Wall shear stress in the human common carotid artery as function of age and gender

OBJECTIVES: It has been postulated that in the arterial system mean wall shear stress is maintained at a constant value. The present study was performed to investigate the level of wall shear stress in the common carotid artery (CCA) as function of age and possible interactions between diameter and storage capacity, defined as the absolute area change per heart beat, with mean wall shear stress. METHODS: Wall shear stress (wall shear rate multiplied by whole blood viscosity) was assessed in the right CCA of 111 presumed healthy male (n = 56) and female (n = 55) volunteers, varying in age between 10 and 60 years. Wall shear rate was measured with a high resolution ultrasound system. Simultaneously, arterial diameter and storage capacity were determined. Whole blood viscosity was calculated from haematocrit, plasma viscosity and shear rate. RESULTS: From the second to the sixth age decade peak wall shear stress was significantly higher in males than in females and decreased from 4.3 Pa to 2.6 Pa (r = -0.56, p < 0.001) in males and from 3.3 Pa to 2.5 Pa (r = -0.54, p < 0.001) in females. Mean wall shear stress tended to decrease from 1.5 Pa to 1.2 Pa (r = -0.26, p = 0.057) in males and decreased significantly from 1.3 Pa to 1.1 Pa (r = -0.30, p = 0.021) in females. No significant difference in mean wall shear stress was found between males and females in any age decade. The diameter of the CCA increased significantly in both males (r = 0.26, p < 0.05) and females (r = 0.40, p < 0.003). Storage capacity decreased significantly in both sexes (males: r = -0.63, p < 0.001; females: r = -0.68, p < 0.001). CONCLUSIONS: These observations suggest that the reduction in mean wall shear stress with age results from the concomitant increase in diameter in an attempt of the arterial system to limit the reduction in storage capacity of the arterial system with increasing age.     

Autoregulation during pressor response elevates wall shear rate in arterioles

Autoregulation of blood flow implies reciprocal changes in vessel diameter and red blood cell velocity (VRBC) when perfusion pressure is altered. We tested two hypotheses: 1) blood flow will be autoregulated throughout arteriolar networks during a pressor response, and 2) wall shear rate (WSR; proportional to VRBC/diameter) will increase during autoregulation. Male hamsters (109 +/- 3 g; n = 22) were anesthetized (pentobarbital sodium 60 mg/kg), and the cremaster muscle was prepared for intravital videomicroscopy. Internal diameter and VRBC were monitored in first (1A)- through fourth (4A)-order arterioles; WSR and blood flow were calculated. Data were acquired at rest and at the peak of diameter responses to bilateral carotid artery occlusion (CAO). At rest, 1) mean arterial and 1A transmural pressures were 100 +/- 5 and 59 +/- 4 mmHg, respectively; 2) as branch order increased, arteriolar diameter, VRBC, and blood flow decreased (P < 0.05); and 3) WSR and resting tone increased with branch order (P < 0.05). During pressor responses to CAO, 1) arterial and 1A pressures increased to 145 +/- 7 and 89 +/- 5 mmHg, respectively (P < 0.05); 2) 1A branches dilated while 2A, 3A, and 4A branches constricted (P < 0.05); 3) VRBC and WSR increased in all branches (P<0.05); and 4) blood flow increased in 1A and 2A branches (P < 0.05), yet was unchanged (i.e., was autoregulated) in 3A and 4A branches. Arteriolar constrictions during CAO were not affected by alpha-adrenoceptor blockade with phentolamine (10(-6) M). We conclude that autoregulation of muscle blood flow during a pressor response involves myogenic constriction of arterioles with concomitant elevation of WSR.     

Automatic accurate non-invasive quantitation of blood flow, cross-sectional vessel area, and wall shear stress by modelling of magnetic resonance velocity data

OBJECTIVES: To apply a new, automatic and non-invasive method for quantification of blood flow, dynamic cross-sectional vessel area, and wall shear stress (WSS) by in vivo magnetic resonance velocity mapping of normal subjects. DESIGN: Prospective, open study. MATERIALS: Six young volunteers. METHODS: A three-dimensional paraboloid model enabling automatic determination of blood flow, vessel distensibility and WSS was applied to blood velocity determinations in the common carotid artery. Blood flow was also determined by a manual edge detection method. RESULTS: Using the new method, the common carotid mean blood flow was 7.28 (5.61-9.63) (mean (range)) ml/s. By the manual-method blood flow was 7.21 (5.55-9.60) ml/s. Mean luminal vessel area was 26% larger in peak systole than in diastole. Mean/peak WSS was 0.82/2.28 N/m2. Manually and automatically determined flows correlated (r2 = 0.998, p < 0.0001). WSS and peak centre velocity were associated (r2 = 0.805, p < 0.0001). CONCLUSIONS: Blood flow, luminal vessel area dilatation, and WSS can be determined by the automatic three-dimensional paraboloid method. The hypothesis of association between peak centre velocity and WSS was not contradicted by the results of the present study.     

