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Tissue plasminogen activator

Taewon Kim, Jaseong Koo, Seong-Hoon Kim, In-Uk Song, Sung-Woo Chung, Kwang-Soo Lee
Hemorrhagic transformation (HT) is one of the most feared complications of acute recanalization therapies. The aim of this study was to evaluate whether blood-brain barrier permeability (BBBP) imaging can predict HT in the setting of acute recanalization therapy and to determine the sensitivity and specificity of BBBP for the prediction of HT according to the type of reperfusion therapy. We assessed a total of 46 patients who received recanalization therapy (intravenous (IV) recombinant tissue plasminogen activator (tPA), mechanical thrombectomy with a stent retriever or both) for acute ischemic stroke within the internal carotid artery or middle cerebral artery...
June 16, 2018: Neurological Sciences
Antonio M Serafin, Angela Chinhengo, Pedro Fernandez, John M Akudugu
No unambiguous role of the involvement of uroplasminogen activator (uPA) and plasminogen activator inhibitor type-1 (PAI-1) in prostate cancer has emerged, with current evidence suggesting that neither biomarker is likely of significant clinical value, save as an overall contributor. In this study, we attempt to discriminate prostate cancer from non-cancer in a cohort of plasma samples, using the Imubind ELISA assay. In this cohort, PAI-1 levels are higher in prostate cancer patients than healthy donors; uPA levels are higher in healthy donors than prostate cancer patients; and the uPA/PAI-1 ratio is higher in healthy donors than in prostate cancer patients...
May 2018: Discovery Medicine
Bibai Ren, Glenmore Lasam
We report a case of a 56-year-old man who presented initially with a sudden onset of right-sided facial droop and weakness, aphasia, and confusion with no associated fever, chills, syncope, fatigue, weight loss, night sweats, nausea, vomiting, diarrhea, odontalgia, palpitations, cough, or dyspnea. Code stroke was called and the patient received tissue plasminogen activator (tPA) with subsequent resolution of his symptoms. Cranial magnetic resonance imaging showed left frontal punctate cortical restricted diffusion consistent with subacute to acute infarction...
June 2018: Cardiology Research
P B García Jurado, E Roldán Romero, M E Pérez Montilla, R Valverde Moyano, I M Bravo Rey, F Delgado Acosta, F A Bravo-Rodríguez
INTRODUCTION: Haemorrhagic transformation is a major complication of acute ischaemic stroke (AIS). We sought to determine the predictors and clinical impact of intracranial haemorrhage (ICH) after revascularisation therapy. METHODS: We conducted a retrospective, single-centre study including 235 patients with AIS who underwent intravenous recombinant tissue plasminogen activator (IV-rtPA) therapy and/or endovascular treatment. A binary logistic regression model was used to determine the variables associated with ICH, parenchymal haematomas (PH), modified Rankin Scale (mRS) scores, and mortality...
June 11, 2018: Neurología: Publicación Oficial de la Sociedad Española de Neurología
Zheng Zhang, Linlei Zhang, Yuchuan Ding, Zhao Han, Xunming Ji
Ischemic stroke is a major cause of death and disability globally, and its incidence is increasing. The only treatment approved by the US Food and Drug Administration for acute ischemic stroke is thrombolytic treatment with recombinant tissue plasminogen activator. As an alternative, therapeutic hypothermia has shown excellent potential in preclinical and small clinical studies, but it has largely failed in large clinical studies. This has led clinicians to explore the combination of therapeutic hypothermia with other neuroprotective strategies...
June 2018: Aging and Disease
Sheng Zhang, Jungen Zhang, Meixia Zhang, Genlong Zhong, Zhicai Chen, Longting Lin, Min Lou
Intravenous thrombolysis (IVT) with recombinant tissue plasminogen activator (rt-PA) can improve clinical outcome in eligible patients with acute ischemic stroke (AIS). However, its efficacy is strongly time-dependent. This study was aimed to examine whether prehospital notification by emergency medical service (EMS) providers could reduce onset to needle time (ONT) and improve neurological outcome in AIS patients who received IVT. We prospectively collected the consecutive clinical and time data of AIS patients who received IVT during one year after the initiation of prehospital notification procedure (PNP)...
June 2018: Aging and Disease
Austin C Boese, Quan-Son Eric Le, Dylan Pham, Milton H Hamblin, Jean-Pyo Lee
Neural stem cells (NSCs) play vital roles in brain homeostasis and exhibit a broad repertoire of potentially therapeutic actions following neurovascular injury. One such injury is stroke, a worldwide leading cause of death and disability. Clinically, extensive injury from ischemic stroke results from ischemia-reperfusion (IR), which is accompanied by inflammation, blood-brain barrier (BBB) damage, neural cell death, and extensive tissue loss. Tissue plasminogen activator (tPA) is still the only US Food and Drug Administration-approved clot-lysing agent...
