Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: EC:3.4.21.73 (urokinase-type plasminogen activator)
 10,685 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

MATERIALS AND METHODS Between 1981 and 1985, 78 iliocaval thrombi were treated by aggressive therapy: 52 surgical thrombectomies were performed by a femoral approach associated, depending on the case, with a caval approach; and 26 iliofemoral thrombi were lysed according to a protocol in which urokinase and plasminogen were used over a 48-h period. Subsequent functional evaluation was based on clinical scoring (0 to 9 points) taking into account functional impairment, edema and trophic disorders. Patency of trunks and the deep valvular state were assessed by Doppler examination and plethysmography. RESULTS In the surgical group, 3 early deaths occurred, only one of which could be attributed to an embolic course. Six weeks after surgery the rate of recurrence of iliac thrombosis was 50% (25% postoperative + 25% secondary). Beyond this period, there were no recurrences of thrombosis. There was a direct, statistically significant relation between the degree of iliac patency and the realization of an ideal thrombectomy on a nonadherent fresh clot. The functional results, assessed after four and a half years of follow-up, are satisfactory (score less than 3) in 80% of patients. The poor results with venous claudication or varicose ulcer all occurred in the case of massive persistent thrombi of the femoral confluence. Valve lesions were signaled in 46% of patients by a massive backflow in orthostatism. In the medical group, a major hemorrhagic complication occurred under urokinase therapy in 11% of patients, including one for whom it was fatal. Sixty percent of patients showed immediate radiological improvement allowing partial or total freeing of a venous confluence. The functional results after 4 years of follow-up were nondisabling in 85% of patients. No leg ulcers were detected. Late iliac patency was low (26%), whereas at the femoral level almost all of the thrombi which remained after lysis became patent again spontaneously. Valve failure was found in 37% of patients. Both groups had very similar late functional results despite rather different anatomical conditions. The iliac patency rate was higher in the surgical group (50% vs 26%), but plethysmographic study showed that in case of therapeutic failure devalvulation was greater after surgery (46% vs 37%).
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PMID:[Thrombectomy or thrombolysis in the treatment of proximal phlebitis. Functional long term results]. 258 85

Bioimmunoassays for tissue and urokinase-type plasminogen activators (t-pA and u-pA), and enzyme-linked immunosorbent assays (ELISA) for t-pA were performed on biopsies from the edge and base of 15 venous ulcers. TGF-beta 1, bFGF and PDGF were assessed by ELISA in the edge and base of 19 further venous ulcers and 7 biopsies of normal skin. The presence of all three growth factors and u-pA was confirmed immunohistochemically. T-pA was detected using the ELISA and the bioimmunoassay, but was quantified in 3/15 ulcer bases and 4/15 ulcer edges using the bioimmunoassay only. U-pA was measured in all ulcer samples except one. TGF-beta 1 was measured in 13/19 ulcer bases and 9/19 edges, while free TGF-beta 1 was measured in only 2/19 bases and 4/19 edges. Venous ulcer bases contain significantly greater quantities of u-pA, TGF-beta 1, and bFGF than ulcer edges. TGF-beta 1 was never detected in normal skin. There is significantly less bFGF in normal skin than in venous ulcer bases, but not edges (p = 0.013, p = 0.31 respectively, Mann Whitney U-test). There was a good correlation between ulcer edge TGF-beta 1 and time to healing in ten ulcers that healed within six months from the date of biopsy (r = -0.56, p = 0.065, Spearman Rank Correlation). There was a significantly greater amount of ulcer edge bFGF in the ulcers that healed within six months than those that remained unhealed (p = 0.036, Mann-Whitney U-test).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Growth factors, tissue and urokinase-type plasminogen activators in venous ulcers. 757 62