Intra-Arterial Glycoprotein IIb/IIIa Inhibitor Treatment for Symptomatic Intracranial Atherosclerotic Stenosis Presenting as Large Vessel Occlusions
CUREUS
Authors: Srivatsan, Aditya; Srinivasan, Visish M.; Chen, Stephen; Kan, Peter; Johnson, Jeremiah N.
Abstract
Introduction There is no consensus on the optimal treatment for acute ischemic stroke (AIS) large vessel occlusions (LVOs) or near-occlusions with underlying intracranial atherosclerotic stenosis (ICAS). We report the first American series using intra-arterial (IA) glycoprotein IIb/IIIa inhibitors (GPIs) as a stand-alone revascularization technique for ICAS presenting with large vessel ischemic syndromes. Methods Records at two centers of 140 patients presenting with AIS undergoing stroke intervention from January 2017 to June 2019 were retrospectively reviewed. Patients treated with IA GPIs were identified, and baseline factors, imaging, procedural characteristics, hospital course, and outcomes were collected. Six patients with ICAS underlying their acute symptomatic near occlusion or LVO were treated with IA GPI. Four near-occlusions were treated with IA GPI as the first-line therapy, while two LVOs were treated with IA GPI as an adjunct therapy to thrombectomy. Results The mean age was 61.3 years (range 36-79), presentation National Institute of Health Stroke Scale (NIHSS) was 10 (4-18), time from last seen well to treatment was 434.5 minutes (164-1290), and time from groin puncture to revascularization was 67.3 minutes (26-94). Three patients received intravenous (IV) tissue plasminogen activator (tPA), and all patients received an IA weight-based GPI infusion. Five patients had thrombolysis in cerebral ischemia (TICI) 3, and one patient had TICI 2b. The mean discharge NIHSS was 2.5 (0-8). The mean modified Rankin scale was 1.3 (range 0-4) at discharge and .8 at three months. No patients had a postprocedural symptomatic hemorrhage. Conclusion Our results highlight the utility of IA GPI administration as the first-line therapy for symptomatic ICAS near occlusions or as a rescue technique after failed thrombectomy for LVO patients suspected of underlying ICAS.
Effects of epsilon-polylysine and rosemary extract on the quality of large yellow croaker (Pseudosciaena crocea) stored on ice at 4 +/- 1 degrees C
JOURNAL OF FOOD BIOCHEMISTRY
Authors: Lan, Wei-Qing; Liu, Lin; Zhang, Nan-Nan; Huang, Xia; Weng, Zhong-Ming; Xie, Jing
Abstract
To evaluate the quality changes in large yellow croaker (Pseudosciaena crocea) with epsilon-polylysine and rosemary extract stored on ice at 4 +/- 1 degrees C. About 0.1% epsilon-polylysine (PL) and 0.2% rosemary extract (RE) were individually or in combination with each other were treated with samples. Samples treated with deionized water were regarded as control check (CK) group. Physicochemical (texture profile analysis (TPA), pH, total volatile basis nitrogen (TVB-N), thiobarbituric acid (TBA)), endogenous enzyme activity (cathepsin B and D), proteolytic degradation (Trichloroacetic Acid (TCA)-soluble peptides and Sodium Salt-polyacrylamide gel electrophoresis (SDS-PAGE)), microbiological (Total viable count (TVC),Shewanellabacteria count,Pseudomonasbacteria count,Psychrophilicbacteria count) and sensory evaluation were conducted during the whole storage. As a result, PL + RE could delay the increase in pH, TVB-N, TBA value, and improve the texture attributes compared with the CK group. In addition, PL + RE could inhibit cathepsin B and D activities, protein degradation, and microbial growth effectively. Moreover, the shelf life of samples could be prolonged at least 4 days when compared with the CK group according to the quality index method (QIM) and physicochemical assay, indicating that the PL + RE treatment could maintain the quality of large yellow croaker more effectively. Practical applications The preservation of fish is becoming increasingly important in aquatic products. According to the fence theory, a combination of biopreservatives with different functions could be used to maintain the freshness synergistically. Furthermore, this research indicates that the combination of epsilon-polylysine and rosemary extract, a promising method for the preservation of aquatic products, could slow down the deterioration of large yellow croaker and prolong its shelf life.