The determination of nitrite and nitrate in human blood plasma by capillary zone electrophoresis

The determination of nitrite and nitrate in human blood plasma by capillary zone electrophoresis (CZE) is described. Electrophoresis was carried out in a 65 cm long, 75 microns wide silica capillary, using 750 mM sodium chloride containing 5% NICE-Pak OFM Anion-BT (an additive reversing the electroosmotic flow) as running buffer, at a potential of 20 kV, with on-column UV detection at 214 nm. Under these conditions, the two anions migrated in the order of nitrite and nitrate, completely resolved from each other. Forty-one samples of ultrafiltered blood plasma of healthy volunteers were analyzed. The concentrations of nitrite and nitrate were 0.15 +/- 0.07 mg/L and 3.2 +/- 1.6 mg/L (mean +/- SD), respectively, with a linear correlation in the range of 0.1-50 mg/L. The within-day and between-day coefficients of variation (CVs) for nitrite and nitrate were lower than 5% and 8%, respectively. The recovery was 97-114%. The estimated plasma volume needed for each determination was 108 nL.

[A survey of utilization of urinary alarm systems in nursing homes]

A questionnaire survey was performed on 63 nursing homes and 1006 care workers in the nursing home, in order to elucidate the actual state of utilization of urinary alarm systems (systems). About 3% of the nursing homes in all of Japan are utilizing the system with 12.5% of all institutionalized elderly having a diaper sensor of those nursing homes with the system, 86% use the system continually. In 51% of the nursing homes, care workers change diapers immediately after sensor alarm is triggered. The reasons for not being able to change the diaper immediately were either care workers had other pressing work, or simultaneous or overlapping sensor alarm calls occurred. The usefulness of the system was recognized for "prevention of decubitus" (66%), "prevention of contact dermatitis from diapers" (82%), "decrease of ammonia smell" (27%), and "discontinuation of diaper" (26%). As for problems associated with the system or factors that increase work load, responses included "sensor does not respond sometimes" (67%), "increased diaper changes" (53%), "increased nurse calls due to urinary urgency" (41%), and "disconnection of the sensor by the patient" (34%). The percentage of care workers who reported an increase in work load was 73%, especially where the ratio of care workers number/institutionalized elderly was low.

[Successful treatment of a 74-year-old man with refractory anemia with excess of blasts in transformation (RAEB in T) by low-dose Ara-C injection]

Myelodysplastic syndromes (MDS) are a heterogeneous group of clonal hematopoietic disorders characterized by normal or hypercellular but dysfunctional bone marrow. They usually are refractory to empirical therapeutic regimens. Recently the prevalence of MDS in the elderly is increasing and now the syndromes are relatively commonly encountered in elderly patients. Two major causes of death in MDS are progression to acute leukemia (especially in subtypes of RAEB and RAEB in T), and bone marrow aplasia. Since cytoreductive therapy for RAEB or RAEB in T in the elderly is often accompanied by serious adverse complications, such as infection and hemorrhage, special care is necessary. Here we describe successful induction remission in a 74-year-old man with MDS (RAEB in T) by twice daily low-dose cytosine arabinoside injections (10 mg/m2, s.c.), which was well-tolerated, free of serious adverse effects, and seemed to be a useful therapeutic option for elderly patient with RAEB or RAEB in T.

[A case of erythroleukemia associated with lung aspergilloma successfully treated with continuous drip infusion of amphotericin B]

In September 1990, a 55-year-old female with erythroleukemia was treated with enocitabine, mitoxantrone, vincristine, and etoposide. Despite prophylaxis of infectious diseases by oral administration of 2,400 mg/day amphotericin B (AMPH), 600 mg/day ofloxacin, and 1,500 mg/day kanamycin, pneumonia with refractory pyrexia appeared and developed cystic lesions with air crescent signs thereafter. Finally, the cystic one formed fungus balls. The pneumonia was diagnosed as aspergillus pneumonia by fungus growth in the tissue in the transbronchial lung biopsy specimens and by an elevation of serum anti-Aspergillus antibody. The patient had continuously been administered with AMPH for 16 days, increasing the drug doses every 2 days. The maximum plasma level of AMPH rose up to 0.78 micrograms/ml, the total amount up to 166 mg. The fungus balls disappeared completely without adverse effects except a transient decrease of plasma potassium level. Pharmacological studies had been reported that tissue AMPH levels elevated more than twice as much as that of the plasma. Although the maximum plasma level was less than that of MIC for Aspergillus, the lung tissue drug level was suspected to have been maintained higher by continuous drip infusion. These findings indicate that continuous drip infusion of AMPH is one of the useful treatment for lung aspergillosis.

