No abstract available.
Anaphylaxis* ; Aprotinin* ; Thoracic Surgery*

No abstract available.
Aprotinin* ; Heart* ; Hemostasis* ; Thoracic Surgery*

In two patients with chronic corneal ulcer, resistant to conventional therapy, analysis of tear fluid and observation of the corneal state were performed before and after treatment using autologous fibronectin and aprotinin for the purpose of estimating the effect of treatment. The plasmin activity which was revealed before treatment was absent after treatment, and corneal reepithelialization was observed after treatment. We think the combined therapy with autologous fibronectin and aprotinin may be effective for the treatment of therapy-resistant chronic corneal ulcer.
Aprotinin* ; Corneal Ulcer* ; Fibrinolysin ; Fibronectins* ; Humans

In two patients with chronic corneal ulcer, resistant to conventional therapy, analysis of tear fluid and observation of the corneal state were performed before and after treatment using autologous fibronectin and aprotinin for the purpose of estimating the effect of treatment. The plasmin activity which was revealed before treatment was absent after treatment, and corneal reepithelialization was observed after treatment. We think the combined therapy with autologous fibronectin and aprotinin may be effective for the treatment of therapy-resistant chronic corneal ulcer.
Aprotinin* ; Corneal Ulcer* ; Fibrinolysin ; Fibronectins* ; Humans

Resistance to heparin therapy during cadiopulmonary bypass(CPB) is infrequent but can result in potentially life-threatening event. The precise etiology of the heparin resistance remains unknown. Clearly, the most predictive risk factor is a history of previous heparin exposure. Assessment of the clinical heparin effect, by determination of the activated clotting time(ACT), identifies those patients with heparin resistance. The potential risk of suboptimal anticoagulation is circumvented by the administration of additional heparin. High dose aprotinin suppress the activation of intrinsic coagulation pathway through surface activators inhibition, as documented by increases in the ACTs during CPB. Such effect of aprotinin on ACT, which can allow heparin-resistant patients to overestimate heparinization. We report a case of pump failure due to inappropriate heparinization in heparin-resistant patient.
Aprotinin ; Cardiopulmonary Bypass ; Heart ; Heparin* ; Humans ; Risk Factors

BACKGROUND: High-dose aprotinin has been reported to enhance the anticoagulant effects of heparin during cardiopulmonary bypass ; hence, som authors have advocated reducing the dose of heparin in patients treated with aprotinin. MATERIAL AND METHOD: The ACT was measured before, during and after cardiopulmonary bypass, with Hemochron 801 system using two activators of celite (C-ACT) and kaolin (K-ACT) as surface activator. From June, 1996 to February, 1997, 22 adult patients who were scheduled for elective operation were enrolled in this study. RESULT: The ACT without heparin did not differ between C-ACT and K-ACT. At 30 minutes after anticoagulation with heparin and cardiopulmonary bypass, the average C-ACT was 928+/-400 s; K-ACT was 572+/-159s (p<0.05). After administration of protamine, C-ACT was 137+/-26 s; K-ACT was 139+/-28s, which were not statistically significant. CONCLUSION: Our results showed that the significant increase in the ACT during heparin-induced anticoagulation in the presence of aprotinin was due to the use of celite as surface activator, rather than due to enhanced anticoagulation of heparin by aprotinin. We conclude that the ACT measured with kaolin provides better monitoring of cardiac surgical patients treated with high dose aprotinin than does the ACT measured with celite. The patients treated with aprotinin should receive the usual doses of heparin.
Adult ; Aprotinin* ; Cardiopulmonary Bypass ; Diatomaceous Earth* ; Heparin ; Humans ; Kaolin*

