• Title/Summary/Keyword: Infusion time

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Clinical Study of Topotecan as Second-Line Treatment in Small Cell Lung Cancer (소세포폐암의 2차요법으로서의 Topotecan의 치료효과)

  • Kim, Hak-Ryul;Yang, Sei-Hoon;Jeong, Eun-Taik
    • Tuberculosis and Respiratory Diseases
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    • v.52 no.3
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    • pp.230-240
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    • 2002
  • Background : The majority of chemotherapy-treated small cell lung cancers(SCLC) patients eventually recur. Although many patients are in excellent physical condition at the time of recurrence, few drugs or drug combinations are capable of effecting a tumor regression in this setting. Topotecan, a topoisomerase I inhibitor, is one of the more widely studied single afents in SCLC. The aim of this study was to determine the response rate, survival and toxicity of topotecan as a second line traeatment SCLC. Materials and Methods : 19 patients with measurable SCLC, progressive during the first line chemotherapy (9 cases) or recurrent after the first line chemotherpy(10 cases), were enrolled in this study. Topotecan was administered as a 30-minute daily infusion at a dose of 1.5mg/$m^2$ for 5 consecutive days, every 3 weeks. Results : The overall response rate was 26.3%(5/19, CR 2, PR 3, SD 3, PD 11). The median survival was 24 weeks. The response rate and survival were poor in the nonresponders during first chemotherapy, those who were refractory to the first chemotherapy(recurrent within 3 months after completion of first chemotherapy) and extensive disease, but the results were not statistically significant. The toxicities were mainly hematologic and anemia grade III 1/90, leukopenia grade III 6/90 IV 4/90, thrombocytopenia grade III 1/90 IV 1/90, vomiting grade III 1/90 of cycles were occurred. There was no treatment-related deaths due to severe myelosuppression. Conclusion : Topotecan can be an active second line chemotherapeutic agent for treating SCLC.

Posttransplantation Lymphoproliferative Disorder after Liver Transplantation in Pediatric Patients: Report from a Single-center Over 21 Years (간 이식 소아에서 발생한 이식 후 림프 증식 질환: 단일 기관에서의 21년 경험)

  • Lee, Jung-Hwa;Ko, Jae-Sung;Seo, Jeong-Kee;Yi, Nam-Joon;Suh, Kyung-Suk;Lee, Kuhn-Uk;Kang, Gyeong-Hoon
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.12 no.2
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    • pp.199-206
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    • 2009
  • Purpose: To analyze the clinical spectrum of posttransplantation lymphoproliferative disorder (PTLD) after liver transplantation in children. Methods: From January 1988 to June 2009, we retrospectively reviewed the medical records of 8 PTLD cases among 148 pediatric patients underwent liver transplantation. The age at transplantation, time of presentation after transplantation, clinical manifestations, histologic diagnosis, results of EBV (Epstein-Barr virus) assessments, managements and outcomes of PTLD were investigated. Results: The prevalence of PTLD in liver transplant pediatric recipients was 5.4% (8 of 148). The mean age of patients was 25.4${\pm}$21.3 months (range 10 to 67 months). Seven of 8 patients (87.5%) underwent liver transplantation before 1 year of age. The common clinical presentations were persistent fever (8 of 8, 100%) and bloody diarrhea (6 of 8, 75%). PTLD was diagnosed with gastrointestinal endoscopic biopsies in five patients and surgical biopsies in three. Histologic findings showed early lesion in three patients, polymorphic in two, and monomorphic in three. Burkitt lymphoma and lymphoblastic lymphoma were found in two of 3 monomorphic patients. Seven of 8 patients were found with EBV-positive. Eight patients were treated with dose reduction of immunosuppressants and infusion of ganciclovir. Rituximab was added to four patients. PTLD were successfully managed in all patients except one who died of sepsis during chemotherapy. Conclusion: Major risk factor of PTLD was to undergo liver transplantation before 1 year of age. Continuous monitoring for EBV viral load and gastrointestinal endoscopic biopsy may be useful to early detection of PTLD.

