Biomedical subjects

J S Cho

Publications and source records attributed to J S Cho.

At least 37 records · Page 2Linked to original sources

PubMed1999

Transforming growth factor-beta in benign and malignant prostate.

BACKGROUND: The present review summarizes the cellular action of TGF-beta in benign and malignant growth of the prostate. METHODS: TGF-beta is a pleiotropic growth factor. It plays an important role in the regulation of growth and differentiation in many cells. In benign prostatic epithelia, its action is mediated through a paracrine mechanism. It inhibits proliferation and induces apoptosis in prostatic epithelia. It provides a mechanism to maintain epithelial homeostasis in the prostate. In prostatic stroma, its continual action leads to smooth muscle differentiation. This effect of TGF-beta may regulate the development of prostatic smooth muscle nodules in benign prostatic hyperplasia. RESULTS: As prostatic epithelial cells undergo malignant transformation, two major events occur regarding TGF-beta action. These include the loss of expression of functional TGF-beta receptors and overproduction of TGF-beta in malignant cells. The loss of expression of functional TGF-beta receptors provides a growth advantage to cancer cells over their benign counterparts. The overproduction of TGF-beta by cancer cells has a multitude of adverse consequences. TGF-beta can promote extracellular matrix production, induce angiogenesis, and inhibit host immune function. The biological consequence of these activities is an enhanced tumorigenicity in prostate cancer. Results of our recent studies with a rat prostate cancer model suggest that the immunosuppressive effect of TGF-beta seems to be the primary cause of tumor progression. This is because, if these cancer cells were engineered to reduce the production of TGF-beta, tumor growth was inhibited in syngeneic hosts but not in immune compromised hosts. CONCLUSIONS: Our future research should take advantage of this knowledge to devise therapeutic strategies aimed at eradicating prostate cancer.

Androgens↗

PubMed1999

Effects of mucokinetic drugs on rheological properties of reconstituted human nasal mucus.

OBJECTIVE: To investigate the effects of mucokinetic drugs on the rheological properties of human nasal mucus in patients with chronic sinusitis. DESIGN: We reconstituted human nasal mucus obtained from 74 patients with chronic sinusitis and determined the effects of 4 mucokinetic drugs, including acetylcysteine, deoxynuclease I, 2% sodium bicarbonate, and a combination product containing tyloxapol (Alevaire), on rheological properties of reconstituted human nasal mucus (RHNM). We used 5% RHNM dissolved in phosphate-buffered solution as the optimal buffer and concentration of RHNM for the study because it showed a viscoelastic response similar to that of freshly collected nasal mucus from patients with chronic sinusitis. METHODS: Four experiments were performed to determine the influence of each drug on dynamic viscosity and elasticity of 5% RHNM. Distilled water was used as a control. RESULTS: Acetylcysteine and deoxynuclease I significantly decreased both dynamic viscosity and elastic modulus, while distilled water had no effect on rheological properties of 5% RHNM in vitro. Alevaire significantly reduced both dynamic viscosity and elastic modulus. Sodium bicarbonate significantly reduced elastic modulus but not dynamic viscosity. Reduction of elastic modulus by Alevaire was significantly greater than that by sodium bicarbonate, while there was no difference in reduction of dynamic viscosity between them. CONCLUSION: Our results indicate that RHNM may be useful for studying the topical effects of various drugs on nasal mucus from patients with chronic sinusitis.

Acetylcysteine↗

PubMed1999

Transforming growth factor-beta type II receptor confers tumor suppressor activity in murine renal carcinoma (Renca) cells.

OBJECTIVES: To demonstrate that the introduction of the transforming growth factor-beta (TGF-beta) type II receptor (TbetaR-II) decreases tumorigenicity in an aggressive murine renal carcinoma line, Renca. These cells do not express TbetaR-II. Because the presence of TbetaR-II in benign epithelial cells is ubiquitous, the ability to restore tumor suppressor activity in the Renca cell line with its introduction would elucidate the role of TbetaR-II as a tumor suppressor gene. METHODS: Renca cells were stably transfected with a retrovirus-mediated TbetaR-II expression vector. In vitro sensitivity to growth inhibitory effect of TGF-beta was assessed by the 3H-thymidine incorporation assay. For in vivo testing, xenograft tumors were produced by subcutaneous injection of tumor cells into immunodeficient nude mice. The tumorigenicity of these TbetaR-II transfected cells was tested. Wild-type Renca cells and cells transfected with the control vector were also tested for comparison. RESULTS: Expression of TbetaR-II mRNA was evident in Renca cells after transfection with the TbetaR-II construct. In vitro sensitivity to the growth inhibitory effect of TGF-beta was restored. This effect of TGF-beta was reversible with a neutralizing antibody specific for the extracellular domain of TbetaR-II. Xenografts grown from TbetaR-II transfected cells were significantly smaller, weighed less, and developed tumors later than those developed from wild-type Renca cells and those transfected with the control vector. CONCLUSIONS: We conclude that TbetaR-II is a central mediator of tumorigenicity in Renca cells. As with other tumor suppressor genes, the loss of TbetaR-II expression allows for the development of an aggressive phenotype.