OBJECTIVE: To determine the therapeutic effect of paratendinous injection of aprotinin, a polyvalent inhibitor of inflammatory proteolytic enzyme, in patients with shoulder tendinitis. METHOD: Thirty patients with shoulder tendinitis diagnosed with ultrasonography were included. Patients were assigned to one of two groups at random to receive paratendinous injection. One group received a paratendinous aprotinin 1.5 ml and 1% lidocaine 2 ml injection of shoulder2~5 times at 1 week apart. The other group received a paratendinous injection one time with mixture of triamcinolone 40 mg and 1% lidocaine 2.5 ml. The effect of treatment was assessed with the visual analogue scale (VAS), and the patients' life activities were assessed with the Western Ontario rotator cuff(WORC) index. RESULTS: The VAS of the two groups showed improvement at 1 week (aprotinin group: 2.9+/-0.7, triamcinolone group: 3.7+/-1.2) and 4 weeks (aprotinin group: 2.1+/-1.0, triamcinolone group: 2.4+/-1.0) after injection compared with pre- injection status (aprotinin group: 8.6+/-1.3, triamcinolone group: 8.2+/-1.3)(p<0.01) and the WORC index of the two groups showed improvement at 1 week (aprotinin group: 36.5+/-7.8, triamcinolone group: 53.2+/-12.3) and 4 weeks (aprotinin group: 33.4+/-6.2, triamcinolone group: 31.4+/-8.8) after injection compared with pre-injection status (aprotinin group: 116.2+/-29.1, triamcinolone group: 123.5+/-37.0)(p< 0.01). There was no significant difference in the improvement of the VAS scores and WORC index between the two groups. CONCLUSION: The short term effect of paratendinous aprotinin injection in patients with shoulder tendinitis was as good as triamcinolone injection, although more frequent injection was necessary.
Aprotinin ; Humans ; Lidocaine ; Ontario ; Rotator Cuff ; Shoulder ; Tendinopathy ; Triamcinolone

BACKGROUND: Activated coagulation time (ACT) is commonly used to guide heparin and protamine dosing during cardiovascular surgery. There are many factors that influence the ACT such as time of test, hemodilution, temperature, aprotinin and etc. We considered the other factor that influence the ACT, the route of blood sample. METHODS: This study included 40 patients who were scheduled for cardiac surgery. Whole blood was sampled through arterial and central venous line at 10 minutes after surgical incision and heparin administration. The ACT was measured with Hemochron 801 blood coagulation timer with 12 mg of celite surface activator. RESULTS: At 10 minutes after surgical incision and heparin administration, arterial blood and venous blood ACTs were 127 20, 537 214 seconds and 118 18, 496 145 seconds respectively (p<0.05). CONCLUSIONS: We conclude that the venous blood ACT is more less than arterial blood ACT during cardiovascular surgery.
Aprotinin ; Blood Coagulation ; Diatomaceous Earth ; Heart* ; Hemodilution ; Heparin ; Humans ; Thoracic Surgery*

BACKGROUND: The patients with end-staged liver failure are subjected to various and complex coagulopathies during liver transplantation. Particularly, fibrinolysis can occur preoperatively and is more prominent and aggravated right after reperfusion to the donated liver. It becomes the main cause of bleeding intraoperatively and postoperatively. We examined the effect of low dose aprotinin on the fibrinolysis and the transfusion amount of the packed red cell during operation. METHODS: We divided the patients into an experimental group, administrating aprotinin (n = 20) and a control group, administrating same volume of normal saline (n = 28). Heparinase-guided thromboelastograph (h-TEG) of preanhepatic 60 minutes was done as basic value. Then we administrated 1 million KIU aprotinin for 20 minutes and infused 0.25 million KIU /hr aprotinin for 3 hours of preanhepatic period in the experimental group. Just after the reperfusion to donated liver, another h-TEG of postanhepatic 10 minutes was done. We obtained CL 60 (clot lysis 60) and MA (maximum amplitude) among the TEG parameters and counted the total number of packed red cell transfused before and after the reperfusion period. RESULTS: The results showed that the experimental group had significantly higher value of CL 60 and MA in the h-TEG of postanhepatic 10 minutes and lower amount of packed red cell transfusion during the period after the reperfusion. CONCLUSIONS: The administration of low dose aprotinin during preanhepatic period reduced the activation of fibrinolysis and the total packed red blood cell transfusion after the reperfusion in liver transplantation.
Aprotinin* ; Erythrocyte Transfusion ; Fibrinolysis* ; Hemorrhage ; Humans ; Liver Failure ; Liver Transplantation* ; Liver* ; Reperfusion

BACKGROUND: The efficacy of the hemostasis of prophylactic aprotinin after cardiac valve replacement was evaluated from January 1994 to December 1996 at Pusan National University Hospital. MATERIAL AND METHOD: In a randomized study, 20 patients received aprotinin(2x106 KIU as a loading dose for 30 minutes after anesthesia, 1x106 KIU for priming and 5x105 KIU/hr as a maintenance dose from the completion of loading dose till skin closure) and another 20 untreated patients served as controls. RESULT: Aprotinin produced a significant reduction in postoperative blood loss compared with controls and significantly decreased total exposure to allogenic blood products compared with the control group(p<0.05). CONCLUSION: We conclude that aprotinin effectively reduces postoperative blood loss and trasfusion in patient undergoing cardiac valve replacement.
Anesthesia ; Aprotinin* ; Busan ; Heart Valves ; Heart* ; Hemostasis* ; Humans ; Postoperative Hemorrhage ; Skin ; Thoracic Surgery*