Improving the outcome of stroke. A new medication has been shown to have long-term benefits when given up to six hours after a person has a stroke.
MED Professor of Neurology Dr. Carlos Kase collaborated on the trial with researchers from 54 other institutions to determine the safety and effectiveness of an intra-arterial thrombolytic (clot-busting) agent called recombinant prourokinase (r-proUK).
A stroke is a sudden loss of brain function caused either by a major reduction in blood flow resulting from clots or by intercranial bleeding. Strokes can result in either temporary or permanent paralysis, difficulty in speaking or eating, and loss of muscular coordination.
The researchers found that when r-proUK, combined with the anticoagulant drug heparin, was administered within the first six hours of the stroke, patients had little or no neurological impairment after 90 days compared with patients treated only with heparin. The administration of heparin is the conventional treatment for stroke victims.
Another significant finding was that r-proUK was effective in patients whose stroke resulted from middle cerebral artery occlusion, a group that has a particularly poor prognosis when treated with currently available methods.
"This trial demonstrated that appropriate therapies given within six hours of a stroke will still have clinical benefits," explains Kase. "We hope stroke researchers will build on these results by combining treatment strategies to further improve outcomes for patients with acute stroke."
The study was published in the December 1 Journal of the American Medical Association.
A milkshake that can diagnose ulcers. When doctors need to diagnose a gastric ulcer, they must use an expensive, invasive procedure: inserting an endoscope down the throat into the stomach to take a sample for analysis.
Until now, that is. Robert Michener, laboratory manager of the CAS Stable Isotope Laboratory, has collaborated with Stanford University doctors Rex Moulton-Barrett and George Triadopholopolus to develop a test that requires just a small blood sample to identify the presence of heliobacter pylori (HP), the bacterium which causes 80 percent of gastric ulcers.
Michener's test uses the naturally occurring stable isotopes carbon 13 (C-13) and carbon 12. "Since everything organic on earth contains these two isotopes, they can act as a natural tracer for various chemical and physical reactions," he explains.
Gastric HP produces the enzyme urease, which converts urea into carbon dioxide and ammonia; the ammonia then neutralizes stomach acid, allowing the bacteria to thrive. The Stanford doctors believed that identifying the enzyme in the blood would be a simple way to confirm the presence of HP.
The test begins when the patient drinks a milkshake laced with urea. If HP is present, it will use the urea and produce carbon dioxide labeled with C-13, which later dissolves in the bloodstream. Michener's test extracts the isotope from blood samples. A mass spectrometer analysis can detect both the organism and the degree of infection.
Clinical trials at Stanford proved the procedure to be highly accurate, very robust -- some samples were shipped thawed, then refrozen -- and effective on very small samples, making it practical for use on children. "Since it only requires a blood sample, it's ideal for use in a doctor's office or in the field, where a health-care worker may be screening a village that doesn't have access to a hospital," Michener says.
Metabolic Solutions, Inc., based in Nashua, N.H., is marketing the test kit, which has received FDA approval.