Animals↗

PubMed1999

Reflux esophagitis and its relationship to hiatal hernia.

We performed this study to evaluate the prevalence of reflux esophagitis and/or hiatal hernia in patients referred to a medical center and to examine the relationship between endoscopic reflux esophagitis and hiatal hernia. The study was carried out in 1,010 patients referred to Yong Dong Severance Hospital for upper gastrointestinal endoscopy because of symptoms related to the gastrointestinal tract from September 1994 to March 1996. The presence of hiatal hernia was defined as a circular extension of the gastric mucosa of 2 cm or more above the diaphragmatic hiatus. Reflux esophagitis was found in 5.3% of patients, hiatal hernia in 4.1%, duodenal ulcer in 7.2% and gastric ulcer in 8.2%. The prevalence rates of reflux esophagitis and hiatal hernia in males were significantly higher than those in females. Thirty-two percent of patients with reflux esophagitis had hiatal hernia. In patients without reflux esophagitis, hiatal hernia was found in only 2.5% (p<0.01). There was no significant association between the presence of hiatal hernia and the degree of esophagitis on endoscopy. Duodenal ulcer was the second most common endoscopic abnormality found in patients with reflux esophagitis. The prevalence rate of reflux esophagitis and/or hiatal hernia at a medical center is relatively low compared to peptic ulcer disease and other reports from the Western countries. Our study confirms the close association between reflux esophagitis and hiatal hernia.

Adolescent↗

PubMed1999

Obstructive jaundice and acute cholangitis due to papillary stenosis.

Papillary stenosis is characterized by fixed fibrosis leading to structural outflow obstruction and it is usually secondary to inflammation and fibrosis from the chronic passage of gallstones, episodes of acute pancreatitis, chronic pancreatitis, sclerosing cholangitis, peptic ulcer disease, and cholesterolosis. However, obstructive jaundice with or without acute cholangitis which leads the physician to suspect the presence of malignancy as a cause is a rare manifestation of papillary stenosis. We report here a case of papillary stenosis presenting with obstructive jaundice and acute cholangitis. The lesion was so difficult to exclude the presence of malignancy preoperatively and intraoperatively that a pylorus-preserving pancreaticoduodenectomy was performed. Histologic examination of the resected specimen revealed fibrosis, adenomatoid ductal hyperplasia, and mild chronic inflammation of the papilla of Vater and distal common bile duct.

Acute Disease↗

PubMed1999

Relationship of CagA to serum gastrin concentrations and antral G, D cell densities in Helicobacter pylori infection.

The purpose of this study was to investigate whether the densities of antral gastrin and somatostatin-immunoreactive cells in Helicobacter pylori (H. pylori) infection were related to the bacterial expression of cytotoxin-associated gene A (CagA). 32 patients who had underwent diagnostic esophagogastroduodenoscopy were studied. On the histologic examination all patients had antral gastritis. We divided the subjects into three groups. Group I consisted of 6 patients who had chronic superficial gastritis, group II, 9 patients who had H. pylori-associated gastritis but with no expression of CagA, and group III, 17 patients who had H. pylori-associated gastritis with the expression of CagA. In group I and II, serum gastrin levels, and antral G cell and D-cell were measured. In group III, serum gastrin levels, and antral G cell and D-cell were measured, before and after the eradication of H. pylori. The results were as follows. Firstly, serum gastrin concentrations were significantly higher in the patients with H. pylori infection than in the negative controls. Nextly, there was no correlation between the changes in antral G or D-cell density and H. pylori infection. Thirdly, group III had a significant increase in serum gastrin concentrations and a significant decrease in antral D-cell density than group I. Forthly, eradication of H. pylori in group III showed a significantly increased antral D-cell density. Our results suggest that hypergastrinemia in H. pylori-associated gastritis is relevant to the presence of CagA, and the possible mechanism of hypergastrinemia may be related to antral D-cell deficiency, which is caused by H. pylori infection with the expression of CagA.

