Comparison of spinal anesthesia with general anesthesia on morphine requirement after abdominal hysterectomy.

PURPOSE: The aim of this study was to compare morphine consumption with patient-controlled analgesia (PCA) between spinal anesthesia (SA) (bupivacaine, morphine and fentanyl) and general anesthesia (GA) (sufentanil) after an abdominal hysterectomy. METHODS: Forty women were randomly assigned to receive SA with bupivacaine 15 mg, 0.15 mg of intrathecal morphine and 15 microg of fentanyl or GA with sufentanil, both combined with PCA. The primary outcome was morphine consumption with the PCA device. The secondary outcomes were post-operative pain at rest and under stress on a visual analog scale, nausea, pruritus and respiratory depression on a standardized scale. Outcome measures were recorded at 6, 12, 18, 24 and 48 h post-anesthesia. The duration of post-anesthesia care unit (PACU) and hospital stay were recorded. RESULTS: Patients in the SA group consumed at least two times less morphine at each time interval than the GA group: at 48 h, they used 19 +/- 17 vs. 81 +/- 31 mg (P<0.0001). Post-operative pain at rest was lower in the SA group until the 18th hour and under stress until the 48th. There was more sedation in the GA group until the 18th hour. Little difference was observed in the incidence of pruritus. Nausea was more intense at the 6th hour in the GA group. There was no difference in the respiratory rate. The duration of PACU stay was shorter for the SA group (52 +/- 9 vs. 73 +/- 11 min, P<0.0001) as was the duration of hospital stay (2.2 +/- 0.4 vs. 3.3 +/- 0.7 days, P=0.01). CONCLUSIONS: It is concluded that intrathecal morphine 0.15 mg with 15 microg of fentanyl decreases post-operative pain and morphine consumption by PCA without increasing adverse reactions for women undergoing an abdominal hysterectomy.

Localization of the chaperone proteins GRP78 and HSP60 on the luminal surface of bovine oviduct epithelial cells and their association with spermatozoa.

Upon their transit through the female genital tract, bovine spermatozoa bind to oviduct epithelial cells, where they are maintained alive for long periods of time until fertilization. Although carbohydrate components of the oviduct epithelial cell membrane are involved in these sperm/oviduct interactions, no protein candidate has been identified to play this role. To identify the oviduct factors involved in their survival, sperm cells were preincubated for 30 min with apical membranes isolated from oviduct epithelial cells, washed extensively, and further incubated for up to 12 h in the absence of apical membranes. During this incubation, sperm viability, motility, and acrosomal integrity were improved compared with cells preincubated in the absence of apical membranes. This suggests that, during the 30-min preincubation with apical membrane extracts, either an oviductal factor triggered intracellular events resulting in positive effects on spermatozoa or that such a factor strongly attached to sperm cells to promote a positive action. Similarly, spermatozoa were incubated with apical membranes isolated from oviduct epithelial cells labeled with [35S]-methionine and, upon extensive washes, proteins were separated by two-dimensional (2-D) gel electrophoresis to identify the factors suspected to have beneficial effects on spermatozoa. The six major proteins, according to their signal intensity on the autoradiographic film, were extracted from a 2-D gel of oviduct epithelial cell proteins run in parallel and processed for N-terminal sequencing of the first 15 amino acids. Of these, one was identical to heat shock protein 60 (HSP60) and one to the glucose-regulated protein 78 (GRP78). Their identities and association with spermatozoa were confirmed using an antibody directed against these proteins. This paper reports the localization of both GRP78 and HSP60 on the luminal/apical surface of oviduct epithelial cells, their binding to spermatozoa, and the presence of endogenous HSP60 in the sperm midpiece.

The use of genomics and proteomics to understand oocyte and early embryo functions in farm animals.

Oocyte maturation, a simple and visible phenomenon, is about to be transformed into a complex and not so visible molecular cascade leading to the marking of the following generation. The study of oocyte maturation in mammals is progressively changing towards a more molecular approach. This review addresses the main challenges in the study of RNA extraction and quantification in oocytes and embryos as well as the importance of the mRNA maturation. The identification of specific genes in oocytes and embryos is now possible with the use of powerful tools, such as library analysis or subtractions, DNA array, comparative analysis of databanks from other mammals or animals and two-dimensional gel electrophoresis analysis. Finally, RNA interference is a useful tool for studying gene function by knocking out the activity of specific genes and will be used in oocytes and embryos.

Evaluation of donor skin disinfection methods.

BACKGROUND: Because most bacteria isolated from contaminated platelet concentrates are thought to originate from the donor's skin, the efficacy of four methods of skin disinfection was compared. STUDY DESIGN AND METHODS: Contact plates were used for antecubital skin cultures after they were demonstrated to be easier to use and at least as sensitive as a swab system. One antecubital fossa of each subject was disinfected by a standard method, the use of a povidone-iodine swabstick containing 0.75-percent available iodine followed by the use of a povidone-iodine swabstick containing 1-percent available iodine. The other arm was disinfected with either a 70-percent isopropyl alcohol scrub followed by an ampoule of 2-percent iodine tincture (Group 1; n = 126); a green-soap sponge followed by a 70-percent isopropyl alcohol swab, used for donors who are allergic to iodine (Group 2; n = 30); or a 0.5-percent chlorhexidine gluconate and 70-percent isopropyl alcohol sponge followed by an ampoule of 0.5-percent chlorhexidine gluconate and 70-percent isopropyl alcohol (Group 3; n = 40). Contact plate cultures were done before and after disinfection, and colonies counted after a 48-hour 37 degrees C incubation period. RESULTS: Similar numbers of bacteria grew from both antecubital fossae of the same subject before disinfection (p = 0.71). Compared to the standard povidoneiodine method, isopropyl alcohol and tincture of iodine resulted in significantly less bacterial growth (p < 0.001), the green soap and isopropyl alcohol method resulted in significantly more bacterial growth (p < 0.001), and the chlorhexidine gluconate and isopropyl alcohol method resulted in similar amounts of bacterial growth (p > 0.3). CONCLUSION: Isopropyl alcohol scrub followed by iodine tincture is more efficacious than povidone-iodine as measured by contact plate cultures. For donors who are allergic to iodine, chlorhexidine gluconate and isopropyl alcohol is more efficacious than green soap and isopropyl alcohol.

Purification and characterization of Treponema hyodysenteriae hemolysin.

A hemolysin produced by Treponema hyodysenteriae ATCC27164 was purified from broth filtrates by acetic and (NH4)2SO4 precipitations followed by ion exchange chromatography on diethylaminoethyl-Sephacel and gel filtration using Ultrogel AcA44. The purified hemolysin displayed only one band on polyacrylamide gel electrophoresis. By gel filtration the molecular weight was estimated as 74,000 daltons. The isolated hemolysin was oxygen resistant, heat labile and was not inactivated over a wide range of pH values. Further analysis indicated that this hemolysin was probably a polypeptide or a protein associated with lipids and nucleotides. Its action on rabbit erythrocytes which did not require any divalent cations could not be related to a lipolytic or proteolytic activity.

[Effect of sodium ribonucleate on the growth and the hemolytic activity of Treponema hyodysenteriae]. / Effet du ribonucléate de sodium sur la croissance et l'activité hémolytique de Treponema hyodysenteriae.

Liquid cultures of different strains of Treponema hyodysenteriae, when supplemented with sodium ribonucleate show an increase in the hemolytic activity titers while the number of colony forming units remain constant.