Change in the distribution of alpha-tocopherol stereoisomers in rats after intravenous administration

Synthetic alpha-tocopherol (alpha-Toc) contains equal amounts of eight different stereoisomers arising from three chiral centers in the phytyl tail. Of these, the four stereoisomers with the 2R configuration are generally more active than their corresponding 2S-isomers. We investigated the change in distribution of alpha-Toc stereoisomers in the plasma and tissues after intravenously administering all-rac- and SRR-alpha-Toc acetate. The concentration of 2R-isomers in the rat plasma after administering all-roc-alpha-Toc acetate was higher than that of the 2S-isomers. On the other hand, the concentration of 2R-isomers in the liver was lower than that of 2S-isomers up to 6 h. In the rat plasma after administering only SRR-alpha-Toc acetate, no SRR-alpha-Toc was detected after 6 h, although SRR-alpha-Toc in the liver was retained at a higher level than in the other tissues. We presume that the intravenously administered 2R- and 2S-isomers were easily transported into the liver from the plasma, the 2R-isomers being preferentially released from the liver into the blood, whereas the 2S-isomers remained in the liver for up to 6 h.

[Application of microdialysis for pharmacokinetic study in rabbit anterior chamber]

We evaluated a microdialysis technique for analyzing the pharmacokinetics of instilled or orally administered ofloxacin in the anterior chamber of pigmented rabbits. A microdialysis probe was inserted into the anterior chamber and was perfused (2 microliters/min) with Ringer solution using a microinjection pump. Two hours later, 20 microliters of 0.15 and 0.3% ofloxacin was instilled into an eye, or 20 mg/kg of the drug was administered into the stomach through an intubated catheter. Dialysate was then collected every 15 or 20 min for 6 (instillation) or 8 (oral administration) hours. Ofloxacin concentration in dialysates was determined with a HPLC-spectrofluorometry system. Ofloxacin levels in dialysates increased after the instillation in a dose-related manner, reached a maximum at 30 and 45 min, and then decreased gradually with t1/2 of 136 and 114 min after the 0.15% and 0.3% instillation, respectively. After oral administration, ofloxacin levels in dialysates reached a maximum at 120 min and decreased with t1/2 of 175 min. These data suggest the usefulness of microdialysis for pharmacokinetic studies in the anterior chamber, since continuous and stable data can be obtained from each animal.

Diagnosis of chronic liver disease from liver scintiscans by fuzzy reasoning

We investigated the possibility that fuzzy reasoning might be used to standardize diagnosis of liver disease based on scintigraphic results and compared the results with those obtained when scintiscans were scored conventionally.

METHODS

Seventy-five patients with chronic liver disease (11 patients had chronic persistent hepatitis, 26 had chronic aggressive hepatitis and 38 had cirrhosis) and 25 controls were studied. Another 75 patients with hepatitis or cirrhosis were examined to test the effectiveness of the membership functions. Liver scintiscans were taken 20 min after the intravenous injection of 111 MBq of 99mTc-phytate. Fuzzy reasoning was used to evaluate the following five items: the ratio of the sizes of the left and right lobes, splenomegaly, radioactivity in the bone marrow, deformity of the liver and distribution of radioactivity in the liver. The degree of conformity to each of the three liver diseases being investigated was substituted into the membership function for the conclusion. The center of gravity for each patient's results was calculated. Conventional scoring was made with three levels for each of the five items examined by fuzzy reasoning.

RESULTS

Distinctions between chronic persistent hepatitis and chronic aggressive hepatitis were difficult to assess with fuzzy reasoning and conventional scoring. The diagnostic accuracy was 95% for patients with cirrhosis and 88% for patients with chronic hepatitis with fuzzy reasoning. With conventional scoring the accuracy was 86% for patients with cirrhosis and 75% for patients with chronic hepatitis. When fuzzy reasoning was used to examine the other 75 patients with chronic liver diseases, the accuracy was 93% for patients with cirrhosis and 86% for patients with chronic hepatitis.

CONCLUSION

The method is simple and can be used routinely in clinical settings.

