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PubMed1993

[Decubitus calcifications of the soft tissues. Comparison between radiology and echography].

In the past, several obstacles hindered the study of decubitus calcifications in soft tissues--i.e., poor prognosis, difficult patients investigation due to their poor health and, finally, unsufficient information yielded by conventional radiology. However, special radiographic techniques and US (with 7.5 MHz probes) allowed satisfactory results to be obtained. US permits the more accurate definition of the site of calcifications, better demonstration of the calcifications with poor calcium content and optimal depiction of structural changes of the muscular bundles following denervation or edema and of skin trophism changes. US limitations, besides those strictly related to the method itself, are: gross calcifications with large posterior shadowing not allowing the deep layers to be investigated, the need of an extremely qualified operator and of a detailed description and, finally, the fact that the exam is long, difficult and stressful to the operator and painful to the patient. In conclusion, US provides both the surgeon and the clinician with useful information and can thus be employed as a routine test, with the additional advantage of not employing ionizing radiations.

Calcinosis↗
PubMed1977

[The significance of coronary artery calcification seen by roentgenoscopy (author's transl)].

The detection of coronary artery calcification by roentgenoscopy is an important hint at possible ischemic heart disease. By the advent of image intensification and magnification, this examination can easily be performed. If no calcifications are visible, an ischemic heart disease must not be excluded. The presence of calcification in the coronary arteries however strongly favours the diagnosis of arteriosclerotic heart disease. The roentgenoscopical search of coronary calcification is considered to be a valuable procedure since it is inexpensive, noninvasive and widely applicable.

Adult↗
PubMedDate not supplied

Disappearance of cerebral calcification as a sign of tumor growth.

Calcification occurs in many benign and malignant neurologic disorders. We describe two patients with cerebral glioma, in whom the disappearance of cerebral calcification was evidence of local malignant change. We discuss the underlying chemical mechanisms that result in tissue calcification, and postulate that calcification may disappear in the presence of a malignant tumor because of a decrease in the pH of the microenvironment.

Adult↗
PubMed1993

[Calcification of the basal ganglia and Fahr disease. Report of two clinical cases and review of the literature].

Computed Tomography (CT) is superior to conventional skull radiographs in detecting calcifications of the basal ganglia. Basal ganglia calcification has been associated with different conditions, abnormality in the calcium-phosphorus metabolism being the most common of these associations. Some patients, without any evident disease, are well documented and called idiopathics of Fahr's syndrome; less numerous patients present familiar trait, with autosomal dominant inheritance. The correlation of neurological impairment with symmetrical calcification of basal ganglia is not so frequent. Here we present two cases of Fahr's disease, in whom CT aspects were very similar, but the neurological manifestations were different. The review of the literature shows, now, that there is no definite pathogenesis of basal ganglia calcifications.

Basal Ganglia↗
PubMedDate not supplied

Myocardial calcification in an extremely low birth weight infant with chronic renal failure and secondary hyperparathyroidism.

Myocardial calcification has been rarely described in premature infants after myocardial infarction and myocarditis with coxsackievirus B1. In adults and older children, metastatic myocardial calcification has been reported in chronic renal failure. We report a case of myocardial calcification in a 680-gm preterm infant after a prolonged course of renal failure complicated by secondary hyperparathyroidism. Subclinical myocardial injury was evidenced by a high serum creatine phosphokinase MB band concentration, which probably provided a susceptible substrate for the deposition of calcium crystals, because the multiplication product of serum calcium and inorganic phosphorus levels transiently exceeded 75 mg x mg/100 ml, indicating serum saturation during the course of secondary hyperparathyroidism. We report this case as an unusual complication of renal immaturity in extremely low birth weight infants and an indication of a relatively intact parathyroid glandular function in them. Hypoxia, myocardial dysfunction, and renal failure are common complications in such infants, and in the presence of renal failure, the serum levels of calcium and inorganic phosphorus should be maintained below the pathologic level to avoid ectopic calcification of the tissues, including the myocardium.

Calcinosis↗
PubMed1995

[Celiac disease with occipital calcifications: 2 late cases].

