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)

An intravenous infusion of Fluosol enhanced significantly the t-PA thrombolysis of the arterio-venous shunt made by insertion of 125I-fibrin clot in rabbits. The plasma radioactivity released through thrombolysis increased in both time and dose-dependent manner after the administration of t-PA. Fluosol in combination with t-PA increased the plasma radioactivity, compared with the t-PA treatment alone at the corresponding dosage. The coronary blood flow was markedly reduced to almost zero after the thrombin injection into narrowed LCX with a clamp in open-chest dogs. An intravenous infusion of Fluosol or Pluronic F-68 solution at a dose of 15 ml/kg significantly shortened the thrombolysis time by intracoronary infusion of urokinase alone. While, little change in the QTc interval of ECG and the plasma CPK-MB activity was observed in the Fluosol group in combination with urokinase, suggesting a myocardial protective action of Fluosol possibly due to its oxygen carrying effect.
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PMID:Extended use of Fluosol emulsion in acute myocardial ischemia treatment. 139 38

The cardiac function and the effect of therapy in patients with acute myocardial infarction (AMI) were assessed in over 100 patients by analysis of 201Tl-scintigraphy and 99mTc-gated pool study in our ICU. The cardiac function and 201Tl-defect ratio were compared with the results obtained in chronic phase. Sixteen of them were treated with intravenous urokinase (UK) within 6 hours from onset. The other 18 patients without UK treatment served as a control group. Significant correlation was recognized between 201Tl-defect ratio and peak-CPK levels, peak-GOT levels, peak-LDH levels. Significant correlation (r = -0.655, r = -0.713) were found between 201Tl-defect ratio and LVEF in acute and chronic phase. The UK group showed a significant increase of LVEF as compared with the control group in patients with antero-septal (A/S) AMI. In inferior (INF) AMI, no significant differences were observed UK and control group in LVEF, RVEF and 201Tl-defect ratio. In chronic phase, improvements of LVEF and 201Tl-defect ratio were observed in patients with A/S AMI. But no significant differences of LVEF, RVEF and 201Tl-defect ratio were observed in A/S AMI in acute and chronic phase. The UK group showed a significant increase of LVEF (50.1%) as compared with the control group of A/S AMI in chronic phase. We have demonstrated that a combination of 201Tl-scintigraphy and 99mTc-gated pool study are useful techniques in ICU, to evaluate the cardiac function and the effect of thrombolysis therapy and thus greatly contribute to the primary care of AMI cases.
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PMID:[The evaluation of cardiac function and the effect of therapy in acute myocardial infarction--comparison by radio nuclide method in acute and chronic phase]. 350 Nov 35

The effects of the intravenous administration of hyaluronidase (HY; 2,500 IU/kg) and urokinase (UK; 20,000 and 40,000 IU/kg), alone or in combination, on the isoproterenol (ISP) induced myocardial infarction (MI) in rats, were studied. The severity of infarction was determined by measuring the levels of serum enzymes (CPK, GOT, LDH) and by evaluating the extent of the injured areas and the incidence of mortality. Plasma thromboxane B2 (TXB2) levels were also determined. All the treatments reduced the infarction area and the enzyme levels (increased by ISP) to a varying degree. However, a definite potentiating activity was obtained when HY was combined with the highest dose of UK. This combination was also capable of reducing the mortality rate. Finally, both HY and UK or the combined preparation brought the plasma TXB2 levels back to normal. These findings suggest the possibility of complementary activities of HY and UK in the treatment of experimental MI.
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PMID:The co-operative action of hyaluronidase and urokinase on the isoproterenol-induced myocardial infarction in rats. 371 99

Emergency coronary angiography and intracoronary thrombolysis were performed on 47 patients who were hospitalized within 12 hours from onset of chest pain. It revealed either a severe stenosis (14 pts: stenosed group) or complete occlusion (33 pts) of infarct-related coronary artery. In 25 out of 33 patients (76%) with complete occlusion, reperfusion was achieved after 10 to 20 minutes of intracoronary urokinase (UK) infusion at a rate of 500IU/kg/min (thrombolysed group). The failure to open coronary artery in remaining 8 patients may have been caused by the occlusion of atheroma itself (unsuccessful group). Left ventricular angiography was performed at one month after attack. In unsuccessful group, the mean age was younger and infarct-nonrelated vessel disease was lower frequency compared to other two groups. Ejection fraction in stenosed, thrombolysed and unsuccessful groups were 56.6 +/- 12, 47.5 +/- 14 and 44.3 +/- 5.1%, respectively. Wall motion assessed by point-score system were 6.7, 5.9 and 3.6, respectively (p less than 0.05 in each group). These facts suggest that early recanalization may result in greater reversal of cardiac function. The time to the peak CPK was shortened in stenosed and thrombolysed groups, but, the values of CPK was maximum in thrombolysed group. Rethrombosis was recognized in 2 patients during 1 to 30 months follow-up. No death and no remarkable complications were seen during this intervention, but 4 late deaths were recognized. Thus, early reperfusion by intracoronary UK infusion is effective therapy to improve cardiac function and reduction of death in AMI.
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PMID:Effects and limitation of CCU--prevention of evolving myocardial infarction. 647 48

