Chain Structure in a Cross-Linked Polyurethane Magnetic Elastomer Under a Magnetic Field.

The morphology of magnetic particles with a size of 7.0 µm was observed for magnetic elastomers with a concentration of magnetic particles of 70 wt% using an X-ray microscope remolded into high resolution. Computed tomography images revealed that magnetic particles were distributed isotopically in the absence of a magnetic field, but they formed a chain structure in the polyurethane network under a magnetic field of 270 mT. It was also established, by image analysis, that magnetic elastomers had an anisotropic structure under the magnetic field.

Nondestructive Monitoring of the Dispersion State of Titanium Dioxide Nanoparticles in Concentrated Suspensions Using Magnetic Resonance Imaging.

The purpose of the present study is to demonstrate the applicability of magnetic resonance imaging, especially T2 relaxation time mapping, for nondestructive monitoring of the dispersion state of nanoparticles (NPs) in concentrated suspensions. TiO2 15-nm-diameter NPs, for use in sunscreen lotion products, were examined as a test NP. First, this study investigated whether T2 is sensitive to the NP concentration. In experiments with pulsed nuclear magnetic resonance on TiO2 NP suspensions with different organic solvents (ethanol, acetone, and decamethylcyclopentasiloxane), the T2 of each solvent varied in the suspensions according to the NP concentration. This study also confirmed that T2 mapping was effective for visualizing differences in NP concentration. Subsequently, gravitational sedimentation of the test suspensions was investigated. T2 mapping exhibited better detection sensitivity to sedimentation occurring in concentrated suspensions than visual observation, as it enabled the detection of changes in NP distributions that could not be visible to the naked eye. In addition, measurements of backscattered light enabled the full understanding of the dispersion stability of the TiO2 NPs in each solvent. Finally, the present study evaluated the centrifuge sedimentation of a commercial TiO2 NP suspension. T2 mapping clearly showed the complicated sedimentation behavior induced by the centrifugation treatment. The simulated fluid flow was consistent with the particle distribution in the centrifuged sample; thus, the sedimentation was believed to have developed in accordance with the vorticity generated by the centrifugation.

Prevalence of Tracheotomy and Percutaneous Endoscopic Gastrostomy in Patients with Guillain-Barré Syndrome.

Some patients with Guillain-Barré syndrome require respiratory management by tracheotomy and/or nutritional management by tube feeding; however, few studies have reported the follow-up course in these patients. The objective of this study was to investigate the follow-up course of tracheotomy and gastrostomy in patients with Guillain-Barré syndrome. The study subjects were 50 patients with Guillain-Barré syndrome (25 males, 25 females; mean age, 51.1 ± 18.7 years) who were admitted to the Hiroshima City Rehabilitation Hospital during the period from April 2008 to December 2015. We retrospectively reviewed the medical records to determine the presence or absence of tracheotomy and/or feeding tube, and the timing of withdrawal from these treatments. During the acute phase, 15 patients underwent tracheotomy and 14 underwent tube feeding management. A tracheotomy tube was inserted for 110 days or longer in five patients, and four of these five patients also had a gastrostomy tube inserted. Among the 14 patients in the tube feeding group, seven underwent nasal feeding and seven underwent percutaneous endoscopic gastrostomy. All patients had the nasal tube removed (mean duration of nasal tube placement, 62.1 ± 46.5 days); however, the gastrostomy tube could not be removed in two patients. Our findings indicate that patients in the acute phase of Guillain-Barré syndrome carry a relevant risk of long-term tube feeding and prolonged need of an artificial airway.

Low-titer anti-GAD-antibody-positive cerebellar ataxia.

The majority of cases of anti-glutamic acid decarboxylase (GAD)-antibody-positive cerebellar ataxia are reported to have high levels of anti-GAD antibody, and the diagnostic value of low titers of anti-GAD antibody in a patient with cerebellar ataxia is still unknown. The purpose of this study was to verify the characteristics of low-titer-anti-GAD-antibody-positive cerebellar ataxia patients and the diagnostic value of low titers of anti-GAD antibody in patients with cerebellar ataxia. The subjects were six patients positive for low-titer GAD antibody (<100 U/mL). We examined them with MRI, including voxel-based morphometry, and with single-photon emission computed tomography and monitored the GAD antibody index in the cerebrospinal fluid. The levels of antineuronal, antigliadin, anti-SS-A, antithyroid antibodies, and of vitamins E, B1, and B12 were determined. Thoracic and abdominal CT scans were performed to exclude a paraneoplastic origin. We treated three patients with immunotherapy. All cases showed cortical cerebellar atrophy. The GAD antibody index in three of the five patients reviewed was >1.0. Two of the six patients were thyroid antibody-positive, and one was both antinuclear- and anti-SS-A antibody-positive. After the administration of immunotherapy to three patients, two showed clear effectiveness, and one, transient effectiveness. Effectiveness was greatest in the two patients with familial occurrence of the disease. In cerebellar ataxia, regardless of family history or isolated illness, it is critical to measure the GAD antibody level, and, even with a low titer level, if the result is positive, immunotherapy should be considered.

