HRP20020573A2 - Novel therapeutic use of enoxaparin - Google Patents
Novel therapeutic use of enoxaparin Download PDFInfo
- Publication number
- HRP20020573A2 HRP20020573A2 HR20020573A HRP20020573A HRP20020573A2 HR P20020573 A2 HRP20020573 A2 HR P20020573A2 HR 20020573 A HR20020573 A HR 20020573A HR P20020573 A HRP20020573 A HR P20020573A HR P20020573 A2 HRP20020573 A2 HR P20020573A2
- Authority
- HR
- Croatia
- Prior art keywords
- enoxaparin
- treatment
- therapeutic use
- novel therapeutic
- cerebral
- Prior art date
Links
- HTTJABKRGRZYRN-UHFFFAOYSA-N Heparin Chemical compound OC1C(NC(=O)C)C(O)OC(COS(O)(=O)=O)C1OC1C(OS(O)(=O)=O)C(O)C(OC2C(C(OS(O)(=O)=O)C(OC3C(C(O)C(O)C(O3)C(O)=O)OS(O)(=O)=O)C(CO)O2)NS(O)(=O)=O)C(C(O)=O)O1 HTTJABKRGRZYRN-UHFFFAOYSA-N 0.000 title claims description 17
- 229960000610 enoxaparin Drugs 0.000 title claims description 15
- 230000001225 therapeutic effect Effects 0.000 title description 3
- 238000011282 treatment Methods 0.000 claims description 10
- 206010008118 cerebral infarction Diseases 0.000 claims description 8
- 201000006474 Brain Ischemia Diseases 0.000 claims description 7
- 206010008120 Cerebral ischaemia Diseases 0.000 claims description 7
- 239000003814 drug Substances 0.000 claims description 6
- 229940079593 drug Drugs 0.000 claims description 4
- 238000002360 preparation method Methods 0.000 claims description 3
- 241000700159 Rattus Species 0.000 description 5
- 230000000926 neurological effect Effects 0.000 description 5
- 230000009509 cortical damage Effects 0.000 description 4
- 230000002265 prevention Effects 0.000 description 3
- 238000001356 surgical procedure Methods 0.000 description 3
- 238000012360 testing method Methods 0.000 description 3
- 206010051055 Deep vein thrombosis Diseases 0.000 description 2
- 206010047249 Venous thrombosis Diseases 0.000 description 2
- 210000001715 carotid artery Anatomy 0.000 description 2
- 229940127215 low-molecular weight heparin Drugs 0.000 description 2
- 238000000034 method Methods 0.000 description 2
- XLYOFNOQVPJJNP-UHFFFAOYSA-N water Chemical compound O XLYOFNOQVPJJNP-UHFFFAOYSA-N 0.000 description 2
- PKDBCJSWQUOKDO-UHFFFAOYSA-M 2,3,5-triphenyltetrazolium chloride Chemical compound [Cl-].C1=CC=CC=C1C(N=[N+]1C=2C=CC=CC=2)=NN1C1=CC=CC=C1 PKDBCJSWQUOKDO-UHFFFAOYSA-M 0.000 description 1
- 206010002091 Anaesthesia Diseases 0.000 description 1
- BSYNRYMUTXBXSQ-UHFFFAOYSA-N Aspirin Chemical compound CC(=O)OC1=CC=CC=C1C(O)=O BSYNRYMUTXBXSQ-UHFFFAOYSA-N 0.000 description 1
- 206010048962 Brain oedema Diseases 0.000 description 1
- 206010014522 Embolism venous Diseases 0.000 description 1
- WSFSSNUMVMOOMR-UHFFFAOYSA-N Formaldehyde Chemical compound O=C WSFSSNUMVMOOMR-UHFFFAOYSA-N 0.000 description 1
- 238000012313 Kruskal-Wallis test Methods 0.000 description 1
- 241001465754 Metazoa Species 0.000 description 1
- 208000001738 Nervous System Trauma Diseases 0.000 description 1
- 208000007814 Unstable Angina Diseases 0.000 description 1
- 229960001138 acetylsalicylic acid Drugs 0.000 description 1
- 230000001154 acute effect Effects 0.000 description 1
- 239000002671 adjuvant Substances 0.000 description 1
- 230000037005 anaesthesia Effects 0.000 description 1
- 239000007864 aqueous solution Substances 0.000 description 1
- 210000001367 artery Anatomy 0.000 description 1
- 230000000740 bleeding effect Effects 0.000 description 1
- 210000004556 brain Anatomy 0.000 description 1
- 208000006752 brain edema Diseases 0.000 description 1
- 210000001168 carotid artery common Anatomy 0.000 description 1
- 210000003169 central nervous system Anatomy 0.000 description 1
- 210000001627 cerebral artery Anatomy 0.000 description 1
- 230000002490 cerebral effect Effects 0.000 description 1
- 208000026106 cerebrovascular disease Diseases 0.000 description 1
- 230000015271 coagulation Effects 0.000 description 1
- 238000005345 coagulation Methods 0.000 description 1
- 230000001054 cortical effect Effects 0.000 description 1
- 238000007428 craniotomy Methods 0.000 description 1
