the iliolumbar ligament plays a very important role in supporting the lower lumbar vertebral column; they extend from 5th lumbar vertebrae to the iliac crest of the pelvis. Injury to this area, can cause from direct trauma and also it is... more
the iliolumbar ligament plays a very important role in supporting the lower lumbar vertebral column; they extend from 5th lumbar vertebrae to the iliac crest of the pelvis. Injury to this area, can cause from direct trauma and also it is quite common in sports persons due to the various spinal movements, which can develop into sacroiliac joint pain and associated problems. In this case report, we present a bilateral ossified iliolumbar of a 59-year-old male with a history of low back pain. The knowledge of ossification of iliolumbar ligament will be important to the clinicians in correct diagnosis and treatment of patients suffering from iliolumbar ligament syndrome, also known as iliac crest pain syndrome.
In marine environments Ostracoda and Foraminifera have been very successful invaders. During the Phanerozoic they colonised the majority of shallow, marginal to deep water, fully marine habitats. Both groups had developed physiological... more
In marine environments Ostracoda and Foraminifera have been very successful invaders. During the Phanerozoic they colonised the majority of shallow, marginal to deep water, fully marine habitats. Both groups had developed physiological adaptations which pre-adapted them to the invasion of new marine habitats. They adopted a broad range of feeding strategies and reproduction modes. The production of resting stages and brood care may also have contributed to them being efficient invaders. They are also both highly tolerant to variations in salinity. The first invasions of non-marine habitats by ostracods appear to have taken place at the turn of the Devonian and Carboniferous. It is estimated that there had been between 9 and 12 independent invasions of fresh waters by the ostracods. In contrast Foraminifera are typically marine organisms, and only a few species of agglutinated and organic-walled Foraminifera are to be found in brackish and freshwater environments. Agglutinated species build their test using ambient components but are not commonly regarded as calcifying organisms. An impact of salinity on foraminiferal calcification has been observed in several studies. It seems that Foraminifera are incapable of constructing a fully calcified test in low salinity regimes; they use sea water not only as a source of ions to construct shell, but also as a biomineralisation solution. Thus, the success of ostracods in invading freshwater habitats can be attributed to their development of a more effective mechanism of calcification in low mineralisation waters. The core question of this study is to examine possible causes for the differences in success between the two taxa.
Patients with chronic kidney disease (CKD) have an increased risk of developing vascular calcifications, as well as bone dynamics impairment, leading to a poor quality of life and increased mortality. Certain vitamin K dependent proteins... more
Patients with chronic kidney disease (CKD) have an increased risk of developing vascular calcifications, as well as bone dynamics impairment, leading to a poor quality of life and increased mortality. Certain vitamin K dependent proteins (VKDPs) act mainly as calcification inhibitors, but their involvement in the onset and progression of CKD are not completely elucidated. This review is an update of the current state of knowledge about the relationship between CKD and four extrahepatic VKDPs: matrix Gla protein, osteocalcin, growth-arrest specific protein 6 and Gla-rich protein. Based on published literature in the last ten years, the purpose of this review is to address fundamental aspects about the link between CKD and circulating VKDPs levels as well as to raise new topics about how the interplay between molecular weight and charge could influence the modifications of circulating VKDPs at the glomerular level, or whether distinct renal etiologies have effect on VKDPs. This review is the output of a systematic literature search and may open future research avenues in this niche domain.
Meconium peritonitis is thought to be the result of a sterile chemical reaction resulting from bowel perforation in-utero. The bowel perforates as a result of bowel obstruction that is caused by atresia or meconium ileus. A secondary... more
Meconium peritonitis is thought to be the result of a sterile chemical reaction resulting from bowel perforation in-utero. The bowel perforates as a result of bowel obstruction that is caused by atresia or meconium ileus. A secondary inflammatory response results in the production of ascites, fibrosis, calcification and sometimes cyst. We are presenting a nine hour old neonate with abdominal distension, and scrotal swelling that were noticed at birth. Abdominal findings revealed shiny, tender, grossly distended, tensed with visible veins and multiple peri-umblical solitary firm small masses. Ascites and left cystic scrotal mass were demonstrable. Plain abdominal X-ray showed dilated bowel, pseudocysts, calcifications and ground glass appearance, while abdomino-pelvic ultrasound showed calcifications and ascites. Intraoperative findings revealed perforation of terminal ileum about 3-5cm from ileocaecal junction with areas of calcifications. Limited right hemicolectomy with adhesiolysis was offered.