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Superiority of Modifiled University of Wiscinsin Solution in the Prolonged Preservation of Isolated Rat Heart (적출 쥐 심장의 장시간 보존에 있어서 University of Wisconsin 수정 용액의 우수성)

  • Lee, Jae-Seong;Kim, Song-Myeong;Kim, Gyu-Tae
    • Journal of Chest Surgery
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    • v.26 no.6
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    • pp.427-440
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    • 1993
  • The paucity of donor hearts for transplantation can be remedied by distant heart procurement. Prolonging donor heart preservation is essential for successful clinical cardiac transplantation. Thirty-two isolated rat hearts were perfused with Krebs-Henseleit buffer solution for 15 minutes, arrested and preserved at 4 oC for 4 hours, and then reperfused for 25 minutes. The following three groups were prepared and hemodynamic changes, creatine kinase-MB isoenzyme levels and ultrastructural changes of the myocardium were analysed before and after cardiac arrest. ; Group I : the heart was arrested with the cardioplegic solution [Plegisol, potassium : 16 mM, sodium : 120 mM] and then stored in a solution with ionic compositions of the extracellular fluid [Hartman, potassium : 4 mM, sodium : 130 mM] ; Group II : the heart was arrested with the cardioplegic solution and stored in a solution with ionic compositions of the intracellular fluid [Modified Euro-Collins, potassium : 108 mM, sodium : 10 mM] ; Group III : the heart was arrested with the cardioplegic solution containing adenosine 20 uM, and then stored in a solution with ionic compositions of the intracellular fluid [Modified University of Wisconsin solution, potassium : 119 mM, sodium: 23 mM]. Left ventricular developed pressure at 20 minutes of the reperfusion was significantly higher in group III [64.3 $\pm$ 3.12 mmHg, p<0.01] and group II [58.3 $\pm$ 1.55 mmHg, p<0.05] as compared with group I [51.4$\pm$ 2.78 mmHg]. The time to induce cardiac arrest after infusion of cardioplegic solution with adenosine 20 uM [5.3 $\pm$ 0.30 second, p<0.005] was significantly shorter than without adenosine [10.6$\pm$ 0.55 second]. Coronary flow at 20 minutes of the reperfusion was augmented significantly in group III [9.6$\pm$ 0.50 ml/min, p<0.05, p<0.05] as compared with group I [8.0 $\pm$ 0.41 ml/min] and group II [8.1$\pm$ 0.51 ml/min]. Percentage recovery of left ventricular developed pressure at 20 minutes of the reperfusion was significantly higher in group III [94.6$\pm$ 2.51 %, p<0.005] as compared with group II and in group II [83.1 $\pm$ 1.22 %, p<0.005] as compared with group I [69.9 $\pm$ 1.73 %], and also percentage recovery of coronary flow at 20 minutes of the reperfusion was significantly higher in group III [82.3 $\pm$ 3.86 %, p<0.05] as compared with group II [71.4 $\pm$ 3.46 %] but there was no significant difference between group I and group II. Measured level of creatine kinase-MB isoenzyme at 15 minutes of the reperfusion was significantly lower in group III [1.23 $\pm$ 0.16 ng/ml, p<0.025] and group II [1.42$\pm$ 0.10 ng/ml, p<0.05] as compared with group I [1.79 0.14 ng/ml]. In the semiquantitative evaluation of the ultrastructural changes of the myocardium, mitochondrial score was lower in group III [0.7 $\pm$ 0.21] than in group I [3.1$\pm$ 0.28] and group II [1.7 $\pm$ 0.19], and also the other structural score was lower in group III [2.7$\pm$ 0.99] than in group I [7.9 $\pm$ 0.89] and group II [5.0 $\pm$ 1.22]. In conclusion, the solution with ionic compositions of the intracellular fluid is appropriate for prolonged cardiac preservation, and it appears to be better preserving method for distant procurement when the donor heart is rapidly arrested with cardioplegic solution containing adenosine 20 uM, and then stored with Modified University of Wisconsin solution.

