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

Since the beginning of the clinical use of low molecular weight (LMW) heparins their thrombolytic or profibrinolytic potency has been a matter of controversial discussions. Regarding this problem, the aim of our study was to test a LMW-heparin (Sandoparin) in an in vivo model comparing its lytic activity to unfractionated heparin and urokinase at different doses. For this purpose a newly developed short-term rabbit jugular vein clot lysis model was developed. Urokinase infused at doses of 3300, 6600 and 10,000 U/kg to control animals for one hour showed a clear dose-dependent clot lysis. Test animals were injected with a bolus of 0.5 mg/kg of LMW-heparin followed by a constant infusion of either 0.5, 1.0 or 2.0 mg/kg for one hour. A similar dose-dependent effect was observed for LMW-heparin as for urokinase. Unfractionated heparin did not exhibit a dose-dependent lytic activity in this model. No lysis was found in rabbits treated with saline. These findings suggest that the LMW-heparin tested exhibits a dose-dependent in vivo lytic activity which can be compared to clinically effective doses of urokinase, and that this activity is not present with unfractionated heparin.
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PMID:The thrombolytic potency of LMW-heparin compared to urokinase in a rabbit jugular vein clot lysis model. 132 52

Saruplase is a relatively new fibrinolytic drug. Dose finding studies indicated that 70-80 mg saruplase given intravenously results in a high perfusion rate. With a 20 mg bolus followed by a 60 mg infusion over 1 h, a rapid and complete restoration of blood flow can be achieved in a fairly high number of patients. This dose regimen was used in subsequent studies comparing saruplase with other thrombolytic agents. The PRIMI (Pro-urokinase In Myocardial Infarction) study compared saruplase with streptokinase. Early patency rate at 60 min (TIMI grade 2 and 3 flow) was significantly higher with saruplase (71.8%) than with streptokinase (48.0%). In the SESAM (Study in Europe with Saruplase and Alteplase in Myocardial Infarction) study comparing saruplase with alteplase, at 60 min patency rate was 79.9% versus 75.3%, respectively, and at 90 min the rate was 79.9% versus 81.4%, respectively. In the LIMITS (Liquemin in Myocardial Infarction during Thrombolysis with Saruplase) study a heparin bolus of 5000 IU was shown to have an important impact on patency rate. Both heparin and acetylsalicylic acid are recommended as adjunctive therapy before fibrinolysis with saruplase. The reocclusion rates within 24-40 h were between 0.9% and 2.4% in the saruplase studies. There is some variation in estimating whether patency rates are higher with anterior or with inferior infarctions. Saruplase appears to be equally effective in the treatment of infarction in both locations.
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PMID:Clinical profile of saruplase: angiographic findings. 1034 35

Because a popliteal artery aneurysm (PAA) generates emboli that progressively deteriorate the distal arterial network, they can constitute limb-threatening lesions. In 20 to 40% of cases, discovery of PAA coincides with sudden occlusion and resulting acute ischemia. In 40 to 60% of these patients, surgical revascularization fails and amputation is required. The objective of this prospective study was to assess the value of intraarterial thrombolysis to restore distal runoff before surgical revascularization. Between January 1, 1992 and December 31, 1996, we treated 15 PAA causing acute ischemia in 15 male patients with a mean age of 66.7 years (range, 44 to 87 years). Diagnosis was documented by clinical examination and ultrasound imaging. Intraarterial thrombolysis was performed under arteriographic control through a multiperforated catheter inserted by the anterograde femoral route to the thrombus. After an initial bolus of 100,000 U of urokinase, 600,000 to 1,600,000 U was continuously infused over a period of 6 to 18 hr. Heparin sodium was administered throughout thrombolysis. Surgical revascularization was performed within 1 to 4 days (mean, 2 days) after thrombolysis by exclusion and bypass in 14 cases and percutaneous transluminal angioplasty with stenting in 1 case. The ensuing results showed that, if performed carefully, intraarterial thrombolysis can safely prepare patients presenting with occluded PAA with acute ischemia for surgical revascularization to restore distal runoff. We use this combined technique routinely in our department. Morbidity is low in comparison with the risks of amputation.
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PMID:Preoperative intraarterial thrombolysis before surgical revascularization for popliteal artery aneurysm with acute ischemia. 1094 88

A 63-year-old man was admitted to a hospital for sudden loss of consciousness. Chest computed tomography (CT) revealed massive pulmonary thromboembolism. Heparin sodium and urokinase were administered, but were not effective. He was then referred to our hospital. His oxygen saturation was 88% in room air. Due to presence of severe hypoxemia and ineffectiveness of the antithrombotic therapy, thrombectomy was done under extracorporeal circulation. Postoperative course was uneventful, and he was discharged on the 24 th postoperative day. Oxygen saturation on discharge was 98% in room air. In conclusion, thrombectomy of subacute pulmonary thromboembolism was performed successfully under extracorporeal circulation.
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PMID:[Thrombectomy of subacute pulmonary thromboembolism under extracorporeal circulation: report of a case]. 1678 68