[Development of a One-minute Educational Video for Eye-drop Instillation and Changes in Instillation Behavior after Watching the Video].

We created a one-minute video titled "a simple method of eye-drop instillation" (video) for online instillation guidance, to compare the instillation method before and after study participants watch the video and verify the usefulness of watching the video. Moreover, we prepared a document questionnaire to investigate instillation habits and clarify instillation behavior. Study participants were randomly recruited from among students and faculty members via a poster posted at Tokushima Bunri University. The instillation behavior of the study participants was videotaped before and after they watched the video created by the authors. The images were played in a super slow motion, to confirm success or failure in instillation, drop sites, and eye-opening method. Of the 109 participants in the study, the successful instillation rate before and after watching the video was 55.0% and 69.7%, respectively. The use rate of wet wipes for finger disinfection before instillation increased from 0.0% before watching the video to 74.3% after watching the video. After watching the video, the blinking rate after instillation decreased from 95.4 to 45.0%, the rate of pressing the nasolacrimal duct increased from 2.8 to 77.1%, and the rate of wiping the drug solution spilled around the eyes increased from 89.9 to 98.2%. According to the questionnaire, 72.5% of the participants instilled one drop, 22.0% instilled two drops, and 5.5% instilled three drops or more. Watching the video significantly increased the successful instillation rate and improved instillation behavior. Thus, the video created by the authors can be used for online instillation guidance.

Progression-free survival and time to progression as surrogate markers of overall survival in patients with advanced gastric cancer: analysis of 36 randomized trials.

Progression-free survival (PFS) and time to progression (TTP) have been reported to correlate with overall survival (OS) in several types of cancers. To our knowledge, however, their use in the evaluation of new agents for AGC has not been investigated. We evaluated the potential of PFS and TTP to act as surrogates of OS in clinical trial settings. Randomized trials of systemic chemotherapy for advanced gastric cancer were identified by comprehensive electronic and manual search. Correlations between PFS/TTP and OS were evaluated. Thirty-six trials with a total of 83 treatment arms and 10,484 patients were selected for analysis. The nonparametric Spearman rank correlation coefficient (ρ) between median PFS/TTP and OS was 0.70 (95% CI, 0.59 to 0.82) and the correlation coefficient between hazard ratios in PFS/TTP and OS was 0.80 (95% CI, 0.68 to 0.92). Correlation tended to be higher in trials reporting PFS (ρ = 0.85; 0.72-0.97) than in those reporting TTP (ρ = 0.60; 0.24-0.97), trials in Non-Asian countries (ρ = 0.80; 0.61-0.99) than Asia (ρ = 0.67; 0.39-0.94), trials in patients with measurable lesions only (ρ = 0.91; 0.77-1.00) than in those including non-measurable lesions (ρ = 0.71; 0.50-0.93), albeit that none of these differences was significant. Our results indicate that improvements in PFS/TTP in advanced gastric cancer strongly correlate with improvements in OS. Further research is needed to clarify the surrogacy of PFS/TTP for OS or the role of PFS as the true end point in future randomized clinical trials of chemotherapy for AGC.

Reporting patient characteristics and stratification factors in randomized trials of systemic chemotherapy for advanced gastric cancer.

