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Cardiovascular Pathology : the Official... 2016Aortic valve replacement for calcific aortic valve stenosis is one of the more common cardiac surgical procedures. However, the underlying pathophysiology of calcific... (Comparative Study)
Comparative Study
BACKGROUND
Aortic valve replacement for calcific aortic valve stenosis is one of the more common cardiac surgical procedures. However, the underlying pathophysiology of calcific aortic valve stenosis is poorly understood. We therefore investigated the histologic findings of aortic valves excised for calcific aortic valve stenosis and correlated these findings with their associated clinical features.
RESULTS AND METHODS
We performed a retrospective analysis on 6685 native aortic valves excised for calcific stenosis and 312 prosthetic tissue aortic valves with calcific degeneration at a single institution between 1987 and 2013. Patient demographics were correlated with valvular histologic features diagnosed on formalin-fixed, decalcified, and paraffin embedded hematoxylin and eosin stained sections. Of the analyzed aortic valves, 5200 (77.8%) were tricuspid, 1473 (22%) were bicuspid, 11 (0.2%) were unicuspid, and 1 was quadricuspid. The overall prevalence of osseous and/or chondromatous metaplasia was 15.6%. Compared to tricuspid valves, bicuspid valves had a higher prevalence of metaplasia (30.1% vs. 11.5%) and had an earlier mean age of excision (60.2 vs. 75.1 years old). In addition, the frequency of osseous metaplasia and/or chondromatous metaplasia increased with age at time of excision of bicuspid aortic valves, while tricuspid aortic valves showed the same incidence regardless of patient age. Males had a higher prevalence of metaplasia in both bicuspid (33.5% vs. 22.3%) and tricuspid (13.8% vs. 8.6%) aortic valves compared to females. Osseous metaplasia and/or chondromatous metaplasia was also more common in patients with bicuspid aortic valves and concurrent chronic kidney disease or atherosclerosis than in those without (33.6% vs. 28.3%). No osseous or chondromatous metaplasia was observed within the cusps of any of the prosthetic tissue valves.
CONCLUSIONS
Osseous and chondromatous metaplasia are common findings in native aortic valves but do not occur in prosthetic tissue aortic valves. Bicuspid valves appear to have an inherent proclivity for metaplasia, as demonstrated by their higher rates of osseous metaplasia and/or chondromatous metaplasia both overall and at earlier age compared to tricuspid and prosthetic tissue aortic valves. This predilection could be due to aberrant hemodynamic forces on bicuspid valves, as well as intrinsic genetic changes associated with bicuspid valve formation. Aortic valve interstitial cells may play a central role in this process. Calcification of prosthetic tissue valves is most likely a primarily dystrophic phenomenon.
Topics: Adult; Aged; Aged, 80 and over; Aortic Valve; Aortic Valve Stenosis; Bicuspid Aortic Valve Disease; Boston; Calcinosis; Female; Heart Valve Diseases; Heart Valve Prosthesis; Heart Valve Prosthesis Implantation; Humans; Male; Metaplasia; Middle Aged; Prevalence; Retrospective Studies; Risk Factors
PubMed: 26386747
DOI: 10.1016/j.carpath.2015.08.008 -
Annals of Biomedical Engineering Aug 2022The reconstruction of large skeletal defects is still a tricky challenge in orthopedics. The newly formed bone tissue migrates sluggishly from the periphery to the... (Review)
Review
The reconstruction of large skeletal defects is still a tricky challenge in orthopedics. The newly formed bone tissue migrates sluggishly from the periphery to the center of the scaffold due to the restrictions of exchange of oxygen and nutrition impotent cells osteogenic differentiation. Angiogenesis plays an important role in bone reconstruction and more and more studies on angiogenesis in bone tissue engineering had been published. Promising advances of angiogenesis in bone tissue engineering by scaffold designs, angiogenic factor delivery, in vivo prevascularization and in vitro prevascularization are discussed in detail. Among all the angiogenesis mode, angiogenic factor delivery is the common methods of angiogenesis in bone tissue engineering and possible research directions in the future.