Experimental assessment of newly devised transcatheter stent-graft for aortic dissection

Despite recent advances, surgical results for Stanford type B dissection are not yet satisfactory because the procedure is so highly invasive. The aim of this study was to devise a new intraaortic (IA) graft that would offer less invasive treatment for type B dissection. To close the entry of type B dissections using transcatheter placement, we devised an IA graft (inner diameter, 15-20 mm; length, 40 to 60 mm) in which a self-expandable stent was covered with a thin, open-cell-structured polyurethane jacket. In acute animal experiments in which type B aortic dissections were prepared in 4 mongrel dogs, IA grafts were implanted to close the entry using a transfemoral catheter sheath, and closure of all the entries was confirmed by aortography. In chronic experiments, five IA grafts for normal descending aortas and one IA graft for an experimentally dissected aorta were implanted to observe histologic biocompatibility for up to 8 months. Histopathologic examination conducted at the projected sacrifice periods revealed that endothelialization of the luminal surface of the IA graft had begun as early as 1 month after implantation and was completed within 4 months. The prototype device that we developed may be promising as an effective, minimally invasive therapeutic intervention for closure of the entry site of type B dissection.

Clearance of surfactant protein B from rabbit lungs

To characterize the metabolism of surfactant protein B (SP-B) in vivo, we measured the clearance of SP-B from adult rabbit lungs. Purified rabbit SP-B was radiolabeled with 125I by the Bolton-Hunter method. Trace amounts of 125I-labeled SP-B mixed with [14C]dipalmitoylphosphatidylcholine (DPPC) were given intratracheally via a bronchoscope to rabbits 0-16 h before collection of alveolar washes (AW). Macrophages were recovered from AW, and lamellar bodies (LB) were isolated from lung tissue by differential centrifugation. 125I-SP-B was cleared more rapidly from the airspaces and the total lung (half-life 7 h) than was DPPC (half-life 11 h in the total lung). There was an approximately threefold accumulation of SP-B relative to saturated phosphatidylcholine in macrophages at all times. The proportion of 125I and 14C radioactivities in lamellar bodies was similar at 2 and 4 h, but there was 14-fold less 125I-SP-B than [14C]DPPC in lamellar bodies by 16 h. This loss of SP-B from the lamellar body fraction is consistent with less recycling of SP-B. The results demonstrate different clearance kinetics of these two components of surfactant and indicate a significant role of macrophages in the clearance of SP-B.

Suppression of pulmonary metastasis by angiogenesis inhibitor TNP-470 in murine osteosarcoma

We treated a murine osteosarcoma cell line, LM8, which preferentially metastasizes to the lungs, with a new angiogenesis inhibitor, TNP-470, to evaluate the efficacy of this compound in the suppression of pulmonary metastasis of osteosarcoma. In an in vivo experiment, tumor cells were inoculated i.v. into C3H mice, and TNP-470 or vehicle alone (control group) was administered s.c. every day for 3 weeks. In the TNP-470-treated groups, both the number of pulmonary metastatic nodules and the lung wet weight were significantly reduced in a dose-dependent manner. Similarly, vascular density in the metastatic tumors estimated by immunohistochemical staining with anti-von-Willebrand factor antibody as an endothelial marker were significantly reduced. No severe side-effects were found. In an in vitro experiment, viable tumor cells were counted after 3 days' treatment with TNP-470. The 50% inhibitory concentration was 0.6 ng/ml for LM8, which was more sensitive than other tumor cells previously reported. Our results show that TNP-470 suppresses the pulmonary metastasis of LM8 and suggest that both its anti-angiogenic activity and cytostatic activity towards LM8 are responsible for the antitumor effect.

Misincorporation of dAMP opposite 2-hydroxyadenine, an oxidative form of adenine

Nucleotide incorporation opposite an oxidative form of adenine, 2-hydroxyadenine (2-OH-Ade) was investigated. When a primed template with 2-OH-Ade was treated with an exonuclease-deficient Klenow fragment of Escherichia coli DNA polymerase I (KFexo-), recombinant rat DNA polymerase beta (pol beta) or calf thymus DNA polymerase alpha (pol alpha), incorporation of dTMP and dAMP was observed. In addition, KFexo- inserted dGMP as well. A steady-state kinetic study indicated that the insertion of dAMP and dTMP opposite the DNA lesion occurred with similar frequency with KFexo- and pol beta. Insertion of dTMP opposite 2-OH-Ade was favored to that of dAMP by pol alpha. Chain extension from the A.2-OH-Ade pair is less favored than that from the T.2-OH-Ade pair by all three DNA polymerase. Analysis of full-length products of in vitro DNA synthesis showed that dTMP and dAMP were incorporated by DNA polymerases and that exonuclease-proficient and -deficient Klenow fragments also inserted dGMP opposite 2-OH-Ade. These results suggest that formation of 2-OH-Ade from A in DNA will induce A-->T and A-->C transversions in cells.

