Further development of the theory and mathematical description of combined toxicity: An approach to classifying types of action of three-factorial combinations (a case study of manganese-chromium-nickel subchronic intoxication).

For characterizing the three-factorial toxicity, we proposed a new health risk-oriented approach, the gist of which is a classification of effects depending on whether a binary combined toxicity's type remains virtually the same or appears to be either more or less adverse when modeled against the background of a third toxic. To explore possibilities of this approach, we used results of an experiment in which rats had been injected ip 3 times a week (up to 20 injections) with a water solution of either one of the toxics (Mn, Ni or Cr-VI salts) in a dose equivalent to 0.05 LD50, or any two of them, or all the three in the same doses, the controls receiving injections of the same volume of distilled water (4mL per rat). Judging by more than 30 indices for the organism's status, all exposures caused subchronic intoxication of mild to moderate strength. For each two-factorial exposure, we found by mathematical modeling based on the isobolograms that the binary combined subchronic toxicity either was of additive type or departed from it (predominantly toward subadditivity) depending on the effect assessed, dose, and effect level. For the three-factorial combination, different classes of effects were observed rather consistently: class A - those regarding which the third toxic's addition made the binary toxicity type more unfavorable for the organism, class B - those regarding which the result was opposite, and class C - those regarding which the type of binary combined toxicity on the background of a third toxic virtually remained the same as in its absence. We found a complicated reciprocal influence of combined metals on their retention in kidneys, liver, spleen and brain which might presumably be one of the possible mechanisms of combined toxicity, but the lack of an explicit correspondence between the above influence and the influence on toxicity effects suggests that this mechanism is not always the most important one. The relevance of the proposed classification to health risk analysis and management is briefly discussed.

[Endoscopic diagnosis of local chemical burn of mucous membranes of the stomach, induced with the purpose of simulation of gastric ulcer].

With the purpose of improvement of diagnosis of induced gastric ulcer were examined 11 patients who took aggressive agents for simulation of gastric ulcer and 33 patients who took pseudo-aggressive agents. Observables, conduced diagnosis of local chemical burn of mucous coat of stomach during initial 6 days after taking aggressive agents. Stages of ulcerous process, resulting from local chemical burn of mucous coat of stomach, coressponds to real gactric ulcer. Gelatin capsule using as a container for delivery of aggressive agents, melts in stomach in 5-6 minutes after taking. Independent from body position, mucous coat of greater curvature of the stomach is damaged. It is impossible to simulate duodenal bulb ulcer using the gelatine capsule or ball made of breadcrumb. The last method of delivery of aggressive agent can damage the small intestine because of uncontrollability of the place of breaking the ball.

Test concentration setting for fish in vivo endocrine screening assays.

Fish in vivo screening methods to detect endocrine active substances, specifically interacting with the hypothalamic-pituitary-gonadal axis, have been developed by both the Organization for Economic Co-operation and Development (OECD) and United States Environmental Protection Agency (US-EPA). In application of these methods, i.e. regulatory testing, this paper provides a proposal on the setting of test concentrations using all available acute and chronic data and also discusses the importance of avoiding the confounding effects of systemic toxicity on endocrine endpoints. This guidance is aimed at reducing the number of false positives and subsequently the number of inappropriate definitive vertebrate studies potentially triggered by effects consequent to systemic, rather than endocrine, toxicity. At the same time it provides a pragmatic approach that maximizes the probability of detecting an effect, if it exists, thus limiting the potential for false negative outcomes.

Emergency Do Not Consume/do Not Use concentrations for potassium permanganate in drinking water.

