Desflurane reduces intraoperative remifentanil requirements more than sevoflurane: comparison using surgical pleth index-guided analgesia.

BACKGROUND: Sevoflurane and desflurane are widely used in balanced anaesthesia in combination with opioid analgesics. The opioid remifentanil is frequently chosen because of its extremely rapid pharmacokinetics. However, intraoperative high-dose remifentanil is associated with increased postoperative pain and rescue analgesic use owing to acute tolerance and opioid-induced hyperalgesia. This study aimed to compare intraoperative remifentanil requirements during equi-minimum alveolar concentration (MAC) sevoflurane and desflurane anaesthesia via surgical pleth index-guided remifentanil administration. METHODS: Eighty-two subjects undergoing laparoscopic cholecystectomy were randomly allocated to two groups receiving either sevoflurane (n=40) or desflurane (n=42). Anaesthesia was maintained with the assigned inhaled anaesthetics and remifentanil. End-tidal anaesthetic concentration was maintained at age-corrected 1.0 MAC, and remifentanil infusion was continuously adjusted to achieve a surgical pleth index of 20-50. Mean remifentanil infusion rate, which was the primary outcome of the study, was calculated as the total infused remifentanil dose per kg body weight per minute of total operative time. RESULTS: Mean remifentanil infusion rate [mean (standard deviation)] was significantly higher in the sevoflurane group than in the desflurane group [0.192 (0.064) vs. 0.099 (0.033) µg kg-1 min-1; difference, 0.093 (95% confidence interval, 0.071-0.115); P<0.001]. CONCLUSIONS: During equi-MAC anaesthesia of 1.0 MAC, sevoflurane and desflurane did not show similar intraoperative remifentanil consumption under surgical pleth index-guided opioid administration. Further studies using other monitors with different measuring mechanisms are warranted to determine the cause of this difference. CLINICAL TRIAL REGISTRATION: NCT02830243 (ClinicalTrials.gov).

Determination of solid-phase loading for the removal of metal ion from effluents using fixed-bed adsorbers.

The sorption of cadmium and copper ions from aqueous solutions onto bone char using fixed-bed adsorbers has been studied. A film-pore diffusion model has been utilized to predict theoretical breakthrough curves, which are compared with experimental breakthrough curves by means of error analysis. The key parameters for correlating the theoretical model are the external film mass-transfer coefficient (kf), the effective diffusion coefficient (Deff), and the solid-phase loading (q). The kf is determined from fixed-bed empirical correlations, and Deff is determined by a best-fit optimization routine. The q value has traditionally been determined using the equilibrium isotherm, which is applicable when the column adsorbent reaches equilibrium, or using the breakthrough curve mass balance when the column does not reach equilibrium. The breakthrough curve mass balance method needs experimental curves for each system and is not a practical solution for general design models. This paper presents two novel predictive equations for q in terms of process variables. The accuracy of the equations is sufficient for application in design models for nonequilibrium and equilibrium systems.

Dynamic movements of organelles containing Niemann-Pick C1 protein: NPC1 involvement in late endocytic events.

People homozygous for mutations in the Niemann-Pick type C1 (NPC1) gene have physiological defects, including excess accumulation of intracellular cholesterol and other lipids, that lead to drastic neural and liver degeneration. The NPC1 multipass transmembrane protein is resident in late endosomes and lysosomes, but its functions are unknown. We find that organelles containing functional NPC1-fluorescent protein fusions undergo dramatic movements, some in association with extending strands of endoplasmic reticulum. In NPC1 mutant cells the NPC1-bearing organelles that normally move at high speed between perinuclear regions and the periphery of the cell are largely absent. Pulse-chase experiments with dialkylindocarbocyanine low-density lipoprotein showed that NPC1 organelles function late in the endocytic pathway; NPC1 protein may aid the partitioning of endocytic and lysosomal compartments. The close connection between NPC1 and the drug U18666A, which causes NPC1-like organelle defects, was established by rescuing drug-treated cells with overproduced NPC1. U18666A inhibits outward movements of NPC1 organelles, trapping membranes and cholesterol in perinuclear organelles similar to those in NPC1 mutant cells, even when cells are grown in lipoprotein-depleted serum. We conclude that NPC1 protein promotes the creation and/or movement of particular late endosomes, which rapidly transport materials to and from the cell periphery.

Film-pore diffusion model for the fixed-bed sorption of copper and cadmium ions onto bone char.

The sorption of copper and cadmium ions onto bone char in single component systems has been studied using fixed-bed column adsorbers. The effects of solution flowrate, initial metal ion concentration and bone char particle size have been studied. A film-pore diffusion model has been developed to predict the fixed-bed breakthrough curves for the two metal ions. A sensitivity analysis has been carried out to investigate the influence of the external mass transfer coefficient (film resistance), the effective diffusion coefficient (pore diffusion) and the solid phase loading capacity. It is found that under the experimental conditions employed in the study, film diffusional resistance was low and the Biot numbers were relatively high. Furthermore, a constant effective pore diffusivity was not sufficient to correlate the breakthrough curves accurately and a variable dependent effective diffusivity was required; suggesting a possible contribution from surface diffusion. Since the metal ion-bone char systems take a long time to reach equilibrium, the solid phase loading capacity, as predicted by the "best-fit" equilibrium isotherm, was not suitable for use in the diffusional mass transport model and the mass balance solid phase loading was utilised instead.

A surface of Escherichia coli sigma 70 required for promoter function and antitermination by phage lambda Q protein.

The sigma initiation factor sigma70 of Escherichia coli acts not only in promoter recognition and DNA strand opening, but also to mediate the transformation of RNA polymerase (RNAP) to an antiterminating form by the phage lambda gene Q protein. Q is able to bind and modify RNAP when alpha70, still present in the initially elongating enzyme, recognizes a repeat of the -10 promoter element and induces a transcription pause. We have isolated mutations in the rpoD gene for sigma70 that impair Q function because they reduce the ability of sigma70 to recognize the downstream pause site. These mutations identify a locus of sigma70 that is important for the formation and stability of open promoter complex, likely because it mediates protein interactions with RNAP core.