[The effect of operating time of PMX-DHP on decrease of platelets].

BACKGROUND: Recently, it is said that long-term PMX-DHP is beneficial for severe septic shock. Decrease in platelets, however, is one of the problems of PMX-DHP. We retrospectively examined the effect of operating time of PMX-DHP on decrease of platelets. METHODS: Forty-nine subjects were divided into three subgroups by their operating times of PMX-DHP. In short (S) group, the operating time was below 4 hours, and the group comsisted of 13 subjects. Intermediate (I) group with operating time of 4-12 hours, had 15 subjects. And long (L) group with operating time of 12-24 hours, had 21 subjects. Rate of decrease of platelets was compared between these subgroups. RESULTS: Decreased rate of platelets of each sub-group is as follows; S group showed 16.7 +/- 28.4%, I group showed 25.5 +/- 28.1%, and L group showed 23.7 +/- 30.3% respectively. And there were no significant differences between these subgroups. CONCLUSIONS: Decreased rate of platelets was around 20% as previously reported and constant regardless of duration of operating times of PMX-DHP. Long-term PMX-DHP within 24 hours is practically safe in case of severe septic shock.

Relationships between fat deposition in the liver and skeletal muscle and insulin sensitivity in Japanese individuals: a pilot study.

PURPOSE: To evaluate the relationships between insulin sensitivity (IS), body fat accumulation, and aerobic capacity in middle- to older-aged Japanese participants with visceral adiposity. PARTICIPANTS AND METHODS: Aerobic capacity was measured during an incremental ramp exercise test. Computed tomography was used to measure visceral (VFA) and subcutaneous (SFA) fat area, the fat in liver-to-spleen ratio (L/S), and low-density skeletal muscle area (LDMA). IS was assessed using euglycemic-hyperinsulinemic clamps. RESULTS: A total of 11 males and 9 females, age 58 ± 9 years (mean ± standard deviation), body mass index 29 ±4.1 kg/m(2), and VFA 190 ±53 cm(2) participated in this study. In unadjusted models, VFA, LDMA, and L/S were significantly correlated with IS, which remained in adjusted models for LDMA and L/S, but not for VFA. In multiple stepwise regression analysis including sex, age, body fat, VFA, SFA, alcohol consumption, and aerobic capacity (oxygen uptake at the lactate threshold), L/S, and LDMA accounted for 70% of the total variance in IS. Percentage body fat and SFA, but not VFA, were significantly correlated with high molecular-weight adiponectin levels (r = 0.58, P < 0.01 and r = 0.54, P < 0.05, respectively). IS and L/S were significantly and negatively correlated with tumor necrosis factor-α (r = -0.67 and -0.63, respectively; both P < 0.01) and plasminogen activator inhibitor-1 (r = -0.58, P < 0.01 and -0.52, P < 0.05, respectively), whereas LDMA was not. CONCLUSION: These findings indicate that ectopic fat deposition in the liver and skeletal muscle may be associated with peripheral IS independently of body fat accumulation and aerobic capacity in middle- to older-aged Japanese individuals with visceral adiposity. Because of the small sample size, additional larger studies are needed to provide further insight into these preliminary findings.