Ulinastatin attenuates reperfusion injury in the isolated blood-perfused rabbit heart Zhi-Li Cao, MD, Yukio Okazaki, MD, Kozo Naito, MD, Tetsuya Ueno,

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Ulinastatin attenuates reperfusion injury in the isolated blood-perfused rabbit heart Zhi-Li Cao, MD, Yukio Okazaki, MD, Kozo Naito, MD, Tetsuya Ueno, MD, Masafumi Natsuaki, MD, Tsuyoshi Itoh, MD The Annals of Thoracic Surgery Volume 69, Issue 4, Pages 1121-1126 (April 2000) DOI: 10.1016/S0003-4975(99)01433-2

Fig 1 Modified Langendorff column used. Arterial blood from the support animal was used to perfuse the isolated heart. The height of the column was set at 80 cm H2O. The Annals of Thoracic Surgery 2000 69, 1121-1126DOI: (10.1016/S0003-4975(99)01433-2)

Fig 2 Percentage recoveries of developed pressure during reperfusion after 4 hours of cardioplegic arrest. ∗p < 0.05 versus control; ∗∗p < 0.001 versus control; ∗∗∗p < 0.05 versus group U-1. (Control = no ulinastatin; U-1 = single dose of ulinastatin (15,000 U/kg) administered just before reperfusion began; U-2 = ulinastatin (15,000 U/kg) administered twice, once at the beginning of the extracorporeal circulation (before ischemia) and once just before reperfusion began.) The Annals of Thoracic Surgery 2000 69, 1121-1126DOI: (10.1016/S0003-4975(99)01433-2)

Fig 3 Percentage recovery of rate of developed pressure (dp/dt) during reperfusion after 4 hours of cardioplegic arrest. ∗p < 0.05 versus control; ∗∗p < 0.01 versus control; ∗∗∗p < 0.05 versus group U-1. Abbreviations as in Figure 2. The Annals of Thoracic Surgery 2000 69, 1121-1126DOI: (10.1016/S0003-4975(99)01433-2)

Fig 4 Percentage recovery of coronary flow during reperfusion after 4 hours of cardioplegic arrest. ∗p < 0.05 versus control. Abbreviations as in Figure 2. The Annals of Thoracic Surgery 2000 69, 1121-1126DOI: (10.1016/S0003-4975(99)01433-2)

Fig 5 Scanning electron micrograph of the coronary endothelium after reperfusion with blood for 60 minutes after 4 hours of cardioplegic arrest, without ulinastatin (control). Many endothelial cells were delaminated. Blood cells were deposited not only in the delaminated area but also on the damaged endothelial cells. (A) original magnification ×350. (B) original magnification ×1,500. The Annals of Thoracic Surgery 2000 69, 1121-1126DOI: (10.1016/S0003-4975(99)01433-2)

Fig. 6 Scanning electron micrograph of the coronary endothelium after reperfusion with blood for 60 minutes after 4 hours of cardioplegic arrest with ulinastatin administration (group U-2). Endothelial delamination was reduced compared with controls. Fewer platelets were deposited than in the controls, and platelets were only seen in the delaminated area. (A) original magnification ×350. (B) original magnification ×1,500. The Annals of Thoracic Surgery 2000 69, 1121-1126DOI: (10.1016/S0003-4975(99)01433-2)