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World Journal of Clinical Cases 2019年第22期7卷 3772-3777页

作者： Chang Han Lee Min-Kyun Oh Jun-Il Yoo Department of Rehabilitation Medicine Gyeongsang National University School of Medicine and Gyeongsang National University HospitalJinju 52727South Korea Department of Orthopaedic Surgery School of MedicineGyeongsang National University90 ChilamdongGyeongsangnam-doJinju 52727South Korea

BACKGROUND calcific tendinopathy denotes calcific deposits in a specific *** is also known as calcifying tendinitis,calcifying periarticulitis,or periarticular apatite deposition ***,extracorporeal shock wave therapy(ESWT)has been reported to be effective in relieving and treating pain in calcific *** SUMMARY A 36-year-old female patient suffered from left hip joint pain for six *** pain was increased during abduction of the hip,waking,and jumping.B-mode ultrasonography was performed by a physiatrist with an L12-5 linear transducer.A single session of ESWT was given in the marking area under ultrasound guidance at 4 Hz,2500 shots with intensity of stimulation using energy of 0.1 mJ/*** hip pain of the patient slowly decreased within 4 wk after starting the *** six weeks of ESWT,her hip pain was completely ***,the size of calcification showed almost no reduction in simple radiography at the final *** Ultrasonography is a very good modality not only for diagnosing calcified tendinitis by classical appearance,but also for evaluating the effect of ESWT during the follow-up period.

关键词： Rectus femoris calcific tendinopathy Extracorporeal shock wave therapy Ultrasonography Hip Joint Case report

Decreased serum HMGB1 associated with M2 macrophagepolarization and patients with calcific aortic valve disease

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BIOCELL 2020年第3期44卷 315-321页

作者： DONG ZHAO QIANG JI SHIJIE ZHU KAI ZHU CHUNSHENG WANG Department of Cardiac Surgery Zhongshan HospitalFudan UniversityShanghai200032China.

Except for the standard aortic valve replacement,no effective medical treatment is available to prevent or delay calcific aortic valve disease(CAVD)***,macrophages and high-mobility group box 1(HMGB1)are the most intriguing candidates in various inflammatory ***,the association between serum HMGB1,CAVD,and macrophage polarization remains ***,we examined whether the level of serum HMGB1 is clinically associated with aortic valve calcification and whether HMGB1 treatment can promote macrophage differentiation toward M1 or M2 *** experimental study included 19 CAVD patients and 20 healthy controls whose serum HMGB1 levels were examined by ELISA ***-1 macrophage polarization system was established to test the polarization capability of HMGB1 *** results showed that serum levels of HMGB1 were significantly reduced in patients with ***1 treatment promoted M2 macrophage polarization but not M1 phenotype with increased IL-10 expression and reduced inducible nitric oxide synthase(iNOS)*** findings suggest that serum HMGB1 is negatively associated with the development of aortic valve calcification,and HMGB1 treatment may facilitate M2 macrophage polarization for reducing aortic valve calcification.

关键词： HMGB1 macrophage polarization anti-inflammatory calcific aortic valve disease

Pathogenetic mechanism of senile calcific aortic stenosis:the role of apoptosis

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Chinese Medical Journal 1998年第10期 70-75页

作者：李英雄周云英

Abstract Objective To investigate the pathogenetic mechanisms leading to the development of calcific degeneration of the aortic valve in the elderly patients with particular reference to the relationship between apoptosis and calcification in the aortic valve tissue. Methods High resolution scanning and transmission electron microscopic observations of the calcified aortic valves obtained during aortic valve replacement were carried out in 10 patients with senile calcific aortic stenosis. Results Various degrees of endothelial alterations from focal disruption of individual endothelial cells to extensive denudation of entire endothelium were observed particularly on the aortic side of the valve tissues. The apoptotic changes occurring in the nuclei of endothelial cells and fibroblasts were common findings in the calcified valve tissues. It was noteworthy that the severity of endothelial damage was closely related to apoptotic changes of the fibroblasts. calcific deposits were frequently observed in association with the cellular fragments mainly derived from the apoptotic fibroblasts. Conclusions Our results strongly indicate that apoptosis may play an important role in the alterations of endothelial integrity leading to the increased filtration of calcium into the deeper layer of the valve tissues. Then, the cellular degradation products and organelles extruded from the dead cells, mainly resulted from apoptosis provided the substrates for calcium binding with progressive development of calcification in the valve tissue. Although the role of apoptosis in contribution to the pathogenesis of senile calcific aortic stenosis is evident, further studies using modern molecular biotechnology are mandatory in order to clarify the mechanism for the initiation of apoptotic process in the endothelial cells and fibroblasts.

