A randomised controlled trial of antiplatelet therapy in combination with Rt-PA thrombolysis in ischemic stroke: rationale and design of the ARTIS-Trial

<p>Abstract</p> <p>Background</p> <p>Thrombolysis with intravenous rt-PA is currently the only approved acute therapy for ischemic stroke. Re-occlusion after initial recanalization occurs in up to 34% in patients treated with rt-PA, probably caused by platelet activation. In acute myocardial infarction, the combination of thrombolysis and antiplatelet therapy leads to a greater reduction of mortality compared to thrombolysis alone. In patients with acute ischemic stroke, several studies showed that patients already on antiplatelet treatment prior to thrombolysis had an equal or even better outcome compared to patients without prior antiplatelet treatment, despite an increased risk of intracerebral bleeding. Based on the fear of intracerebral haemorrhage, current international guidelines recommend postponing antiplatelet therapy until 24 hours after thrombolysis. Remarkably, prior use of antiplatelet therapy is not a contra-indication for thrombolysis. We hypothesize that antiplatelet therapy in combination with rt-PA thrombolysis will improve outcome by enhancing fibrinolysis and preventing re-occlusion.</p> <p>Methods/Design</p> <p>ARTIS is a randomised multi-center controlled trial with blind endpoint assessment. Our objective is to investigate whether immediate addition of aspirin to rt-PA thrombolysis improves functional outcome in ischemic stroke. Patients with acute ischemic stroke eligible for rt-PA thrombolysis are randomised to receive 300 mg aspirin within 1.5 hours after start of thrombolysis or standard care, consisting of antiplatelet therapy after 24 hours. Primary outcome is poor functional health at 3 months follow-up (modified Rankin Scale 3 - 6).</p> <p>Discussion</p> <p>This is the first clinical trial investigating the combination of rt-PA and acute aspirin by means of a simple and cheap adjustment of current antiplatelet regimen. We expect the net benefit of improved functional outcome will overcome the possible slightly increased risk of intracerebral haemorrhage.</p> <p>Trial registration</p> <p>The Netherlands National Trial Register NTR822. The condensed rationale of the ARTIS-Trial has already been published in Cerebrovascular Diseases.</p

Agrobacterium-mediated transformation of kabocha squash (Cucurbita moschata Duch) induced by wounding with aluminum borate whiskers

An efficient genetic transformation method for kabocha squash (Cucurbita moschata Duch cv. Heiankogiku) was established by wounding cotyledonary node explants with aluminum borate whiskers prior to inoculation with Agrobacterium. Adventitious shoots were induced from only the proximal regions of the cotyledonary nodes and were most efficiently induced on Murashige–Skoog agar medium with 1 mg/L benzyladenine. Vortexing with 1% (w/v) aluminum borate whiskers significantly increased Agrobacterium infection efficiency in the proximal region of the explants. Transgenic plants were screened at the T0 generation by sGFP fluorescence, genomic PCR, and Southern blot analyses. These transgenic plants grew normally and T1 seeds were obtained. We confirmed stable integration of the transgene and its inheritance in T1 generation plants by sGFP fluorescence and genomic PCR analyses. The average transgenic efficiency for producing kabocha squashes with our method was about 2.7%, a value sufficient for practical use

The Giant Planet Orbiting The Cataclysmic Binary DP Leonis

Planets orbiting post-common envelope binaries provide fundamental information on planet formation and evolution, especially for the yet nearly unexplored class of circumbinary planets. We searched for such planets in DP Leo, an eclipsing short-period binary, which shows long-term eclipse-time variations. Using published, reanalysed, and new mid-eclipse times of the white dwarf in DP Leo, obtained between 1979 and 2010, we find agreement with the light-travel-time effect produced by a third body in an elliptical orbit. In particular, the measured binary period in 2009/2010 and the implied radial velocity coincide with the values predicted for the motion of the binary and the third body around the common center of mass. The orbital period, semi-major axis, and eccentricity of the third body are P-c = 28.0 +/- 2.0 yrs, a(c) = 8.2 +/- 0.4 AU, and e(c) = 0.39 +/- 0.13. Its mass of sin i(c) M-c = 6.1 +/- 0.5 M-Jup qualifies it as a giant planet. It formed either as a first generation object in a protoplanetary disk around the original binary or as a second generation object in a disk formed in the common envelope shed by the progenitor of the white dwarf. Even a third generation origin in matter lost from the present accreting binary can not be entirely excluded. We searched for, but found no evidence for a fourth body.Alfried Krupp von Bohlen und Halbach-FoundationGeorg-August-Universität GöttingenUniversity of Texas at AustinSouth African Astronomical ObservatoryAstronom