Purpose: It is not yet known whether admission to a hospital itself influences the clinical outcome of deep vein thrombosis (DVT). This study prospectively evaluated the prevalence and indicators of DVT in patients with neurological disorders admitted to medical wards. Methods: In 108 patients positioned supine for 48 hours in two hospitals in 2007, the D-dimer level, soluble fibrin level, gender, age, (pleural effusion and/or ascites) and presence/absence of central venous catheter placement were studied in relation to the prevalence of DVT, assessed using ultrasonography. Results: Twenty-one patients with DVT (19.4%) were identified, among whom pulmonary thromboembolism was diagnosed in two. No factors but D-dimer level and age were associated with the presence of DVT. In the DVT (+) group. D-dimer level (7.5 ± 8.5 vs. 2.8 ± 4.0μg/ml,p = 0.024) and age (p = 0.044) were higher than in the DVT (−) group. Conclusion: In medical patients with neurological diseases, the prevalence of DVT was high, and much higher in elderly patients. D-dimer level might be a useful indicator. Admission to a hospital may influence the clinical outcome.
Objective: Early identification of patients at risk of arteriosclerosis is critical, as such patients require considerable information about lifestyle modification and methods of treatment. One purpose of periodic health checkups is to prevent the development and progression of arteriosclerosis. We performed carotid artery ultrasonography at a health checkup and examined the associations between maximal progression of carotid intima-media thickness (max IMT) and risk factors for arteriosclerosis. Methods: The study comprised 1007 persons with no history of cerebrovascular disorders (602 men, mean age ± SD 53.2 ± 10.8 years ; 405 women. 53.1 ± 11.7 years) . The risk of arteriosclerosis was defined according to The Examination Committee of Criteria for Metabolic Syndrome; age and body mass index were added to each item. Results: Max IMT was positively associated with age and risk of arteriosclerosis. A max IMT over 1.1 mm was positively associated with age. systolic arterial pressure. abdominal circumference, and triglyceride level. In addition, after adjustment for age. the risk of arteriosclerosis was significantly associated with abdominal circumference (odds ratio. 1.86 ; 95% confidence interval. 1.15 to 3.00; p = 0.011) and triglyceride level (2.20,1.39 to 3.46, p = 0.001). Conclusion: Our findings indicate that reduction of abdominal circumference and triglyceride level may help limit the progression of arteriosclerosis in the carotid artery.
Introduction: Central systolic blood pressure (cSBP)and augmentation index (Al),the parameters of arterial stiffness. are obtained through pulse wave analysis. Recently these parameters have been a focus of increasing attention. We studied the relationship of cSBP and AI with the indices determined by carotid artery ultrasonography, namely carotid intima-media thickness (CCA-IMT), plaque score (PS)and plaque number (PN). Methods:A total of 141 consecutive subjects underwent radial applanation tonometric measurement of cSBP and AI at the wrist and B-mode ultrasound examination of the carotid arteries for CCA-IMT. Results: AI and cSBP showed a good correlation with increasing age. MT was well correlated with both AI and cSBP (r=0.23, p<0.01 and r=0.37, p<0. 001, respectively). Females showed higher AI and cSBP values and better correlation with IMT than males (r=0.45 versus 0.29 and 0.32 versus 0. 21, respectively. p<0.01).PS and PN did not show significant correlation with AI and cSBP. Analysis of differences in AI and cSBP values between the subjects with and without a history of cerebrovascular disease (CVD)revealed no significant correlation. Conclusion: CCA-IMT is significantly correlated with arterial stiffness parameters, AI and cSBP. However, further validation of the results will be necessary.
Intraoperative hemodynamics in moyamoya disease (MMD) should be clarified to establish suitable treatments. We carried out micro-Doppler flowmetry during STA-MCA anastomosis for MMD. Methods: Fifteen patients with MMD were treated by STA-MCA anastomosis, and a micro-Doppler probe was applied to the recipient arteries (M4) before and after anastomosis. Flow velocity (FV) and direction of blood flow were investigated proximal and distal to the anastomosis sites of the recipient arteries. Results: Direction of blood flow in the pre-anastomosis artery (M4) was anterograde in 19 of 28 arteries (68%) and antidromic in g arteries (32%) .STA-MCA anastomosis produced a new direction of blood flow away from the anastomosis site in a proximal and distal direction in the recipient artery in 20 of 24 anastomoses. Only two anastomosis recipients showed antegrade flow, and two showed regurgitant flow. Time-averaged maximum flow velocity (V max) in M4 increased significantly from 11.4cm/s to 47.6 cm/s (p<0.001) following bypass surgery. Mean V max in the normal M4 recorded in patients with unruptured aneurysm was 14.0 cm/s. Conclusion: This study demonstrated that FV in M4 is very low with regardant direction in many MMD patients, and that STA-MCA anastomosis can considerably increase FV of the MCA and change the direction of blood flow.