June 13, 2018: Stem Cell Research & Therapy
S Wang, F Ma, L J Huang, Y Zhang, Y C Peng, C H Xing, Y P Feng, X L Wang, Y Peng
Stroke is a leading cause of morbidity and mortality in both developed and developing countries all over the world. The only drug for ischemic stroke approved by FDA is recombinant tissue plasminogen activator (rtPA). However, only 2-5% stroke patients receive rtPAs treatment due to its strict therapeutic time window. As ischemic stroke is a complex disease involving in multiple mechanisms, medications with multi-targets may be more powerful compared with single-target drugs. Dl-3-n-Butylphthalide (NBP) is a synthetic compound based on l-3-n-Butylphthalide that is isolated from seeds of Apium graveolens...
June 12, 2018: CNS & Neurological Disorders Drug Targets
Digvijaya Navalkele, Amelia Boehme, Karen Albright, Cindy Leissinger, Laurie Schluter, Melissa Freeman, Stacy Drury, Ramy El Khoury, T Mark Beasley, Sheryl Martin-Schild
We conducted a prospective serial laboratory cohort study to assess the correlation of factor VIII (FVIII) levels in response to thrombolysis in patients with large vessel occlusion (LVO) and acute ischemic stroke (AIS). Patients with AIS with anterior circulation LVO were eligible for enrollment if treated within 4.5 hours from last seen normal with intravenous tissue plasminogen activator (tPA). Patients (n = 29) had a mean age of 71 years and median National Institute of Health Stroke Scale of 14. Baseline pre-tPA FVIII was not significantly correlated with clot burden score (-0...
January 1, 2018: Clinical and Applied Thrombosis/hemostasis
V Montalván Ayala, Z Rojas Cheje, R Aldave Salazar
INTRODUCTION: The use of low doses of recombinant tissue plasminogen activator (rt-PA) was initially proposed in Asian countries in response to racial peculiarities related to the functionality of fibrinogen and coagulation factors that potentially increased the risk of intracerebral haemorrhage, and with a view to saving costs. In view of the controversy over the use of rt-PA below the standard dose, we conducted a literature review of studies promoting the use of low doses or comparing different doses of rt-PA...
June 8, 2018: Neurología: Publicación Oficial de la Sociedad Española de Neurología
Ajal Dave, Kendra Cagniart, Matthew D Holtkamp
BACKGROUND: The development of primary stroke centers has improved outcomes for stroke patients. Telestroke networks have expanded the reach of stroke experts to underserved, geographically remote areas. This study illustrates the outcome and cost differences between neurology and primary care ischemic stroke admissions to demonstrate a need for telestroke networks within the Military Health System (MHS). MATERIALS AND METHODS: All adult admissions with a primary diagnosis of ischemic stroke in the MHS Military Mart database from calendar years 2010 to 2015 were reviewed...
June 7, 2018: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
Prativa Pandey, Ravi Vadlamudi, Rashila Pradhan, Kishore R Pandey, Alex Kumar, Peter Hackett
Severe frostbite occurs frequently at extreme altitude in the Himalayas, often resulting in amputations. Recent advances in treatment of frostbite injuries with either intravenous or intra-arterial tissue plasminogen activator, or with iloprost, have improved outcomes in frostbite injuries, but only if the patient has access to these within 24 to 48 h postinjury, and ideally even sooner. Frostbitten Himalayan climbers are seldom able to reach medical care in this time frame. We wished to see if delayed iloprost use (up to 72 h) would help reduce tissue loss in grade 3 to 4 frostbite...
June 7, 2018: Wilderness & Environmental Medicine
Clare J Wilhelm, Joel G Hashimoto, Melissa L Roberts, Xiaolu Zhang, Calla M Goeke, Shelley H Bloom, Marina Guizzetti
In utero alcohol exposure can cause fetal alcohol spectrum disorders (FASD), characterized by structural brain abnormalities and long-lasting behavioral and cognitive dysfunction. Neuronal plasticity is affected by in utero alcohol exposure and can be modulated by extracellular proteolysis. Plasmin is a major extracellular serine-protease whose activation is tightly regulated by the plasminogen activator (PA) system. In the present study we explored the effect of ethanol on the expression of the main components of the brain PA system in sex-specific cortical astrocyte primary cultures in vitro and in the cortex and hippocampus of post-natal day (PD) 9 male and female rats...
June 6, 2018: Neuropharmacology
Michele Ruggeri, Matteo Basile, Andrea Zini, Salvatore Mangiafico, Elio Clemente Agostoni, Kyriakos Lobotesis, Jeffrey Saver, Silvia Coretti, Cralo Drago, Americo Cicchetti
BACKGROUND: Stroke has a significant disease burden in terms of acute and long-term disability in Italy and throughout the world. Endovascular treatments for the management of a stroke event have been coupled in the past years with the possibility to mechanically remove the occlusion by means of specially designed thrombectomy devices, and their exclusive use showed levels of effectiveness in line with those of the existing pharmacological treatments. OBJECTIVE: To assess the cost-effectiveness of mechanical thrombectomy (MT) with the Solitaire™ Revascularization Device (stent retriever) for the treatment of acute ischemic stroke (AIS) in patients with large vessel occlusions (LVOs), comparing MT plus intravenous tissue plasminogen activation (MT plus IV t-PA) versus IV t-PA alone, in Italy...