The association of celiac disease, epilepsy and occipital calcifications with initial clinical manifestations of epilepsy during the first two decades of life with an often progressive and variable course and clinical expression of malabsorption has recently been described. Two cases of celiac disease with occipital calcifications and a presentation with neurologic symptoms in adulthood are reported. The first case is that of a 40-year-old male who presented recurrent and alternating pure brachial monoparesis and later acute abdominal pain following which celiac sprue was diagnosed. The second case is that of a 53-year-old woman diagnosed with celiac sprue 20 years before, presenting permanent myoclonus in the lower limbs which were progressive in severity, ataxic march and generalized tonoclonic seizures. Both patients had bilateral occipital calcifications on CT and celiac disease was demonstrated on biopsy. The first case also showed marked signal alteration in the white matter on MRI. Celiac disease with cerebral calcifications presents also in adulthood with atypical clinical manifestations. Suspicion of celiac disease may be confirmed by non-invasive methods such as antigliadin and antiendomysium antibody determination. CT imaging is characteristic.

Adult↗
PubMed1996

Incidence of Armillifer armillatus (pentastome) calcification in the abdomen.

Analysis of plain abdominal radiographs in 214 patients showed Armillier armillatus calcification in three cases (1.4 pc). Two of these cases were males aged 50 and 70 years respectively. The only female with pentastome calcification was aged 35 years giving a male to female ratio of 2:1. Typically the calcifications were either comma-shaped or rounded with central lucency measuring about 5 mm in diameter. Two (66.7 pc) of the three patients who were positive for parasitic calcification complained of abdominal pain. This however, does not necessarily imply a causal relationship between pentastome infestation and abdominal discomfort.

Abdominal Pain↗
PubMed1996

Digital calcification in systemic sclerosis: effective treatment with good tissue preservation using the carbon dioxide laser.

Tissue calcification of the fingers associated with limited systemic sclerosis is a common problem and is the source of considerable morbidity as it may be extremely tender and cause considerable functional disability. The current treatment of digital calcification is unsatisfactory. We evaluated the use of the carbon dioxide (CO2) laser in the management of this condition in six patients with the limited form of systemic sclerosis. A total of 21 areas of symptomatic digital calcification of the fingers were treated. Complete resolution of symptoms occurred in 12, moderate response with partial improvement was seen in five, little improvement was observed in two, and recurrence of calcinosis was found in two. The patient's average healing time was 6 weeks (range 4-10). The median duration of follow-up was 20 months (range 12-40). Postoperative infection was seen in two patients, and resolved completely in both with the use of topical and oral antibiotics. We found the CO2 laser a simple and effective treatment for most of the symptomatic lesions of digital calcification, and it may obviate the need for deforming surgery in many cases.

Adult↗
PubMed1996

Calcific degeneration of bioprosthetic aortic valves in patients receiving steroid therapy.

BACKGROUND AND AIMS OF THE STUDY: Calcification of glutaraldehyde-preserved bioprosthetic valves is a frequent long-term complication of valve replacement, although the mechanism responsible for such degeneration is not clearly understood. In the current study, we investigated the calcific degeneration of bioprosthetic aortic valves in patients who had been given steroid treatment for aortitis in order to evaluate the immune response to glutaraldehyde-preserved bioprostheses. METHODS: Ten patients who had undergone aortic valve replacement with bioprosthetic valves were studied. Their mean age was 48.4 years (range: 27 to 64 years). Aortitis was due to Takayasu disease in eight patients and to Behcet aortitis in two. The bioprosthetic valves used included bovine pericardial xenografts (n = 8) and porcine aortic valves (n = 2). The mean daily dosage of prednisone was 10.1 mg (range: 2.5 to 60 mg); mean duration of therapy was 8.0 years. The mean patient follow up, using echocardiography, was 11.5 years (range: 8.5 to 16 years). The total follow up period was 115 patient-years. RESULTS: During follow up, three reoperations were required because of valve detachment, aortic insufficiency due to perforation of the aortic cusp, and aortic insufficiency with coronary orifice stenosis, respectively. No reoperations were required for stenotic degeneration of the bioprosthetic valves. Seven bioprosthetic valves were still functioning between 8.5 and 16 years after implantation. Calcific degeneration in two of three bovine pericardial valves that required replacing was surprisingly minimal; separation of collagen fibers in the valves by infiltration with plasma proteins was also minimal. CONCLUSIONS: These results suggest that the calcific degeneration of bioprosthetic valves may be decreased by concomitant steroid therapy for aortitis, though further research will be required to confirm this effect and to determine the mechanism(s) involved.