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Use of Undiluted Potassium Solution in Intermittent Antegrade Warm Blood Cardioplegia (IAWBC) (간헐적 전방온혈심정지액에서 희석되지 않은 고농도 포타슘의 사용)

  • 백완기;손국희;김영삼;윤용한;김혜숙;임현경;이춘수;김광호;김정택
    • Journal of Chest Surgery
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    • v.37 no.8
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    • pp.660-664
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    • 2004
  • Background: Dilution of blood cardioplegia is not needed in IAWBC as it is in cold blood cardioplegia because it does not aggregate red blood cells on normal body temperature and does not compromise micro coronary circulation. This study was designed to evaluate the safety and efficacy of undiluted potassium solution in IAWBC. Material and Method: Thirty patients who underwent CABG with IAWBC were grouped into dilutedplegia (n=14) and microplegia (n=16). Potassium was delivered conventionally with 4 : 1 delivery kit in the dilutedplegia group. The undiluted potassium was directly connected on the blood of oxygenator in the microplegia group. Result: There were no differences in sex, age, left ventricular ejection fraction, number of grafts, aortic cross clamping time, and the value of perioperative myocardial enzyme between the two groups. There were no perioperative myocardial infarction and hospital mortality. The amount of crystalloid cardioplegia was 1346$\pm$597 mL in dilutedplegia (mean$\pm$standard deviation, and 28$\pm$9 mL in microplegia (p<0.0001). The hematocrit during cardiopulmonary bypass was 21$\pm$4% in dilutedplegia and 24$\pm$3% in microplegia (p>0.05). 11 patients in dilultedplegia received blood transfusion, but 4 patients in microplegia received blood transfusion (p<0.05). The amount of urine and hemofiltration during the operation were more in dilutedplegia (1250$\pm$810 mL, 1689$\pm$548 mL) than in microplegia (959$\pm$410 mL, 1461$\pm$784 mL; p<0.05). Conclusion: The undiluted potassium of IAWBC in CABG operation is a safe, effective technique for myocardial protection to prevent fluid overload, and blood transfusion. There is no need to use the delivery kit.

Results of Concurrent Chemoradiotherapy and Intraluminal Brachytherapy in Esophageal Carcinoma - Retrospective Analysis with Respect to Survival - (식도암에서 동시 항암화학방사선요법과 관내근접치료의 결과 -생존율을 중심으로 한 후향적 분석-)

  • Nam Taek-Keun;Nah Byung-Sik;Chung Woong-Ki;Ahn Sung-Ja;Song Ju-Young
    • Radiation Oncology Journal
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    • v.22 no.1
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    • pp.25-32
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    • 2004
  • Purpose : Evaluate the efficacies and toxicities of concurrent chemoradiotherapy (CCRT), with or without intraluminal brachytherapy (ILB), using a retrospective analysis in esophageal carcinomas with respect to survival. Materials and Methods : From April 1995 to July 2001, a total of 65 patients, diagnosed with an esophageal carcinoma, were treated by CCRT, with 21 also treated by ILB after CCRT. External radiotherapy was peformed using 6 or 10 MV X-rays, with a dose range of $46.8~\69.6$ Gy (median; 59.4). The ILB was peformed using high-dose-rate brachytherapy with Ir-192. The fractionation of ILB was 3 Gy by 4, or 5 Gy by 2 fractions. Cisplatin $(75\;mg/m^2)$ was given on each first day of weeks 1, 5, 9 and 13, and 5-FU $(1,000\;mg/m^2)$ as a continuous infusion for the first 4 days of each course. Results : The median survival time of all patients was 15 months, and the 1, 2 and 3-year survival rates were 55.4, 29.2 and $20.7\%$, respectively. The 2-year survival rates of the patients with and without ILB were 33.3 and $27.3\%$, respectively (p=0.80). The 2-year survival rates of the patients with a complete, partial and no response were 44.1, 13.8 and $0\%$, respectively (p=0.02). The response to treatment was the only significant factor affecting the overall survival from a multivariate analysis. Conclusion : This study has shown that the survival outcomes of CCRT were much better than previous results with radiotherapy alone. However, the addition of ILB after CCRT showed no advantage over that of CCRT alone.

