A 17-year-old with neurofibromatosis and spontaneous coronary artery dissection

Abstract

A 17-year-old girl with neurofibromatosis type 1 presented with unstable angina. Cardiac catheterization revealed an aneurysm with thrombus in the left anterior descending coronary artery. She was discharged on medical treatment but returned 2 months later with severe chest pains. Angiography revealed an increase in the size of the aneurysm in the left anterior descending coronary artery, with thrombus and dissection. The patient underwent coronary artery bypass surgery. Follow-up after 1 year revealed no problems.

Immobilized protease on the magnetic nanoparticles used for the hydrolysis of rapeseed meals

“…The enzyme method to obtain peptides by hydrolyzing protein attracts considerable attention because of its mild reaction conditions, safety, controllability, and the capability of large-scale production of specific peptides [16]. Alkaline protease is a kind of proteolytic enzyme produced by fermenting bacillus subtilis 2709, and its catalytic site is serine [17]. Alkaline protease exhibits outstanding capability to degrade protein, and has many free amino acids which serve as the active sites for covalent conjugation.…”

Türk-Fransız İlişkileri Örneğinde, Parti-Devlet Beraberliği Konusunun İncelenmesi (1923-1939)

“…İki savaş arası dönemde Avrupa'nın radikal, sosyalist ve demokrat partileriyle ilişki kurulması, partinin ideolojik çizgisini göstermesi bakımından önem taşımaktadır. 43 Bu yakınlaşmayı Avrupa'daki siyasi parti grupları içerisinde CHP'nin yerini belirleyen girişim olarak tanımlamak mümkündür. 44…”

Isolated Huge Aneurysm of the Left Main Coronary Artery in a 22-Year-Old Patient With Type 1 Neurofibromatosis

“…The most common cause of coronary aneurysm is atherosclerosis, and associations have been reported with coronary trauma, percutaneous coronary angioplasty, Kawasaki and Takayasu diseases, polyarteritis nodosa, systemic lupus, and syphilis, but rarely with neurofibromatosis [1][2][3][4][5]. There is no proper type of medical or surgical therapy for coronary aneurysm, and few reports are available on the subject.…”

“…There have been descriptions of 2 patients with coronary aneurysms in association with type 1 neurofibromatosis who required coronary artery bypass. Uyar and colleagues [5] reported the case of a 17-year-old girl who required a coronary bypass operation for ongoing angina episodes, despite medical therapy, due to a coronary aneurysm with thrombus in the left anterior descending artery. Kandarpa and colleagues [1] reported the case of a 30-year-old patient who required an immediate operation for left anterior descending artery occlusion below a large aneurysm almost filled with thrombus.…”

“…Although numerous vascular malformations affecting the aorta and great vessels, cerebral, visceral and renal arteries have been described, changes in the coronary arteries have rarely been reported [1][2][3][4][5]. We describe here the case of a 22-year-old patient with neurofibromatosis who required cardiac bypass grafting due to thrombosis formation within a huge aneurysm of the left main coronary artery that was responsible for downstream repeated thromboembolic migration with enzymatic elevation.…”