Adult↗

PubMed1999

Body fat measurement in computed tomography image.

In this paper, we suggest an automatic fat region setting method in computed tomography to measure body fat. Quantitative measurement of body fat is important for the diagnosis and treatment of diseases related to obesity. The evaluation methods of obesity such as weight and height ratio, waiste and hip circumference ratio, and subcutaneous fat thickness by clipper, have a weak point that they do not measure body fat quantitatively. To overcome the weak point a body fat measurement method by computed tomography has been tried recently. The body fat measurement by computed tomography presents volume of body fat quantitatively at a specific region such as subcutaneous and abdominal fats. Computed tomography provides an image consisting of voxels with Hounsfield unit which is proportional to the density at the voxels. In general, the Hounsfield units of the body fat is known as it has the values from -150 to -50. However, the Hounsfield unit range of the fat is different for every person and every region of a person. In this paper, we show the difference of the body fat range in the Hounsfield units for 20 persons and various regions of a person, and we suggest an automatic setting method of the body fat region in the Hounsfield units due to the Gaussian function fitting of the histogram in the computed tomography image.

Adipose Tissue↗

PubMed1998

Effects of thrombolysis and venous thrombectomy on valvular competence, thrombogenicity, venous wall morphology, and function.

PURPOSE: The experiments were designed to compare the effects of thrombolytic therapy (TL) and balloon-catheter thrombectomy (TX) on valvular competence, thrombogenicity, venous wall morphology, and function after acute deep venous thrombosis (DVT) in canine veins. METHODS: The femoral veins of male mongrel dogs were ligated proximally and distally for 48 hours to induce DVT. The thrombosed veins were treated with either TL (n = 5) or TX (n = 9), or no treatment was rendered (n = 6). Sham-operated dogs were used as controls. TL was performed with catheter-directed infusion of urokinase at 4000 U/min for 90 minutes. Three hours after the treatment, the valvular competence was determined with duplex scanning, thrombogenicity determined with deposition of radio-labeled platelet and fibrin, and function determined with response to contractile and relaxing agonists in organ chambers. The structural integrity of the endothelial layer was assessed by means of scanning electron microscopy. RESULTS: The removal or lysis of the thrombus was successful in all cases. The valvular competence did not differ among the groups. The platelet deposition was the highest after TX (P <.05), and the fibrin deposition was not significantly different among the groups. In the organ chamber experiments, relaxations to adenosine diphosphate and nitric oxide were reduced after TX (P <.05). The contractions to serotonin were enhanced after TX. Scanning electron microscopy results showed a comparable (51% to 75%) endothelial loss with either treatment. CONCLUSIONS: After experimental acute DVT, the TL and the TX at 3 hours had similar effects on the valvular competence and the endothelial morphology. However, the TL reduced thrombogenicity, which is consistent with the preserved endothelial responses to platelet products. These data suggest that TL may preserve vein function after DVT and may reduce the long-term potential for recurrent DVT and post-thrombotic syndrome.

Animals↗

PubMed1998

Long-term survival and late complications after repair of ruptured abdominal aortic aneurysms.

