Background: Standard treatment for pleural infection includes of drainage and antibiotics. Chest tube drainage often fails if the fluid is loculated by fibrinous adhesions. Intrapleural fibrinolysis may facilitate pleural drainage. Objective: To evaluate the role of Streptokinase (STK) in the treatment of empyema and exudative pleural effusions. Subjects and method: A study included 34 patients (21 patients with exudative pleural effusions, 13 patients with empyema), aged 15-77 years. All patients received intrapleural STK daily with dose of 300.0000-500.000 UI for empyema and 300.000 UI for exudative pleural effusions. Response was assessed by clinical outcome, pleural fluid drainage, chest radiography, pleural ultrasound. Results: Mean pleural fluid drainage after STK instillation was higher in all patients. Pleural fluid drainage was 640 \xb1 494 ml before STK instillation and 823 \xb1 755 ml after STK instillation for empyema; 765 \xb1 691 ml before STK instillation and 1,033 \xb1 757 ml after STK instillation for exudative pleural effusions. The success rate of clinical outcome was 100%. Only 2 patients required decortications. Fever occurred in 3 patients (8.8%) and allergy in 1 patient (3%). Conclusions: Intrapleural STK was safe and effective in the treatment of empyema and exudative pleural effusions. STK prevents pleural adhesions and reduces the risks for surgery.
Streptokinase/ therapeutic use ; Empyema ; Pleural/therapy ; Pleural Effusion/ therapy

Fibrinolytic Agents ; therapeutic use ; Humans ; Lung Neoplasms ; complications ; Mesothelioma ; complications ; Pleural Effusion, Malignant ; drug therapy ; Streptokinase ; therapeutic use

With the development of the research on biotechnology and modern pharmacy, the application of enzyme drugs have grown rapidly and enzyme drugs have become an important branch of biopharmaceutics. In this article, some new varieties of therapeutic enzymes, enzyme targets, mechanisms and new technologies of application in therapeutic enzymes were reviewed, and the direction of development of therapeutic enzymes were discussed.
Adenosine Deaminase ; genetics ; therapeutic use ; Antineoplastic Agents ; therapeutic use ; Enzyme Replacement Therapy ; methods ; Fibrinolytic Agents ; therapeutic use ; Protein C ; genetics ; therapeutic use ; RNA, Catalytic ; genetics ; therapeutic use ; Streptokinase ; genetics ; therapeutic use ; Urokinase-Type Plasminogen Activator ; genetics ; therapeutic use

OBJECTIVETo analyze the clinical features of patients with acute myocardial infarction underwent successful thrombolytic therapy post cardiopulmonary resuscitation.

METHODSThis retrospective analysis included 65 patients with acute myocardial infarction underwent successful intravenous thrombolysis post cardiopulmonary resuscitation. The cases were collected from Chinese Journal Full-text Database from 1996 to 2006, only patients met the recanalization criteria of coronary artery were included.

RESULTSMost of the patients were male (93.8%, 61/65) and aged less than 65 years (81.5%, 53/65). Cardiopulmonary resuscitation was performed within 5 min after cardiac arrest in 63 patients (96.9%). Defibrillation was performed 3.2 times per patient, chest compression in 52 patients (80.0%) and tracheal intubation in 21 patients (32.3%). The restoration time of spontaneous circulation were achieved within 10 min in 36 cases (55.4%), between 11 - 30 min in 19 cases (29.2%)and between 31 - 107 min in 10 cases (15.4%). Thrombolysis agents (urokinase, recombinant streptokinase or recombinant tissue-type plasminogen activator) were given intravenously at 172 +/- 92 min after acute myocardial infarction. Mild hemorrhage was seen in 12 cases (18.5%) and there was no report on severe hemorrhage event. The hemorrhage incidence tended to be higher than that of reported large Chinese thrombolysis trials (11.1% - 15.1%, P > 0.05).

CONCLUSIONThrombolytic therapy was relatively safe and effective for those middle-aged male AMI patients received rapid cardiopulmonary resuscitation (< 5 min after cardiac arrest) and with shorter spontaneous circulation restoration time (<30 min).

Adult ; Aged ; Aged, 80 and over ; Cardiopulmonary Resuscitation ; Female ; Fibrinolytic Agents ; therapeutic use ; Humans ; Male ; Middle Aged ; Myocardial Infarction ; drug therapy ; therapy ; Streptokinase ; therapeutic use ; Thrombolytic Therapy ; methods