Access to paid content on this site is currently suspended due to excessive activity being detected from your IP address Please contact the publisher to request reinstatement.
We're unable to sign you in at this time. Please try again in a few minutes.
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
Article |

Urokinase in the Management of Acute Arterial and Venous Thrombosis

Donald Silver, MD
Arch Surg. 1968;97(6):910-916. doi:10.1001/archsurg.1968.01340060088009.
Text Size: A A A
Published online


ALTHOUGH fibrinolysis was recognized by Denis in 18381 and Dastre used the term "fibrinolysis" in 1893,2 it was not until 1933, when Tillet and Garner3 demonstrated that filtrates of strains of β-hemolytic strptococci were capable of liquifying human fibrin clots, that induced thrombolysis became a possibility. In recent years, a variety of proteolytic enzymes, plasminogen activators, and plasmin (as well as mixtures of these agents) have been used to induce thrombolysis with unpredictable results and frequent undesirable reactions. A fibrinolytic agent which acted predictably and was nontoxic was needed.

The fibrinolytic activity of urine was noted by Macfarlane and Pilling in 1947.4 Subsequent investigators have shown that the fibrinolytic activity of urine is due to an activator (urokinase) of plasminogen,5 that the activator can be extracted in a relatively pure state,6 and that the activator is nontoxic and nonantigenic. This pedigree suggested that urokinase


Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

First Page Preview

View Large
First page PDF preview





Also Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Please click the checkbox indicating that you have read the full article in order to submit your answers.
Your answers have been saved for later.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.


Some tools below are only available to our subscribers or users with an online account.

0 Citations

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

Related Content

Customize your page view by dragging & repositioning the boxes below.