Fibrinogen and inflammatory reaction influence of hydrocortisone

Influence of local steroid injections on traumatized tendon properties. A biomechanical and histological study

We investigated the effects of peritendon injections of hydrocortisone acetate on the separation force required to completely avulse a posttraumatized Achilles tendon of the adult male rat. One hundred thirty-five rats were randomly assigned to 3 groups and subsequently traumatized, treated, and sacrificed. One group was used to examine the effect of trauma; the second to examine effects of trauma and injections of hydrocortisone acetate on the tension to failure strength of tendons; the third group was the control group. Injected animals received one, three, or five injections of 0.10 cc (125 mg/ml) hydrocortisone acetate and were sacrificed 3, 6, or 9 weeks following initial injection. Experimental animals (anesthetized) were traumatized by dropping a weight onto the Achilles tendon. The tendon was tested in tension to failure employing a soft tissue linear disseminator. Histologic analysis using light microscopy was performed. We concluded that hydrocortisone acetate has no deleterious effect on the rat Achilles tendon as measured biomechanically or histologically.

Etiologic aspects of coagulopathy in Takayasu's aortitis

Sixteen patients with Takayasu's aortitis were studied to evaluate the significance of coagulopathy in the etiology. In the initial stage of the disease (three cases) characterized by severe inflammatory symptoms with aortic lesions localized in the thoracic portion, marked hyperfibrinogenemia, and hypofibrinolytic activity of the plasma were observed. In the intermediate stage (five cases) characterized by moderate inflammation and aortic lesions expanded into thoracic and abdominal portions, hyperfibrinogenemia and hypofibrinolytic activity were also seen; in three of these cases, hypercoagulability was evident because of the presence of fibrinogen derivatives having gamma-gamma-diads in the plasma. When the inflammation subsided after the establishment of aortic lesions, the end-stage (eight cases), hyperfibrinolytic activity with normal plasma fibrinogen was observed. It is suggested that hypercoagulability may be in response to the arterial disease and may possibly play a part in the development of this disorder.