Background: The effectiveness of intravenous tissue plasminogen activator (IV tPA) in patients with large-vessel occlusion (LVO) receiving endovascular treatment (EVT) for acute ischemic stroke (AIS) has been questioned. We investigated IV tPA effectiveness in real-world AIS patients, including those with intracranial LVO receiving EVT. Methods: We identified patients with AIS who presented to hospital with National Institutes of Health Stroke Scale ≥4 within 8 hours of symptom onset from the institutional stroke registry. The association of IV tPA use with effectiveness and safety outcomes was analyzed in overall enrolled AIS patients; LVO patients; and patients treated with EVT. The effect of IV tPA was assessed using multiple logistic regression. Results: Among the 654 patients meeting study entry criteria, 238 (36.4%) received IV tPA and 416 (63.6%) did not. Multiple logistic regression analysis and shift analysis revealed IV tPA was associated with improved outcomes in overall enrolled AIS population, LVO, and EVT-treated subgroups. Among EVT-treated patients, IV tPA was associated with higher likelihood of ambulatory or better outcome (modified Rankin Scale 0–3) with odds ratio of 1.95 (P=0.03). Conclusions In this real-world study, IV tPA use was associated with improved outcomes for patients with AIS, including among LVO patients treated and not treated with EVT, in the contemporary mechanical thrombectomy era.

A 13-year-old neutered male Poodle dog was presented with a third eyelid mass in the left eye. The dog had undergone local resection of the mass about a year prior in a private practice. On cytological examination, the mass was diagnosed as adenocarcinoma. Although lung and lymph node metastases were suspected, based upon the computed tomographic results, exenteration was performed to relieve chronic pain and to improve the dog's quality of life. Exenteration carried a good prognosis with no tumor recurrence until 1 year and 10 months after surgery, when local recurrence occurred near the left zygomatic arch.

A 13-year-old neutered male Poodle dog was presented with a third eyelid mass in the left eye. The dog had undergone local resection of the mass about a year prior in a private practice. On cytological examination, the mass was diagnosed as adenocarcinoma. Although lung and lymph node metastases were suspected, based upon the computed tomographic results, exenteration was performed to relieve chronic pain and to improve the dog's quality of life. Exenteration carried a good prognosis with no tumor recurrence until 1 year and 10 months after surgery, when local recurrence occurred near the left zygomatic arch.
Adenocarcinoma ; Adolescent ; Animals ; Chronic Pain ; Dogs ; Humans ; Lung ; Lymph Nodes ; Male ; Neoplasm Metastasis ; Nictitating Membrane ; Orbit ; Private Practice ; Prognosis ; Quality of Life ; Recurrence ; Zygoma