Surfactant protein-B supplementation improves in vivo function of a modified natural surfactant

The effect of the addition of surfactant protein (SP)-B or SP-B plus SP-C (SP-BC) to a surfactant made from bovine lung (Survanta) was evaluated in 27-d-gestation preterm rabbits. The animals were treated with Survanta, Survanta + 2% SP-B, Survanta + 3% SP-BC, or sheep surfactant. They were then ventilated with 3 cm H2O positive end-expiratory pressure and tidal volumes of 8 mL/kg. Survanta + 2% SP-B was prepared by adding SP-B in water to Survanta or by adding SP-B in chloroform [SP-B(Chl)] to lipid-extracted Survanta. Dynamic compliances of the Survanta + 2% SP-B(Chl)- and Survanta + 3% SP-BC-treated rabbits were greater (p < 0.05) than those treated with Survanta or Survanta + 2% SP-B in water and were comparable to sheep surfactant. Postventilation pressure-volume curves for the groups treated with Survanta supplemented with SP-B had significantly larger retained volumes on deflation compared with those treated only with Survanta (p < 0.01). The effects of ventilation style on the responses were assessed by ventilating other groups of rabbits treated with Survanta, Survanta + 0.5% SP-B(Chl), Survanta + 2% SP-B(Chl), or sheep surfactant with tidal volumes of 10 mL/kg and 0 cm H2O positive end-expiratory pressure. SP-B (2%) augmented the in vivo function of Survanta without positive end-expiratory pressure, and 0.5% SP-B had no effect. Infasurf, a surfactant with more SP-B, was more effective than Survanta when tested in the preterm rabbits. SP-B is a critical factor for optimum immediate surfactant function.

Exogenous surfactant function in very preterm lambs with and without fetal corticosteroid treatment

We have asked whether the function of a bovine source surfactant frequently used clinically (Survanta) could be enhanced after exposure to the very preterm lung when the surfactant was subsequently tested in vivo in preterm surfactant-deficient rabbits. We also evaluated whether there would be effects resulting from fetal treatment with 0.5 mg/kg betamethasone given 48 h before delivery of lambs at 121 days gestational age. The fetal corticosteroid treatment significantly improved gas exchange, increased compliance, increased functional residual capacity, decreased vascular-to-alveolar protein leak, and increased static lung volumes. However, surfactant from both groups of lambs, recovered by alveolar wash and subsequently fractionated to recover the large-aggregate functional surfactant, was equivalent in function to the Survants given to the lambs when tested in preterm surfactant-deficient rabbits. Addition of plasma to Survanta resulted in high minimum surface tensions in vitro, and this inhibition could be prevented by supplementation of the Survanta with 5 or 10% sheep surfactant. No activation occurred with treatment of the very preterm lung, a result consistent with the lung being too immature to contribute components to the surfactant used for treatment. Fetal corticosteroid treatment had no effect on surfactant function at this gestational age.

Absolute stereostructures of hovenidulciosides A1 and A2, bioactive novel triterpene glycosides from hoveniae semen seu fructus, the seeds and fruit of Hovenia dulcis Thunb

Two bioactive novel triterpene glycosides named hovenidulciosides A1 and A2 have been isolated from a Chinese natural medicine, Hoveniae Semen Seu Fructus, the seeds and fruit of Hovenia dulcis Thunb. (Rhamnaceae). The absolute stereostructures of hovenidulciosides A1 and A2 with a migrated 16,17-seco-dammarane skeleton have been determined on the basis of chemical and physicochemical evidence which included the X-ray crystallographic analysis of the p-bromobenzoate of their common aglycone, hovenidulcigenin A. Hovenidulciosides A1 and A2 exhibited inhibitory activity on the histamine release from rat mast cells induced by compound 48/80 or calcium ionophore A-23187.