Keywords: Meconium Peritonitis, Meconium Pseudocyst, Intraabdominal Calcifications, Neonate
Head and neck soft tissues calcifications can result from physiological or pathological mineralization. Some of these calcifications may be found on panoramic radiography because of their proximity to the focal trough and their... more
Head and neck soft tissues calcifications can result from physiological or pathological mineralization. Some of these calcifications may be found on panoramic radiography because of their proximity to the focal trough and their superimposition over hard and soft tissue structures. Such radiographic images are common and create a diagnostic challenge. Differentiation of these entities can be done when radiographic features and locations are taken into consideration. Since cone-beam computed tomography (CBCT) has been used in dentistry, fortuitous discovery of such calcifications has increased. However, by providing images in the third dimension, CBCT facilitates their precise localization. Adequate diagnosis of these calcifications may enhance their approach and management by clinicians. The aim of this article is to describe the radiographic characteristics of some head and neck calcifications in dental practice on panoramic X-rays and CBCT.
Patients with chronic kidney disease (CKD) have an increased risk of developing vascular calcifications, as well as bone dynamics impairment, leading to a poor quality of life and increased mortality. Certain vitamin K dependent proteins... more
Patients with chronic kidney disease (CKD) have an increased risk of developing vascular calcifications, as well as bone dynamics impairment, leading to a poor quality of life and increased mortality. Certain vitamin K dependent proteins (VKDPs) act mainly as calcification inhibitors, but their involvement in the onset and progression of CKD are not completely elucidated. This review is an update of the current state of knowledge about the relationship between CKD and four extrahepatic VKDPs: matrix Gla protein, osteocalcin, growth-arrest specific protein 6 and Gla-rich protein. Based on published literature in the last ten years, the purpose of this review is to address fundamental aspects about the link between CKD and circulating VKDPs levels as well as to raise new topics about how the interplay between molecular weight and charge could influence the modifications of circulating VKDPs at the glomerular level, or whether distinct renal etiologies have effect on VKDPs. This review...
1 C. Langdon: Lamont-Doherty Earth Observatory, Palisades, NY 10983, USA. langdon@ldeo.columbia.edu Abstract This paper reviews the experimental evidence that a rise in atmospheric CO2 will have an effect on the calcification rate of reef... more
1 C. Langdon: Lamont-Doherty Earth Observatory, Palisades, NY 10983, USA. langdon@ldeo.columbia.edu Abstract This paper reviews the experimental evidence that a rise in atmospheric CO2 will have an effect on the calcification rate of reef building organisms. There have been five studies where the carbonate chemistry of seawater has been varied between present day and what is projected if atmospheric CO2 doubles or triples. These studies found that calcification declined by an average of 25% (range 11-40%). Three older studies also varied carbonate chemistry but the treatments were extreme relative to projected changes in the next 50-100 years. These studies reported larger decreases in calcification, 36±9%, that probably should be used with caution. Based on current estimates of dissolution rates on reefs, banks and tropical shelves dissolution will not be able to buffer the drop in [CO3] over the next 50-100 years.
The leading cause of illness in aging is a group known as Noncommunicable Diseases. There should be some meeting points that modify the cells homeostasis and impaired the cell physiology developing different diseases. Quantum physics... more
The leading cause of illness in aging is a group known as Noncommunicable Diseases. There should be some meeting points that modify the cells homeostasis and impaired the cell physiology developing different diseases. Quantum physics studied the atomic and subatomic particles and revolutionized the reality perception with paradoxical and weird concepts. Heisenberg's uncertainty principle established that it is not possible to determine the two characteristic properties of particles with accuracy. Subatomic particles have a wave-particle duality. Two subatomic particles are entangled, something happening over here can have an instantaneous effect over there, no matter how far away there are. All these concepts have tried to apply to biology and life sciences, quantum biology is behind photosynthesis, mitochondrial respiration, enzyme activity, the sense of smell, animal migration, heredity's fidelity, and consciousness. We can apply all these concepts to diseases pathogeny. So, we describe quantum phenomena in oxidative stress, calcification, signal transduction, vitamin D production and cancer mutations. Aging diseases also could be explained by applying quantum physics concepts. It is a new, hard to believe, and an incredible path to be built, but we need to open the treatment options to our patients with new perspectives.
