Spinal-general anaesthesia decreases neuroendocrine stress response in laparoscopic cholecystectomy.

OBJECTIVE: A randomized clinical study to compare the stress response to laparoscopic cholecystectomy during spinal-general anaesthesia and epidural- general anaesthesia. METHODS: Women undergoing elective laparoscopic chole cystectomy were assigned to receive either spinal anaesthesia (SA group; n = 12) or epidural anaesthesia (EA group; n = 12), in addition to general anaesthesia. Plasma concentrations of cortisol, adrenocorticotrophic hormone (ACTH), noradrenaline, adrenaline and total catecholamines were measured pre- and intraoperatively. RESULTS: Intraoperative cortisol, noradrenaline and total catecholamine levels were significantly lower in the SA group compared with the EA group. When pre- and intraoperative values were compared, the SA group showed a decrease in adrenaline, noradrenaline and total catecholamine levels, and the EA group showed an increase in ACTH and noradrenaline levels. CONCLUSIONS: The type of regional anaesthesia significantly affected the stress response: spinal anaesthesia produced a more favourable endocrine response than epidural anaesthesia. Spinal-general anaesthesia may reduce postoperative morbidity in laparoscopic cholecystectomy.

Astrocytic and microglia cells reactivity induced by neonatal administration of glutamate in cerebral cortex of the adult rats.

Recent studies confirm that astrocytes and neurons are associated with the synaptic transmission, particularly with the regulation of glutamate (Glu) levels. Therefore, they have the capacity to modulate the Glu released from neurons into the extracellular space. It has also been demonstrated an intense astrocytic and microglia response to physical or chemical lesions of the central nervous system. However, the persistence of the response of the glial cells in adult brain had not been previously reported, after the excitotoxic damage caused by neonatal dosage of monosodium glutamate (MSG) to newborn rats. In this study, 4 mg/g body weight of MSG were administered to newborn rats at 1, 3, 5, and 7 days after birth, at the age of 60 days the astrocytes and the microglia cells were analyzed with immunohistochemical methods in the fronto-parietal cortex. Double labeling to glial fibrillary acidic protein (GFAP) and BrdU, or isolectin-B(4) and BrdU identified astrocytes or microglia cells that proliferated; immunoblotting and immunoreactivity to vimentin served for assess immaturity of astrocytic intermediate filaments. The results show that the neonatal administration of MSG-induced reactivity of astrocytes and microglia cells in the fronto-parietal cortex, which was characterized by hyperplasia; an increased number of astrocytes and microglia cells that proliferated, hypertrophy; increased complexity of the cytoplasm extension of both glial cells and expression of RNAm to vimentin, with the presence of vimentin-positive astrocytes. This glial response to neuroexcitotoxic stimulus of Glu on the immature brain, which persisted to adulthood, suggests that the neurotransmitter Glu could trigger neuro-degenerative illnesses.

Utilización de prótesis de quitosana y silicona en la regeneración del nervio ciático axotomizado de ratas / Quitosan and silicon protesis of the axiotomized cyatic nerve in rats

Para la tubulización de nervios lesionados se ha utilizado silicona con buenos resultados en defectos menores de 3 cm. La silicona es considerada como un material inerte, pero tiene como inconveniente que no es absorbible y es necesaria una segunda cirugía para retirarla. Recientemente, se ha centrado el interés en la utilización de compuestos bioactivos, tales como, la quitosana, homopolímero de estructura lineal con enlaces1-4, N acetilglucosamina, obtenida de la desacetilación de la quitina. La quitosana es absorbible, hipoalergénica, inmunoestimulante y puede actuar como vehículo para liberación prolongada de compuestos. En este trabajo, fue usada para tubulizar el nervio ciático de ratas, para ello se compararon los efectos de ambas prótesis (silicona y quitosana), se analizó la supervivencia neuronal en el dominio medular del nervio ciático y la recuperación locomotriz por medio del índice funcional del nervio ciático. En ninguno de los grupos de animales tubulizados con quitosana o silicona se encontraron indicios de degeneración neuronal en el dominio medular correspondiente. Los animales tubulizados con prótesis de quitosana presentaron una mejor recuperación funcional, esto indica que las prótesis de quitosana produjeron efectos similares a los que resultaron con silicona. Una de las ventajas inmediatas por el uso de quitosana fue evitar una segunda cirugía para retirar la prótesis; sin embargo, este biomaterial posee muchas otras cualidades que facilitan la recuperación de nervios seccionados, mismas que deberán estudiarse utilizando otras técnicas.

Changes in NMDA-receptor gene expression are associated with neurotoxicity induced neonatally by glutamate in the rat brain.

The N-methyl-D-aspartate receptor (NMDA-R) is fully functional in the rat early in embryogenesis, and diverse neuronal plasticity events are regulated through its activation later in postnatal development. On the other hand, systemic administration of glutamate (Glu) to rats at birth induces neuronal degeneration in glutamatergic central nervous system regions via Glu receptor activation. However, it is not known whether an increase in neonatal Glu levels modifies the gene expression of NMDA-R subunits, or if these putative changes are related to gamma-aminobutyric acid-mediated (GABAergic) neurotransmission. We measured, by means of semi-quantitative reverse transcriptase polymerase chain reaction, changes in gene expression of the NMDA-R subunits: NMDA-R1, NMDA-R 2A and NMDA-R 2B in cerebral cortex (CC), striatum (ST) and hippocampus (HP) in the brains of rats treated neonatally with monosodium L-glutamate (MSG). These studies were supported by histological and quantitative analysis of the glia. Our results showed histological evidence of neuronal damage, and increased glial cell number and activity were detected. This was seen mainly in the ST and HP of MSG-treated animals. Significant increases in NMDA-R1, 2A and 2B subunits gene expression was also observed in ST and HP but not in CC, where only NMDA-R 2B was increased in MSG-treated rats. Our data suggest that increases in Glu levels and activation of Glu-receptors after neonatal administration of MSG induce an increase in glial cell reactivity and important changes in NMDA-R molecular composition, with signs of neuronal damage.