Genetic diversity of N2-fixing bacteria associated with rice roots by molecular evolutionary analysis of a nifD library

The rhizosphere of wetland rice has significant N2-fixing activity. It has been suggested that N2 fixation in the rice root zone is associated with the activity of various N2-fixing heterotrophic bacteria that inhabit the rice rhizosphere. Because of the generic diversity, many different isolation media and conditions are required to count and isolate these bacteria. In an attempt to overcome any bias from culture-dependent methods we amplified nifD segments from crude rice root DNA by the polymerase chain reaction. The nifD fragments were then cloned into a pT7 Blue T-vector to construct a nifD library. Sixteen cloned nifD genes chosen at random from the library were sequenced. A comparison with published sequences indicated the presence of seven novel groups of NifD proteins, which implies the existence of at least seven components in the diazotrophic community of rice roots, dominated mainly by proteobacteria. We also observed genetic variability within the clusters, which suggests the coexistence of many closely related bacterial lineages. However, we did not find Azospirillum-like nifD clones, although many reports indicated the widespread presence of Azospirillum spp. Therefore, it remains to be clarified whether Azospirillum species are the widespread N2-fixing bacteria in rice roots.

Clinical usefulness of evaluation of portal circulation by per rectal portal scintigraphy with technetium-99m pertechnetate

OBJECTIVE

Portal circulation, in particular the contribution of the inferior mesenteric vein, can be evaluated in a relatively noninvasive way by per rectal portal scintigraphy (J Nucl Med 1988; 29:460-5). The clinical usefulness of the method was evaluated.

METHODS

A solution containing technitium-99m pertechnetate was instilled into the rectum, and serial scintigrams were taken while radioactivity curves for the liver and heart were recorded sequentially. By analyses of the curves, the per rectal portal shunt index (SI) was calculated.

RESULTS

The SI was higher for disorders that were more severe, increasing in the order of chronic persistent hepatitis, chronic aggressive hepatitis, and cirrhosis, and the SI was higher in cirrhotic patients than in patients with chronic hepatitis or in healthy subjects. The SI was significantly higher when a complication (varices, ascites, or encephalopathy) was present. Correlation between the SI and classic indicators for functional reserve was significant. The SI was significantly related to survival according to results of regression analysis by Cox's proportional hazards model. On the basis of the SI when patients were first examined, the patients with cirrhosis were divided into three groups of roughly equal size: group A, SI under 30%; group B, SI between 30 and 70%; and group C, SI over 70%. The survival rate was lower in group B than in A, lower in group C than in A, and lower in group C than in B.

CONCLUSIONS

This method is clinically useful, especially in establishing the prognosis.

Adsorption-desorption of proteins on phospholipid polymer surfaces evaluated by dynamic contact angle measurement

Adsorption-desorption of plasma protein on various polymer membranes was evaluated by a dynamic contact angle (DCA) measurement using the Wilhelmy plate method. Poly(ethylene terephthalate) (PET) was used as a substrate membrane; we examined this membrane coated with hydrophilic polymers such as poly[2-methacryloyloxethyl phosphorylcholine (MPC)-co-n-butyl methacrylate (BMA)] or poly[2-hydroxyethyl methacrylate (HEMA)]. Although the zeta-potential of the PET membrane was negative, the coating with poly(MPC-co-BMA) induced increase of value to nearly zero. The DCA loops observed on the polymer membranes after protein adsorption were unity and hysteresis of the loop was reduced. In the cases of protein adsorbed on both the PET and the poly(HEMA) membranes, the shape and hysteresis of the loops were almost same during the rinsing process with a phosphate-buffered solution (PBS). However, the hysteresis of the DCA loops that appeared on the protein-adsorbed poly(MPC-co-BMA) membrane became large during the rinsing process with the PBS, and the shape of the DCA loop returned to its non-protein-adsorbed state. Therefore, proteins adsorbed on poly(MPC-co-BMA) could desorb more readily than those on PET and poly(HEMA) because of the weak interaction between poly(MPC-co-BMA) and the proteins.

A new approach for performing a one-stage operation through the mediastinum to resect bilateral lung metastases: report of a case

We describe herein a new operative technique for reaching the opposite lung from the thoracotomy site through the mediastinum. This procedure was successfully performed on a 76-year-old woman with bilateral lung metastases whose case is presented. After resection of the right lower lobe which contained two metastases, the anterior mediastinum was opened, and contralateral metastasis located in the lingular segment was resected using a neodymium:yttrium-aluminum-garnet (Nd:YAG) laser. A chest drainage tube was inserted through the mediastinal window. This transmediastinal approach seems to be a feasible technique for preserving the respiratory function of the chest wall in patients with imbalanced bilateral metastases.