The response of the marine carbon cycle to changes in atmospheric CO 2 concentrations will be determined , in part, by the relative response of calcifying and non-calcifying organisms to global change. Planktonic foraminifera are... more
The response of the marine carbon cycle to changes in atmospheric CO 2 concentrations will be determined , in part, by the relative response of calcifying and non-calcifying organisms to global change. Planktonic foraminifera are responsible for a quarter or more of global carbonate production, therefore understanding the sensitivity of calcification in these organisms to environmental change is critical. Despite this, there remains little consensus as to whether, or to what extent, chemical and physical factors affect foraminiferal calcification. To address this, we directly test the effect of multiple controls on calcification in culture experiments and core-top measurements of Globigeri-noides ruber. We find that two factors, body size and the carbonate system, strongly influence calcification intensity in life, but that exposure to corrosive bottom waters can overprint this signal post mortem. Using a simple model for the addition of calcite through ontogeny, we show that variable body size between and within datasets could complicate studies that examine environmental controls on foraminiferal shell weight. In addition, we suggest that size could ultimately play a role in determining whether calcification will increase or decrease with acidification. Our models highlight that knowledge of the specific morphological and physiological mechanisms driving ontogenetic change in calcification in different species will be critical in predicting the response of foraminiferal calcification to future change in atmospheric pCO 2 .
The roles played by various determinants in physiological, pathological or experimental calcification are still unclear. In this investigation, new insights were gained into structural changes occurring in porcine aortic valves undergoing... more
The roles played by various determinants in physiological, pathological or experimental calcification are still unclear. In this investigation, new insights were gained into structural changes occurring in porcine aortic valves undergoing mineralization in the rat subdermal model and then subjected to reactions with cationic phthalocyanines (PHTs), at salt-critical electrolyte concentrations (CEC). PHT reactions showed decalcifying effects, depending on both acidic pH in the media employed and mineral substitution by Cuprolinic Blue (CB) itself, as well as specific reactivity which enabled the ultrastructural detection of unusual, PHT-positive layers (PPLs) encircling cells and matrix vesicles, at 0.05 M CEC conditions. Other reactions at different CEC conditions, or subsequent to enzymatical or specific extractive treatments, suggest PPL appearance is due to PHT uptake by clustered anionic phospholipids, which seem to be involved in mineral precipitation. PPLs present as a novel, reliable ultrastructural parameter indicating cell propensity in priming experimental and, possibly, pathological calcification.
It is increasingly acknowledged that mineral and bone disorders (MBDs) contribute to the excessively high cardiovascular (CV) disease morbidity and mortality observed in patients with chronic kidney disease (CKD). There is ongoing debate... more
It is increasingly acknowledged that mineral and bone disorders (MBDs) contribute to the excessively high cardiovascular (CV) disease morbidity and mortality observed in patients with chronic kidney disease (CKD). There is ongoing debate as to whether screening for CV calcification, one of the hallmarks of CKD-MBD, should be implemented in clinical practice in patients with CKD. Issues to be considered in this controversy relate to prevalence, severity, relevance, and last but not least, modifiability and reversibility of vascular and valvular calcifications in the setting of CKD. The recent expansion of the armamentarium to treat CKD-MBD (calcium-free phosphate binders and calcimimetics) creates new opportunities. Mounting experimental and clinical evidence indicates that progression of CV calcification may indeed be attenuated. Whether this will translate into better outcomes remains to be proven. We acknowledge that hard outcome data so far are limited and, overall, yielded inconclusive results. Nevertheless, in an era in which personalized medicine has gained much popularity, we consider it reasonable, awaiting the results of additional studies, to screen for CV calcification in selected individuals. This policy may help to stratify CV risk and to guide therapy. We speculate that such an approach will ultimately improve outcomes and reduce health costs.