Anxiety and the variability of word associates.

15 Ss who scored high on the Taylor MA scale and 15 Ss who scored low on the MA scale were given a word associate task. The highly anxious Ss tended to have sets of word associates lower in intersubject variability than the nonanxious Ss for stimulus words that elicited sets of word associates that are low in variability. Highly anxious Ss tended to give sets of word associates higher in intersubject variability than nonanxious Ss for stimulus words that elicited sets of word associates that are high in intersubject variability. A 2nd experiment reports data indicating a relationship between inter- and intrasubject variability of word associates. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A spreadsheet program for simulation of bioequivalence and bioavailability studies

This paper presents a spreadsheet for Excel for Windows, which simulates bioequivalence (BE) trials. The program incorporates intersubject and intrasubject variability in drug absorption and disposition as well as assay precision and the uniformity of the administered dose. The output provides confidence intervals and a pass/fail code for each study. This program is useful for simulating BE trials using widely available and simple-to-use spreadsheet programs. An example of the application of the program in assessing the influence of intrasubject variability on the outcome of BE testing of two identical formulations is also presented.     

Effect of fasting, refeeding, and dietary fat restriction on plasma leptin levels

The factors responsible for the variability in plasma leptin levels observed among individuals with similar body compositions remain unclear. To examine the impact of dietary variables, we compared the changes in leptin levels induced by fasting and dietary fat restriction with the expected decrease following a significant loss in adipose mass. A 21.4 +/- 3.7% weight loss led to a 76.3 +/- 8.1% decrease in mean plasma leptin level (25.2 +/- 9.3 to 6.1 +/- 3.4 ng/mL, P = 0.0001) in a group of 9 obese males. Despite a weight loss of only 2.6 +/- 0.8%, mean plasma leptin levels fell by 61.9 +/- 25.2% (8.5 +/- 4.5 to 2.4 +/- 0.5 ng/mL, P < 0.01) in 7 nonobese females subjected to 3 days of fasting. Leptin levels in fasted subjects returned to baseline within 12 h of refeeding. Individual high- and low-fat meals given to 19 subjects after an overnight fast had no effect on plasma leptin levels. Reduction in dietary fat content from 37-10% of total calories for 7 weeks was also without effect on plasma leptin levels in these subjects. We conclude that plasma leptin levels primarily reflect total adipose mass, rather than meal consumption or dietary energy source, but that the reduction in leptin levels with ongoing fasting is disproportionate to the reduction in adipose mass. The ability of fasting to deactivate this presumed physiological satiety system may have been advantageous in environments characterized by rapid changes in food availability.     

Anatomical and morphological factors correlating with rupture of intracranial aneurysms in patients referred for endovascular treatment

Ambulatory blood pressure (ABP) measurements were performed in a Danish population of 295 males and 275 females aged 19-21 years. Individualised day and night periods were defined from the subjects own recording of bedtime and rising on the day of their ABP measurements. During these individualised periods the ABP values for daytime, night-time and for the whole 24-h period were measured. The mean +/- s.d. values for systolic/diastolic ABP for the whole population were (124+/-11)/(70+/-7) mm Hg in the daytime, (106+/-12)/(60+/-9) mm Hg in the night-time, and (120+/-11)/(68+/-7) mm Hg in the whole 24-h period. Males had a mean systolic ABP of 9 mm Hg and mean diastolic ABP of 5 mm Hg higher than females. In males mean +/- s.d. systolic/diastolic ABP values in the daytime were (129+/-10)/(73+/-7) mm Hg, in the night-time (111+/-12)/(63+/-8) mm Hg, and in the whole 24-h period (125+/-10)/(71+/-7) mm Hg. The corresponding values in females were (119+/-10)/(68+/-6) mm Hg, (103+/-11)/(57+/-8) mmHg, and (115+/-10)/(66+/-6) mm Hg, respectively. In conclusion this study provides sex-specific normal values for ABP in a 19 to 21-year-old age group based on individualised daytime and night-time periods.     