Topics: Angiogenesis Inducing Agents; Bone Regeneration; Bone and Bones; Cell Differentiation; Humans; Neovascularization, Pathologic; Neovascularization, Physiologic; Osteogenesis; Tissue Engineering; Tissue Scaffolds
PubMed: 35525871
DOI: 10.1007/s10439-022-02970-9 -
Veterinary Pathology Mar 2021Degenerative changes in the aorta are commonly observed in both dogs and humans, and those changes that occur with age morphologically overlap with those observed in...
Degenerative changes in the aorta are commonly observed in both dogs and humans, and those changes that occur with age morphologically overlap with those observed in genetic or degenerative diseases. Therefore, recognition of age-related aortic changes is important for diagnosticians, as such histologic findings should be distinguished from lesions of specific diseases. The aortas from 37 dogs without clinical cardiovascular disease ranging in age from 2 months to 15 years were divided into 3 cohorts to assess age-relatedness, and evaluated histologically using standardized nomenclature and diagnostic criteria adapted and modified from the human literature. We found that the histopathologic severity scores for intimal thickening, translamellar medial fibrosis, loss of smooth muscle cell nuclei, and medial microcalcification were higher in older dogs, whereas the scores for both intralamellar and translamellar mucoid extracellular matrix accumulation ("cystic medial necrosis") were not different among age groups. Dogs with translamellar medial fibrosis and aortic medial microcalcification were significantly older compared with dogs without these findings, while the presence of aortic medial chondro-osseous metaplasia was not related to age. Taken together, we demonstrate a range of age-related aortic histologic changes in dogs without clinical cardiovascular disease and suggest that integration of signalment and clinical data can aid in the differentiation of such findings from non-age-related disease processes.
Topics: Animals; Aorta; Dogs
PubMed: 33205711
DOI: 10.1177/0300985820970499 -
Eplasty 2017Lipomas are very common benign tumors located in any part of the body in which fat is normally present, but lipomas containing both osseous and cartilaginous elements...
Lipomas are very common benign tumors located in any part of the body in which fat is normally present, but lipomas containing both osseous and cartilaginous elements are rare. A case of osteochondrolipoma in a 72-year-old man is reported. The tumor in the mental region was 2×1.5×1.5 cm. After resection of the tumor, there has been no recurrence during the 6-month postoperative follow-up. Histological examination confirmed the definitive diagnosis. Osteochondrolipoma is an extremely unusual lesion that should be kept in mind in the differential diagnosis of soft-tissue tumors.
PubMed: 29238440
DOI: No ID Found -
Rheumatic Diseases Clinics of North... Nov 2016Inflammatory and chronic structural changes are objective signs of axial spondyloarthritis. In the sacroiliac joints (SIJs), inflammation (sacroiliitis) can be... (Review)
Review
Inflammatory and chronic structural changes are objective signs of axial spondyloarthritis. In the sacroiliac joints (SIJs), inflammation (sacroiliitis) can be visualized as bone marrow edema, whereas chronic structural changes are visualized as fat metaplasia, erosions, sclerosis, or ankylosis in the area of the SIJ. In the spine, bone marrow edema in the vertebral bodies represents spondylitis but can also affect the facet and the costovertebral and costotransverse joints (arthritis), whereas structural changes are visualized as fat metaplasia, sclerosis or syndesmophytes and ankylosis at the vertebral edges.
Topics: Arthritis; Humans; Inflammation; Magnetic Resonance Imaging; Radiography; Sacroiliac Joint; Severity of Illness Index; Spine; Spondylarthropathies; Spondylitis, Ankylosing
PubMed: 27742020
DOI: 10.1016/j.rdc.2016.07.006 -
Annals of Palliative Medicine Feb 2021Tracheobronchopathia osteochondroplastica (TO) is a benign rare disease characterized by multiple tracheobronchial nodules, which has not been clearly illuminated and...