Adult↗
PubMed1996

[Influence of the degree of aortic valve calcification on the estimate of valvular area using planimetry with transesophageal echocardiography].

BACKGROUND AND PURPOSE: Continuity equation to measure aortic valve area is limited by poor acoustic window or difficulty in obtaining acceptable Doppler signal. Our aim has been to analyze the accuracy of planimetry by transesophageal echocardiography to calculate aortic valve area and the impact of calcification on results. METHODS: Planimetry of aortic valve area by transesophageal echocardiography has been compared to continuity equation by transthoracic approach and the Gorlin formula in 26 consecutive patients with aortic stenosis. Degree of calcification was qualitatively estimated by the 3 methods and 2 groups were distinguished: group A (mild or moderate calcification) and group B (severe calcification). RESULTS: An excellent agreement between continuity equation and the Gorlin formula was found (mean difference: 0.03 +/- 0.15 cm2). Agreement between transesophageal planimetry and the Gorlin formula was poor (mean difference: 0.14 +/- 0.25 cm2). Planimetry and the Gorlin formula demonstrated an excellent agreement in group A (mean difference: -0.03 +/- 0.17 cm2). By contrast, agreement in group B was not acceptable (mean difference: 0.27 +/- 0.22 cm2). CONCLUSIONS: 1) continuity equation by transthoracic echocardiography is useful in calculating aortic valve area. 2) aortic planimetry by transesophageal echocardiography is an excellent method in noncalcified aortic valves, and must not be used on severely calcified valves.

Adult↗
PubMed1996

Mammograms may convey more than breast cancer risk: breast arterial calcification and arterio-sclerotic related diseases in women of the DOM cohort.

In a cohort of 12,239 women aged 50-69, who participated in a population-based breast cancer screening project (DOM-project) in Utrecht, The Netherlands, as well as being coded for micro-calcifications indicative of breast cancer, the mammograms were also coded for arterial calcifications. This allowed for a secondary analysis of associations between breast arterial calcification (BAC) and the occurrence of arteriosclerosis-associated morbidity (ie diabetes, hypertension, albuminuria, stroke, thrombosis and myocardial infarction). Arterial calcifications were seen on screening mammograms in 9.1% of the women. Significant relations were found between BAC and albuminuria [Relative risk (RR) 2.7; 95% CI 1.0-7.0], BAC and hypertension (RR 1.1; 95% CI 1.0-1.3), transient ischaemic attack (TIA)/stroke (RR 1.4; 95% CI 1.1-1.8), thrombosis (RR 1.5; 95% CI 1.0-2.2) and myocardial infarction (RR 1.8; 95% CI 1.1-2.9). In addition BAC were associated with diabetes in the oldest age-group (RR 1.7; 95% CI 1.2-2.4). All relations were adjusted for age, smoking, parity and Quetelet index. The results of the present study show that BAC as detected on breast cancer screening mammograms are associated with disorders related to increased or accelerated arterio-sclerosis. Where increased parity is associated with a decrease in breast cancer risk, parity increases the occurrence of BAC. The present study suggests that breast-cancer screening mammograms may allow for the early detection of enhanced cardiovascular disease risk among otherwise healthy women.

Aged↗
PubMed1997

[Calcification of the tunica vaginalis].

