Pharmacologic Anticoagulation Research Articles

Protein S is inducible by interleukin 4 in T cells and inhibits lymphoid cell procoagulant activity.

Extravascular procoagulant activity often accompanies cell-mediated immune responses and systemic administration of pharmacologic anticoagulants prevents cell-mediated delayed-type hypersensitivity reactions. These observations suggest a direct association between coagulation and cell-mediated immunity. The cytokine interleukin (IL)-4 potently suppresses cell-mediated immune responses, but its mechanism of action remains to be determined. Herein we demonstrate that the physiologic anticoagulant protein S is IL-4-inducible in primary T cells. Although protein S was known to inhibit the classic factor Va-dependent prothrombinase assembled by endothelial cells and platelets, we found that protein S also inhibits the factor Va-independent prothrombinase assembled by lymphoid cells. Thus, protein S-mediated down-regulation of lymphoid cell procoagulant activity may be one mechanism by which IL-4 antagonizes cell-mediated immunity.

Long-Term Follow-Up Evaluation of 1000 Consecutive Cemented Total Knee Arthroplasties

This is a report of a retrospective study of 1000 consecutive, cemented total knee arthroplasties performed by one surgeon from January 1976 to August 1989. Eighty-five percent of the patients were available after a mean of 51 months. Using The Knee Society Clinical Rating System, a good to excellent result was found in 95% of the knees; function was good to excellent in 54% of the knees. By using an actuarial method, 94% of the knees can be expected to survive 13 years. A deep venous thrombosis or pulmonary embolus was found in 1.7% and was no less common in the 25% of the patients who received pharmacologic anticoagulation. The mortality rate was 0.4%. The infection rate was 0.7% and did not correlate with intraoperative cultures. There were 14 failures for a variety of reasons, and six unsuccessful knees were revised. Preoperative medical problems did not generally predict the postoperative complications. The average duration of hospitalization during the last five years of the study was 9.7 days. Careful and consistent preoperative, intraoperative, and postoperative care is responsible for the low complication rate. The cemented knee arthroplasty consistently continues to yield good results.

Effect of anticoagulants, vasodilators, and dipyridamole on postischemic cerebral vascular obstruction

The effect of various pharmacological agents, anticoagulants, vasodilators, and dipyridamole on postischemic cerebral vascular obstruction was assessed. Of these agents only heparin when administered with NaHCO 3 proved significantly effective.