PURPOSE: Long-term survival and late vascular complications in patients who survived repair of ruptured abdominal aortic aneurysms (RAAA) is not well known. The current study compared late outcome after repair of RAAA with those observed in patients who survived elective repair of abdominal aortic aneurysms (AAA). METHODS: The records of 116 patients, 102 men and 14 women (mean age: 72.5 (8.3 years), who survived repair of RAAA (group I) between 1980 to 1989 were reviewed. Late vascular complications and survival were compared with an equal number of survivors of elective AAA repair matched for sex, age, surgeon, and date of operation (group II). Survival was also compared with the age and sex-matched white population of west-north central United States. RESULTS: Late vascular complications occurred in 17% (20/116) of patients in group I and in 8% (9/116) in group II. Paraanastomotic aneurysms occurred more frequently in group I than in group II (17 vs. 8, p = 0.004). At follow-up, 32 patients (28%) were alive in group I (median survival: 9.4 years) and 53 patients (46%) were alive in group II (median survival: 8.7 years). Cumulative survival rates after successful RAAA repair at 1, 5, and 10 years were 86%, 64%, and 33%, respectively. These were significantly lower than survival rates at the same intervals after elective repair (97%, 74%, and 43%, respectively, p = 0.02) or survival of the general population (95%, 75%, and 52%, respectively, p < 0.001). Coronary artery disease was the most frequent cause of late death in both groups. Vascular and graft-related complications caused death in 3% (3/116) in group I and 1% (1/116) in group II. Cox proportional hazards modeling identified age (p = 0.0001), cerebrovascular disease (p = 0.009), and number of days on mechanical ventilation (p = 0.01) to be independent prognostic determinants of late survival in group I. CONCLUSIONS: Late vascular complications after repair of RAAA were higher and late survival rates lower than after elective repair. These data support elective repair of AAA. As two-thirds of the patients discharged after repair of RAAA are alive at 5 years, aggressive management of RAAA remains justified.

Age Factors↗

PubMed1997

Implementation of natural attenuation at a JP-4 jet fuel release after active remediation.

After eighteen months of active remediation at a JP-4 jet-fuel spill, a residual of unremediated hydrocarbon remained. Further site characterization was conducted to evaluate the contribution of natural attenuation to control exposure to hazards associated with the residual contamination in the subsurface. Activities included the detailed characterization of ground-water flow through the spill; the distribution of fuel contaminants in groundwater; and the analysis of soluble electron acceptors moving into the spill from upgradient. These activities allowed a rigorous evaluation of the transport of contaminants from the spill to the receptor of groundwater, the Pasquotank River. The transport of dissolved contaminants of concern, that is benzene, toluene, ethyl benzene, xylene isomers (BTEX) and methyl-tertiary-butyl ether (MTBE), into the river from the source area was controlled by equilibrium dissolution from the fuel spill to the adjacent groundwater, diffusion in groundwater from the spill to permeable layers in the aquifer, and advective transport in the permeable layers. The estimated yearly loading of BTEX compounds and MTBE into the receptor was trivial even without considering biological degradation. The biodegradation of hydrocarbon dissolved in groundwater through aerobic respiration, denitrification, sulfate reduction, and iron reduction was estimated from changes in ground-water chemistry along the flow path. The concentrations of target components in permanent monitoring wells continue to decline over time. Long term monitoring will ensure that the plume is under control, and no further active remediation is required.

Biodegradation, Environmental↗

PubMed1997

Thermal comfort properties of cotton and nonwoven surgical gowns with dual functional finish.

The purpose of this study was to evaluate thermal comfort properties of surgical gowns made of dual functional finish cotton and nonwoven fabrics which have barrier properties of blood and micro-organism. Four types of surgical gowns, which were made of nonwoven fabrics with finish or without and were made of cotton with finish or without, were tested. The thermal insulations of four surgical gowns were measured with thermal manikin. Subjective experiments on thermal comfort, skin temperature and clothing microclimate were conducted. Six male subjects, between 26 and 28 years age old, participated in the wear trials tests. Typical activities for surgeons in the operation theater were simulated during the experimental sessions. Air temperature in a climate chamber was kept at 22 degrees C and its humidity was 60% RH. Air velocity was controlled at less than 0.15 m/s. Inner radiant temperature was almost equal to the air temperature. Basic thermal insulation of the dual functional finished nonwoven surgical gown was 0.87 clo, which was slightly higher than that of untreated (0.84 clo). However, the skin temperature of the subject wearing a dual functional finished surgical gown was significantly lower at P < .05. When the subject wears the dual functional finished gown, the amount of sweating was less than that when wearing untreated. Microclimate temperature and humidity of dual functional finished surgical gown were lower than untreated and it was statistically significant. There was no significant difference in subjective humid and overall comfort sensation between finished and untreated ones. Thermal sensation of dual functional finished one was significantly different from untreated one only during the first exercise. The results of this study indicate that the dual functional finish surgical gown allowed heat to be transferred from the skin of subject to the atmosphere better than untreated. The nonwoven surgical gown showed no difference in comfort properties from cotton one.

Adult↗

PubMed1997

Congenital bronchoesophageal fistula associated with esophageal diverticulum in the adult.