BACKGROUND: There is no consensus on which patient characteristics are the most suitable to report or to be used as stratification factors in clinical trials for advanced gastric cancer (AGC), to our knowledge. METHODS: We conducted a comprehensive review of published randomized trials for AGC to examine the patient characteristics that were reported. RESULTS: Among the 67 analyzed trials, age, gender, performance status, proportion of patients with measurable disease, and previous gastrectomy were frequently reported (>69%). Histology, number of disease sites, and adjuvant treatment were reported in less than 50% of trials. Although the reporting of second-line chemotherapy has increased in recent trials, it remains at less than 50%. Notably, recent trials have tended to include patients with better performance status and less locally advanced disease, with Asian trials more frequently including patients with more diffuse histology and less locally advanced disease or liver metastasis than non-Asian trials. Stratification was conducted in approximately 60% of the trials, using quite variable stratifying factors. CONCLUSION: Inconsistency exists in the reporting of patient characteristics, the characteristics themselves, and the use of stratification factors in clinical trials for AGC. A consensus set of important patient characteristics and strata may be necessary to conduct and interpret quality randomized studies.

[Factors related to subjective fatigue symptoms of adolescent girls].

OBJECTIVES: To assess changes in subjective fatigue symptoms of adolescent girls over a 15-year period and investigate factors related to these symptoms. METHODS: A total of 86 items on physical health (including subjective fatigue symptoms), dietary life, and daily living were investigated and five items on physical activity were measured for approximately 100 female first-year dietetic students at a junior college each October over the 15-year period from 1994 to 2008. A total of 1,547 students (mean age, 19.2 +/- 0.3 years) were studied. Subjects were first divided into two groups using the median subjective fatigue score as the cutoff point, and annual changes in the proportion of students in the high subjective fatigue group were investigated by simple regression analysis. In addition, relationships between the two subjective fatigue groups and each item were investigated. RESULTS: 1) The proportion of students with many subjective fatigue symptoms showed a significantly increasing trend over the 15-year period. 2) Investigation of relationships between subjective fatigue symptoms and each factor revealed significance for many items, including dietary habits, life satisfaction, amount of sleep, and desire for a positive body image. 3) In order to determine which of the items were most strongly related to subjective fatigue symptoms, multiple logistic regression analysis was performed for the 15-year period as well as three 5-year periods into which it was divided. The results showed that the dietary habits score (an indicator of dietary habits) and life satisfaction were related to subjective fatigue symptoms during all four periods. As for other items, relationships were observed for amount of sleep in three, diet and salt intake score in two, and liking for coffee/tea, juice drinks, and oily food, bedtime snack, desire for body image, self-assessment of body type, and health consciousness in one. CONCLUSION: These findings indicate that perspectives in education for promoting the health of adolescent girls must include attention to dietary habits, satisfaction with life, and correct awareness of body type.

Flowability of Gel-Matrix and Magnetorheological Response for Carrageenan Magnetic Hydrogels.

The relationship between rheological features in the absence of a magnetic field and magnetic response was investigated for κ-carrageenan magnetic hydrogels containing carbonyl iron particles. The concentration of carrageenan was varied from 1.0 to 5.0 wt%, while the concentration of carbonyl iron was kept at 70 wt%. The magnetic response revealed that the change in storage modulus ΔG' decreased inversely proportional to the carrageenan concentration. A characteristic strain γ1 where G' equals to G″ was seen in a strain range of 10-3. It was found that ΔG' was inversely proportional to the characteristic stress at γ1. Another characteristic strain γ2 where the loss tangent significantly increased was also analyzed. Similar to the behavior of γ1, ΔG' was inversely proportional to γ2. The characteristic stresses at γ1 and γ2 were distributed at 80-720 Pa and 40-310 Pa, respectively. It was revealed that a giant magnetorheology higher than 1 MPa can be observed when the characteristic stresses at γ1 and γ2 are below approximately 240 Pa and 110 Pa, respectively.

Magnetorheological Response for Magnetic Elastomers Containing Carbonyl Iron Particles Coated with Poly(methyl methacrylate).

The magnetorheological response for magnetic elastomers containing carbonyl iron (CI) particles with a diameter of 6.7 µm coated with poly(methyl methacrylate) (PMMA) was investigated to estimate the diameter of secondary particles from the amplitude of magnetorheological response. Fourier-transformed infrared spectroscopy revealed that the CI particles were coated with PMMA, and the thickness of the PMMA layer was determined to be 71 nm by density measurement. The change in the storage modulus for magnetic elastomers decreased by coating and it was scaled by the number density of CI particles as ΔG~N2.8. The diameter of secondary particle of CI particles coated with PMMA was calculated to be 8.4 µm. SEM images revealed that the CI particles coated with PMMA aggregated in the polyurethane matrix.

[The effects of dietary calcium and protein intake on changes in bone mineral density during early and late stages of pregnancy].

