Cardiac Calcified Amorphous Tumor in the Neonatal Period

Calcified amorphous tumor (CAT) of the heart is a rare nonneoplastic cardiac mass that may exhibit symptoms resembling malignancy. In this report, we presented a 4-month-old male baby with repeated attacks of cyanosis and a cardiac murmur. Echocardiography revealed a tumoral noncircumscribed mass in the right atrium adhering to the interatrial septum which extends to the inferior vena cava. Cardiac exploration was carried out to excise the tumor. A histopathological study demonstrated the presence of thrombus-like tissue with extensive calcification and foreign body type giant cell reactions. After operation, the patient had an uneventful hospitalization. Although CAT is mainly diagnosed in adult patients, it should be considered in the causes of cardiac mass in the neonatal period.

Idiopathic mesenteric phlebosclerosis (IMP) with sepsis and death: a case study

Idiopathic mesenteric phlebosclerosis (IMP) is a rare clinical manifestation of ischemic enteropathy. There are no specific manifestations in the early stages. Digestive symptoms only present in the advanced stage. Diagnosis relies on extensive calcification of the mesenteric venule and extensive intestinal wall thickening via computed tomography (CT) scanning. A 50 years old Chinese woman who had taken herbal medicine for three years was diagnosed with IMP. All treatment after admission was in vain and she died 30 days thereafter. Therefore, when a patient with long-term oral intake of herbal medicine, which contains geniposde, presents with unknown ischemia, abdominal pain, mucinous stools, bloody stools, attention should be paid to screen IMP.

3D-Printed Coronary Plaques to Simulate High Calcification in the Coronary Arteries for Investigation of Blooming Artifacts

The diagnostic value of coronary computed tomography angiography (CCTA) is significantly affected by high calcification in the coronary arteries owing to blooming artifacts limiting its accuracy in assessing the calcified plaques. This study aimed to simulate highly calcified plaques in 3D-printed coronary models. A combination of silicone + 32.8% calcium carbonate was found to produce 800 HU, representing extensive calcification. Six patient-specific coronary artery models were printed using the photosensitive polyurethane resin and a total of 22 calcified plaques with diameters ranging from 1 to 4 mm were inserted into different segments of these 3D-printed coronary models. The coronary models were scanned on a 192-slice CT scanner with 70 kV, pitch of 1.4, and slice thickness of 1 mm. Plaque attenuation was measured between 1100 and 1400 HU. Both maximum-intensity projection (MIP) and volume rendering (VR) images (wide and narrow window widths) were generated for measuring the diameters of these calcified plaques. An overestimation of plaque diameters was noticed on both MIP and VR images, with measurements on the MIP images close to those of the actual plaque sizes (<10% deviation), and a large measurement discrepancy observed on the VR images (up to 50% overestimation). This study proves the feasibility of simulating extensive calcification in coronary arteries using a 3D printing technique to develop calcified plaques and generate 3D-printed coronary models.

EFFICACY OF KSHEERABASTI IN THE MANAGEMENT OF GARBHAKSHAYA W.S.R. TO INTRAUTERINE GROWTH RETARTDATION - A CASE REPORT

Intrauterine growth restriction is quite common condition now a days and needs intensive fetal surveillance and proper antepartum and intra-partum care. IUGR may result in significant fetal morbidity and mortality if not properly diagnosed and treated. The condition is most commonly caused by inadequate maternal-fetal circulation, resulting in decrease in fetal growth. In Ayurveda, IUGR can be considered under Garbhakshaya. In Garbhakshaya according to Acharya Sushruta, Garbhaaspandana and Anunatkukshitta mentioned which is mainly due to the inadequate nutrition to fetus. Acharya Sushruta has mentioned the usage of Ksheerabasti from 8th month onwards to nourish the fetus in Garbhakshaya. In present case study, A 29-year-old pregnant woman with period of gestation 37 weeks 1 day was came to OPD of PTSR dept. National institute of Ayurveda (Deemed to be university). On examination her fundal height was found less than period of amenorrhoea. USG report showed single live intrauterine pregnancy of 35 weeks 3 days with IUGR and extensive calcification in placenta, was treated with Ksheerabasti, administered for 10 days once in the morning in the dose of 450 ml per day. After 10 days of above said treatment USG report was repeated and marked improvement was observed with no calcification and a healthy baby was delivered with normal Apgar score. So here Shatavari, Vidarikanda and Yashtimadhu sadhita Ksheerabasti is very effective treatment modality to improve IUGR and for good nourishment of fetus. Keywords: Garbhakshaya, IUGR, Ksheerabasti, Shatavari, Vidarikanda, Yashtimadhu etc.

Disruption of Abcc6 Transporter in Zebrafish Causes Ocular Calcification and Cardiac Fibrosis

Pseudoxanthoma elasticum (PXE), caused by ABCC6/MRP6 mutation, is a heritable multisystem disorder in humans. The progressive clinical manifestations of PXE are accompanied by ectopic mineralization in various connective tissues. However, the pathomechanisms underlying the PXE multisystem disorder remains obscure, and effective treatment is currently available. In this study, we generated zebrafish abcc6a mutants using the transcription activator-like effector nuclease (TALEN) technique. In young adult zebrafish, abcc6a is expressed in the eyes, heart, intestine, and other tissues. abcc6a mutants exhibit extensive calcification in the ocular sclera and Bruch’s membrane, recapitulating part of the PXE manifestations. Mutations in abcc6a upregulate extracellular matrix (ECM) genes, leading to fibrotic heart with reduced cardiomyocyte number. We found that abcc6a mutation reduced levels of both vitamin K and pyrophosphate (PPi) in the serum and diverse tissues. Vitamin K administration increased the gamma-glutamyl carboxylated form of matrix gla protein (cMGP), alleviating ectopic calcification and fibrosis in vertebrae, eyes, and hearts. Our findings contribute to a comprehensive understanding of PXE pathophysiology from zebrafish models.

Anton Ghon and His Colleagues and Their Studies of the Primary Focus and Complex of Tuberculosis Infection and Their Relevance for the Twenty-First Century

Anton Ghon is well known in the field of childhood tuberculosis, and the tuberculosis primary focus and complex are frequently called the Ghon focus and complex; this is largely the result of the wide publication of the English translation of his monograph <b>“</b>Der primäre Lungenherd bei der Tuberkulose der Kinder.” Ghon’s studies are frequently quoted, but precise details of his monograph are neglected, his results often misquoted, and his later publications virtually unknown. This review highlights aspects of Ghon’s anatomical pathology studies in children and adults not necessarily dying of tuberculosis but with signs of tuberculosis infection. Ghon found a single primary tuberculosis focus in approximately 80% of tuberculosis-infected children situated close to the pleura in two-thirds of cases. Cavitation of the focus was common, and lymphatic spread involved lymph nodes in the abdomen and neck in many children. Studies amongst adults and children frequently found the healed primary tuberculosis focus to be completely calcified without histological signs of tuberculosis activity; however, particularly in the presence of pulmonary tuberculosis, histological signs of tuberculosis activity were often found in the lymph nodes of the angulus venosus, despite apparent healing with extensive calcification. Both earlier studies and more recent investigations, with molecular biological tools, unavailable to Ghon and earlier researchers, have confirmed the presence of viable mycobacteria in apparently normal or healed thoracic nodes and also found molecular biological indications of viable mycobacteria in these nodes. As suggested by Ghon, lympho-haematogenous spread of tuberculosis may be more common than is usually appreciated.