BACKGROUND
Tracheobronchopathia osteochondroplastica (TO) is a benign rare disease characterized by multiple tracheobronchial nodules, which has not been clearly illuminated and there are no standard guidelines for TO management. The aim of this study was to clarify the clinical features and treatment outcomes of TO and provide basis for clinical diagnosis and treatment.
METHODS
A total of 32,215 patients taken bronchoscopy were retrospectively reviewed to select patients diagnosed with TO. Clinical characteristics, bronchoscopic manifestations, CT images, histopathological features, treatments and clinical course were investigated.
RESULTS
13 male and 6 female were identified as TO. The average age was 47.42±12.12 years. The incidence rate of TO in our study by bronchoscopy was 0.06%. The most frequent manifestation was chronic cough. Based on bronchoscopic manifestations, patients were categorized as three groups: the largest proportion was group of Stage II (10/19), followed by Stage III (5/19) and Stage I (4/19). The positive rate of CT in stage I, stage II and stage III was 0%, 50%, 100%, respectively. Histopathological analysis presented inflammatory exudation, squamous metaplasia, submucosal cartilaginous and osseous deposition. Bronchoscopic intervention and inhaled corticosteroids were administered to subjects in stage II and III, which improved their life qualities to some degree.
CONCLUSIONS
Not only multi-disciplinary cooperation of clinical, endoscopic and histological assessment, but also awareness are crucial to TO diagnosis, especially in early stage of TO, which was difficult to identify. The stage of TO based on bronchoscopic visualization might be applied to guide the choice of clinical treatment strategy.
Topics: Adult; Bronchoscopy; Female; Humans; Male; Middle Aged; Osteochondrodysplasias; Retrospective Studies; Tracheal Diseases
PubMed: 33183038
DOI: 10.21037/apm-20-316 -
Joint Bone Spine Jul 2016The infrapatellar fat pad (IFP) of Hoffa's fat pad is the main adipose structure within the knee joint. It is located between the joint capsule and the synovial... (Review)
Review
The infrapatellar fat pad (IFP) of Hoffa's fat pad is the main adipose structure within the knee joint. It is located between the joint capsule and the synovial membrane, which lines its posterior aspect. The IFP is composed chiefly of adipocytes and receives an abundant supply of blood vessels and nerves. Immune cells can infiltrate the IFP, which can become a major source of numerous proinflammatory mediators (cytokines and adipokines). The physiological role for the IFP remains unclear but may involve shock absorption and the protection of adjacent tissues. Hoffa's disease is characterized by inflammation, hypertrophy, and fibrosis of the pad in response to repetitive trauma. Anterior knee pain is the most common symptom. In advanced forms, metaplasia of the IFP may result in the development of a sometimes sizable osteochondroma. The IFP may also contribute to the pathophysiology of knee osteoarthritis, in particular via procatabolic and proinflammatory effects on its synovial lining. Finally, in patients with knee osteoarthritis, inflammation of the IFP may be a source of pain.
Topics: Adipose Tissue; Arthralgia; Female; Humans; Inflammation; Knee Joint; Magnetic Resonance Imaging; Male; Osteoarthritis, Knee; Pain Measurement; Patella; Prognosis; Risk Assessment
PubMed: 27068617
DOI: 10.1016/j.jbspin.2016.02.016 -
ACS Applied Bio Materials Jan 2022Craniofacial tissue injuries, diseases, and defects, including those within bone, dental, and periodontal tissues and salivary glands, impact an estimated 1 billion... (Review)
Review
Craniofacial tissue injuries, diseases, and defects, including those within bone, dental, and periodontal tissues and salivary glands, impact an estimated 1 billion patients globally. Craniofacial tissue dysfunction significantly reduces quality of life, and successful repair of damaged tissues remains a significant challenge. Blood vessels and nerves are colocalized within craniofacial tissues and act synergistically during tissue regeneration. Therefore, the success of craniofacial regenerative approaches is predicated on successful recruitment, regeneration, or integration of both vascularization and innervation. Tissue engineering strategies have been widely used to encourage vascularization and, more recently, to improve innervation through host tissue recruitment or prevascularization/innervation of engineered tissues. However, current scaffold designs and cell or growth factor delivery approaches often fail to synergistically coordinate both vascularization and innervation to orchestrate successful tissue regeneration. Additionally, tissue engineering approaches are typically investigated separately for vascularization and innervation. Since both tissues act in concert to improve craniofacial tissue regeneration outcomes, a revised approach for development of engineered materials is required. This review aims to provide an overview of neurovascularization in craniofacial tissues and strategies to target either process thus far. Finally, key design principles are described for engineering approaches that will support both vascularization and innervation for successful craniofacial tissue regeneration.
