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(Circulation. 1995;92:2026-2028.)
© 1995 American Heart Association, Inc.

Articles

New Standard for Success of Thrombolytic Therapy

An Earnest Proposal

James S. Forrester, MD

From Cedars-Sinai Medical Center, Los Angeles, Calif.

Correspondence to James S. Forrester, MD, Division of Cardiology, Cedars-Sinai Medical Center, 8700 Beverly Blvd, Los Angeles, CA 90048.

Key Words: Editorials • angioplasty • myocardial infarction • peripheral vascular disease • plasminogen activators

	Introduction

 
Some years ago, the late Lewis Thomas made "an earnest proposal"¹ : that the world powers agree to restrain computers from launching nuclear warheads until we acquire a really complete set of information describing at least one living creature. "When this is done," he wrote, "and the information programmed into all our computers, I for one would be willing to take my chances." As the subject for this investigation, he proposes the simple protozoan, Myxotricha paradoxa, a fast-swimming inhabitant of the intestine of the Australian termite. But it turns out that the myxotricha is not as simple as it appears. Under the scrutiny of the electron microscope, its flagella, which beat in synchrony to propel it through its watery world, are perfectly spaced, fully formed spirochetes. Myxotricha's oval cytoplasmic organelles, engorged with undigested wood, are bacteria contributing enzymes to break down cellulose, and its centrioles are a third set of separate creatures. At the end of a decade of collecting information, Thomas envisions the moment when science's remarkable discoveries about myxotricha are fed into the computers. After a few seconds of whirring, there comes a neat and speedily printed message: "Request more data. How are spirochetes attached? Do not fire!"

So it seems to be with treatment of acute thrombotic occlusion of blood vessels: there is never quite enough information. In this issue of Circulation, Vanderschueren et al² describe recanalization of thrombosed peripheral arteries with staphylokinase, called STAR, a proteolytic enzyme produced by certain strains of Staphylococcus aureus. . . [Full Text of this Article]

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