Objective: Soft tissue calcifications are mostly benign adaptations to ageing, injury or inflammation. However, calcifications can disrupt organ function in the cardiovascular system and the kidney, and are particularly common in patients... more
Objective: Soft tissue calcifications are mostly benign adaptations to ageing, injury or inflammation. However, calcifications can disrupt organ function in the cardiovascular system and the kidney, and are particularly common in patients with chronic kidney disease (CKD). Fetuin-A deficient mice maintained against the genetic background DBA/2 exhibit severe soft tissue calcifications with premature ageing and organ failure, while fetuin-A deficient C57BL/6 mice remain healthy. Approach and Results: We studied the calcification in progeny of an intercross of fetuin-A deficient DBA/2 and C57BL/6 mice. We analyzed by DNA sequencing and gene expression analysis candidate risk genes involved in the strong calcification phenotype of fetuin-A deficient DBA/2 mice. We determined that a hypomorphic mutation of the Abcc6 gene, a liver ATP transporter supplying systemic pyrophosphate, and failure to regulate expression of the TRPM6 magnesium transporter in kidney were associated with severity...
Adhesive capsulitis is a painful condition of unknown etiology with restriction of active and passive movements of the glenohumeral joint. The condition is a result of inflammation, adherence, and swelling in the lining of the shoulder... more
Adhesive capsulitis is a painful condition of unknown etiology with restriction of active and passive movements of the glenohumeral joint. The condition is a result of inflammation, adherence, and swelling in the lining of the shoulder joint capsule and its associated ligaments, causing resultant contracture of the capsule. We describe a patient with calcified and thickened coracohumeral ligament with adhesive cap-sulitis and diabetes mellitus.
Source code for the analysis of observed pairwise genetic difference (PWD), expected PWD under panmixia, and permutation test for departure from expected pairwise genetic difference for microsatellite MLGs datasets from a population of... more
Source code for the analysis of observed pairwise genetic difference (PWD), expected PWD under panmixia, and permutation test for departure from expected pairwise genetic difference for microsatellite MLGs datasets from a population of Symbiodinium ‘glynni’ (nomen nudum, = type D1) in the Gulf of California (La Paz), Eastern Pacific Ocean
Source code for the analysis of observed pairwise genetic difference (PWD), expected PWD under panmixia, and permutation test for departure from expected pairwise genetic difference for microsatellite MLGs datasets from a population of... more
Source code for the analysis of observed pairwise genetic difference (PWD), expected PWD under panmixia, and permutation test for departure from expected pairwise genetic difference for microsatellite MLGs datasets from a population of Symbiodinium B7 from corals in the genus Madracis in the Caribbean, West Atlantic Ocean
Coronary artery calcification is a calcium buildup within the walls of the arteries. It is considered a predominant marker for coronary artery disease. Thus many approaches have been developed for the automatic detection of calcification.... more
Coronary artery calcification is a calcium buildup within the walls of the arteries. It is considered a predominant marker for coronary artery disease. Thus many approaches have been developed for the automatic detection of calcification. The previous calcification detection was on segmentation of other structures as pre-processing steps or using the fact that the calcification often appears as a bright region. In this paper, an automated system proposed using a deep learning approach to detect the calcification absence and calcification presence in coronary artery IVUS image. A useful advantage of deep learning, compared to other methods is, it uses representations and features directly from the raw data, bypassing the need to manually extract features, a common that required in the traditional machine learning framework. The type of deep learning architecture used is 27 layers of convolutional neural networks (CNNs) using Direct Acyclic Graph. The proposed system used 2175 images...