Over the past decade, regulatory authorities and water purveyors have become increasingly concerned with accidental or intentional adulteration of municipal drinking water. Emergency response guidelines, such as the 'Do Not Consume' or use concentration limits derived herein, can be used to notify the public in such cases. Potassium permanganate (KMnO(4)) is used to control iron concentrations and to reduce the levels of nuisance materials that affect odor or taste of finished drinking water. Manganese (Mn) is recognized an essential nutrient, permanganate (MnO4 (-)) and manganous (Mn(+2)) ions are caustic, and the acute toxicity of KMnO(4) is defined by its oxidant/irritant properties and by the toxicity of Mn. Ingestion of small amounts (4-20 mg/kg) of aqueous KMnO(4) solutions that are above 200 mg/L causes gastrointestinal distress, while bolus ingestion has caused respiratory arrest following coagulative necrosis and hemorrhage in the esophagus, stomach, or liver. Dilute KMnO(4) solutions (1-100 mg/L) are used as a topical antiseptics and astringents, but >1:5000 (200 mg/L) dilutions can irritate or discolor sensitive mucous membranes and direct skin or ocular contact with concentrated KMnO(4) can perforate tissues. Based on clinical experience with 200 mg/L KMnO(4), a Do Not Consume concentration of 7 mg/L KMnO(4) (equivalent to 2 mg Mn/L) is recommended. Recognizing limited empirical data from which to calculate an ocular reference value, a skin contact 'Do Not Use' concentration of 30 mg Mn/L is recommended based on the skin irritation in some patients after a 10-min contact with 100 mg KMnO4/L.

Increased reflection impulsivity in patients with ephedrone-induced Parkinsonism.

AIMS: To examine a syndrome of chronic manganism that occurs in drug addicts in eastern Europe who use intravenous methcathinone (ephedrone) contaminated with potassium permanganate. In many cases the basal ganglia, especially the globus pallidus and the putamen, are damaged irreversibly. Routine neuropsychological assessment has revealed no cognitive deficits, despite widespread abnormalities on brain imaging studies and severe extrapyramidal motor handicap on clinical examination. DESIGN: Case-control study. SETTING: Ephedrone patients and patients with opioid dependence were recruited from Lviv, Ukraine. PARTICIPANTS: We tested 15 patients with ephedrone-induced toxicity, 13 opiate-dependent patients who were receiving opioid replacement therapy and 18 matched healthy volunteers. MEASUREMENTS: The 'beads task', an information-gathering task to assess reflection impulsivity, was used and feedback learning, working memory and risk-taking were also assessed. FINDINGS: Opiate-dependent patients differed from controls on three of four tasks, whereas ephedrone patients differed from controls on only one task. More specifically, both patient groups were more impulsive and made more irrational choices on the beads task than controls (P < 0.001). However, ephedrone patients had no deficits in working memory (P > 0.1) or risk-taking (P > 0.1) compared with controls. Opioid-dependent patients had significantly worse working memory (P < 0.001) and were significantly more risk-prone than controls (P = 0.002). CONCLUSIONS: Ephedrone patients may have similar deficits in information-gathering and decision-making to opiate-dependent patients, with preservation of working memory and risk-taking. This may reflect specific damage to anterior cingulate- basal ganglia loops.

[Perianal ulcerations caused by potassium permanganate bath]. / Perianale Ulzerationen durch Kaliumpermanganatbäder.

A 73-year-old female patient presented with acute very painful perianal ulcerations. She reported using various ointments and later potassium permanganate baths because of maceration of the rima ani as a manifestation of her psoriasis vulgaris. Suddenly after starting the potassium permanganate baths, necrotic areas developed with then became ulcerated. After excluding the relevant differential diagnostic considerations, we diagnosed ulcerations caused by a caustic burn from potassium permanganate. After stooping potassium permanganate baths and employing modern moist wound therapy, we attained complete healing after 8 months of treatment.

Comparison of the sensitivity of different fish species to medical substances.

OBJECTIVES: Formaldehyde, sodium chloride and potassium permanganate belong to the commonly used substances for fish treatment. The aim is to define and compare their acute toxicity and therapeutic index between two fish species - Danio rerio and Poecilia reticulata. DESIGN: To determine acute toxicity of these compounds, the semistatic method was implemented in compliance with the OECD No. 203 (Fish acute toxicity test). In each test series, 4 acute toxicity tests were performed. The results were subjected to the probit analysis to determine the 96hLC50 values. Therapeutic index (TI) was calculated with respect to short-term LC50 and effective therapeutic concentrations commonly used for fish treatment. RESULTS: The mean 96hLC50 values for sodium chloride were 21.69 +/- 0.92 g l-1 (TI = 1.4) for P. reticulata and 10.39 +/- 0.12 g l-1 (TI = 1.0) for D. rerio. The acute toxicity of formaldehyde for D. rerio expressed as 96LC50 was 0.12 +/- 0.003 ml l-1 (TI = 5.24) and for P. reticulata 0.1 +/- 0.003 ml l-1 (TI = 4.9). The acute toxicity of potassium permanganate for D. rerio expressed as 96LC50 was 1.25 +/- 0.15 mg l-1(TI = 1.5) and for P. reticulata 1.43 +/- 0.05 mg l-1 (TI = 2). CONCLUSION: P. reticulata showed significantly higher (p < 0.05) tolerance to sodium chloride than D. rerio, whereas D. rerio showed significantly higher (p < 0.05) tolerance to formaldehyde than P. reticulata. The acute toxicity of potassium permanganate was comparable for both fish species. Calculated therapeutic indexes of all tested substances were low; therefore it is important to conduct preliminary tolerance tests before application of treatment baths.