To lyse intracoronary (IC) thrombi, coronary angiography was performed for 36 patients with acute myocardial infarction who were admitted within 12 hours of the onset of symptoms. Their average age was 59.6 years. Twenty-four patients (66.7%) had total occlusions of the infarct-related coronary artery, and 12 patients (33.3%) had severe atherosclerotic stenosis without occlusion (group A = Stenosis). In 19 of the 24 patients (79.2%) with total occlusion, IC infusion of urokinase (UK) at a rate of 500 units/kg/min during 10 to 20 min resulted in reperfusion of the distal coronary artery (group B = Thrombolysis). In the remaining five patients, IC thrombolysis was not successfully performed (group C = No effect). The degree of coronary artery stenosis immediately after reperfusion was 88.7 +/- 18.8% in group B. Long-term follow-up (four weeks) coronary angiography in groups A and B revealed improved patency to 79.2 +/- 19.3% and 79.4 +/- 27.8%, respectively. By contrast, total occlusion remained in group C. The ejection fraction measured four weeks later was slightly greater in group B than in group C, and was significantly greater in group A than in group C. If the average ages and complications of the other coronary vessels were considered, a significant difference was recognized among these three groups. The amplitude of the anterior wall motion of the patients with anterior infarction in each group assessed by a point score system was significantly increased in groups A and B as compared to group C. Peak CPK, GOT and LDH rose rapidly immediately after reperfusion and the time interval from the onset of symptoms to peak enzyme production was significantly shortened after reperfusion. These data supported the following concept: 1) coronary thrombus formation frequently occurs in acute myocardial infarction and can be rapidly lysed by IC infusion of UK with a total dose of 250,000 to 600,000 units, 2) reperfusion by lysis of IC thrombi in patients with acute myocardial infarction improves left ventricular wall motion, 3) peak enzyme rises rapidly after reperfusion, 4) the time interval from the onset of symptoms to peak enzyme production is remarkably shortened after repeat perfusion and that 5) no fatal arrhythmia nor bleeding are recognized. Thus, IC infusion of UK in the early stage of acute myocardial infarction was effective and useful.
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PMID:[Intracoronary thrombolysis in acute myocardial infarction]. 653 93

A multicenter controlled study versus heparin was conducted to explore the activity of defibrotide, a polydesoxyribonucleotide drug, in preventing reocclusion after urokinase thrombolysis in patients with acute myocardial infarction (AMI). The study involved 137 consecutive patients with AMI and a time from the onset of symptoms < or = 6 hours, treated with urokinase (1,000,000 U intravenous bolus followed by 1,000,000 U slow-drip infusion over 12 hours). Immediately after thrombolysis, patients were allocated to treatment with defibrotide (group D: day 0, 3.6 g by intravenous infusion in 12 hours; days +1 to +6, 800 mg tid intravenously; days +7 to +10/+12, 400 mg tid intramuscularly), or heparin (group H: day 0, 1000 IU/hour infused over 12 hours; days +1 to +10/+12, 5000 IU tid subcutaneously). Coronary angiography was done, whenever possible, at +10/+12 days. The following parameters were assessed: (a) noninvasive estimate of myocardial reperfusion, through the analysis of CPK time-activity curves; (b) incidence of infarct-related artery (IRA) patency (TIMI scores 2-3) at coronary angiography. A total of 125 patients had a complete enzymatic curve (63 in group D and 62 in group H) and 106 had coronary angiography as well. IRA patency (the main end point) was observed in 63% of group D versus 43% of group H patients (p = 0.07). No statistically significant differences were found in the proportion of patients with indirect signs of early reperfusion (63% in group D versus 52% in group H patients).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Defibrotide versus heparin in the prevention of coronary reocclusion after thrombolysis in acute myocardial infarction. 811 Jun 25

A 53-year-old-man afflicted with combined valvular heart disease and atrial fibrillation was admitted to our department complaining of chest pain. ST elevation on ECG (II, III, aVF) and elevated CPK value were recognized. He was diagnosed as having acute myocardial infarction, and percutaneous transluminal coronary recanalization was performed immediately. The coronary angiogram showed occlusions at the proximal left branch (#12). But these lesions could not be recanalized by 960000 IU urokinase administration. The cineangiogram after one month revealed perfect recanalization of these occlusions. Mitral stenosis with neovascularity to the left atrium and aortic regurgitation were recognized. We supposed this infarction caused by coronary embolism originated from left atrial thrombi. Acute myocardial infarction associated with mitral stenosis has been reported in fifteen cases previously in Japan, but only three cases revealed coronary occlusion in the acute phase with normal coronary artery in the chronic stage. However, there has been no report, except for this case, demonstrating occlusion in two coronary arteries at the same time. So, our case is the first report of the involvement of two coronary artery occlusions.
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PMID:[A case of coronary artery embolism associated with combined valvular heart disease]. 843 64

A 55-year-old female afflicted with mitral valve stenosis and atrial fibrillation was admitted to our hospital complaining of chest pain, ST elevation of ECG (V2-5) and elevated CPK value were recognized. She was diagnosed as having acute myocardial infarction, and percutaneous transluminal coronary recanalization was performed immediately. The coronary angiogram showed occlusion by the thrombus at the proximal left anterior descending branch (#7), even, left ventriculogram showed ventricular aneurysm on the anterior wall. But these lesions could not be recanalized by 960,000 IU urokinase administration. She underwent aneurysmectomy and mitral valve replacement with 27 mm SJM prosthesis. When mitral valve stenosis accompanied with left ventricular aneurysm we considered in order to improve left ventricular function, it is necessary to undergo not only mitral valve operation but left ventricular aneurysmectomy aggressively.
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PMID:[Surgical treatment of left ventricular aneurysm with acute myocardial infarction associated to mitral valve stenosis: a case report]. 913 38