Vascular calcification causes more than 20,000 deaths each year, and the aortic valve is the most commonly affected due to it. It leads to mineral deposition in the aortic side of heart valves which leads to stenosis,-characterized by the... more
Vascular calcification causes more than 20,000 deaths each year, and the aortic valve is the most commonly affected due to it. It leads to mineral deposition in the aortic side of heart valves which leads to stenosis,-characterized by the narrowing of the vessel lumen, and often requires surgical valve replacement. Initially this condition was attributed to a passive process of "wear and tear" of the heart but recent studies have confirmed the presence of inflammation, infiltration of lipids, and presence of bone related proteins in affected valves. In human-beings, the aortic valve is a trileaflet structure which is generally divided into an outer layer of Valve Endothelial Cells (VECs) and three internal layers of Valve Interstitial Cells (VICs), less than 5 % of smooth muscle cells and myofibroblasts. Bone Morphogenetic Proteins (BMPs) are members of the Transforming Growth Factor (TGFβ) Superfamily, which play inevitable roles in the maintenance and repair of bone and other tissues in an adult. BMPs were first identified to be potential inducers of ectopic bone formation, after being injected subcutaneously in rats. With respect to the calcification of the heart tissue, their fundamental effect is seen in the smooth muscle cells, which gradually change their phenotype from vascular to synthetic, and lay down the ground for subsequent calcification. Common to the variant processes of vascular calcification is a prominent involvement of BMP-2 paracrine signaling. It may also be noted that the processes of bone formation and atherosclerosis are similar to each other in many instances and hence bring about the possibility of common pathways to combat the two similar conditions. This review article focuses on the effects of BMPs in the control and development of vascular calcification, and the probable pathways that may interfere with or augment this BMP-induced vascular calcification process.
A diagnosis of myocardial dystrophic calcification, a rare cause of fetal cardiac masses, is presented. The fetal echocardiography of a 26-year-old pregnant woman who was referred to the Pediatric Cardiology Department at 20... more
A diagnosis of myocardial dystrophic calcification, a rare cause of fetal cardiac masses, is presented. The fetal echocardiography of a 26-year-old pregnant woman who was referred to the Pediatric Cardiology Department at 20 weeks' gestation revealed an echogenic mass in the post wall of the left ventricle. The pregnancy was terminated. The histopathology of the necropsy material revealed dystrophic calcification. The dystrophic calcification of myocardium must be kept in mind in prenatal differential diagnosis of intracardiac masses for patient management and genetic counseling.
Biliary atresia (BA) is the most severe hepatic disorder in newborns and its etiopathogenesis remains unknown. Viral involvement has been proposed, including the human cytomegalovirus (HCMV). The aims of the study were to use the... more
Biliary atresia (BA) is the most severe hepatic disorder in newborns and its etiopathogenesis remains unknown. Viral involvement has been proposed, including the human cytomegalovirus (HCMV). The aims of the study were to use the polymerase chain reaction (PCR) to screen the liver tissue of infants with extrahepatic cholestasis for HCMV and to correlate the results with serological antibodies against HCMV and histological findings. A retrospective study in a tertiary care setting included 35 patients (31 BA, 1 BA associated with a choledochal cyst, 2 congenital stenosis of the distal common bile duct and 1 hepatic cyst). HCMV serology was determined by ELISA. Liver and porta hepatis were examined histologically. Liver samples from infants and a control group were screened for HCMV DNA. Twelve patients had HCMV negative serology, 9 were positive for IgG antibodies and 14 were positive for IgG and IgM. Nine liver and seven porta hepatis samples were positive for HCMV DNA but none of t...
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,... more
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...
Adhesive capsulitis is a painful condition of unknown etiology with restriction of active and passive movements of the glenohumeral joint. The condition is a result of inflammation, adherence, and swelling in the lining of the shoulder... more
Adhesive capsulitis is a painful condition of unknown etiology with restriction of active and passive movements of the glenohumeral joint. The condition is a result of inflammation, adherence, and swelling in the lining of the shoulder joint capsule and its associated ligaments, causing resultant contracture of the capsule. We describe a patient with calcified and thickened coracohumeral ligament with adhesive cap-sulitis and diabetes mellitus.