RANTES (CCL5) potentiates calcium ionophore in the production of LTB4 in rat adherent macrophages from granuloma induced by KMnO4: inhibiton by NDGA.

The activation of monocytes/macrophages by several stimuli is an initial event in the inflammatory response. To ascertain the importance of LTB(4) and 5-lypoxigenase in the inflammatory site, we isolated and stimulated rat adherent granuloma macrophages (RAGMs) with calcium ionophore in the presence or absence of regulated on activation, normal T expressed and secreted (RANTES) [CCL5] at different concentrations. We tested the hypothesis that RANTES may influence the production of LTB(4) stimulated by calcium ionophore A23187 (2.5 microM/ml) in rat adherent granuloma macrophages derived from granuloma induced by potassium permanganate diluted 1:40 saturated solution. To test this hypothesis, we measured LTB(4) production, in rat granuloma macrophages stimulated with A23187 (2.5 microM) alone and in combination with RANTES at different concentrations. In these studies, the cell-free supernatant of stimulated RAGMs with the ionophore A23187, resulted in a drastic increase of LTB(4). However, when the cells were treated with the combination RANTES plus A23187 the stimulatory effect was more pronounced than A23187 alone. LTB(4) production was quantitated. The calcium ionophore A23187 directly induced LTB(4) in macrophages, this production was markedly enhanced when the cells were pretreated with RANTES. However, the addition of RANTES in the absence of calcium ionophore A23187 did not directly induce LTB(4) release, nor was lypoxigenase expression augmented. Preincubation of RAGMs with NDGA (nordihydroguiaretic acid) (10(-5)M) completely abolished the production of LTB4 on RAGMSs challenged with A23187 in combination with RANTES or A23187 alone in the supernatants. Similar effects were obtained when the cells were pretreated with dexamethasone. These data suggest, for the first time, that RANTES may stimulate the release of LTB(4), only when it is associated to other stimuli and for this reason we conclude that RANTES modulates inflammatory diseases, and may require other stimuli to be effective in amplifying its spectrum of action(s).

Acute toxicity studies of potassium permanganate in Swiss albino mice.

Acute toxicity study of potassium permanganate was carried out in Swiss albino mice. Potassium permanganate was administered at dose rate of 0.0, 500, 1000, 1500, 2000, 2500, 3000 and 3500mg/kg body weight to groups 1, 2, 3, 4, 5, 6, 7 and 8, ten per group for LD50 determination. The dead animals were posted for gross lesions. A predetermined dose of 160mg/kg of the chemical was administered to experimental group of 12 mice, whereas control group of 12 mice received 16ml/kg body weight of distilled water for a period of 7 days. Grower's marsh and water were provided ad libitum. The animals were weighed daily before administration of potassium permanganate. On the eighth day 1ml of blood sample was collected from both control and experimental mice for haematology and plasma biochemistry into ethylene diamine tetraacetic acid bottles. The median lethal dose (LD50) was estimated at 1449.7mg/kg body weight. There was no significant difference between the mean weight of control and experimental group. Haematological and biochemical parameters of both control and experimental groups did not increase significantly though there was a significant (P < 0.05) decrease in chloride ion level in plasma. Toxicity signs observed are rapid and shallow respiration, rough hair coat, dullness, diarrhoea, bloat, gastroenteritis, congestion of liver, paleness of lungs and hypochloraemia.

Oxidation of MC-LR and -RR with chlorine and potassium permanganate: toxicity of the reaction products.