- 239000002270 dispersing agent Substances 0.000 description 1
- 239000012153 distilled water Substances 0.000 description 1
- 230000000042 effect on ischemia Effects 0.000 description 1
- 230000000694 effects Effects 0.000 description 1
- 239000003995 emulsifying agent Substances 0.000 description 1
- 230000001747 exhibiting effect Effects 0.000 description 1
- 238000001914 filtration Methods 0.000 description 1
- 235000010855 food raising agent Nutrition 0.000 description 1
- 239000008098 formaldehyde solution Substances 0.000 description 1
- 238000001631 haemodialysis Methods 0.000 description 1
- BCQZXOMGPXTTIC-UHFFFAOYSA-N halothane Chemical compound FC(F)(F)C(Cl)Br BCQZXOMGPXTTIC-UHFFFAOYSA-N 0.000 description 1
- 229960003132 halothane Drugs 0.000 description 1
- 230000000322 hemodialysis Effects 0.000 description 1
- 230000023597 hemostasis Effects 0.000 description 1
- 238000002347 injection Methods 0.000 description 1
- 239000007924 injection Substances 0.000 description 1
- 238000001990 intravenous administration Methods 0.000 description 1
- 229940118179 lovenox Drugs 0.000 description 1
- 239000003055 low molecular weight heparin Substances 0.000 description 1
- 210000003657 middle cerebral artery Anatomy 0.000 description 1
- 239000000203 mixture Substances 0.000 description 1
- 208000010125 myocardial infarction Diseases 0.000 description 1
- 238000010984 neurological examination Methods 0.000 description 1
- 230000037000 normothermia Effects 0.000 description 1
- 238000011321 prophylaxis Methods 0.000 description 1
- 239000000243 solution Substances 0.000 description 1
- 238000013222 sprague-dawley male rat Methods 0.000 description 1
- 239000003381 stabilizer Substances 0.000 description 1
- 238000007619 statistical method Methods 0.000 description 1
- 239000008223 sterile water Substances 0.000 description 1
- 230000001954 sterilising effect Effects 0.000 description 1
- 238000004659 sterilization and disinfection Methods 0.000 description 1
- 239000003206 sterilizing agent Substances 0.000 description 1
- 238000007920 subcutaneous administration Methods 0.000 description 1
- 208000004043 venous thromboembolism Diseases 0.000 description 1
Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
- A61K31/00—Medicinal preparations containing organic active ingredients
- A61K31/70—Carbohydrates; Sugars; Derivatives thereof
- A61K31/715—Polysaccharides, i.e. having more than five saccharide radicals attached to each other by glycosidic linkages; Derivatives thereof, e.g. ethers, esters
- A61K31/726—Glycosaminoglycans, i.e. mucopolysaccharides
- A61K31/727—Heparin; Heparan
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
- A61P9/00—Drugs for disorders of the cardiovascular system
- A61P9/10—Drugs for disorders of the cardiovascular system for treating ischaemic or atherosclerotic diseases, e.g. antianginal drugs, coronary vasodilators, drugs for myocardial infarction, retinopathy, cerebrovascula insufficiency, renal arteriosclerosis
Landscapes
- Health & Medical Sciences (AREA)
- Life Sciences & Earth Sciences (AREA)
- Public Health (AREA)
- Chemical & Material Sciences (AREA)
- Veterinary Medicine (AREA)
- Medicinal Chemistry (AREA)
- General Health & Medical Sciences (AREA)
- Animal Behavior & Ethology (AREA)
- Pharmacology & Pharmacy (AREA)
- Epidemiology (AREA)
- Molecular Biology (AREA)
- Dermatology (AREA)
- Bioinformatics & Cheminformatics (AREA)
- Engineering & Computer Science (AREA)
- Heart & Thoracic Surgery (AREA)
- Organic Chemistry (AREA)
- Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
- General Chemical & Material Sciences (AREA)
- Chemical Kinetics & Catalysis (AREA)
- Cardiology (AREA)
- Vascular Medicine (AREA)
- Urology & Nephrology (AREA)
- Pharmaceuticals Containing Other Organic And Inorganic Compounds (AREA)
- Medicines That Contain Protein Lipid Enzymes And Other Medicines (AREA)
Description
Ovaj izum se odnosi na novu terapeutsku primjenu enoxaparina.