Efficacy of deferoxamine on paraquat poisoning (파라쿼트 중독 환자에서 deferoxamine의 치료 효과)

  • Huh, Jin Won;Jegal, Yangjin;Hong, Sang-Bum;Oh, Yeon Mok;Shim, Tae Sun;Lim, Chae-Man;Lee, Sang Do;Kim, Woo Sung;Kim, Dong Soon;Kim, Won Dong;Koh, Younsuck
    • Tuberculosis and Respiratory Diseases
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    • v.62 no.2
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    • pp.113-118
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    • 2007
  • Background: Paraquat is known to induce oxidant injury that results in multiorgan failure and lung fibrosis. Iron has been considered to play a key role in paraquat-induced oxidant lung injury. This study examined the effect of deferoxamine, an iron-chelating agent, in the treatment of paraquat poisoning. Methods: From September, 2001 to April, 2005, 28 patients with paraquat poisoning who were admitted at a medical intensive care unit of a University-affiliated hospital, were enrolled in this study. Sixteen patients were treated according to the paraquat poisoning treatment guidelines and 12 received an intravenous infusion of deferoxamine in addition to the treatment guidelines. Results: There were no differences between the two groups in terms of age, gender, severity of paraquat poisoning, and the time elapsed from ingestion to presentation at hospital. There was no difference in overall mortality between the two groups but the incidence of respiratory failure in the deferoxamine group was higher than in the conventional group(4/7 versus 0/9, p=0.019). Conclusion: Deferoxamine seems to have no clinical benefit compared with the conventional treatment.

Influence of $TiO_2$ Concentrations and Irradiation Lights on the Photocatalytic Reaction for Inhibiting Growth of Streptococcus mutans ($TiO_2$ 농도 및 여기광에 따른 광촉매 반응이 Streptococcus mutans의 생장에 미치는 영향)

  • Kang, Si-Mook;Lee, Hae-Na;Kim, Hee-Eun;Kim, Baek-Il
    • Journal of dental hygiene science
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    • v.14 no.3
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    • pp.319-324
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    • 2014
  • The aim of this study was to evaluate influences of titanium dioxide ($TiO_2$) concentrations and irradiation times on growth of Streptococcus mutans when irradiated by visible light (405 nm wavelength) and by ultraviolet light (254 nm wavelength). To find the optimal antibacterial concentration of $TiO_2$, 0.01, 0.1, 1.0, and 10.0 mg/ml $TiO_2$ suspension was prepared with sterilized distilled water. S. mutans cultured media was added to $TiO_2$ solution to set the final cell count to $10^4CFU/ml$. The photocatalytic reaction was induced by irradiating 254 nm and 405 nm lights for 10 minutes. To compare the bactericidal activities according to irradiation times, all photocatalytic reaction was carried out with 0.1 mg/ml $TiO_2$ for 0, 10, 20, 30, and 40 minutes with both lights. After the photocatalytic reaction, $100{\mu}m$ of the reaction mixture was immediately plated on brain heart infusion agar. These plates were placed at 5% $CO_2$, $37^{\circ}C$, for 24 hours and the bacterial colonies were counted. All experiments were performed in quintuplicate. One-way ANOVA was used to determine whether there were any significant differences between the $TiO_2$ concentrations or the irradiation times. The most effective concentration of $TiO_2$ for its photocatalytic bactericidal effect on S. mutans was 0.1 mg/ml when irradiated with 254 nm and 405 nm lights. The longer the irradiation time, the bigger the bactericidal effect for both wavelengths. Over 99% of bacteria in the inoculum were killed after irradiation with 254 nm for 20 minutes and with 405 nm for 40 minutes. In conclusion, a photocatalytic reaction of $TiO_2$ induced by visible light of 405 nm constitutes the bactericidal effect on S. mutans.