OBJECTIVE: The study was performed to examine the effects of calcium (Ca) and protein intake on changes in bone mineral density during early and late stages of pregnancy, including the relationship to bone metabolism. SUBJECTS AND METHODS: In 40 pregnant women, bone mineral density (BMD) was measured three times: at 11-16 weeks of gestation, at 24-28 weeks and within one week postpartum using ultrasonic bone densitometry. Bone metabolic markers in urine and serum were measured at the same time points. Ca and protein intakes over a three-day period were analyzed in relation to changes in BMD during the early and late stages of pregnancy, as well as to bone metabolic markers. Nutrient intake was adjusted for energy intake. Stiffness calculated from the combined value of the speed of sound transfer and broadband ultrasound attenuation was used as an index of BMD. RESULTS: Ca intake was positively correlated with change in BMD, whereas protein intake was negatively correlated in early and late stages of pregnancy. The extent of bone loss adjusted for Ga intake was significantly greater in women with a higher protein intake. In the early stage, Ca intake showed a positive correlation, whereas protein intake showed a negative correlation with the serum calcium/phosphorus ratio. In the late stage, Ca intake showed a positive correlation with bone alkaline phosphatase/urinary N-terminal cross-linking telopeptides of type I collagen ratio. CONCLUSION: These findings suggest that an increase in dietary Ga intake in both early and latestages of pregnancy may be important to maintain BMD during pregnancy. An increase in Ca intake in relation to greater protein intake may be necessary to prevent bone loss during pregnancy.

[Investigation of Successful Eyedrop Instillation Rates and Analysis of Drop Positions Using High-speed Digital Video Recording System].

We investigated the success rates of eyedrop instillation and the distance between the cornea and the dropper tip in 100 volunteers using high-speed digital video recording. Past eyedrop adherence studies assumed that instillation occurred without failure. The ideal distance between the cornea and dropper tip remained unclear, although the general estimate was approximately 2.54 cm (1 inch). This study was approved by the Institutional Review Boards of all participating medical institutions, and all volunteers provided written, informed consent. Successful instillation was defined as when 1 drop fell accurately into the eye on the first attempt. The instillation of ≥2 drops or drops delivered outside the eye was considered a failure. The distance between the eye and dropper tip was measured using still images from a paused digital video camera and a digital ruler. Forty percent of the volunteers instilled eyedrops without instructions from ophthalmologists, pharmacists, or other healthcare workers. When the images were analyzed, the success rate of the first instillation was 70.1%. When the eye was arbitrarily divided into 9 sections, most of the drop sites were the iris or the center of the eye. The distance between the dropper tip and cornea was 2.62±1.75 (median 2.20) cm. These results indicate that the generally recommended distance is usually followed. The successful instillation rate based on the distance from the dropper tip to the cornea was 77% at 1.6±0.88 cm and 54.9% at 4.8±1.25 cm.

Particle Size in Secondary Particle and Magnetic Response for Carrageenan Magnetic Hydrogels.

The relation between the number of magnetic particles and the change in storage modulus induced by a magnetic field was investigated for weak hydrogels containing carbonyl iron, iron oxide, and barium ferrite particles with different diameters in primary particles while maintaining the magnetization of magnetic particles. The change in storage modulus exhibited a power dependency against the number of magnetic particles, which was nearly independent of the magnetic particles. The change in storage modulus was successfully scaled by the reduced number of magnetic particles using the diameter of secondary particles. Microphotographs revealed that iron oxide and barium ferrite particles form aggregations while carbonyl iron particles are well dispersed in carrageenan gels. The diameter of secondary particles determined by a relation between the change in storage modulus and the reduced number of magnetic particles showed similar values with those observed in microphotographs.

Incidence of dementia, Alzheimer disease, and vascular dementia in a Japanese population: Radiation Effects Research Foundation adult health study.

OBJECTIVE: To determine the age-, sex-, and subtype-specific incidence of dementia and to assess the effect of education level on the incidence in a Japanese population. METHODS: 2,286 dementia-free subjects, aged > or =60 years, were followed for 5.9 years through biennial two-phase examinations. RESULTS: 206 cases of dementia were newly diagnosed based on DSM IV. The incidence per 1,000 person-years was 12.0 for men and 16.6 for women. Based on NINCDS-ADRDA criteria, 80 cases of probable Alzheimer disease (AD) and 50 cases of possible AD were diagnosed. Based on NINDS-AIREN criteria, 36 cases of probable vascular dementia (VaD) and 40 cases of possible VaD were diagnosed. Age and education showed the most statistically significant effects for all dementia. Probable AD showed the most remarkable increase with age and decreased with increasing education level (p = 0.001). Probable VaD showed significant effects of sex (p = 0.033) and sex-age interaction (p = 0.048), but not education (p = 0.26). CONCLUSION: AD was the predominant type of dementia in this recent incidence study conducted in Japan, suggesting a reduction in VaD and an increase in AD. Age, sex, and education effects differed by dementia subtype.