关键词： mechanism senile calcific aortic Pathogenetic

calcific tendinitis of the rotator cuff

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World Journal of Orthopedics 2016年第1期7卷 55-60页

作者： Mohamed Taha ElShewy Orthopedic Department Cairo University

calcific tendinitis within the rotator cuff tendon is a common shoulder disorder that should be differentiated from dystrophic calcification as the pathogenesis and natural history of both is totally different. calcific tendinitis usually occurs in the fifth and sixth decades of life among sedentary workers. It is classified into formative and resorptive phases. The chronic formative phase results from transient hypoxia that is commonlyassociated with repeated microtrauma causing calcium deposition into the matrix vesicles within the chondrocytes forming bone foci that later coalesce. This phase may extend from 1 to 6 years, and is usually asymptomatic. The resorptive phase extends from 3 wk up to 6 mo with vascularization at the periphery of the calcium deposits causing macrophage and mononuclear giant cell infiltration, together with fibroblast formation leading to an aggressive inflammatory reaction with inflammatory cell accumulation, excessive edema and rise of the intra-tendineous pressure. This results in a severely painful shoulder. Radiological investigations confirm the diagnosis and suggest the phase of the condition and are used to follow its progression. Although routine conventional X-ray allows detection of the deposits, magnetic resonance imaging studies allow better evaluation of any coexisting pathology. Various methods of treatment have been suggested. The appropriate method should be individualized for each patient. Conservative treatment includes pain killers and physiotherapy, or "minimally invasive" techniques as needling or puncture and aspiration. It is almost always successful since the natural history of the condition ends with resorption of the deposits and complete relief of pain. Due to the intolerable pain of the acute and severely painful resorptive stage, the patient often demands any sort of operative intervention. In such case arthroscopic removal is the best option as complete removal of the deposits is unnecessary.

关键词： Rotator cuff calcific tendenitis Prevalence Pathogenesis Natural history Classification Clinical picture Imaging Treatment

Predictors of malignancy in chronic calcific pancreatitis with head mass

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World Journal of Gastrointestinal Surgery 2013年第4期5卷 97-103页

作者： Senthilkumar Perumal Ravichandran Palaniappan Sastha Ahanatha Pillai Vimalraj Velayutham Jeswanth Sathyanesan Institute of Surgical Gastroenterology and Liver Transplantation Government Stanley Medical College

AIM: To prospectively analyse the clinical, biochemical and radiological characteristics of the mass lesions arising in a background of chronic calcific pancreatitis (CCP). METHODS: Eighty three patients, who presented with chronic pancreatitis (CP) and a mass lesion in the head of pancreas between February 2005 and December 2011, were included in the study. Patients who were identified to have malignancy underwent Whipple' s procedure and patients whose investigations were suggestive of a benign lesion underwent Frey's procedure. Student t-test was used to compare the mean values of imaging findings [common bile duct (CBD), main pancreatic duct (MPD) size] and laboratory data [Serum bilirubin, carbohydrate antigen 19-9 (CA 19-9)] between the groups. Receiver operating characteristic curve (ROC curve) analysis was done to calculate the cutoff valves of serum bilirubin, CA 19-9, MPD and CBD size. The sensitivity, specificity, positive predictive valve (PPV) and negative predictive value (NPV) were calculated using these cut off points. Multivariate analysis was performed using logistic regression model. RESULTS: The study included 56 men (67.5%) and 27 women (32.5%). Sixty (72.3%) patients had tropical calcific pancreatitis and 23 (27.7%) had alcohol related CCP. Histologically, it was confirmed that 55 (66.3%) of the 83 patients had an inflammatory head mass and 28 (33.7%) had a malignant head mass. The mean age of individuals with benign inflammatory mass and those with malignant mass was 38.4 years and 45 years respectively. Significant clinical features that predicted a malignant head mass in CP were presence of a head mass in CCP of tropics, old age, jaundice, sudden worsening abdominal pain, gastric outlet obstruction and significant weight loss (P ≤ 0.05). The ROC curve analysis showed a cut off value of 5.8 mg/dL for serum bilirubin, 127 U/mL for CA 19-9, 11.5 mm for MPD size and 14.5 mm for CBD size. CONCLUSION: Elevated Serum bilirubin and CA 19-9, and dila