Pharmacological Studies of Cefoperazone(T-1551) (Cefoperazone(T-1551)의 약리학적 연구)

  • Lim J.K.;Hong S.A.;Park C.W.;Kim M.S.;Suh Y.H.;Shin S.G.;Kim Y.S.;Kim H.W.;Lee J.S.;Chang K.C.;Lee S.K.;Chang K.C.;Kim I.S.
    • The Korean Journal of Pharmacology
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    • v.16 no.2 s.27
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    • pp.55-70
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    • 1980
  • The pharmacological and microbiological studies of Cefoperazone (T-1551, Toyama Chemical Co., Japan) were conducted in vitro and in vivo. The studies included stability and physicochemical characteristics, antimicrobial activity, animal and human pharmacokinetics, animal pharmacodynamics and safety evaluation of Cefoperazone sodium for injection. 1) Stability and physicochemical characteristics. Sodium salt of cefoperazone for injection had a general appearance of white crystalline powder which contained 0.5% water, and of which melting point was $187.2^{\circ}C$. The pH's of 10% and 25% aqueous solutions were 5.03 ana 5.16 at $25^{\circ}C$. The preparations of cefoperazone did not contain any pyrogenic substances and did not liberate histamine in cats. The drug was highly compatible with common infusion solutions including 5% Dextrose solution and no significant potency decrease was observed in 5 hours after mixing. Powdered cefoperazone sodium contained in hermetically sealed and ligt-shielded container was highly stable at $4^circ}C{\sim}37^{\circ}C$ for 12 weeks. When stored at $4^{\circ}C$ the potency was retained almost completely for up to one year. 2) Antimicrobial activity against clinical isolates. Among the 230 clinical isolates included, Salmonella typhi was the most susceptible to cefoperazone, with 100% inhibition at MIC of ${\leq}0.5{\mu}g/ml$. Cefoperazone was also highly active against Streptococcus pyogenes(group A), Kletsiella pneumoniae, Staphylococcus aureus and Shigella flexneri, with 100% inhibition at $16{\mu}g/ml$ or less. More than 80% of Escherichia coli, Enterobacter aerogenes and Salmonella paratyphi was inhibited at ${\leq}16{\mu}/ml$, while Enterobacter cloaceae, Serratia marcescens and Pseudomonas aerogenosa were somewhat less sensitive to cefoperagone, with inhibitions of 60%, 55% and 35% respectively at the same MIC. 3) Animal pharmacokinetics Serum concentration, organ distritution and excretion of cefoperazone in rats were observed after single intramuscular injections at doses of 20 mg/kg and 50 mg/kg. The extent of protein binding to human plasma protein was also measured in vitro br equilibrium dialysis method. The mean Peak serum concentrations of $7.4{\mu}g/ml$ and $16.4{\mu}/ml$ were obtained at 30 min. after administration of cefoperazone at doses of 20 mg/kg and 50 mg/kg respectively. The tissue concentrations of cefoperazone measured at 30 and 60 min. were highest in kidney. And the concentrations of the drug in kidney, liver and small intestine were much higher than in blood. Urinary and fecal excretion over 24 hours after injetcion ranged form 12.5% to 15.0% in urine and from 19.6% to 25.0% in feces, indicating that the gastrointestinal system is more important than renal system for the excretion of cefoperazone. The extent of binding to human plasma protein measured by equilibrium dialysis was $76.3%{\sim}76.9%$, which was somewhat lower than the others utilizing centrifugal ultrafiltration method. 4) Animal pharmacodynamics Central nervous system : Effects of cefoperazone on the spontaneous movement and general behavioral patterns of rats, the pentobarbital sleeping time in mice and the body temperature in rabbits were observed. Single intraperitoneal injections at doses of $500{\sim}2,000mg/kg$ in rats did not affect the spontaneous movement ana the general behavioral patterns of the animal. Doses of $125{\sim}500mg/kg$ of cefoperazone injected intraperitonealy in mice neither increased nor decreased the pentobarbital-induced sleeping time. In rabbits the normal body temperature was maintained following the single intravenous injections of $125{\sim}2,000mg/kg$ dose. Respiratory and circulatory system: Respiration rate, blood