OBJECTIVE: To describe a case of calcification of the tunica vaginalis testis in a patient with hydrocele and a history of trauma to the external genitalia. METHODS: The patient consulted for progressively increasing size of right hemiscrotum. Patient evaluation led to the diagnosis of hydrocele with calcification of the tunica vaginalis testis, which had to be distinguished from other calcified intrascrotal lesions, especially testicular cancer. RESULTS: The surgical and histopathological findings confirmed the diagnosis of hydrocele with calcification of the tunica vaginalis. CONCLUSION: Calcification of the tunica vaginalis testis is uncommon and difficulty is encountered in making the preoperative differential diagnosis. Ultrasound and subsequent histopathological analysis confirmed the nature of the lesion in the case described.

Aged↗
PubMed1998

Unique CT imaging advantages. Hemorrhage and calcification.

Computed tomography remains the imaging modality of choice in the detection of two processes: acute intracranial hemorrhage and calcification; however, in the subacute and chronic stages of hemorrhage, MR imaging is more sensitive in aging and staging hemorrhage. FLAIR imaging increases the sensitivity of MR imaging in the detection of subarachnoid hemorrhage. The signal characteristics of calcification on MR imaging is variable, especially on T1-weighted images decreasing its detectability. CT is superior to MR imaging in the detection of calcification. A number of factors including slice thickness, as well as window width and level may affect the detectability of calcification on CT.

Acute Disease↗
PubMed1976

Gonadal calcification. Indication for gonadectomy in gonadal dysgenesis.

Germ cell tumors, including gonadoblastoma, are usually found in patients with gonadal dysgenesis who have Y chromatin in their genotype. Diffuse calcification is a common finding in gonadoblastomas. Bilateral calcifications in the gonadal sites were seen on the intravenous pyelogram of a patient with 46,XX pure gonadal dysgenesis. Although the calcification was present in the fimbria of the fallopian tube, we suggest that gonadectomy is indicated in the patient with gonadal dysgenesis and probably gonadal calcification.

Adolescent↗
PubMed1998

The effect of cholesterol reduction with fluvastatin on aortic compliance, coronary calcification and carotid intimal-medial thickness: a pilot study.

BACKGROUND: Regression of atheroma with reduction of cholesterol levels is recognized to occur, but less is known about reversal of sclerosis. Non-invasive indices of sclerosis have largely been based on carotid ultrasound measurements. OBJECTIVE: To measure aortic compliance, coronary calcification and carotid intimal-medial thickness during reduction of cholesterol level in patients with and without coronary artery disease. METHODS: We studied 64 hypercholesterolaemic patients, 24 with and 40 without coronary artery disease. All were administered fluvastatin for 1 year. Aortic compliance was assessed using magnetic resonance and coronary calcification score was determined by electron beam computed tomography. Carotid intimal-medial thickness in 34 patients was measured by carotid ultrasound means. RESULTS: There was a rise in high-density lipoprotein cholesterol level and falls in total cholesterol level, low-density lipoprotein cholesterol level, low: high-density lipoprotein ratio, triglyceride level and very-low-density lipoprotein cholesterol level. Coronary artery disease patients had a higher coronary calcification score (442 +/- 551) than did other patients (269 +/- 724, P = 0.0002). For both groups there was a small rise in coronary calcification score during the study. Mean aortic compliance rose and blood pressure and carotid intimal-medial thickness fell. Analysis revealed significant correlations between change in mean aortic compliance and changes in high-density lipoprotein level (r = 0.3, P = 0.036), very-low-density lipoprotein level (r = -0.31, P = 0.038) and low: high-density lipoprotein ratio (r = -0.35, P = 0.014). There was no significant difference in these changes between the two patient groups. CONCLUSION: An improvement in aortic compliance over 1 year indicates that increase in high-density lipoprotein level, decrease in very-low-density lipoprotein level and improvement in low: high-density lipoprotein ratio caused by administration of fluvastatin beneficially influenced vascular pathophysiology in hypercholesterolaemic patients with and without coronary artery disease. In those patients studied with carotid ultrasound means, carotid intimal-medial thickness decreased from 1.09 to 0.87 mm (P = 0.004), corroborating these results.