June 8, 2018: Journal of Medical Economics
Mukremin Er
Anticoagulants are the standard form of treatment used in deep vein thrombosis (DVT). Thrombolytic therapy is another method to treat thromboembolism by using intravenous administration of streptokinase, urokinase and recombinant tissue plasminogen activator (r-tPA). We have investigated the effect of r-tPA, a systemic thrombolytic used for the treatment of pulmonary emboli, on DVT in the same patients. 130 patients who were diagnosed with both pulmonary embolism and DVT were included in this study. Lower extremity Doppler ultrasonography (DUS) was conducted on all of the patients upon admission and then on the 6th month...
June 6, 2018: Journal of Investigative Medicine: the Official Publication of the American Federation for Clinical Research
Nolwenn Pasquet, Sara Douceau, Mickael Naveau, Flavie Lesept, Morgane Louessard, Laurent Lebouvier, Yannick Hommet, Denis Vivien, Isabelle Bardou
Modifications of neuronal migration during development, including processes that control cortical lamination are associated with functional deficits at adult stage. Here, we report for the first time that the lack of the serine protease tissue-type Plasminogen Activator (tPA), previously characterized as a neuromodulator and a gliotransmitter, leads to an altered cortical lamination in adult. This results in a neuronal migration defect of tPA deficient neurons which are stopped in the intermediate zone at E16...
June 6, 2018: Cerebral Cortex
Kiyobumi Ota, Ayako Oniki, Zen Kobayashi, Shoichiro Ishihara, Hiroyuki Tomimitsu, Shuzo Shintani
Background: Although acute pancreatitis is listed among the exclusion criteria for the administration of recombinant tissue plasminogen activator according to the Japanese Guideline for the Management of Stroke, the co-occurrence of acute pancreatitis and acute ischemic stroke has not been investigated. The present study aimed to assess the incidence rate of acute pancreatitis in patients with acute ischemic stroke. Methods: This study consecutively enrolled all patients with ischemic stroke admitted to the Department of Neurology, JA Toride Medical Center between April 2014 and March 2016...
May 2018: Journal of Rural Medicine: JRM
Jie V Zhao, C Mary Schooling
BACKGROUND: Coagulation plays a role in ischemic heart disease (IHD). However, which coagulation factors are targets of intervention is unclear. We assessed how genetically predicted vWF (von Willebrand factor), ETP (endogenous thrombin potential), FVIII (factor VIII), d-dimer, tPA (tissue-type plasminogen activator), and PAI (plasminogen activator inhibitor)-1 affected IHD. We similarly estimated effects on lipids to determine whether any associations were independent of lipids. METHODS AND RESULTS: Separate sample instrumental variable analysis with genetic instruments, that is, Mendelian randomization, was used to obtain unconfounded estimates of effects on IHD using extensively genotyped studies of coronary artery disease/myocardial infarction, CARDIoGRAMplusC4D Metabochip (64 374 cases, 130 681 controls) and CARDIoGRAMplusC4D 1000 Genomes (60 801 cases, 123 504 controls), and on lipids using the Global Lipids Genetics Consortium Results (n=196 475)...
January 2018: Circulation. Genomic and precision medicine
Haixin Li, Ying Huang, Xian Wu, Ting Wu, Ying Cao, Qimei Wang, Yuchang Qiu, Weiming Fu, Qun Zhang, Jianxin Pang
Objective: Hemocoagulase agkistrodon (HCA), a thrombin-like enzyme (TLE) from the venom of the Chinese moccasin snake ( Deinagkistrodon acutus ), has been used in clinical practice as a hemostatic compound. The aim of this study was to further investigate the pharmacological properties of HCA. Materials and methods: Sodium dodecyl sulfate or native polyacrylamide gel electrophoresis (SDS- or N-PAGE) as well as enzyme linked immunosorbent assays (ELISAs) were conducted to study the effects of HCA on the human plasma fibrinogen and prothrombin levels, as well as its in vitro interactions with some coagulation factors...
2018: Drug Design, Development and Therapy
Ryo Kanematsu, Toshikazu Kimura, Yasumitsu Ichikawa, Tomohiro Inoue
BACKGROUND: Intravenous recombinant tissue-type plasminogen activator (rt-PA) with/without endovascular treatment is not as effective in atherosclerotic steno-occlusive acute ischemic stroke. Urgent superficial temporal artery-middle cerebral artery (STA-MCA) anastomosis is effective to some extent in progressing stroke, but the safety of STA-MCA anastomosis soon after rt-PA therapy is unknown. Our aim was to clarify the safety of STA-MCA anastomosis within 24 h after intravenous rt-PA...
June 4, 2018: Acta Neurochirurgica
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