Chronic ethanol treatment leads to increased ornithine decarboxylase activity: implications for a role of polyamines in ethanol dependence and withdrawal

STUDY OBJECTIVES: To determine intrasubject and intersubject variability in, and the effects of food and antacids on, the pharmacokinetics of pyrazinamide (PZA). DESIGN: Randomized, four-period, crossover phase I study. SUBJECTS: Fourteen healthy men and women volunteers. INTERVENTIONS: Subjects ingested single doses of PZA 30 mg/kg under fasting conditions twice, without a high-fat meal and with an aluminum-magnesium antacid. They also received standard dosages of isoniazid, rifampin, and ethambutol. MEASUREMENTS AND MAIN RESULTS: Serum was collected for 48 hours and assayed by gas chromatography with mass selective detector. Data were analyzed by noncompartmental methods and a compartmental analysis using nonparametric expectation maximization. Both fasting conditions produced similar results: mean PZA Cmax 53.4+/-10.4 microg/ml, Tmax 1.43+/-1.06 hours, and AUC(0-infinity) 673+/-79.7 microg x hr/ml. Fasting results are similar to those in previous reports. In the presence of antacids, subjects had a mean Cmax of 55.6+/-9.0 microg/ml, Tmax of 1.43+/-1.23 hours, and AUC(0-infinity) of 628+/-88.4 microg x hr/ml. In the presence of the high-fat meal, mean Cmax was 45.6+/-9.44 pg/ml, Tmax 3.09+/-1.74 hours, and AUC(0-infinity) 687+/-116 microg x hr/ml. CONCLUSIONS: These small changes in Cmax, Tmax, and AUC(0-infinity) can be avoided by giving PZA on an empty stomach whenever possible.     

Characterization of stability of performance in patients with traumatic brain injury: Variability and consistency on reaction time tests.

The stability of performance of reaction times (RTs) on 3 visual discrimination tasks was assessed in patients with varying severity of traumatic brain injury (TBI) and in matched control Ss. Results were analyzed for group and individual variability and consistency of performance over time. There was significantly greater intersubject (group) variability in the TBI group. Individual patients (intrasubject) tended to be more variable in performance and less consistent over time than control Ss, but this occurred only with specific measures, which suggests that increased lack of stability in performance is not a general impairment after brain damage but requires specific analyses for identification of performance differences. This intrasubject variability was indepedent of test–retest and split-half test reliability. No obvious factors such as severity of brain injury were related to the variability and inconsistency of performance. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Differences in near-wall shear rate in the carotid artery within subjects are associated with different intima-media thicknesses

In the common carotid artery, reflections originating from the periphery and the flow divider may affect the shape of the flow velocity profile and, hence, near-wall shear rate (WSR) differently just before the bifurcation (location B) than 20 to 30 mm farther upstream (location A). Recent developments in ultrasound technology allow the assessment of WSR and intima-media thickness (IMT) at the same site in the carotid artery in vivo. We therefore determined WSR at locations A and B and investigated whether the differences between both sites, if any, were associated with different IMTs and different mechanical properties of the arterial wall. The effect of age on the possible differences was assessed as well. The study was performed on presumably healthy volunteers (n=53). In all individuals, IMT was larger at location B than at location A. The relative difference in IMT between both locations was not affected by age. No significant differences in diameter and distension were found between locations. Near peak systolic and near mean WSR at the posterior wall (PWSRp and MWSRp, respectively) were significantly lower at location B than at location A. The relative differences in PWSRp and MWSRp between both locations within subjects were independent of age. The velocity profiles were more blunted at location A than at location B. PWSRp and MWSRp significantly decreased and IMT significantly increased with age at both locations. IMT was negatively correlated with PWSRP and MWSRP at location B, but this correlation was not significant at location A. In summary, in the common carotid artery, the lower WSR near the bifurcation, as compared with 20 to 30 mm upstream, is associated with a larger IMT than at the more proximal site. The relative difference between both locations within subjects is independent of age.     

Some tests of response habituation in rats with discrete lesions to the orbital or medial frontal cortex.