Lack of association of the Trp64Arg polymorphism of beta3-adrenergic receptor gene with energy expenditure in response to caffeine among young healthy women.

A close relationship between coffee intake and certain metabolic disorders is known. Caffeine, one of coffee components, can increase energy expenditure (EE), but there are considerable individual differences in the caffeine effects on EE, and the causes have not been fully established in humans. The Arg allele in the beta(3)-adrenergic receptor gene (beta(3)-AR), a marker for obesity-related traits, may be a contributor to individual variations in EE. This study investigated the effect of the Arg allele of beta(3)-AR on caffeine-induced increases in EE. In 44 healthy young women (21 +/- 1 years), physical characteristics, blood pressure, biochemical profiles and dietary nutritional intake were measured. A caffeine-loading test was conducted at a dosage of 4 mg per body weight (kg). EE was measured using an indirect open-circuit calorimeter for a 10-min period before, and at 30 min and 60 min after the caffeine-loading test. The beta(3)-AR Trp64Arg polymorphism was detected with a PCR-restriction fragment length polymorphism method. The frequency of the Arg allele was 24%. The distribution of the Trp/Trp, Trp/Arg, and Arg/Arg genotypes was 58%, 36%, and 6%, respectively. At the baseline, subjects with the Arg/Arg genotype had a significantly lower EE level than those with the Trp/Trp or Trp/Arg genotype. After the caffeine-loading test, there were caffeine-induced increases in EE in all genotypes, but there were no differences in the levels of increase among the genotypes. These findings suggest that the genotypes of beta(3)-AR Trp64Arg polymorphism might be not associated with caffeine-induced increases in EE levels.

Effect of Sonication Time on Magnetorheological Effect for Monomodal Magnetic Elastomers.

The effect of sonication time on the storage modulus and particle morphology for magnetic elastomers was investigated by dynamic viscoelastic measurements and morphological studies. An ultrasonic wave using a homogenizer was irradiated to magnetic liquids containing 70 wt % carbonyl iron, for up to 30 min before cure. SEM photographs revealed that magnetic particles were randomly dispersed in the polyurethane matrix for magnetic elastomers with sonication. A parameter showing nonlinear viscoelasticity for magnetic elastomers with sonication decreased from 0.75 to 0.4, indicating that the aggregations of magnetic particles had been destroyed by the sonication. The storage modulus at 500 mT at the linear viscoelastic regime significantly increased with the irradiation time, reaching saturation after 10 min; this suggests an increase in the number of chains of magnetic particles by sonication, due to the random dispersion of magnetic particles. At high strains, the storage modulus at 500 mT increased by 8.9 kPa by sonication, indicating the number of chains of magnetic particles which were not destroyed by increased sonication. It was also found that the storage modulus for polyurethane elastomers without magnetic particles was not varied by sonication, suggesting that the polyurethane network was not broken. The effect of sonication time on the viscoelastic properties, and on the magnetorheological response for magnetic elastomers, is discussed.

Therapeutic effects of intensive inpatient rehabilitation in advanced Parkinson's disease.

BACKGROUND: The importance of rehabilitation therapy in Parkinson's disease is well recognized. However, the effects of an inpatient rehabilitation program for advanced Parkinson's disease have not been fully investigated. AIM: To assess the effects of intensive inpatient rehabilitation. METHODS: We enrolled 31 patients (mean age 69.5 ± 9.4 years; mean disease duration 8.8 ± 6.4 years) with advanced Parkinson's disease, without severe cognitive impairment. The median Hoehn-Yahr stage was IV. Patients received 2 h of individualized rehabilitation for 6-7 days each week for 1 month. At hospital discharge, patients and caregivers were instructed to continue daily exercise. RESULTS: Motor and total scores of Functional Independence Measures significantly improved between admission and discharge in patients with stage III and IV disease, but not stage V. There was no significant effect of Hoehn-Yahr stage on improvements in Unified Parkinson's Disease Rating Scale scores, (total, part I, II or III), cognitive Functional Independence Measures or Berg Balance Scale. CONCLUSION: Intensive inpatient rehabilitation was effective even in advanced Parkinson's disease. Intensive inpatient rehabilitation, together with home and day-care exercise, might counteract the progressive motor decline in Parkinson's disease.

