Primary Percutaneous Coronary Intervention for Acute Myocardial Infarction in a Young Female with Idiopathic Thrombocytopenic Purpura: A Case Report and Review

A 23-year-old female with the diagnosis of idiopathic thrombocytopenic purpura (ITP) was admitted to our hospital with severe chest pain. The electrocardiogram (ECG) revealed acute anterior myocardial infarction. She underwent an immediate cardiac catheterization. An occluded left anterior descending (LAD) was detected by coronary angiography. Reperfusion was performed successfully by angioplasty and stenting with optimal distal flow without any complications. In this report we discussed the management strategies of acute myocardial infarction (AMI) in a patient with ITP

Aspergillus terreus MRC 200365 ve Aspergillus fumigatus MRC 200358 Küfleri ile (-)-Mirtenol Bileşiğinin Biyotransformasyonları

(-)-Mirtenol bileşiğinin Aspergillus terreus MRC 200365 ve Aspergillus fumigatus MRC 200358 küflerinde nasıl metabolize edileceğini incelemek ve bunun sonucunda farklı amaçlar için çıkış maddesi olarak kullanılabilecek maddeler elde etmek amacı doğrultusunda söz konusu mikroorganizmalar ile biyotransformasyonları geçekleştirildi. Biyotransformasyon çalışmaları için çalkalamalı inkübatörde yetiştirilen küf kültürleri kullanıldı. A. terreus ile (-)-mirtenol'ün 7 gün süren inkübasyonu neticesinde sentetik çalışmalar için çıkış maddesi olarak kullanılabilecek (-)-1-p-menten-7,8-diol bileşiği elde edildi. (-)-Mirtenol bileşiği A. fumigatus ile 7 gün süren inkübasyonu sonucunda metabolize edilemedi ve sadece başlangıç maddesi elde edildi. Anahtar Kelimeler: Biyotransformasyon, Terpen, Monoterpenoid, (-)-Mirtenol, Aspergillus terreus. Aspergillus fumigatu

BIOTRANSFORMATION OF (-)-VERBENONE BY Aspergillus tamarii AND Aspergillus terreus

The biotransformations of (-)-verbenone by Aspergillus tamarii and Aspergillus terreus were described. The biotransformation of (-)-verbenone with A. tamarii and A. terreus for 7 days gave (-)-10-hydroxyverbenone. The biotransformation of (-)-verbenone by A. tamarii resulted in a higher yield. A. tamarii and A. terreus were first two microorganisms to hydroxylate (-)-verbenone

Iliac artery perforation and treatment during lumbar disc surgery by simple balloon tamponade

WOS: 000319150300010PubMed ID: 22805757Introduction Although vascular injury during lumbar disc surgery is quite rare, it may be life threatening if not recognized and treated immediately. Case We report the case of a woman who had a left common iliac artery laceration during spinal surgery and was treated by endovascular therapy. In the past, open surgery was the only way to repair a vascular injury, but thanks to the advance of new endovascular techniques and devices, endovascular therapy has become a strong alternative. Conclusion This case differs from those published in the literature as we used a single balloon inflation and subtotal occlusion without the need for a covered stent

Geçilemeyen koroner lezyonlarda stenti ilerletmenin pratik tekniği: Prospektif kohort çalışması

Objective: Uncrossable coronary lesions are still challenging to treat. Several devices and techniques are introduced, including rotational atherectomy, or anchor balloon. However, these methods are expensive, not always available, and associated with lower procedural success and higher major adverse cardiac events. Our study describes a simple, effective method [patience technique (PT)] to advance a stent through uncrossable lesions that has not been described in the literature. Material and Methods: In a prospective study with 24 patients undergoing uncrossable lesion percutaneous coronary intervention with stent advancement failures, we identify PT and describe our experience with PT. The PT is the process of pushing the uncrossed same stent for a prolonged time under an optimum constant force to overcome the intraluminal friction. Results: Twenty-three (95.8%) patients had modified American College of Cardiology/ American Heart Association classification Type C, 22 (91.70%) diffuse [median length: 38 mm (quartiles 31.25-52.25)], 22 (91.70%) eccentric and 20 (83.30%) moderate-extensive calcified lesions. Respectively, 8 (27.59%) of 29 stenosis was in left anterior descending, and right coronary artery, 6 (20.69%) left circumflex coronary artery, 3 (10.35%) D1, 2 (6.90%) left main coronary artery-Cx, 1 (3.45%) LCxOM2 and saphenous vein graft-LCxOM2. The median stent advancement time was 134.00 seconds (quartiles 95.25-178.50). All procedures progressed after using the PT and finally resulted successfully without complications. Conclusion: The PT is feasible, and safe for facilitating the passage of stents through uncrossable lesions. Before advancing percutaneous cardiac intervention techniques, this method could be used advantageously in calcified, diffuse, and eccentric lesions.ÖZET Amaç: Geçilemeyen koroner lezyonların tedavisi hâlen zorlayıcıdır. Bunun için rotasyonel aterektomi veya çapa balonu gibi çeşitli cihaz ve teknikler tanımlanmıştır. Ancak bu ve benzeri cihaz ve yöntemler pahalıdır, her zaman mevcut değildir, başarı oranları düşüktür, komplikasyon oranları yüksektir ve belirli koşullar altında uygulanabilmektedirler. Çalışmamızda, karmaşık yöntemlerden önce zorlayıcı geçilemeyen lezyonlarda stenti ilerletmek için basit, etkili, maliyetsiz, güvenli ve literatürde daha önce tanımlanmamış bir tekniği [sabır tekniği (ST)] açıklıyoruz. Gereç ve Yöntemler: Geçilmesi zor koroner lezyonların girişimi esnasında stent ilerletme işlemi başarısızlığa uğrayan 24 hasta üzerinde ileriye dönük çalışma ile yeni bir teknik tanımladık. ST, koroner arter ile stent arasındaki lümen içi sürtünme kuvvetinin üstesinden gelmek için optimum sabit bir kuvvet altında, periyodu uzatarak, uzun süre stenti itme işlemidir. Bulgular: Hastaların 23’ünde (%95,8) modifiye Amerikan Kardiyoloji Koleji/Amerikan Kalp Birliği sınıflandırması Tip C, 22’sinde (%91,70) yaygın [medyan lezyon uzunluğu: 38 mm (çeyrekler 31,25-52,25)], 22’sinde (%91,70) eksantrik ve 20’sinde (%83,30) orta-ileri düzeyde kalsifiye lezyonlar mevcuttu. Yirmi dokuz lezyonun 8’inde (%27,59) sağ koroner arter ve sol ön inen koroner arter, 6’sında (%20,69) sol sirkumfleks koroner arter, 3’ünde (%10,35) D1, 2’sinde (%6,90) sol ana koroner arter-Cx, 1’inde (%3,45) LCxOM2 ve safen ven greft lezyonları izlendi. Ortanca stent ilerletme süresi 134,00 sn (çeyrekler 95,25-178,50) saptandı. ST kullandıktan sonra tüm koroner girişimsel işlemleri komplikasyonsuz olarak başarıyla sonuçlandırıldı. Sonuç: Stentin geçirilmesi zor, eksantrik, diffüz ve ileri kalsifik koroner lezyonlarda, stent geçişini kolaylaştırmak için karmaşık yöntemlere geçmeden önce başarılı ve güvenilir bir yöntem olan ST kullanılabilir