Enoxaparin (Lovenox®, Clexane®) je heparin niske molekularne težine koji se nalazi na tržištu za profilaktičko liječenje venske tromboembolije u kirurgiji umjerenog ili povećanog rizika, za preveniranje koagulacije izvantjelesnog cirkulacijskog kruga tijekom hemodijalize, za liječenje dubokih venskih tromboza a u kombinaciji s aspirinom za liječenje instabilne angine pektoris i infarkta miokarda bez Q vala i u akutnoj fazi.
Enoxaparin je također koristan za preveniranje i/ili liječenje trauma središnjeg živčanog sustava (WO 98/53833) i cerebralnih edema (WO 98/53834).
Heparini niske molekularne težine su testirani za preveniranje i/ili liječenje dubinske venske tromboze kod pacijenata koji pokazuju cerebralnu ishemiju ali pritom nije uočen nikakav učinak na ishemiju (A. ELIAS i surad., Revija Interne Medicine, I, tom XI, 95-98 (1990); MH. PRINS i surad., Hemostaze, 19, 245-250 (1989); AGG. TURPIE i surad., The Lancet, 523-526 (1987)).
Sada je ustanovljeno da enoxaparin omogućava smanjenje posljedica cerebralne ishemije te se stoga može upotrebljavati za liječenje cerebralnih ishemija.
Ova nova terapeutska primjena utvrđena je kod štakora prema sljedećem protokolu:
Mužjaci štakora Sprague Dawley (230-250 g Iffa Credo) hranjeni su i napajani ad libitum i održavani su u ciklusu svjetlo-tama tijekom 12 sati. Kirurgija je realizirana pod halotanom (1,4 % u smjesi od 70 % N2O/30 % O2). Tijekom anestezije, normotermija je održavana tako što je štakor bio smješten pod termostatirani pokrivač. Zajednička lijeva karotidna arterija je bila izolirana i labavo podvezana. Srednja lijeva cerebralna arterija je bila izložena pomoću su-temmporalne kraniotomije a mikrostezaljka postavljena u proksimalnu regiju arterije, odmah popraćena podvezivanjem karotidne arterije. Nakon dva sata, životinje su reanimirane a cerebralna cirkulacija je uspostavljena skidanjem stezaljke sa središnje cerebralne arterije kao i podveza s karotidne arterije. Štakori su tada vraćeni u njihov kavez u prostoriju s termostatom podešenim na 26-28°.
48 sati nakon kirurškog zahvata ispitivači koji nisu upoznati s prethodnim tretmanom obavljaju neurološka ispitivanja na svakom štakoru. Korištena neurološka ljestvica opisana je u tabeli 1.
TABELA 1
[image]
Nakon neurološkog ispitivanja, štakori su eutanazirani a njihov mozak je izvađen. Napravljena je serija presjeka debljine 1,5 mm i obojena je 2 % 2,3,5-trifeniltetrazolij kloridom (TTC). Nakon 24 sata post-fiksacije u 10 % otopini formaldehida, oštećene površine (cerebralni infarkt) se mjere na kortikalnom i striatalnom nivou; Zapremnine su izračunate integriranjem oštećenih površina. Vrijednosti su izražene u mm3 (prosjek ± E.S.M).
Statistička analiza je izvršena testom prema Mann-Whitney testu ili prema Kruskal-Wallis testu za analizu neparametarske varijance popraćena Dunn testom za usporedbu grupa (*: p <0,05, **: p <0,01, ***: p <=0,001 vs kontrolna grupa).
TABELA 2
[image]
Ovi rezultati pokazuju da
- u proučavanju 1, enoxaparin znatno poboljšava neurološki skor 48 sati nakon cerebralne ishemije i, što više, znatno smanjenje kortikalnog oštećenja za 30 %.