Toxin-producing cyanobacteria are abundant in surface waters used as drinking water resources. Microcystins (MC) produced by certain cyanobacteria present acute and chronic toxicity, and their removal in drinking water treatment processes is of increasing concern. Previous studies have demonstrated that chlorine and potassium permanganate are feasible oxidants for the removal of MCs present in drinking water resources, although the oxidation might lead to toxic oxidation products. In this paper, the toxicity of the oxidation products of MC-LR and -RR has been studied using protein phosphatase 1 inhibition assay (PPIA). The HPLC and ELISA analyses correlated with the PPIA results for both toxins. The samples containing the oxidation products were fractionated by HPLC and the toxicity of the fractions was tested with PPIA. The results revealed that protein phosphatase 1 inhibition emerged only from intact MC, while the oxidation products were non-toxic. Similar results were obtained in experiments performed in natural waters: no reaction products or interactions exhibiting protein phosphatase 1 inhibition were detected.

[Therapeutic effect of the latest extracorporal elimination procedure (Prometheus treatment) in acute liver failure caused by intoxication]. / A legújabb extracorporalis eliminációs eljárás (Prometheus-kezelés) terápiás hatékonysága mérgezés okozta akut májelégtelenségben.

INTRODUCTION: Despite intensive therapy the mortality of acute liver failure without organ transplantation is 60-90%. Because of organ shortage in liver transplantation, a significant number of patients dies while being on the waiting list. In order to diminish the mortality, various trials were introduced to remove the albumin-bound and water-soluble toxins in liver failure with the aim to support the spontaneous regeneration of the liver and maintaining the patients alive until liver transplantation. Prometheus treatment is a relatively new technique combining Fractionated Plasma Separation and Adsorption (FPSA) with a high-flux dialysis. During the procedure the patient's own separated albumin-rich plasma passes through special adsorbents making possible the elimination of albumin-bound toxins, while hemodialysis gets rid of water-soluble toxins. AIM: The authors' intention was to demonstrate the efficiency of Prometheus treatment in acute liver failure caused by intoxication. PATIENTS AND METHOD: Prometheus treatment was indicated in three patients who suffered from severe intoxication with paracetamol, potassium permanganate and Amanita phalloides, which resulted in a hepatic failure incurable with conservative therapy. RESULTS: Ten treatments were performed in the three female patients. No serious complication was observed. Due to the treatment the albumin-bound (indirect bilirubin p = 0.048; bile acid p = 0.001) and water-soluble (direct bilirubin p = 0.002; creatinine p = 0.007) toxins were significantly decreased. The level of ammonia, urea nitrogen, fibrinogen and antithrombin III did not change significantly. All the three patients were cured without liver transplantation. CONCLUSION: Prometheus treatment removes efficiently the accumulating toxins in acute liver failure. It is a safe elimination technique. In cases untreatable with conservative therapy it makes possible maintaining the patients alive until the liver regenerates spontaneously, or liver transplantation is feasible.

Mitigation of lethal effects of Karlodinium veneficum and K. armiger on Sparus aurata: changes in haematocrit and plasma osmolality.

Between January and April 2000, several experiments were performed during a Karlodinium spp. proliferation in Alfacs Bay (Ebro delta, NW Mediterranean) to determine the effects of these dinoflagellates on sea bream Sparus aurata cultivated in the area. Moribund fish showed an increase in plasma osmolality together with a decrease in the haematocrit percentage compared to control fish. The efficacy of copper sulphate, hydrogen peroxide, potassium permanganate and formalin against Karlodinium spp. was also tested. None of these treatments had mitigation effects when applied in the presence of fish; on the contrary, lethal effects appeared at lower Karlodinium spp. densities compared to fish control groups. When a lytic agent, such as copper sulphate, was used as a water pre-treatment, in the absence of fish, Karlodinium spp. toxicity was significantly reduced. Protocols for water pre-treatments were studied as a potential tool for combating Karlodinium spp. in fish farms.

Tolerance of benzalkonium chloride, formalin, malachite green, and potassium permanganate in goldfish and zebrafish.