Congenital bronchoesophageal fistula is a rare clinical entity in adults. This anomaly may cause various symptoms such as respiratory infections, coughing bouts when eating or drinking, and even hemoptysis. The fistula can cause symptoms in childhood but may not appear until adulthood. We recently experienced a case of congenital bronchoesophageal fistula associated with esophageal diverticulum in an adult. A 63-year-old woman was admitted to our hospital due to chest discomfort, sore throat and coughing bouts when eating. An empyema with lung abscess had occurred eight years previously. Results of the physical examination were unremarkable. A Barium swallowing revealed a medium-sized diverticulum at the right anterior aspect of the esophagus, which had developed a fistulous connection with the right lower lobe bronchus. The patient was treated by fistulectomy and lobectomy of the right lower lobe. The postoperative course was smooth and uneventful.

Bronchial Diseases↗

PubMed1996

Chorionic villus sampling: clinical experience of the initial 750 cases.

OBJECTIVE: To assess the factors that might influence the success rate, safety and reliability of chorionic villus sampling (CVS) and to evaluate the relationship between CVS and other congenital anomalies. DESIGN: Analysis of the outcome of 750 cases of CVS (730 cases with transcervical and 20 cases with transabdominal). SETTING: The outpatient prenatal genetic clinic of a university tertiary care center. SUBJECT: Seven hundred and fifty pregnant women that underwent CVS for prenatal genetic diagnosis from 7 to 12 weeks of gestation. RESULTS: Advanced maternal age was the most common indication for CVS (32.8%). The overall sampling success rate was 98.0% (735/750), representing 93.9% at 7 to 8 weeks, 98.1% at 9 to 10 weeks, and 98.3% at 11 to 12 weeks of gestation. The majority of cases (93.1%) required one or two aspirations. Cytogenetic analysis routinely included direct overnight and long-term culture methods which revealed 16 abnormalities (2.2%). Of 735 cases in which CVS was successful, 700 advanced to normal offspring, 17 had therapeutic termination, and 18 resulted in spontaneous abortions; there was an overall fetal loss rate of 2.4% (18/750). CONCLUSION: CVS in early pregnancy is a relatively safe and reliable method of prenatal genetic diagnosis capable of replacing genetic amniocentesis. However, it must be done by experienced personnel. No congenital anomalies were found to be related to CVS in this series.

Adult↗

PubMed1996

The clinical implications of early diastolic notch in third trimester Doppler waveform analysis of the uterine artery.

To evaluate the clinical utility of third trimester Doppler waveform analysis of the uterine artery in predicting complicated pregnancies and fetal well-being, we compared adverse pregnancy outcomes in 2321 women with the presence of an elevated systolic-diastolic ratio (greater than 2.6) with the persistence of an early diastolic notch and with the combination of an elevated systolic-diastolic ratio and an early diastolic notch. The positive predictive values are 47.5%, 82.9%, and 92.6%, respectively. From these data we can conclude that determination of the presence or absence of an early diastolic notch is more valuable in predicting the perinatal outcome than is the presence of an elevated systolic-diastolic ratio alone. We also suggest that an assessment of the uterine artery systolic-diastolic ratio combined with the evaluation for persistent early diastolic notch would be a clinically useful test for fetal well-being.

Apgar Score↗

PubMed1995

Differential thrombogenicity of artery and vein: the role of von Willebrand factor.

There exists clinical evidence for a difference in the relative thrombogenicity of arterial and venous surfaces. We studied this phenomenon in an in vitro model where the effects of hemodynamic differences could be controlled. Nonanticoagulated human blood was perfused across injured (air-insufflated) arterial and venous surfaces in a recirculating perfusion system at shear rates of 500 and 1500/sec. Thrombus formation was assessed by measuring radiolabeled platelet (111In) and fibrin (125I) deposition on the surfaces. The role of von Willebrand factor (vWF) in arterial and venous thrombosis was evaluated by blocking its effect with polyclonal anti-vWF antibody (vWF Ab). Raw data were converted to log10 for statistical analysis. The increased thrombogenicity of injured venous vs. arterial segments was confirmed by these studies (p < 0.001). The addition of vWF Ab decreased platelet and fibrin deposition (p < 0.001) and these effects were greater in veins than in arteries. The difference in platelet deposition between arteries and veins was more pronounced at lower shear rates (p < 0.05), an effect not observed with fibrin deposition. To determine whether the increased thrombogenicity of veins could be explained by an increased content of subendothelial vWF, the amount of vWF was assessed by incubating injured vessels with 125I vWF Ab and then measuring the radioactivity of the vessels. Veins had a higher content of vWF than arteries, as implied by the higher amount of radiolabeled vWF Ab (813 +/- 90 in veins vs. 2173 +/- 317 in arteries, p < 0.001). These observations suggest that increased thrombogenicity of veins may in part be explained by intrinsic differences in subendothelial vWF and subsequent platelet attachment.

