A prospective comparison of costs and morbidity of laparoscopic versus open cholecystectomy.

BACKGROUND/AIMS: The aims of this study were to compare pain and discomfort after laparoscopic cholecystectomy (LC) and open cholecystectomy (OC), and to quantify the costs of both procedures. MATERIAL AND METHODS: Seventy-six patients undergoing a LC were prospectively compared with 24 patients who had an OC. Pain was assessed with a visual analog scale, and two rating indexes, one day, three months, and six months postoperatively. Hospital costs per patients covered direct expenditures, hospital overhead and depreciation of equipment, and salaries allocated on a per-diem basis. RESULTS: Pain and discomfort were significantly lower in the LC group than in the OC group. Cost for the operation was higher after LC, and lower for post operative care (p < 0.001). Total costs of hospitalization were similar. The mean number of days out of work was less in the LC group (14.7 days) than in the OC group (35.5 days) and the difference of cost due to loss of productivity was significant (p < 0.0001). CONCLUSIONS: The advantages of LC must be counter-balanced with a higher rate of postoperative complications than after OC, mainly common bile duct injuries.

The bovine protamine 2 gene: evidence for alternative splicing.

Protamine 2 (PRM2) is a low molecular weight arginine-rich protein which is present in haploid spermatogenic cells of human and mouse. Although the bull PRM2 gene is translated and transcribed at low levels, the protein could not be detected. The gene was isolated from a cosmid library and was found to consist of two exons (298 and 50 bp, respectively) interrupted by an intron of 142 bp. As compared to the PRM2 genes of man, mouse and rat the bovine gene lacks a highly conserved sequence coding for the amino acids RLHRIH. Furthermore, primer extension experiments on bull PRM2 mRNA and sequencing of junction fragments revealed alternative splicing of mRNA resulting in two putative isoforms of the protein. The most abundant transcript is spliced at the conserved splice donor site found in exon 1 at position 236 giving rise to an in-frame deletion of 63 bp as compared to the cDNA sequence (Maier et al. (1990) Nucleic Acids Res. 18, 1249-1254). The less abundant longer mRNA was not detectable by radioactive primer extension. The corresponding cDNA was obtained by performing PCR with reverse transcribed bull testis RNA or with a spermatid specific cDNA library. Alternative splicing should result in an addition of 21 nonpolar amino acids in the derived polypeptide and an altered protein conformation and function.

Characterization of a gene encoding a basic protein of the spermatid nucleus, TNP2, and its close linkage to the protamine genes in the bull.

During elongation and condensation of the spermatid nucleus, histones are replaced by spermatid-specific transition proteins (TNP). TNP1 is well characterized at the cDNA and at the genomic level and was found to be highly conserved during mammalian evolution (similarity between 83 to 98%). We here describe for the first time the nucleotide sequence and organization of the gene for TNP2. The gene was isolated from a bull cosmid library and was found to contain a single intron of 910 bp. The coding sequence consists of 390 bp and has a similarity of about 70% to that of the TNP2 cDNAs of mouse and rat. At the basis of amino-acid sequences, the bull TNP2 is 14 and 15 amino acids longer than that of mouse and rat, respectively, and the similarity is only 45% between bull and mouse and 42% between bull and rat. However, the evolutionary divergence has not occurred at the cost of basic amino acids which are of functional importance in DNA-protein interaction in the condensing spermatid nucleus. The TNP2 gene is closely linked to the protamine genes in the bull genome.

[Use of hormonal parameters of phospho-calcium metabolism as a means of discriminating bone and joint disorders in patients with renal insufficiency]. / Utilisation des paramètres hormonaux du métabolisme phospho-calcique comme moyen de discrimination des troubles ostéo-articulaires chez les patients insuffisants rénaux.

Serum carboxyterminal parathyroid hormone (PTH) concentration (homologous measurement of the 53-84 fragment and heterologous bovine measurement) has been measured and correlated with both clinical and radiological findings of secondary hyperparathyroidism (HPT), studied quantitatively according to a score published in literature, in 95 patients with chronic renal failure on maintenance hemodialysis. Mean serum PTH concentration (53.84) is statistically higher in patients with severe clinical and radiological evaluation of HPT than in patients with moderate or slight manifestations of HPT (M +/- DS: 515.8 +/- 243.7 pg/ml VS 271.3 +/- 166.1 pg/ml p less than 0.001). However, even with high serum concentration, serum PTH level does not allow to predict HPT severity, suggesting a retention of PTH fragments in serum without biologic activity probably.