关键词： Chronic calcific pancreatitis Pancreatic head mass Carcinoma head of pancreas Risk factors of malignancy

Acute calcific Tendinitis of the Flexor Digitorum Superficialis of the Finger: A Case Report

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Open Journal of Orthopedics 2014年第3期4卷 45-47页

作者： Young Sung Kim Ho Min Lee Jong Pil Kim Department of Orthopaedic Surgery College of Medicine Dongguk University Gyeongju South Korea

Acute calcific tendinitis of the shoulder is a well-known condition, but it is rare in the hand or finger. It is often misdiagnosed when it occurs outside the shoulder. We report an unusual case of acute calcific tendinitis of the flexor digitorum superficialis insertion of the 4th finger in a young female martial art athlete after minor trauma history, and discuss with a review of the literature.

关键词： calcific Tendinitis Flexor Digitorum Superficialis Finger

Intracerebral calcific Hydatic Cyst Mimicking calcific Hematoma: A Case Report

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Yangtze Medicine 2020年第1期4卷 79-83页

作者： N. D. A. Bankole M. Denou M. C. Sayore A. Melhaoui M. Boutarbouch Y. Arkha A. Elouahabi L. Rifi Service de Neurochirurgie de l’Hôpital Des Spécialités Rabat Morocco Mohammed v University in Rabat Rabat Morocco

Introduction: Hydatid cyst intracranial is an endemic parasitosis and rare of the order of 1% to 4% of the cases. The calcified cerebral hydatid cyst is even more exceptional, we report a case collected in our service to illustrate the difficulties of diagnosis and the management. We will not discuss the outcome. Case Report: We reported a 22-year-old female which presented to right body, seizures of the type Bravais Jackson with facial participation, headache, dizziness, pre-critical and post critical seizures evolving over a month, and subsequently followed by a heaviness of the right hemi-body responsible for mowing when walking. She was hospitalized for management after performing a CT scan and brain MRI. The surgical treatment consisted of a left parietal flap with a complete excision of a process whose macroscopic appearance first evoked a calcified hydatid cyst confirmed by histology. Conclusion: The cerebral calcified hydatid cyst remains an exceptional pathology with some difficulties in diagnosis and management.

关键词： Cyst Hydatid calcific Intracerebral Cyst Hydatid Disease

Focused extracorporeal shock wave therapy combined with supervised eccentric training for supraspinatus calcific tendinopathy

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中华物理医学与康复杂志 2019年第8期41卷 626-626页

作者： Carlisi E Lisi C Dall'angelo A 不详

BACKGROUND AND OBJECTIVE Extracorporeal shockwave therapy (ESWT) is effective in reducing shoulder pain and improving function in calcific supraspinatus tendinopathy. Eccentric exercise has been introduced as an effective treatment choice for Achilles tendinopathy, but poor evidence exists about its role in the treatment of rotator cuff tendinopathy. METHODS The study-group was assigned to receive focal ESWT (f-ESWT) plus a supervised eccentric training (SET) of the shoulder abductor muscles. The matched control-group received f-ESWT only. The post-treatment assessment at follow-up (T1) was performed nine weeks after the enrollment (T0). We assessed shoulder pain and function by the means of a numeric rating scale (p-NRS) and a DASH scale. As secondary outcome, we measured the isometric strength of the abductor muscles of the affected shoulder using a handheld dynamometer. RESULTS At T1, we recorded a significant decrease in pain (P<0.001) and an improvement in upper limb function (P<0.001) in both groups. However, we observed no statistical differences in favor of the study-group, in terms of p-NRS and DASH total score. A mild increase (+13% from baseline) of the maximum isometric abduction strength was noticed in the study group at T1. CONCLUSION Our findings did not support the hypothesis that adding a supervised eccentric training of the shoulder abductor muscles could improve the outcome (pain and function) of shock wave therapy.