Studied the inter- and intrasession habituation rates of 33 male albino rats with aspiration lesions to the medial frontal or orbital frontal cortex or with no lesions in 2 situations (open field and investigatory head poke). Medial frontal lesions produced impaired intrasession habituation in both test situations, while orbital frontal lesions failed to alter significantly intrasession habituation in either situation, and neither lesion significantly altered intersession habituation rates. Data confirm earlier reports of functional dissociation within the prefrontal cortex of the rat and suggest that only the medial frontal cortex is involved in the habituation process. (French summary) (24 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Impact of gender on the metabolism of apolipoprotein A-I in HDL subclasses LpAI and LpAI:AII in older subjects

The behavior of apolipoprotein (apo) A-I in lipoprotein (Lp) AI and LpAI:AII was studied in 11 postmenopausal females and 11 males matched for plasma triglyceride and total cholesterol levels. Subjects consumed a baseline diet [35% fat (14% saturated, 15% monounsaturated, and 7% polyunsaturated), 15% protein, 49% carbohydrate, and 147 mg cholesterol/1000 kcal] for 6 weeks before the start of the kinetic study. At the end of the diet period, using a primed-constant infusion of [5,5,5-2H3]leucine, residence times (RT) and secretion rates (SR) of apoA-I were determined in 2 subpopulations of high-density lipoprotein (HDL) particles, LpAI and LpAI:AII. Plasma total cholesterol, low-density lipoprotein cholesterol, and triglyceride concentrations were similar in males and females. The mean plasma HDL cholesterol concentration in males (1.14 +/- 0.23 mmol/L; mean +/- SD) was lower than in females (1.42 +/- 0.18 mmol/L; P =. 0034). Similarly, the mean plasma concentration of apoA-I in males (130 +/- 21 mg/dL) was lower than that in females (150 +/- 19 mg/dL; P = .0421). The RT of apoA-I in either LpAI or LpAI:AII was similar between men and women. Despite the higher plasma apo A-I levels in female compared with male subjects, total apoA-I and apoA-I in LpAI and LpAI:AII pool sizes were similar between the two groups, attributable to the lower body weight of the female subjects. The mean SR of total apoA-I in males (8.5 +/- 2.7 mg.kg-1.d-1) was 22% lower than in females (10.9 +/- 2.3 mg.kg-1.d-1; P = .0389). The SR of both apoA-I in LpAI and LpAI:AII was lower in males than females, although the differences did not reach statistical significance. These data suggest that the difference observed in HDL cholesterol concentration between males and females is attributable to SR of apoA-I and not the catabolic rate.     

Functional outcome of patients with chronic obstructive pulmonary disease and exercise hypercapnia

Chronic hypercapnia is associated with a poor prognosis in chronic obstructive pulmonary disease (COPD). Some patients are normocapnic at rest but retain CO2 during exercise. The significance of this abnormality on the course of the disease is unknown. Sixteen stable COPD patients (13 males and 3 females, aged 60 +/- 5 yrs, mean +/- SD) who had previously undergone pulmonary function tests and progressive exercise testing with arterial blood sampling at rest and maximal capacity, entered the study. At first evaluation (E1), subjects were normocapnic at rest (arterial carbon dioxide tension (Pa,CO2): 4.9-5.7 kPa, (37-43 mmHg)) and all presented exercise-induced hypercapnia (end-exercise Pa,CO2 > 5.7 kPa (43 mmHg) with a minimal 0.5 kPa (4 mmHg) increase from resting value). The subjects were re-evaluated 24-54 months later (34 +/- 8 months) (second evaluation (E2)). At E2, forced expiratory volume in one second (FEV1) had decreased from 42 +/- 13 to 38 +/- 15% of predicted values, and mean resting Pa,CO2 had increased from 5.2 +/- 0.3 to 5.7 + 0.4 kPa. Maximal exercise capacity (Wmax) decreased between E1 and E2 from 76 +/- 30 to 56 +/- 22 W. Even if Wmax was lower at E2, end-exercise, Pa,CO2 was higher than at E1 (6.6 +/- 0.8 vs 6.4 +/- 0.5 kPa). At E2, eight subjects presented resting hypercapnia (group H), whilst the others remained normocapnic (Group N). Group H subjects had higher Pa,CO2, at Wmax than Group N and lower Wmax than Group N at E2.(ABSTRACT TRUNCATED AT 250 WORDS)     

Relationship between anatomic lesions of the temporal lobe and temporal lobe epilepsy

A structural lesion of the brain is a frequent finding in intractable partial epileptic patients. We analyse anatomo-electro-clinical characteristics of 58 patients in which MR showed a lesion inside the temporal lobe. They are 29 males and 29 females with a mean age at surgery of 23.5 +/- 10.7 years (2.6-45.9). The mean epilepsy duration is of 13.4 +/- 8 years (1.3-35.5), with a mean seizure frequency of 28.7 +/- 43.6 per month, with a great inter-individual variability (from 3 per month to 15 a day). The minimum follow-up is 3.5 years. A video-EEG monitoring was performed in 21 cases, while a stereo-EEG investigation was judged mandatory in 26. On the basis of anatomo-electro-clinical correlations and of the results of presurgical investigations, the epileptogenic area was proved to be temporal in 49 cases, temporal but controlateral to the lesion in 1, and at least bilobar in 8 patients.     