pressure, heart rate and ECG of anesthetized rabbits were monitored for 3 hours following single intravenous injections of cefoperazone at doses of $125{\sim}2,000mg/kg$. The respiration rate decreased by $3{\sim}l7%$ at all the doses of cefoperazone administered. Blood pressure did not show any changes but slight decrease from 130/113 to 125/107 by the highest dose(2,000 mg/kg) injected in this experiment. The dosages of 1,000 and 2,000 mg/kg seemed to slightly decrease the heart rate, but it was not significantly different from the normal control. All the doses of cefoperazone injected were not associated with any abnormal changes in ECG findings throughout the monitering period. Autonomic nervous system and smooth muscle: Effects of cefoperazone on the automatic movement of rabbit isolated small intestine, large intestine, stomach and uterus were observed in vitro. The autonomic movement and tonus of intestinal smooth muscle increased at dose of $40{\mu}g/ml$ in small intestine and at 0.4 mg/ml in large intestine. However, in stomach and uterine smooth muscle the autonomic movement was slightly increased by the much higher doses of 5-10 mg/ml. Blood: In vitro osmotic fragility of rabbit RBC suspension was not affected by cefoperazone of $1{\sim}10mg/ml$. Doses of 7.5 and 10 mg/ml were associated with 11.8% and 15.3% prolongation of whole blood coagulation time. Liver and kidney function: When measured at 3 hours after single intravenous injections of cefoperaonze in rabbits, the values of serum GOT, GPT, Bilirubin, TTT, BUN and creatine were not significantly different from the normal control. 5) Safety evaluation Acute toxicity: The acute toxicity of cefoperazone was studied following intraperitoneal and intravenous injections to mice(A strain, 4 week old) and rats(Sprague-Dawler, 6 week old). The LD_(50)'s of intraperitonealy injected cefoperazone were 9.7g/kg in male mice, 9.6g/kg in female mice and over 15g/kg in both male and female rats. And when administered intravenously in rats, LD_(50)'s were 5.1g/kg in male and 5.0g/kg in female. Administrations of the high doses of the drug were associated with slight inhibition of spontaneous movement and convulsion. Atdominal transudate and intestinal hyperemia were observed in animals administered intraperitonealy. In rats receiving high doses of the drug intravenously rhinorrhea and pulmonary congestion and edema were also observed. Renal proximal tubular epithelial degeneration was found in animals dosing in high concentrations of cefoperazone. Subacute toxicity: Rats(Sprague-Dawley, 6 week old) dosing 0.5, 1.0 and 2.0 g/kg/day of cefoperazone intraperitonealy were observed for one month and sacrificed at 24 hours after the last dose. In animals with a high dose, slight inhibition of spontaneous movement was observed during the experimental period. Soft stool or diarrhea appeared at first or second week of the administration in rats receiving 2.0g/kg. Daily food consumption and weekly weight gain were similar to control during the administration. Urinalysis, blood chemistry and hematology after one month administration were not different from control either. Cecal enlargement, which is an expected effect of broad spectrum antibiotic altering the normal intestinal microbial flora, was observed. Intestinal or peritoneal congestion and peritonitis were found. These findings seemed to be attributed to the local irritation following prolonged intraperitoneal injections of hypertonic and acidic cefoperazone solution. Among the histopathologic findings renal proximal tubular epithelial degeneration was characteristic in rats receiving 1 and 2g/kg/day, which were 10 and 20 times higher than the maximal clinical dose (100 mg/kg) of the drug. 6) Human pharmacokinetics Serum concentrations and urinary excretion were determined following a single intravenous injection of 1g cefoperazone in eight healthy, male volunteers. Mean serum concentrations of 89.3, 61.3, 26.6, 12.3, 2.3, and $1.8{\mu}g/ml$ occured at 1,2,4,6,8 and 12 hours after injection respectively, and the biological half-life was 108 minutes. Urinary excretion over 24 hours after injection was up to 43.5% of administered dose.

