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

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: 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*

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