- u proučavanju 2, enoxaparin smanjuje kortikalno oštećenje za 30 % (2x1 mg/kg) i 36 % (2x1,5 mg/kg).
- u proučavanju 3, enoxaparin znatno poboljšava neurološki skor i smanjuje kortikalno oštećenje za 34 %.
- u proučavanju 4, enoxaparin znatno poboljšava neurološki skor i smanjuje kortikalno oštećenje za 49 %.
Nikakav problem u svezi krvarenja nije se pojavio tijekom proučavanja.
Lijekovi su se sastojali od enoxaparina u obliku strukture u kojoj je on pripojen svakom drugom farmaceutski kompatibilnom proizvodu, koji može biti inertan ili fiziološki aktivan. Lijekovi prema izumu mogu se primjeniti, prvenstveno, intravenozno ili potkožno.
Sterilne strukture za intravenozno ili potkožno davanje, su uglavnom vodene otopine. Ove strukture mogu također sadržavati adjuvanse, naročito kvasila, izotonizante, emulgatore, disperzante i stabilizatore. Sterilizacija se može izvesti na više načina, na primjer aseptičkim filtriranjem, inkorporiranjem u strukturu sterilizirajućih agensa, zračenjem. One se mogu također, pripremiti u obliku krutih sterilnih struktura koje se mogu otopiti u momentu primjene u sterilnoj vodi ili svakom drugom sterilnom miljeu pogodnom za ubrizgavanje.
Kao primjer jedne takve strukture, može se otopiti 20 mg enoxaparina u destiliranoj vodi u količini koja je dovoljna za pripremanje 0,2 ml otopine.
Doze ovise o traženom učinku, o trajanju liječenja te o primjenjenom načinu davanja; ove doze se uglavnom kreću između 0,2 mg i 4 mg/kg dnevno potkožno odnosno 14 do 280 mg dnevno za odraslu osobu s jediničnim dozama koje se kreću od 5 do 280 mg.
Općenito uzevši, liječnik mora odrediti pozologiju primjerenu dobi, težini i svim drugim faktorima primjerenima subjektu koji se podvrgava liječenju.
Ovaj izum se također tiče metode liječenja cerebralne ishemije kod ljudi koja obuhvaća davanje učinkovite količine enoxaparina.
Ovaj izum se također tiče primjene enoxaparina za pripremanje lijeka korisnog za liječenje cerebralne ishemije.
Claims (2)
1. Upotreba enoxaparina za pripremanje lijeka korisnog za liječenje cerebralne ishemije.
2. Upotreba prema zahtjevu 1 za pripremanje lijekova koji sadrže od 5 do 280 mg enoxaparina.
Applications Claiming Priority (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| FR0000137A FR2803522B1 (fr) | 2000-01-06 | 2000-01-06 | Nouvelle application therapeutique de l'enoxaparine |
Publications (1)
| Publication Number | Publication Date |
|---|---|
| HRP20020573A2 true HRP20020573A2 (en) | 2003-10-31 |
Family
ID=8845669
Family Applications (1)
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| HR20020573A HRP20020573A2 (en) | 2000-01-06 | 2002-07-04 | Novel therapeutic use of enoxaparin |
Country Status (30)
| Country | Link |
|---|---|
| EP (1) | EP1248638B1 (hr) |
| JP (1) | JP2003519185A (hr) |
| KR (1) | KR20020069240A (hr) |
| CN (1) | CN1400905A (hr) |
| AR (1) | AR026804A1 (hr) |
| AT (1) | ATE344671T1 (hr) |
| AU (1) | AU784656B2 (hr) |
| BR (1) | BR0107442A (hr) |
| CA (1) | CA2396178A1 (hr) |
| CZ (1) | CZ20022303A3 (hr) |
| DE (1) | DE60124373T2 (hr) |
| DK (1) | DK1248638T3 (hr) |
| EA (1) | EA006035B1 (hr) |
| EE (1) | EE200200374A (hr) |
| ES (1) | ES2275648T3 (hr) |
| FR (1) | FR2803522B1 (hr) |
| HK (1) | HK1052649A1 (hr) |
| HR (1) | HRP20020573A2 (hr) |
| HU (1) | HUP0204040A3 (hr) |
| IL (1) | IL150477A0 (hr) |
| MX (1) | MXPA02006672A (hr) |