Inpatient Multidisciplinary Rehabilitation Intervention Outcomes for Neuromyelitis Optica Spectrum Disorder: A Retrospective Observational Study.

OBJECTIVE: Neuromyelitis optica spectrum disorders (NMOSD) are immune-mediated chronic inflammatory disorders of the central nervous system that are predominantly characterized by attacks of optic neuritis and/or transverse myelitis. The aim of this study was to investigate the clinical rehabilitation course of patients with NMOSD. METHODS: We carried out a retrospective evaluation of 20 cases of NMOSD in which the patients underwent multidisciplinary inpatient rehabilitation intervention starting within 2 months after acute exacerbation. Rehabilitation outcomes were assessed using the modified Rankin Scale, the Expanded Disability Status Scale (EDSS), and the Functional Independence Measure (FIM). RESULTS: A total of 19 cases were finally included in this study. The average EDSS scores ranged from 5.9 to 7.1 during hospitalization. Lower age significantly correlated with improved EDSS scores. Changes in the EDSS score during rehabilitation varied in patients experiencing their first attack; however, improvements in the EDSS score of ≥ 1.5 were observed only in patients who had experienced two or less attacks. During rehabilitation, the FIM significantly improved from 81.4 to 101.7, with a gain of 20.3 and efficacy of 0.2/day. CONCLUSION: Multidisciplinary rehabilitation may improve functional recovery after NMOSD attacks. Younger age and two or less attacks were associated with better outcomes in this study.

[Relationship between life satisfaction and lifestyle in residents of Kyoto].

OBJECTIVE: The purpose of this study was to assess relationships between life satisfaction and lifestyle in residents of the city of Kyoto, Japan, by addressing their subjective evaluation of their own health status. METHODS: The subjects comprised 4746 men and women (15-97 years old) who had completed a questionnaire on life style in the 1998 Kyoto Citizen's Health and Nutrition Study. Stratified by their responses to subjective health, the relationship between life-satisfaction and lifestyle was evaluated by odds ratios and chi-square tests of the subjects classified by age and gender. RESULTS: The proportion of respondents who felt their subjective health was good decreased with age, while the proportion of respondents who considered their life satisfaction good increased with age. Whether the residents had good or poor subjective health, the proportion of respondents who had a healthy lifestyle, as exemplified by having breakfast everyday, having dinner with their family regularly and having a good intake of greeny-ellow vegetables increased with age in both men and women. This healthy lifestyle was also positively associated with good life satisfaction. CONCLUSION: Whether the residents had good or poor subjective health, these results suggest that thos with a healthy lifestyle feel good life satisfaction.

Endothelial markers and adhesion molecules in acute ischemic stroke--sequential change and differences in stroke subtype.

The progress of a stroke concerns the activation of endothelial cells and platelets. We measured the plasma activities of von Willebrand factor (vWf) and the serum levels of soluble thrombomodulin (sTM) as endothelial markers, and the plasma concentrations of soluble P-selectin (sP-selectin) and soluble E-selectin (sE-selectin) as adhesion molecules during the acute (within 48 h from onset) and subacute (after 1 month from the onset) phases of 52 consecutive patients with acute ischemic stroke and 86 age-matched control subjects. The plasma vWf activities and levels of sP-and sE-selectins in stroke patients were significantly elevated compared with those in controls during both the acute and subacute phases. The serum levels of sTM in stroke patients were significantly higher than those in controls only during the subacute phase. In atherothrombotic infarction, the vWf activities and the levels of sP-selectin, markers for endothelial and platelet activation, remained higher until the subacute phase compared with controls, and the concentrations of sTM, a marker for endothelial injury, were increased during the subacute phase compared with during the acute phase. In lacunar infarction, the levels of sTM and sE-selectin of patients were higher only during the acute phase than controls. These findings suggest that the endothelial cell damage might be maintained until the subacute phase in atherothrombotic infarction, whereas it is remarkable only during the acute phase in lacunar infarction. The evaluation of endothelial markers and adhesion molecules would represent the pathophysiological states of stroke and may provide useful information for the treatment of the ischemic infarction.