Polarized Raman spectra of oriented fibers of A DNA and B DNA: anisotropic and isotropic local Raman tensors of base and backbone vibrations

Polarized Raman spectra of oriented fibers of calf thymus DNA in the A and B conformations have been obtained by use of a Raman microscope operating in the 180 degrees back-scattering geometry. The following polarized Raman intensities in the spectral interval 200-1800 cm-1 were measured with both 514.5 and 488.0 nm laser excitations: (1) Icc, in which the incident and scattered light are polarized parallel to the DNA helical axis (c axis); (2) Ibb, in which the incident and scattered light are polarized perpendicular to c; and (3) Ibc and Icb, in which the incident and scattered light are polarized in mutually perpendicular directions. High degrees of structural homogeneity and unidirectional orientation were confirmed for both the A and B form fibers, as judged by comparison of the observed Raman markers and intensity anisotropies with measurements reported previously for oligonucleotide single crystals of known three-dimensional structures. The fiber Raman anisotropies have been combined with solution Raman depolarization ratios to evaluate the local tensors corresponding to key conformation-sensitive Raman bands of the DNA bases and sugar-phosphate backbone. The present study yields novel vibrational assignments for both A DNA and BDNA conformers and also confirms many previously proposed Raman vibrational assignments. Among the significant new findings are the demonstration of complex patterns of A form and B form indicator bands in the spectral intervals 750-900 and 1050-1100 cm-1, the identification of highly anisotropic tensors corresponding to vibrations of base, deoxyribose, and phosphate moieties, and the determination of relatively isotropic Raman tensors for the symmetrical stretching mode of phosphodioxy groups in A and B DNA. The present fiber results provide a basis for exploitation of polarized Raman spectroscopy to determine DNA helix orientation as well as to probe specific nucleotide residue orientations in nucleoproteins, viruses, and other complex biological assemblies.

Remarkable N2-fixing bacterial diversity detected in rice roots by molecular evolutionary analysis of nifH gene sequences

To demonstrate the extent of phylogenetic diversity of diazotrophic bacteria associated with rice roots, we characterized phylogenetically 23 nifH gene sequences obtained by PCR amplification of mixed organism DNA extracted directly from rice roots without culturing the organisms. The analyses document the presence of eight novel NifH types, which appear to be a variety of significant components of the diazotrophic community, dominated mainly by proteobacteria.

Changes in coagulation and fibrinolytic system after local intra-arterial thrombolysis for acute ischemic stroke

Intracerebral hemorrhagic transformation is one of the most important complications of thrombolytic therapy for acute ischemic stroke. The relationship between changes in markers for the coagulation and fibrinolytic systems and occurrence of hemorrhagic transformation was determined after local intra-arterial thrombolytic therapy using urokinase (UK) (24 patients) or recombinant tissue plasminogen activator (t-PA) (10 patients) within 6 hours of onset. All 34 patients had no hypodensity areas on initial computed tomography scans. Plasma concentrations of fibrinogen-fibrin degradation products (FDP), fibrinogen, alpha 2-plasmin inhibitor (alpha 2-PI), plasmin-alpha 2 plasmin inhibitor complex (PIC), thrombin-antithrombin III complex (TAT), and D-dimer were measured. Hemorrhagic transformation occurred in seven patients (21%) with complete or partial recanalization; four in the UK group and three in the t-PA group. Doses of the thrombolytic agents did not correlate with the incidence of hemorrhagic transformation. The FDP levels in the hemorrhagic transformation group treated with UK significantly increased immediately and 1 hour after the therapy. The alpha 2-PI activities decreased and PIC levels increased in both the hemorrhagic transformation and the nonhemorrhagic groups after the therapy. The TAT levels in both groups tended to be higher than the normal range, but there was no significant difference from the pretreatment levels. The D-dimer levels in the hemorrhagic transformation group were higher than those in the nonhemorrhagic group at 24 hours after the therapy. Furthermore, the D-dimer levels were significantly higher in patients with complete recanalization compared with those with none or partial recanalization.(ABSTRACT TRUNCATED AT 250 WORDS)