Animals↗

PubMed1995

Thrombus formation on polytetrafluoroethylene surfaces: the importance of von Willebrand factor.

The importance of von Willebrand factor (vWf) in the formation of platelet-fibrin thrombi on expanded polytetrafluoroethylene (ePTFE) surfaces was studied in an in vitro system, perfusing non-anticoagulated human blood over ePTFE grafts for 3 min at varying shear rates (100, 500 and 1500/s shear). Platelet (111In) and fibrin (125I) deposition was assessed on ePTFE surfaces in the presence and relative absence of vWf, achieved by use of polyclonal anti-vWf antibody (anti-vWf Ab). A total of 29 perfusions were performed. Increasing shear rate was associated with greater platelet deposition in the presence of vWf (p < 0.001). This shear-dependent rise in platelet deposition was not observed when vWf was blocked by anti-vWf Ab (P < 0.1), confirming the role of vWf in platelet deposition at high shear rates. Fibrin deposition increased with increasing shear rate in the presence of vWf (P < 0.01). Inhibiting vWf abolished the shear-dependent increase in fibrin deposition. These data suggest that vWf plays a critical role in platelet and fibrin thrombus formation on ePTFE surfaces. These effects are particularly important under conditions of high shear rate. These mechanisms may lead to the observed pathologic thrombus formation and platelet-dependent neointimal processes occurring at areas of high shear rate within the anastomotic regions of ePTFE grafts.

Blood Platelets↗

PubMed1995

Rapid chromosome analysis and prenatal diagnosis using fluid from the cystic hygroma, hydrothorax and isolated ascites: new source for chromosome analysis.

OBJECTIVE: To determine whether abnormally collected fetal body fluid could be used as alternative cell sources for cytogenetic assessment. METHOD: Using modified lymphocyte culture, the abnormal fetal body fluids obtained from the five fetal anomaly cases (3 cystic hygromas, 1 hydrothorax, and 1 isolated ascites) were analyzed in order to determine their karyotypes. RESULTS: Two cases showed 45, X and 46, XX/45, X and the other three showed a normal karyotype. CONCLUSION: The cytogenetic analysis from body fluid aspiration yields a rapid and accurate result within 96 hours. This method could be helpful when cordocentesis or placental biopsy is not feasible or when time requirement for amniotic fluid cell culture is burdensome to patient management.

Adult↗

PubMed1994

Plasminogen acceleration of urokinase thrombolysis.

PURPOSE: A relative deficiency of plasminogen within the thrombus may be the rate limiting factor in clot lysis. METHODS: To investigate this hypothesis, we used an in vitro perfusion system and expanded polytetrafluoroethylene graft segments filled with radiolabeled human thrombus. Three groups of five perfusions were compared: (1) urokinase infusion (333 IU/min) into clots laced with buffer, (2) urokinase infusion (333 IU/min) into clots laced with plasminogen (44 CU), and (3) control, D5W infusion into clots laced with buffer. Two end points were measured over time: the amount of lysed thrombus and the flow through the graft. RESULTS: Urokinase infusion resulted in augmented flow through the graft when compared with control (p < 0.05). Lacing with plasminogen resulted in more rapid restoration of flow when compared with urokinase infusion alone (p < 0.05). Similarly, the rate of clot dissolution was significantly greater in plasminogen-laced thrombi (p < 0.05) when compared with the control and urokinase groups. Embolization of particles of thrombus was uniformly observed in the urokinase group, resulting in a temporary decrease in flow through the thrombosed graft. This event characteristically occurred after 60 minutes of infusion but was never seen in the urokinase/plasminogen treatment group. CONCLUSIONS: These results suggest that plasminogen supplementation of urokinase thrombolysis may result in significant clinical benefits with respect to the rate of clot lysis and the uniformity of clot dissolution with a lower likelihood of secondary embolization.

Analysis of Variance↗