OBJECTIVE: To determine tolerance of goldfish and zebrafish to benzalkonium chloride, formalin, malachite green, and potassium permanganate. DESIGN: Tolerance study. ANIMALS: Adult goldfish (Carassius auratus) and zebrafish (Danio rerio). PROCEDURES: Groups of fish (n = 10/group) were exposed to each disinfectant at the therapeutic dosage; at 0.25, 0.5, 3, and 5 times the concentration used for the therapeutic dosage; and at the concentration used for the therapeutic dosage but for 3 or 5 times the recommended exposure time. RESULTS: In both species, exposure to malachite green at the therapeutic dosage resulted in toxic effects, including death. Exposure to formalin at the therapeutic dosage resulted in toxic effects in goldfish, but not zebrafish, and exposure to potassium permanganate resulted in toxic effects in zebrafish, but not goldfish. On the basis of the ratio of therapeutic dosage to median lethal dosage, in goldfish, formalin was more toxic than benzalkonium chloride, which was more toxic than malachite green, which was more toxic than potassium permanganate. In zebrafish, potassium permanganate was more toxic than formalin and benzalkonium chloride, which were approximately equally toxic and more toxic than malachite green. Extending treatment time increased the toxicity of potassium permanganate in zebrafish and the toxicity of formalin and malachite green in goldfish, but did not alter the toxicity of the other disinfectants. CONCLUSIONS AND CLINICAL RELEVANCE: Results indicated that there was no consistency between zebrafish and goldfish in their tolerance to disinfectants, and that therapeutic dosages reported in the literature for these disinfectants were not always safe.

Comparative acute toxicity of potassium permanganate to nontarget aquatic organisms.

Potassium permanganate (KMnO4) is used worldwide in freshwater pond aquaculture for treatment and prevention of waterborne external parasitic, bacterial, and fungal diseases. Nevertheless, KMnO4 has not been approved by the U.S. Food and Drug Administration, and insufficient information exists to allow evaluation of the environmental risk of KMnO4 exposures. Limited data exist concerning KMnO4 toxicity to nontarget species in systems receiving aquaculture effluent from treated ponds. The goal of this research is to generate effects data for use in developing an ecological risk assessment of KMnO4. Toxicity tests were used to compare the relative sensitivities of five standard aquatic test species to KMnO4. Acute toxicity test results using synthetic moderately hard water show static 96-h mean median lethal concentration (LC50) values +/- standard deviation (SD) of 0.058 +/- 0.006 mg/L for Ceriodaphnia dubia, 0.053 +/- 0.009 mg/L for Daphnia magna, 2.13 +/- 0.07 mg/L for Pimephales promelas, 4.74 +/- 1.05 mg/L for Hyalella azteca, and 4.43 +/- 0.79 mg/L for Chironomus tentans. Most of these values are below the recommended KMnO4 treatment rate of at least 2.0 mg/L or 2.5 times the water's potassium permanganate demand (PPD; an estimation of the available reducing agents in the exposure water), suggesting significant environmental risk. However, repeating these laboratory tests using pond water resulted in significantly reduced toxicity, with static 96-h mean LC50 values (+/-SD) of 2.39 +/- 0.36 mg/L for C. dubia, 1.98 +/- 0.12 mg/L for D. magna, 11.22 +/- 1.07 mg/L for P. promelas, 13.55 +/- 2.24 mg/L for H. azteca, and 12.30 +/- 2.83 mg/L for C. tentans. The PPD of synthetic moderately hard water was 0.329 +/- 0.114 mg/L; however, pond water PPD was 5.357 +/- 0.967 mg/L. The effective disease-treating dose based on 2.5 times the PPD would thus be 0.823 and 13.392 mg KMnO4/L, respectively, exceeding the LC50 for most of these nontarget organisms, even in pond water, immediately after treatment.

The mechanisms of potassium permanganate on algae removal.

The effect of potassium permanganate as preoxidant for algae-laden source water and the mechanism that it causes algae cells aggregation was investigated. Synthetic algae suspensions, prepared from lab-cultured Chodatella sp., were used for batch preoxidation and settling tests. In order to study the effect of water hardness on the function of permanganate, some algae suspensions were spiked with CaCl2 solution. Experiments with preformed MnO2 to look into its effect on algae cell aggregation were also conducted. The results show that preoxidation with potassium permanganate would promote the aggregation of algae cells, and this phenomenon was even more significant with the existence of hardness causing ion, calcium. In addition to incorporating its reducing product, MnO2, into algae floc, and increased its specific gravity, and therefore its settling velocity, permanganate may also induce the release of extracellular organic matters (EOM) from algae cell. Based on SEM observation, EOM probably enhanced the incorporation of MnO2 into algae floc. The role played by calcium ion in promoting the function of permanganate can be explained by charge neutralization and also bridging between negatively charged surfaces.

