deoxycholic-acid and Calcinosis

Topics: Animals; Calcinosis; Chenodeoxycholic Acid; Cholelithiasis; Cholesterol; Colonic Neoplasms; Cost-Benefit Analysis; Deoxycholic Acid; Diarrhea; Female; Humans; Liver; Macaca mulatta; Male; Transaminases; Ursodeoxycholic Acid

Topics: Adult; Calcinosis; Cholelithiasis; Deoxycholic Acid; Female; Follow-Up Studies; Humans; Male; Middle Aged; Radiography; Ursodeoxycholic Acid

Topics: Calcinosis; Chenodeoxycholic Acid; Cholelithiasis; Deoxycholic Acid; Humans; Ursodeoxycholic Acid

Decellularized porcine heart valves treated with deoxycholic acid (DOA) have demonstrated complete recellularization and absence of calcification when implanted into the pulmonary position in sheep. We studied recellularization and calcification in stented DOA-treated heart valves compared with conventional stented glutaraldehyde-treated valves in the aortic position in juvenile pigs 6 months after implantation.. DOA heart valves (n=12) and glutaraldehyde-treated valves (Carpentier-Edwards) (n=15) were implanted into the aortic position in 8-month old 90 kg female pigs. Six months postoperatively, the valves were explanted and subjected to gross pathology examination, high-resolution (HR) X-ray imaging, and histological evaluation.. Five DOA valves and five glutaraldehyde-treated valves were explanted after 6 months. Fourteen animals died before follow-up because of non-valve related causes and three because of infective endocarditis. Gross pathologic examination showed all DOA valves to be well functioning with only minor thrombotic depositions located mostly in the commissural area. Three glutaraldehyde valves had limited thrombosis and two had severe thrombosis. HR X-ray imaging demonstrated almost complete absence of cusp calcification in the DOA valves, but severe calcification in all glutaraldehyde valves. Overgrowth of endothelial cells and ingrowth of fibroblasts in the stent-adjacent area and basal part of the cusps were seen in all DOA valves, but not in glutaraldehyde valves. Immunohistochemistry revealed larger amounts of inflammatory cells in all glutaraldehyde valves compared with DOA valves.. DOA-treated heart valves demonstrated greater recellularization and less calcification compared with standard glutaraldehyde-treated valves 6 months after implantation in the aortic position in pigs. DOA-treated heart valves demonstrated less calcification compared with standard glutaraldehyde-treated valves by qualitative analysis. Endothelial and fibroblast recellularization of the cusps was only observed in DOA-treated valves.

Topics: Animals; Aortic Valve; Bioprosthesis; Calcinosis; Deoxycholic Acid; Disease Models, Animal; Female; Fibroblasts; Glutaral; Heart Valve Prosthesis; Heart Valve Prosthesis Implantation; Prosthesis Design; Radiography; Stents; Sus scrofa

Glutaraldehyde-preserved bioprosthetic heart valves are non-viable and have a limited durability because of calcification, tissue wear, and inflammation, especially in children. Decellularized porcine heart valves, when treated with deoxycholic acid (DOA), have exhibited complete recellularization and an absence of calcification when implanted into the pulmonary position in juvenile sheep. The study aim was to determine the degree of recellularization and calcification in DOA-treated heart valve prostheses in the mitral position in juvenile pigs.. A mitral heart valve prosthesis was implanted into each of 17 pigs, and subsequently explanted and fixed in formaldehyde after between five and 26 weeks. A gross pathologic assessment, high-resolution X-ray imaging and histological examination were then performed on each valve.. Eight pigs survived the observational period. Five valves had only a slight fibrin deposition and calcification foci within the fibrin deposits. Three valves had severe thrombotic material deposits with disseminated calcification and valve stenosis, and one valve had infective endocarditis. A myofibroblast-like cell ingrowth was observed at different locations of the valve housing in all explanted heart valves, but ingrowth in the basal part of the cusp matrix was limited. In four valve prostheses, endothelial cells covered up to 10% of the cusp surface after six months. Inflammatory cells were observed in large numbers in those valves showing endocarditis and severe thrombosis, but in only limited numbers in the other valves.. All valves showed the deposition of fibrin and platelet material, in three cases to a severe degree. A limited ingrowth of both endothelial and myofibroblast-like cells was observed in five valves in which calcification was limited to a few commissural foci. The non-endothelialized surface of the decellularized valves makes them very susceptible to platelet and fibrin deposition; however, slow revitalization seems possible.

Topics: Animals; Bioprosthesis; Calcinosis; Deoxycholic Acid; Equipment Failure Analysis; Fibrin; Heart Valve Prosthesis; Mitral Valve; Models, Animal; Swine; Time Factors

Fourteen patients with radiolucent gallstones proved by oral cholecystography (OC) and ultrasonography were treated with daily doses of 600 mg of ursodeoxycholic acid (UDCA) for one year. Among them, 2 patients had complete dissolution of gallstones and another one had partial dissolution. The success rate was 21.4% (3/14). Of the remaining 11 patients who failed to respond to UDCA treatment, calcifications of varied degrees were demonstrated in every gallstone by computed tomography (CT). None of these 14 patients had statistically significant changes in serum lipids, liver function tests and hemograms during the course of treatment and only one (7.1%) patient had transient diarrhea. It was concluded that UDCA was effective and safe for medical dissolution of non-calcified gallstones. However, the underestimation of the calcification of gallstones by OC precluded successful medical dissolution by UDCA. Therefore, meticulous selection of non-calcified gallstones by CT rather than OC as candidates for dissolution may improve the success rate.

Topics: Adult; Aged; Calcinosis; Cholelithiasis; Deoxycholic Acid; Female; Humans; Male; Middle Aged; Ursodeoxycholic Acid

Topics: Aged; Calcinosis; Cholelithiasis; Deoxycholic Acid; Female; Humans; Ursodeoxycholic Acid

Topics: Calcinosis; Chenodeoxycholic Acid; Cholelithiasis; Deoxycholic Acid; Humans; Radiography; Ursodeoxycholic Acid

Topics: Calcinosis; Chenodeoxycholic Acid; Cholelithiasis; Deoxycholic Acid; Dose-Response Relationship, Drug; Humans; Micelles; Solubility; Ursodeoxycholic Acid

Topics: Calcinosis; Calcium; Cholelithiasis; Cholesterol; Deoxycholic Acid; Humans; Solubility; Ursodeoxycholic Acid