Topics: Bone and Bones; Humans; Neovascularization, Pathologic; Quality of Life; Tissue Engineering; Wound Healing
PubMed: 35014834
DOI: 10.1021/acsabm.1c00979 -
European Journal of Obstetrics,... Oct 2021To describe clinical and demographic characteristics, ultrasound appearance, and hysteroscopic outcomes of patients with endometrial osseous metaplasia.
OBJECTIVE
To describe clinical and demographic characteristics, ultrasound appearance, and hysteroscopic outcomes of patients with endometrial osseous metaplasia.
STUDY DESIGN
We conducted a multicenter retrospective study. We retrospectively reviewed the medical records of all consecutive patients who were referred for hysteroscopy at fourteen institutions in Venezuela, Spain, Morocco, India, Ukraine, Argentina, the United States, and Italy between 1994 and 2018. We identified and included all patients who had a diagnosis of osseous metaplasia at the pathologic report, and data were retrieved from the medical records.
RESULTS
Between January 1st, 1994, and December 31st, 2018, 63 patients out of a total of 419,673 women who underwent hysteroscopy had a diagnosis of osseous metaplasia (0.015%). Most patients were 31-40 years old (53.7%), were Caucasian or Hispanic (95.5%), and had at least one previous pregnancy (86.9%). Forty-one out of 63 patients (65.1%) had at least one miscarriage before the index hysteroscopy. Dysmenorrhea, abnormal uterine bleeding, and infertility were reported by 34.9%, 27.0%, and 23.8% of patients. 14.3% of women were asymptomatic. Preoperative transvaginal ultrasound was available and identified a hyperechoic area of variable size with posterior acoustic shadowing in all cases. Hysteroscopy was successful without complications in all 63 cases. Follow-up data were available in 30.2% of patients: 69.2% of patients were infertile, and 44.4% of them conceived and achieved a live birth; all other symptoms improved after hysteroscopic treatment in all patients.
CONCLUSIONS
Osseous metaplasia appears associated with multiple unspecific gynecologic symptoms without the predominant role of infertility, as previously suggested. Although endometrial osseous metaplasia is rare, gynecologists should consider this pathologic condition when the characteristic ultrasound appearance is detected, being hysteroscopic treatment effective.
Topics: Adult; Choristoma; Endometrium; Female; Humans; Hysteroscopy; Metaplasia; Pregnancy; Retrospective Studies
PubMed: 34500212
DOI: 10.1016/j.ejogrb.2021.08.032 -
BMJ Case Reports Sep 2023Rectal polyps are finger-like projections of the mucosal surface that generally present with complaints of bleeding or mass per rectum. Polyps are classified...
Rectal polyps are finger-like projections of the mucosal surface that generally present with complaints of bleeding or mass per rectum. Polyps are classified histopathologically as neoplastic and non-neoplastic. Here, we present one such rare case of a middle-childhood boy who presented with complaints of bleeding per-rectum and revealed a 1.5 cm long rectal polyp. Histopathological examination revealed an osseous change in the rectal polyp. A detailed literature review of reported cases of benign rectal polyps with osseous metaplasia was conducted and consolidated all postulated theories of pathogenesis. This case report shows an interesting incidental finding of osseous metaplasia of the rectal polyp.
Topics: Male; Humans; Child; Rectal Neoplasms; Calcinosis; Rectum; Intestinal Polyps; Metaplasia; Choristoma
PubMed: 37751981
DOI: 10.1136/bcr-2023-254819