Anticholesteremic Agents↗
PubMed1998

Surface modification of polyurethane heart valves: effects on fatigue life and calcification.

Polyurethane heart valves can be functionally durable with minimal calcification, in vitro. In vivo, these characteristics will depend on the resistance of the polyurethane to thrombogenesis and biodegradation. Surface modification may improve the polyurethane in these respects, but may adversely affect calcification and durability. This study investigates the effects of surface modifications of two polyurethane heart valves (PEU and PEUE) on their in vitro fatigue and calcification behaviour. Modifications included heparin, taurine, 3-aminopropyltriethoxysilane and polyethylene oxide (PEO). Neither hydrodynamic function nor leaflet thickness distribution was significantly altered by surface modification. PEO-modification was detrimental to valve fatigue durability and calcification. Heparin, taurine or aminosilane modifications of PEU valves increased durability. Aminosilane modification of PEUE valves increased durability compared with PEO modification. Appropriate surface modification may be useful to improve blood compatibility of implantable polyurethanes, and may also be advantageous as regards fatigue durability of flexing materials in longterm applications.

Analysis of Variance↗
PubMed1996

Dental development in chimpanzees (Pan troglodytes): the timing of tooth calcification stages.

Data are presented documenting the timing of tooth calcification for the left mandibular dentition (I1-M3) based on a cross-sectional series of intraoral dental X-rays from a sample of 118 captive chimpanzees. Mean, median, and midpoint ages of attainment; standard deviations (SD); interquartile ranges (IQR); and age ranges were calculated for the eight developmental stages of these teeth. Minor differences with previous studies of chimpanzee dental development were found (Anemone et al. [1991] Am. J. Phys. Anthropol. 86:229-241; Anemone and Watts [1992] J. Hum. Evol. 22:149-153), but the similarities with previous studies are more striking despite the differences in samples. In contrast to other pongid studies, sex differences in developmental timing were documented, particularly for the canine. Regression models for age estimation from dental maturity scores were also presented. This chimpanzee standard is compared with human standards to determine absolute and relative differences in the timing of crown and root calcification. The overall period of canine development in both species is nearly identical, although those for crown and root formation are markedly different--making this tooth the most distinctive feature between chimpanzee and human dental development periods. Although the molars demonstrate differences in the timing of crown and root calcification periods, they are more proportional than for other teeth. This contributes to the difficulties in distinguishing between "human" and "chimpanzee" patterns of molar development. The developmental differences discussed are placed in perspective with consideration to microstructural and morphological features of chimpanzee and human teeth, and to overall growth periods in these species.

Animals↗
PubMed1997

Factors which affect the calcification of tissue-derived bioprostheses.

Mineralization of implanted bioprostheses poses a major clinical problem. Crosslinking of collagenous matrices, a process used to render tissues relatively inert and nonbiodegradable, seems to encourage calcification. Residual, noncovalently bound glutaraldehyde, as well as glutaraldehyde crosslinks which can be degraded with time, seem to play a role in this connection. Our findings demonstrate the need to carefully remove noncovalently or labile-associated glutaraldehyde by thorough rinsing or neutralization before implantation. Components of a valve prosthesis such as cusps and aortic wall, which are known to vary in their proportions of collagen, elastin, and noncollagenous proteins and to calcify to different extents, can both be prevented from calcifying if treated with a biphosphonate before implantation. Calcification can also be reduced by selective enzymatic removal of noncollagenous materials. In addition to the age of rats, animals usually used to evaluate calcification, the strain of animal can markedly affect the response. The Fischer-344 rat, a highly inbred animal, will not calcify exhaustively rinsed implants. Our findings suggest that multifactorial approaches may have to be combined to generate the most ideal bioprostheses. These should include careful removal of noncovalently bound glutaraldehyde, neutralization of the nonbifunctionally reacted residues, removal of lipids and noncollagenous proteins (and possibly the more antigenic nonhelical collagen telopeptides), as well as inclusion of agents such as biphosphohates, which by interfering with crystal growth prevent the accumulation of mineral in the interstices of the tissue.

Animals↗