关键词： extracorporeal shock wave supervised eccentric supraspinatus calcific tendinopathy

Fabella Syndrome: A Typical Case of Misdiagnosis and Discussion

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Case Reports in Clinical Medicine 2019年第9期8卷 258-273页

作者： Mohammed H. Karrar Alsharif Juman M. Almasaad Nagi M. Bakhit Khalid M. Taha Mohammed I. Eltahir Mamoun A. Alfaki Abubaker Y. Elamin Mohammed A. Noureddin Department of Basic Medical Science College of Medicine Prince Sattam Bin Abdulaziz University Al Kharj KSA Department of Histology & Embryology Medical Faculty Ondukuz Mayis University Samsun Turkey Department of Anatomy Faculty of Medicine National University Khartoum Sudan College of Medicine King Saud Bin Abdulaziz for Health Sciences University Jeddah KSA Department of Anatomy Faculty of Medicine El Deain University El Deain Sudan Department of Anatomy Faculty of Medicine University of Science and Technology Khartoum Sudan Department of Anatomy Faculty of Medicine University of Bahri Khartoum Sudan Department of Medicine College of Medicine Prince Sattam Bin Abdulaziz University Al Kharj KSA

Background: Fabella is a natural occurring sesamoid bone, cartilage or a mixture of both that is usually located at the posterolateral corner (PLC) of the knee [1]. Recently the PLC of the knee has been extensively investigated because it is a common site of injuries and diseases [2] [3]. The complexity of PLC anatomy needs to be fully understood because the fabella could be missed diagnosis as an osteochondral defect, osteochondritis dissecans (OCD), calcific tendinitis, or foreign body. We present a case report of fabella syndrome triggered by trauma and also performed a review of literature for the various diagnoses that might be confused with fabella syndrome. Case presentation: A 29-year-old, Sudanese male presented to the trauma center in King Khalid Hospital in KSA, complaining of pain and partial swelling in his left knee joint due to trauma. Fabella was detected in the posterior lateral corner (PLC) of the knee joint embedded in the lateral head of the gastrocnemius muscle. All other pathological conditions were excluded. Conclusion: Fabella is sesamoid bone with variable size, found in the PLC. Commonly if present it causes periodic pain especially in the fully extended knee or it remains asymptomatic. Trauma, surgery, sports or heavy extreme activities may trigger the pain of asymptomatic fabella. Clinicians should consider that pain in the PLC of the knee can result from the presence of the fabella in a condition called fabella syndrome.

关键词： Fabella Syndrome Sesamoid Bone Osteochondral Defect Osteochondritis Dissecans calcific Tendinitis Foreign Body

Can extracorporeal shock-wave therapy be used for the management of lateral elbow tendinopathy?

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World Journal of Methodology 2018年第3期8卷 37-39页

作者： Dimitrios Stasinopoulos Department Health Sciences School of Sciences European University Cyprus

Lateral elbow tendinopathy(LET) is one of the two most common tendinopathies of the upper limb. The most effective treatment in the management of LET is the exercise program. Clinicians combine exercise program with other physiotherapy, electrotherapeutic and no, techniques. Extracorporeal shock wave therapy(ESWT) is one of the most common recommended electrotherapeutic modalities for the management of LET. Further research is needed to find out the optimal treatment protocol of ESWT in the management of

关键词： Lateral elbow tendinopathy Extracorporeal shock wave therapy Exercise program Electrotherapy Tennis elbow Lateral epicondylitis Physiotherapy calcific tendinopathy