[Brain attack in Japan, now and future].
In Japan, all of the stroke center hospital equipped by high level diagnostic systems including MRI. Number of MRI is twice as that of U.S.A. Therefore, we can perform correct and effective treatment for ultra-acute cerebral infarction if rt-PA is permitted to clinical use for cerebral infarction. We are making Japan Standard Stroke Registry Study (JSSR Study) now, and already registered 2,740 acute stroke cases in 25 hospitals. Atherothrombotic embolism (artery to artery embolism) was found in 16.5% of the all atherothrombotic infarction. It suggests that diagnostic accuracy of our database is high level. Concerning with ultra acute thrombolysis, about 10,000 stroke patients per year are estimated to be treatable with rt-PA in Japan. Yamaguchi's study for acute cerebral infarction showed intra-arterial thrombolytic therapy using urokinase was significantly effective. Our JSSR Study also showed effectiveness of thrombolytic therapy using rt-PA or high dose urokinase in the patients with cerebral infarction treated within 6 hours. Therapeutic time windows for acute cerebral infarction using rt-PA is expected to be more longer by the newly developed free radical scavenger (edarabin). We must create evidence based medicine for Japanese stroke patients based on database system (JSSR).
Kobayashi
S
S
Department of Internal Medicine III, Shimane Medical University.
D004630:Emergencies; D019317:Evidence-Based Medicine; D005544:Forecasting; D006801:Humans; D007564:Japan; D008279:Magnetic Resonance Imaging; D011994:Recombinant Proteins; D020521:Stroke / Q000175:diagnosis* / Q000188:drug therapy*; D015912:Thrombolytic Therapy / Q000639:trends; D013997:Time Factors; D010959:Tissue Plasminogen Activator / Q000008:administration & dosage; D014568:Urokinase-Type Plasminogen Activator / Q000008:administration & dosage
D011994:Recombinant Proteins; D010959:Tissue Plasminogen Activator; D014568:Urokinase-Type Plasminogen Activator