Low-dose administration of protamine, based on a heparin-protamine titration method, restores not only the blood coagulation but also the platelet responses to thrombin and attenuates platelet alpha-granule secretion during heparin neutralization. Overdose of protamine activates platelets and may predispose patients to excessive bleeding after cardiac surgery.
Aprotinin has indirect effects to inhibit platelet activation, and this may partly explain the reduction of blood loss during cardiac surgery. To prevent the adverse effects, a single and minimal use of aprotinin is important. The results of in vivo and in vitro studies suggest that platelet preservation was demonstrated by the lower concentration of aprotinin (1.0 x 10(6) KIU per patient or 10 KIU/mL) compared with the concentration that inhibits plasma fibrinolysis.
Objective: Penetrating atherosclerotic ulcer (PAU) of the aorta is defined as an atherosclerotic lesion with ulceration of the aortic intima and media and rupture of the internal elastic lamina. PAU induced aortic dissection, aortic rupture, and secular aortic aneurysm and typically occurs in elderly hypertensive patients with severe atherosclerosis. Although it has been reported that atherosclerosis similarly occurs in the abdominal aorta, its natural history and treatment are still unclear. This study investigated the clinical features, natural history, and treatment of PAU of the abdominal aorta.
The purpose of this study was to eliminate fluid dynamic causes of thrombus formation for the monopivot magnetic suspension centrifugal pump under development with the aid of flow visualization as an indirect measurement tool for animal experiments. The formation of thrombus observed in early animal experiments was successfully overcome by combining the multiple washout holes at the center into a single hole, optimizing the hole diameter, and eliminating the pivot gap. Flow visualization was used to optimize the washout hole diameter influencing the flow around the pivot. In animal experiments flow visualization showed that the contours of thrombus corresponded to shear rates of 300 s(-1) or 1300-1700 s(-1). It was found that flow visualization is a useful technique to predict locations where low shear thrombi form and to optimize the pump design in the development stage.
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