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

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*

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

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

Recently, many works to treat chronic corneal ulcer have been progressed. It has been reported that the Aprotinin, one of them, is serine protease inhibitor and is useful to treat therapy-resistant chronic corneal ulcer because it decreases the plasmin level in tear fluid that was increased in corneal ulcer. We performed this study to evaluate the effect of Aprotinin to the reepithelization of cornea according to its concentration. We made corneal burn in rabbits and instilled topical antibiotics and Aprotinin 500u/ml and 200u/ml, four times a day. After instillation, we compared the process of corneal epithelial wound healing, according to the time interval, clinically and histopathologically in each group. As a result, wound healing of cornea treated with combination of antibiotics and Aprotinin was delayed rather than that treated with antibiotics only. And combination therapy with Aprotinin 500n/ml is more effective than with Aprotinin 2000n/ml. This data suggests that high concentration of Aprotinin alone is not helpful to tresat the therapyresistant chronic corneal ulcer.
Anti-Bacterial Agents ; Aprotinin* ; Burns* ; Cornea ; Corneal Ulcer ; Fibrinolysin ; Rabbits* ; Serine Proteases ; Wound Healing

Jehovah,s Witnesses who require operation represent a challenge to the physician because of the patient,s refusal to accept blood transfusion. An orthotopic heart transplantation was succesfully performed in a 40-year old Jehovah,s Witness without use of any blood product. During the operation, cell saver was used for shed blood and aprotinin was administered intravenously. The use of blood conserving methods, meticulous operative technique and brisk postoperative diuresis has added to the efficacy of heart transplantation in this patient. Total postoperative drainage was 860 ml and the lowest hemoglobin level was 11.8 g%. The patient recovered uneventfully and discharged on the 60th postoperative day.
Adult ; Anesthesia* ; Aprotinin ; Blood Transfusion ; Disulfiram ; Diuresis ; Drainage ; Heart Transplantation* ; Heart* ; Humans ; Transplantation

BACKGROUND: Activated clotting time (ACT) and thromboelastography (TEG) are generally accepted as adequate measures of the coagulation system for monitoring of the cardiac system. Aprotinin is alleged to affect ACT and TEG. We performed this study to see if the determination of ACT and TEG can provide a basis for the assessment of coagulation and the prediction of postoperative hemorrhage in cardiac surgical patients treated with aprotinin. METHODS: Twenty patients undergoing cardiac operation were studied. The values (control) of ACT and TEG were obtained just after induction of anesthesia. Each patient was fully heparinized and received aprotinin, 2,000,000 KIU added to the prime solution. At the end of the procedure, protamine, 3 mg/kg was given for the neutralization of heparin. Measurement of ACT and TEG were made 20 minutes after the administration of protamine, at the end of surgery, and 1 hour after transfer to ICU. The values were compared with the amount of hemorrage collected by chest tubes 1 hour, 2 hours and 8 hours after transferred to ICU. RESULTS: The values of ACT at 20 minutes after protamine administration and at the end of surgery significantly (P < 0.05) increased compared with the values of control, but the values in ICU did not show significant change. All values of TEG significantly (P < 0.05) changed compared with the values of control. No single variable of ACT and TEG showed correlation with the amount of hemorrhage through chest tubing postoperatively. CONCLUSIONS: The results indicate that neither ACT nor TEG predict the amount of postperative hemorrhage in aprotinin-treated patients having cardiac surgery. Therefore the TEG results should be interpreted cautiously because of the high rate of unreliable results.
Anesthesia ; Aprotinin* ; Chest Tubes ; Hemorrhage* ; Heparin ; Humans ; Postoperative Hemorrhage ; Thoracic Surgery ; Thorax ; Thrombelastography*