BAC KG R O U N DThe calcification of pericardial bioprosthetic biomaterialsis a clinical concern.The aim of this study was toinvestigate the effect of a decalcifying agent, picric acid,on decalcification in bovine pericardial tissue.M ET... more
BAC KG R O U N DThe calcification of pericardial bioprosthetic biomaterialsis a clinical concern.The aim of this study was toinvestigate the effect of a decalcifying agent, picric acid,on decalcification in bovine pericardial tissue.M ET H O D SBovine pericardium, cut into 1 cm2pieces weretransferred into +4°C phosphate buffered salinesolution containing 0.625% glutaraldehyde for initialfixation, then allocated into two groups. Group Ireceived identical treatment in refreshed solution forfive more days. Group II underwent further fixation inphosphate buffered sa l i n e+2% picric acid solution(pH=7.4, 37°C) for a period of 48 h and thentransferred into a fresh phosphate buffered sa l i n e+0.625% glutaraldehyde solution at 37°C for three mored a y s .Pericardial patches were implanted into dorsalpouches of 20 juvenile male Wistar rats for 42 days. R E S U LTSGroup II demonstrated a decrease in calcification(130±25.3 μg/mg of tissue). Value estimated in GroupI was 262.4±51.5 μg/mg of tissue (p=0.000). Histo-pathologic evaluation revealed higher calcification ingroup I than in group II (p=0.023). CO N C LU S I O N SPicric acid, once being a destructive explosive, might bea constructive component by decalcifying prostheticheart valve materials.
The aim of this study was to estimate the incidence of carotid artery calcification (CAC) in a sample of Lebanese population using digital panoramic radiographs. Panoramic radiographs of 500 patients (281 females and 219 males), aged... more
The aim of this study was to estimate the incidence of carotid artery calcification (CAC) in a sample of Lebanese population using digital panoramic radiographs. Panoramic radiographs of 500 patients (281 females and 219 males), aged between 18 and 88 years (mean: 47.9 years), were assessed for CAC. Data collected were analyzed statistically using IBMSPSSfor Windows version 20.0 (SPSS, Chicago, IL, USA). CAC were found in 34 cases (6.8%), among them, 23 females (8.18%) and 11 males (5.02%). Six of all the calcifications were on the right side, against six on the left side, and 22 on both sides. The mean age of patients affected with CAC was 60.9 years (ranging from 18 to 88 years). Chi-square test showed no statistical significance between gender and CAC, while Spearman correlation analysis showed positive low correlation with age (= 0.179). CAC can be found on routine panoramic radiographs taken in dental clinics; dentists should automatically refer the patients in question for spe...
Abnormal mineralization occurs in the context of several common conditions, including advanced age, diabetes, hypercholesterolemia, chronic renal failure, and certain genetic conditions. Metabolic, mechanical, infectious, and inflammatory... more
Abnormal mineralization occurs in the context of several common conditions, including advanced age, diabetes, hypercholesterolemia, chronic renal failure, and certain genetic conditions. Metabolic, mechanical, infectious, and inflammatory injuries promote ectopic mineralization through overlapping yet distinct molecular mechanisms of initiation and progression. The ABCC6 protein is an ATP-dependent transporter primarily found in the plasma membrane of hepatocytes. ABCC6 exports unknown substrates from the liver presumably for systemic circulation. ABCC6 deficiency is the primary cause for chronic and acute forms of ectopic mineralization described in diseases such as pseudoxanthoma elasticum (PXE), β-thalassemia, and generalized arterial calcification of infancy (GACI) in humans and dystrophic cardiac calcification (DCC) in mice. These pathologies are characterized by mineralization of cardiovascular, ocular, and dermal tissues. PXE and to an extent GACI are caused by inactivating ABCC6 mutations, whereas the mineralization associated with β-thalassemia patients derives from a liver-specific change in ABCC6 expression. DCC is an acquired phenotype resulting from cardiovascular insults (ischemic injury or hyperlipidemia) and secondary to ABCC6 insufficiency. Abcc6-deficient mice develop ectopic calcifications similar to both the human PXE and mouse DCC phenotypes. The precise molecular and cellular mechanism linking deficient hepatic ABCC6 function to distal ectopic mineral deposition is not understood and has captured the attention of many research groups. Our previously published work along with that of others show that ABCC6 influences other modulators of calcification and that it plays a much greater physiological role than originally thought.