Distortion product otoacoustic emission delay measurement in human ears

The measurement of distortion product otoacoustic emission (DPOAE) delay using the phase gradient method is discussed. A short f2 sweep paradigm is described. Its merits are discussed and comparisons made with other methods. Using sweeps of less than 4%, consistent and reliable measurements were obtained from 12 normal ears, except for a few isolated measurements. Investigation of these apparent anomalies indicated that the short f2 sweep method was sensitive to the localized effects of narrow distortion product intensity notches and spontaneous emissions. It is possible that middle ear pressure instability or some local change in the cochlea sometimes compounded the situation. The intersubject range (63% of the mean) of DPOAE delay values was greater than the range of values observed due to measurement variability (5.6% of the mean) or intrasubject variability (8.5% of the mean) demonstrating that the method can detect real differences between ears. However, comparison with previous work shows that caution is needed in interpreting these data, as all DPOAE phase methods provide only partial latency values. The physical interpretation depends on both the stimulus sweep used and the origin of DPOAES. Our data shows that f1 sweep derived latency is lower than f2 sweep data by more than 20%. Caution also needs to be exercised when comparing cochlear traveling wave delay, as inferred from electrophysiological data, with that obtained from DPOAE delay measurements.     

Development of a research-based standard for assessment, intervention, and evaluation of pain after neonatal and pediatric cardiac surgery

OBJECTIVE: To apply a new non-invasive method for quantification of in vivo wall shear stress (WSS) by magnetic resonance (MR) FAcE velocity mapping and measure WSS in the human abdominal aorta. DESIGN: Prospective, open study. MATERIAL: Six volunteers. METHODS: MR FAcE velocity method was developed for measurements of mean, maximum, minimum WSS and oscillating shear index (OSI) values at the anterior and posterior walls of suprarenal and infrarenal abdominal aorta. RESULTS: The mean, maximum and minimum WSS values were 0.63/0.28, 4.07/2.72 and -0.71/-1.00 N/m2, respectively, in the suprarenal/infrarenal aorta. The mean WSS was 0.35 N/m2 (p < 0.001) and the maximum WSS was 1.36 N/m2 (p < 0.0001) lower in the infrarenal aorta than in the suprarenal aorta. Mean, maximum minimum WSS and OSI values in the infrarenal position differed (p < 0.01) between the anterior and posterior walls. CONCLUSION: WSS can be determined in vivo by MR FAcE velocity technique. Since the lowest WSS values were measured in the infrarenal, posterior blood-to-wall interface, the theory of more pronounced atherosclerosis development in low and oscillating WSS domains was not contradicted by the results of the present study.     

Measurement of blood loss and bleeding pattern from the bleeding time incision

Intervention studies have shown that the adaptation of fat oxidation to fat intake, when changing the dietary fat content, is not abrupt. This study was conducted to measure the time course of adaptation of oxidation rates to increases in the fat content of the diet, when feeding subjects at energy balance. Twelve healthy, non-obese males and females (age: 26 +/- 2, BMI: 21.4 +/- 0.5, habitual fat intake: 29 +/- 1% energy) consumed a low-fat diet for 6 days (days 1-6) followed by a high-fat diet for 7 days (day 7-13). Days 5-9 and day 13 were spent in a respiration chamber. After adjusting energy intake to 24h energy expenditure on day 5, subjects were in energy balance (range -0.15 to +0.23 kJ/day) on days 6-9 and day 13. Fat balance was zero on day 6 but became positive after changing to the high-fat diet (1.06 +/- 0.15, 0.75 +/- 0.15, and 0.55 +/- 0.14 MJ/day for days 7, 8, and 9 respectively, p. < 0.05), reaching a new balance on day 13, 7 days afterwards. Thus, in case of energy balance, lean subjects are capable of adjusting fat oxidation to fat intake within 7 days, when dietary fat content is increased.     

