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

The effects of the topically applied antibiotics and Aprotinin were evaluated in the experimentally induced pseudomonas aeruginosa keratitis in rabbits. 40 albino rabbits were used for this study and were divided into 8 groups according to the treatment protocols as follows: Aprotinin 40u/ml, 1,OOOu/ml, 1O,000u/ml, antibiotics (Ciprofloxacin and Tobramycin), and antibiotics and Aprotinin combined-treated group. The drugs were instilled in the rabbits, cornea 6 times per day for 2 weeks. The clinical evaluation was performed using a hand-held slit lamp every day. For the histopathologic examination, we enucleated every samples at different time intervals and prepared specimens for light microscope. The results were Aprotinin-treated group showed progression of ulcer infiltrates regardless of its concentrations. There was a statistically significant difference between the antibiotics-treated group and the control group (p<0.05). However, the combination of Aprotinin and antibiotics were not able to gain statistical significance when compare with antibiotics alone (p>0.05). There was no clinical and histopathological differences in the rabbit cornea between ciprofloxacin and tobramycin treated group (p>0.05).
Anti-Bacterial Agents* ; Aprotinin* ; Ciprofloxacin ; Clinical Protocols ; Cornea ; Keratitis ; Pseudomonas aeruginosa ; Pseudomonas* ; Rabbits ; Tobramycin ; Ulcer

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: Aprotinin and tranexamic acid are commonly used antifibrinolytics during liver transplantation, or cardiac surgery. However, it is not clear which drug is more effective to ameliorate the fibrinolysis. The aim of the study was to investigate the antifibrinolytic effect of both drugs at previously reported blood concentration and dose. METHODS: After inducing fibrinolysis by administering recombinant tissue plasminogen activator to rabbits, we checked the in vitro and in vivo antifibrinolytic effects at previously reported blood concentration and dose, and determined the minimum antifibrinolytic blood concentration. The previously reported blood concentration was 200 KIU/ml for aprotinin and 10 mcg/ml for tranexamic acid, and the previously reported dose was 4 mg/kg bolus plus 1 mg/kg/hr infusion for aprotinin and 10 mg/kg bolus plus 1 mg/kg/hr for tranexamic acid. RESULTS: In vitro experiment, there was effective antifibrinolytic action at previously reported blood concentration of aprotinin and the minimum antifibrinolytic blood concentration was 40 KIU/ml. For tranexamic acid, there was no antifibrinolytic action at previously reported blood concentration and the minimum antifibrinolytic blood concentration was 100 mcg/ml. In vivo experiment, there was antifibrinolytic action at previously reported dose of aprotinin and the minimum antifibrinolytic dose was 60% of previously reported dose. For tranexamic acid, there was no antifibrinolytic action at previously reported dose and the minimum antifibrinolytic dose was 10 times previously reported dose. CONCLUSION: The previously reported blood concentration and dose of aprotinin were greater and those of tranexamic acid were less than the minimum antifibrinolytic blood concentration and dose.
Antifibrinolytic Agents ; Aprotinin* ; Fibrinolysis ; Liver Transplantation ; Rabbits* ; Thoracic Surgery ; Tissue Plasminogen Activator ; Tranexamic Acid*