confirmed as low-signal areas on SE T1- and T2-weighted MR scans where the calcifications were present, but areas of increased signal intensity were also evident on SE T2-weighted images; in one patient, low-signal areas were surrounded by a ring of increased signal intensity on SE T1-weighted scans. Low-signal areas reflect an early stage of calcium deposition; on the other hand, high-signal areas are probably caused by proteins and mucopolysaccharides or by liquid pools secondary to endothelial membrane incompetence. CT better defined the site and extent of the calcifications which may be found in both idiopathic and postoperative hypoparathyroidism, in symptomatic or asymptomatic patients. On the other hand, MRI seems to be capable of depicting the various stages of calcium deposition on the basis of the presence of reduced or increased SE T2 signal intensity.

Adult↗
PubMedDate not supplied

[The hemodynamic characterization of the diabetic patient with arterial calcifications].

This study was designed to describe the presence of calcifications according to the clinical features of the diabetic patient and the hemodynamics of the calcified arteries. With this purpose, 197 lower limbs from diabetic patients (type I and II) and carbon-hydrate intolerant patients, were studied. In all of the patients, the pressure ratio leg/arm was measured. On the same way, the arterial flow velocity was recorded using the Doppler ultrasonography on the pedia and postero-tibial arteries. The arterial calcifications, evident on the radiography of the foot, were more frequent between the type I patients and the neuro-infections diabetic foot. According to the hemodynamics point of view, we found a trend of association of more pathologic arterial flow velocity curves with the presence of calcifications (specially on the intima layer). It was also remarkable that an arterial incomprensibility was always associated with arterial calcifications.

Adult↗
PubMed1993

[Immunohistological evaluation of parathyroid hormone-related protein in breast cancer with and without calcification on mammography].

PTHrP is the main factor of humoral hypercalcemia of malignancy. PTHrP produces the same effect on renal and osteoblast membrane in vitro and on calcium and inorganic phosphate fluxes in vivo as human PTH. Physiologically, PTHrP is produced by rat mammary tissue during lactation. It is suggested that PTHrP correlates to the metabolism of calcium in the mammary gland. Using anti-PHTrP (1-34) monoclonal antibody 4B3, we investigated the correlation of PTHrP and calcification in breast cancer. All the breast cancers with calcification on mammography showed positive immunostaining. Most cases without calcification, on the other hand, showed negative. Positive PTHrP staining was not related to the any clinical parameter. It is suspected that PTHrP is also one of the main factors of calcification in breast cancer.

Adult↗