Background and Purpose-In acute ischemic stroke, thrombolytic treatment with recombinant tissue plasminogen activator (rtPA) is limited by a concomitant activation of the coagulatory system, leading to incomplete or delayed reperfusion, microcirculatory disturbances, or even repeated vessel occlusions. Our pilot study sought to assess the therapeutic potential of a new treatment strategy combining rtPA at reduced dosages with a platelet glycoprotein IIb/IIIa (GPIIb/IIIa) inhibitory agent in acute middle cerebral artery occlusion. Methods-Nineteen patients suffering from acute middle cerebral artery occlusion (Thrombolysis in Myocardial Infarction[TIMI] flow grade 0 to 1) underwent combined intravenous thrombolytic treatment using rtPA at reduced dosages and the GPIIb/IIIa antagonist tirofiban. Stroke MRI (diffusion-and perfusion-weighted imaging) and MR angiography were performed at baseline and between days 1 and 2 after treatment. Clinical scores (National Institutes of Health Stroke Scale and modified Rankin Scale) were assessed at baseline and after 1 week. Results-Middle cerebral artery recanalization (TIMI flow grade 2 and 3) occurred in 13 of 19 patients (68%). The ischemic lesion on follow-up MRI was significantly smaller in patients with recanalization compared with those without recanalization (Pϭ0.001). Only patients with recanalization improved neurologically (PϽ0.001). Because no symptomatic hemorrhage was observed, the power of our study to detect a symptomatic bleeding rate of Ն8% was at least 80%. Conclusions-Combined

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Steam oxidation has become an important issue for steam power plants as operating temperatures increase from the current 550 to 600-650 8C. For the last 10 years several groups have been carrying out steam oxidation testing of both uncoated substrates and coatings in the laboratory. On the other hand, field testing results are very scarce. In this paper, a comparison of laboratory steam oxidation testing with field test results carried out by Alstom at the Kraftwerk Westfalen power station located in Hamm, Germany will be presented. Both slurry deposited aluminide coatings and uncoated P92 steel have been included in the study. Under steam (atmospheric pressure) and isothermal conditions in the laboratory at 650 8C, spallation of oxides formed on ferritic steels occurs after significantly longer time when compared to exposure to real operating conditions. Oxide spallation results in serious damage in steam power plants by obstructing heat exchanger tubes, erosion of valves and turbine blades, etc. Moreover, the thickness of the oxide scales formed under field testing conditions is significantly higher after similar exposure. On the other hand, aluminide coated P92, which exhibit thickness through cracks, have shown to be stable in the laboratory for up to 60 000 h at 650 8C under steam, without evidence of crack propagation. However, field test results indicate that some degree of crack propagation occurs but without causing substrate attack up to 21 700 h of exposure. Moreover, the aluminium oxide observed in both laboratory and field tested specimens is different.

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