| NO (1) | NO20023243D0 (hr) |
| NZ (1) | NZ520283A (hr) |
| PL (1) | PL357192A1 (hr) |
| PT (1) | PT1248638E (hr) |
| SK (1) | SK9612002A3 (hr) |
| UA (1) | UA75587C2 (hr) |
| WO (1) | WO2001049298A2 (hr) |
| YU (1) | YU51802A (hr) |
| ZA (1) | ZA200205415B (hr) |
Families Citing this family (2)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| AR063530A1 (es) * | 2006-10-30 | 2009-01-28 | Aventis Pharma Sa | Procedimiento de utilizacion de enoxaparina sodica para la preparacion de un medicamento |
| ITMI20091445A1 (it) * | 2009-08-07 | 2011-02-08 | Inalco S P A A Socio Unico | Derivati semi-sintetici del polisaccaride k5 per la prevenzione ed il trattamento del danno tissutale associato a ischemia e/o riperfusione |
Family Cites Families (2)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| WO1994008595A1 (en) * | 1992-10-13 | 1994-04-28 | Virginia Commonwealth University | Use of non-anticoagulant heparin for treating ischemia/reperfusion injury |
| US5767269A (en) * | 1996-10-01 | 1998-06-16 | Hamilton Civic Hospitals Research Development Inc. | Processes for the preparation of low-affinity, low molecular weight heparins useful as antithrombotics |
-
2000
- 2000-01-06 FR FR0000137A patent/FR2803522B1/fr not_active Expired - Fee Related
-
2001
- 2001-01-03 EE EEP200200374A patent/EE200200374A/xx unknown
- 2001-01-03 DK DK01903859T patent/DK1248638T3/da active
- 2001-01-03 IL IL15047701A patent/IL150477A0/xx unknown
- 2001-01-03 EA EA200200750A patent/EA006035B1/ru not_active IP Right Cessation
- 2001-01-03 SK SK961-2002A patent/SK9612002A3/sk not_active Application Discontinuation
- 2001-01-03 KR KR1020027008754A patent/KR20020069240A/ko not_active Application Discontinuation
- 2001-01-03 CZ CZ20022303A patent/CZ20022303A3/cs unknown
- 2001-01-03 YU YU51802A patent/YU51802A/sh unknown
- 2001-01-03 HU HU0204040A patent/HUP0204040A3/hu unknown
- 2001-01-03 NZ NZ520283A patent/NZ520283A/en unknown
- 2001-01-03 AT AT01903859T patent/ATE344671T1/de not_active IP Right Cessation
- 2001-01-03 DE DE60124373T patent/DE60124373T2/de not_active Expired - Fee Related
- 2001-01-03 PL PL01357192A patent/PL357192A1/xx unknown
- 2001-01-03 WO PCT/FR2001/000014 patent/WO2001049298A2/fr not_active Application Discontinuation
- 2001-01-03 MX MXPA02006672A patent/MXPA02006672A/es active IP Right Grant
- 2001-01-03 CN CN01803471A patent/CN1400905A/zh active Pending
- 2001-01-03 BR BR0107442-3A patent/BR0107442A/pt not_active IP Right Cessation
- 2001-01-03 JP JP2001549666A patent/JP2003519185A/ja active Pending
- 2001-01-03 PT PT01903859T patent/PT1248638E/pt unknown
- 2001-01-03 ES ES01903859T patent/ES2275648T3/es not_active Expired - Lifetime
- 2001-01-03 AU AU31830/01A patent/AU784656B2/en not_active Ceased
- 2001-01-03 CA CA002396178A patent/CA2396178A1/fr not_active Abandoned
- 2001-01-03 EP EP01903859A patent/EP1248638B1/fr not_active Expired - Lifetime
- 2001-01-05 AR ARP010100054A patent/AR026804A1/es unknown
- 2001-03-01 UA UA2002076399A patent/UA75587C2/uk unknown
-
2002
- 2002-07-04 HR HR20020573A patent/HRP20020573A2/hr not_active Application Discontinuation
- 2002-07-04 NO NO20023243A patent/NO20023243D0/no not_active Application Discontinuation
- 2002-07-05 ZA ZA200205415A patent/ZA200205415B/xx unknown
-
2003
- 2003-07-09 HK HK03104944.6A patent/HK1052649A1/zh unknown
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