Prediction of dynamic tendon forces from electromyographic signals: an artificial neural network approach

Artificial neural networks (ANN) with a backpropagation algorithm were used to predict dynamic tendon forces from electromyographic (EMG) signals. To achieve this goal, tendon forces and EMG-signals were recorded simultaneously in the gastrocnemius muscle of three cats while walking and trotting at different speeds on a motor-driven treadmill. The quality of the tendon force predictions were evaluated for three levels of generalization. First, at the intrasession level, tendon force predictions were made for step cycles from the same experimental session as the step cycles which were used to train the ANN. At this level of generalization very good results were obtained. Second, at the intrasubject level, tendon force predictions were made for one cat walking at a given speed while the ANN was trained with data from the same animal walking at different speeds. For the intrasubject predictions, the quality of the results depended on the walking speed for which the predictions were made: for the speeds at the low and high extremes, the predictions were worse than for the intermediate speeds. The cross-correlation coefficients between predicted and actual force time histories ranged from 0.78 to 0.91. Third, at the intersubject level, tendon forces were predicted for one animal walking at a given speed while the ANN was trained with data from the remaining two animals walking at the corresponding speed. The cross-correlation coefficients between predicted and actual force time histories ranged from 0.72 to 0.98. It was concluded that the ANN-approach is a powerful technique to predict dynamic tendon forces from EMG-signals.     

Intracellular application of calmidazolium increases Ca2+ current through activation of protein kinase A in cultured vascular smooth muscle cells

This study compared markers of the metabolic processes occurring in male and female adolescent triathletes from two age groups (over 15 years of age [O15] and under 15 years of age [U15]) during a laboratory based duathlon. Participants were tested on three separate occasions; two peak VO2 tests on a treadmill and cycle ergometer, and a third session involved a simulated duathlon (2 km run, 12 km ride and 4 km run for the O15 group or 1 km run, 8 km ride and 2 km run for the U15). Data collection included performance speed, cardiorespiratory responses and blood borne markers of exercise metabolism. The performance speeds selected by the two age groups did not differ. The mean relative percentage of VO2peak at which subjects participated were 79+/-3, 77+/-4%, for the O15 males and females, and 71+/-5 and 82+/-2%, for the U15 males and females, respectively. While the plasma metabolites of ammonia [NH3] and lactate [La] were not different between age groups and sex (p>0.05) there were however, higher concentrations recorded during the cycling phase when compared with the running phases (p < 0.05). The respective mean concentrations for NH3 and La were 80.5+/-5.6 microM, and 4.9+/-0.3 microM for cycling, and 56.3+/-2.7 microM, and 2.7+/-0.2 microM for the combined running phases.     

Ovarian sensitivity to exogenous gonadotrophins in phenobarbital treated unilaterally ovariectomized albino rats

To evaluate platelet activity in patients with non-insulin-dependent diabetes mellitus (NIDDM), we measured the mean platelet volume (MPV) and 24-hour urinary excretion of 11-dehydro-thromboxane B2 (11-dTXB2) and 6-keto-prostaglandin F1 alpha (6-kPGF1 alpha), stable metabolites of thromboxane A2 and prostacyclin, respectively. The MPV of the 103 subjects in the NIDDM group were 10.72 +/- 0.82 fl for males and 10.52 +/- 1.01 fl for females (mean +/- SD), significantly higher than those of normal controls (9.95 +/- 0.75 fl for males and 9.84 +/- 0.72 fl for females). The MPV of patients with NIDDM showed positive correlations with fasting plasma glucose level and HbA1c (r = 0.234, P < 0.05; r = 0.267, P < 0.01, respectively). The urinary excretion of 11-dTXB2 was greater in the NIDDM group (7.58 +/- 4.42 micrograms/day for males and 5.65 +/- 2.38 micrograms/day for females) than in the normal controls (4.61 +/- 2.31 and 3.83 +/- 1.60, respectively), suggesting that the synthesis of thromboxane A2 by platelets may be accelerated in vivo in patients with NIDDM. The urinary 6-kPGF1 alpha was not different between the NIDDM group and normal controls among the males, but was greater in the NIDDM group among the females. As MPV showed a positive correlation (r = 0.364, P < 0.05) with urinary excretion of 11-dTXB2, MPV may be related to platelet activity. These findings suggest that the platelets of patients with NIDDM may be in a hyperactive state.