Treatment of ichthyophthiriasis after malachite green. I. Concrete tanks at salmonid farms.

Since the use of malachite green was banned in many European countries, new alternative treatments have been tested to prevent white spot disease caused by Ichthyophthirius multifiliis. We tested formalin, potassium permanganate (KMnO4), chloramine-T, hydrogen peroxide (H2O2) and Per Aqua or Desirox alone or in combinations of 2 chemicals, one of which was always formalin, in 50 m2 concrete tanks at 2 farms producing salmon Salmo salar smolt in 2001 and 2002. Both Per Aqua and Desirox are combinations of peracetic acid, acetic acid and hydrogen peroxide. The alternative chemicals or their combinations can be used successfully to lower the parasite burden to such a level that no high mortality occurs during the first 4 wk after the start of an infection. This period of time allows the fish to develop immunity against these ciliates, and treatments can be reduced and stopped in due course. I. multifiliis decreased in number 3 to 4 wk after the beginning of the infection in all the treatments. Large differences in parasite burden and mortality occurred among the replicates in all except the Desirox-formalin tanks, which means that they are not as reliable as the malachite green-formalin used previously. It was also evident that the chemicals and their concentrations must be planned carefully to suit the conditions on each farm.

Changes of C-reactive protein levels in rainbow trout (Oncorhynchus mykiss) sera after exposure to anti-ectoparasitic chemicals used in aquaculture.

Changes of serum C-reactive protein (CRP) levels in rainbow trout (Oncorhynchus mykiss) were studied after exposure to formalin, metriphonate or potassium permanganate, which are used in aquaculture as anti-ectoparasitic chemicals. The CRP level in normal trout sera is 88+/-5 microg ml(-1) according to sandwich enzyme-linked immunosorbent assay. CRP levels increased to a maximum at six or nine days after exposure to formalin for 3.5 h at 300 ppm or 9.5 h at 30 ppm, respectively; these levels are 4.3 and 18 times higher than normal. At 18 days after treatment, the CRP level had decreased to significantly below the normal level. After exposure to metriphonate (0.4 ppm for 30 min), the CRP level increased significantly to a maximum at three days after exposure (9.9 times higher than normal), then decreased to below normal. With exposure to potassium permanganate at 40 ppm for 45 min, fish showed significantly lower CRP levels than the normal level at 14 days after exposure. Fish reared at a water temperature of 16.5-19.5 degrees C showed significantly higher CRP levels than those reared at 13 degrees C. Measurement of CRP levels in trout serum can be used as a bioindicator of the health condition of the fish.

Dietary myo-inositol hexaphosphate prevents dystrophic calcifications in soft tissues: a pilot study in Wistar rats.

Myo-inositol hexaphosphate (InsP6) is an abundant component of plant seeds. It is also found in significant levels in blood and mammalian tissues, but they are totally dependent on their dietary intake. In the present paper, we describe studies on the effect of InsP6 on a model of dystrophic calcification, which was chemically induced by subcutaneous injection of a 0.1% KMnO4 solution. Male Wistar rats were randomly divided into four groups for treatment over 31 days. A: animals consuming a purified diet in which InsP6 was absent but to which 1% of InsP6 (as sodium salt) was added. In this group, the InsP6 plasma levels (0.393 +/- 0.013 microM) were similar to those observed in rats consuming a standard diet. B: animals consuming only the purified diet in which InsP6 was absent. In this case the InsP6 plasma levels decreased (0.026 +/- 0.006 microM); C: animals consuming the same purified diet as group B but received daily subcutaneous injections of 50 microg kg(-1) etidronate during the last 14 days. In this case the InsP6 plasma levels were also very low (0.025 +/- 0.007 microM); D: animals consuming the same diet as group B but a 6% of carob germ (InsP6 rich product) was added. The InsP6 plasma levels (0.363 +/- 0.035 microM) were also similar to those observed in rats consuming a standard diet. After 21 days plaque formation was induced. Calcification plaques were allowed to proceed for 10 days, after which the plaque material present was excised, dried and weighed. It was found that the presence of myo-inositol hexaphosphate (phytate) in plasma at normal concentrations (0.3-0.4 microM) clearly inhibited the development of dystrophic calcifications in soft tissues. These results demonstrates that myo-inositol hexaphosphate acts as an inhibitor of calcium salt crystallization.