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Retrograde Autologous Priming: Is It Really Effective in Reducing Red Blood Cell Transfusions during Extracorporeal Circulation? (역행성 자가혈액 충전법: 체외순환 중 동종적혈구 수혈량을 줄일 수 있는가?)

  • Lim, Cheong;Son, Kuk-Hui;Park, Kay-Hyun;Jheon, Sang-Hoon;Sung, Sook-Whan
    • Journal of Chest Surgery
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    • v.42 no.4
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    • pp.473-479
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    • 2009
  • Background: Retrograde autologous priming (RAP) is known to be useful in decreasing the need of transfusions in cardiac surgery because it prevents excessive hemodilution due to the crystalloid priming of cardiopulmonary bypass circuit. However, there are also negative side effects in terms of blood conservation. We analyzed the intraoperative blood-conserving effect of RAP and also investigated the efficacy of autotransfusion and ultrafiltration as a supplemental method for RAP. Material and Method: From January 2005 to December 2007, 117 patients who underwent isolated coronary artery bypass operations using cardiopulmonary bypass (CPB) were enrolled. Mean age was 63.9$\pm$9.1 years (range 36$\sim$83 years) and 34 patients were female. There were 62 patients in the RAP group and 55 patients in he control group. Intraoperative autotransfusion was performed via the arterial line. RAP was done just before initiating CPB using retrograde drainage of the crystalloid priming solution. Both conventional (CUF) and modified (MUF) ultrafiltrations were done during and after CPB, respectively. The transfusion threshold was less than 20% in hematocrit. Result: Autotransfusions were done in 79 patients (67.5%) and the average amount was 142.5$\pm$65.4 mL (range 30$\sim$320 mL). Homologous red blood cell (RBC) transfusion was done in 47 patients (40.2%) and mean amount of transfused RBC was 404.3$\pm$222.6 mL. Risk factors for transfusions were body surface area (OR 0.01, 95% CI 0.00 $\sim$ 0.63, p=0.030) and cardiopulmonary bypass time (OR 1.04, 95% CI 1.01 $\sim$ 1.08, p=0.019). RAP was not effective in terms of the rate of transfusion (34.5% vs 45.2%, p=0.24). However, the amount of transfused RBC was significantly decreased (526.3$\pm$242.3ml vs 321.4$\pm$166.3 mL, p=0.001). Autotransfusion and ultrafiltration revealed additive and cumulative effects decreasing transfusion amount (one; 600.0$\pm$231.0 mL, two; 533.3$\pm$264.6 mL, three; 346.7$\pm$176.7 mL, four; 300.0$\pm$146.1 mL, p=0.002). Conclusion: Even though RAP did not appear to be effective in terms of the number of patients receiving intraoperative RBC transfusions, it could conserve blood in terms of the amount transfused and with the additive effects of autotransfusion and ultrafiltration. If we want to maximize the blood conserving effect of RAP, more aggressive control will be necessary - such as high threshold of transfusion trigger or strict regulation of crystalloid infusion, and so forth.