Biotransformation of androst-4-ene-3,17-dione by some fungi

The incubations of androst-4-ene-3,17-dione with Aspergillus candidus MRC 200634, Aspergillus tamarii MRC 72400, Aspergillus wentii MRC 200316 and Mucor hiemalis MRC 70325 for 5 days are reported. A. candidus MRC 200634 mainly hydroxylated androst-4-ene-3,17-dione at C-11 alpha, C-15 alpha and C-15 beta whilst A. wentii MRC 200316 hydroxylated it mainly at C-6 beta. A. tamarii MRC 72400 showed predominately a Baeyer-Villiger monooxygenase activity. M. hiemalis MRC 70325 hydroxylated the substrate at C-14 alpha and reduced most of it at C-17

Effect of Sacubitril/Valsartan Combined with Dapagliflozin on Long-Term Cardiac Mortality in Heart Failure with Reduced Ejection Fraction

The angiotensin receptor-neprilysin inhibitor (ARNI) sacubitril/valsartan and sodium-glucose cotransporter-2 (SGLT-2) inhibitor dapagliflozin have been shown to reduce rehospitalization and cardiac mortality in patients with heart failure (HF) with reduced ejection fraction (HFrEF). We aimed to compare the long-term cardiac and all-cause mortality of ARNI and dapagliflozin combination therapy against ARNI monotherapy in patients with HFrEF. This retrospective study involved 244 patients with HF with New York Heart Association (NYHA) class II-IV symptoms and ejection fraction <= 40%. The patients were divided into 2 groups: ARNI monotherapy and ARNI+dapagliflozin. Median follow-up was 2.5 (.16-3.72) years. One hundred and seventy-five (71.7%) patients were male, and the mean age was 65.9 (SD, 10.2) years. Long-term cardiac mortality rates were significantly lower in the ARNI+dapagliflozin group (7.4%) than in the ARNI monotherapy group (19.5%) (P = .01). Dapagliflozin [Hazard Ratio (HR) [95% Confidence Interval (CI)] = .29 [.10-.77]; P = .014] and left ventricular ejection fraction (LVEF) [HR (95% CI) = .89 (.85-.93); P < .001] were found to be independent predictors of cardiac mortality. Our study showed a significant reduction in cardiac mortality with ARNI and dapagliflozin combination therapy compared with ARNI monotherapy

Evaluation of Epicardial Fat Thickness in Young Patients With Embolic Stroke of Undetermined Source

WOS: 000457779200001PubMed ID: 29953033Objectives:Epicardial adipose tissue is metabolically active and is an important predictor of metabolic and cardiovascular diseases. This study investigated the echocardiographic epicardial adipose tissue measurement in young patients with embolic stroke of undetermined source (ESUS).Materials and Methods:We studied 77 volunteers, including 40 patients with ESUS (mean age 438y, 16 female patients) and 37 healthy subjects (mean age 387y, 20 female subjects). All necessary biochemical parameters were analyzed, and epicardial fat thickness (EFT) was measured by echocardiography in all subjects. Additional related diagnostic work-up was conducted in each patient, according to the patients' clinical presentation.Results:The patients with ESUS had a significantly higher EFT than the control group (5.51 +/- 0.82 vs. 3.96 +/- 0.51; P<0.01). Furthermore, there was a positive correlation between EFT and serum C-reactive protein levels (r=0.284; P<0.05). As an optimal cut-off point, a high-risk EFT value of 4.6mm was determined to predict ESUS, with an 87.5% sensitivity and an 81.1% specificity.Conclusion:We found that echocardiographic EFT was significantly higher in young patients with ESUS than in healthy individuals. Increased EFT might be a novel risk factor in these patient