Correlations between metal uptake in the soft tissue of Perna perna and gill filament pathology after exposure to mercury

The accumulation of metal in soft tissues, filtration rate and gill filament morphology are correlated in the southern African rock mussel, Perna perna, during exposure to mercury (24 days) and recovery (24 days). The amount of Hg in soft tissues increased from 0.13 to 87.5 microg/g dry weight after 24 days exposure, and declined to 13 microg/g during recovery. Mean filtration rate fell from 3,979 to 1,818 ml/h/g dry weight by day 2, but recovered slightly through days 4 and 8 (3,037 ml/h/g), with a higher average rate (5,030 ml/h/g) being maintained over the 24-48 days recovery period. The initial decline in filtration coincided with epithelial cell deterioration presented as interstitial oedema, neural and epithelial cell degeneration and reduced ciliation. Between days 8 and 24, cilia regenerated and there was a general improvement in cell morphology. Gill filament morphology returned to near normal during the metal-free recovery period. The usefulness of P. perna as an indicator of pollution is discussed.

B-Myc is preferentially expressed in hormonally-controlled tissues and inhibits cellular proliferation

The myc family of genes plays an important role in several cellular processes including proliferation, apoptosis, differentiation, and transformation. B-myc, a relatively new and largely unstudied member of the myc family, encodes a protein that is highly homologous to the N-terminal transcriptional regulatory domain of c-Myc. Here, we show that high level B-myc expression is restricted to specific mouse tissues, primarily hormonally-controlled tissues, with the highest level of expression in the epididymis. We also report the identification of the endogenous B-Myc protein from mouse tissues. Like other Myc family proteins, B-Myc is a short-lived nuclear protein which is phosphorylated on residues Ser-60 and Ser-68. Rapid proteolysis of B-Myc occurs via the ubiquitin-proteasome pathway. Finally, we found that overexpression of B-Myc significantly slows the growth of Rat la fibroblasts and COS cells suggesting B-Myc functions as an inhibitor of cellular proliferation.

Disruption of Myc-tubulin interaction by hyperphosphorylation of c-Myc during mitosis or by constitutive hyperphosphorylation of mutant c-Myc in Burkitt's lymphoma

Somatic mutations at Thr-58 of c-Myc have been detected in Burkitt's lymphoma (BL) tumors and have been shown to affect the transforming potential of the Myc oncoprotein. In addition, the N-terminal domain of c-Myc has been shown to interact with microtubules in vivo, and the binding of c-Myc to alpha-tubulin was localized to amino acids 48 to 135 within the c-Myc protein. We demonstrate that c-Myc proteins harboring a naturally occurring mutation at Thr-58 from BL cell lines have increased stability and are constitutively hyperphosphorylated, which disrupts the in vivo interaction of c-Myc with alpha-tubulin. In addition, we show that wild-type c-Myc-alpha-tubulin interactions are also disrupted during a transient mitosis-specific hyperphosphorylation of c-Myc, which resembles the constitutive hyperphosphorylation pattern of Thr-58 in BL cells.

Mongolian gerbil (Meriones unguiculatus) as a model of cerebral infarction for testing new therapeutic agents

Stroke mortality represents the third leading cause of death worldwide, after coronary artery disease and cancer. It has been demonstrated that in Mongolian gerbils, a unilateral hemispheric cerebral infarction can be produced following unilateral occlusion of the carotid artery because of the absence of connecting arteries between the basilar and carotid systems in these animals. The objective of this study was to comprehensively characterize the model of cerebral infarction in gerbil, clinically, biochemically and especially morphologically for prospective use in testing new therapeutic agents. Cerebral infarction was produced by ligation of the left common carotid artery in experimental gerbils. The control animals were sham-operated. One hour after surgery, 0.5 ml of 1% trypan blue was administered intraperitoneally to all animals. Initial clinical evaluations were made 8 h after surgery and every day thereafter for 30 days. On each of days 10 and 30, 4 animals were sacrificed. The degree of cerebral infarction was evaluated on the basis of clinical response, electrolyte and enzyme changes, vascular permeability of blood-brain barrier and morphological alterations. The total post-infarction mortality rate was 50%. The clinical symptoms presented as ipsilateral hemiparesis, ptosis of the eyelid, circling behavior, decreased breathing rate, decreased blood pressure and increased heart rate. Such symptoms developed within 8 h of ligation and persisted to sacrifice at day 30. Creatine kinase increased significantly on the 10th day and remained high to day 30. Increased potassium from the damaged cells and breakdown of the blood-brain barrier were first detected 72 h post-infarction. The morphological data showed evidence of brain cell necrosis, autolysis and phagocytosis 10 and 30 days post-ligation in left hemispheres. Minor intercellular edema and some cell shrinkage was evident in the right brain. Areas of focal necrosis in the vicinity of blood vessels, especially in the left brain suggested a reperfusion injury as a consequence of minimal collateral reflow from the right brain into the left brain microvasculature. Experimental infarction in gerbil recreates the ischemic conditions causing stroke in humans. The animal model may be used for evaluating the efficacy of therapeutic agents that may ameliorate the condition in man.

c-Myc proteolysis by the ubiquitin-proteasome pathway: stabilization of c-Myc in Burkitt's lymphoma cells

The c-Myc oncoprotein is a transcription factor which is a critical regulator of cellular proliferation. Deregulated expression of c-Myc is associated with many human cancers, including Burkitt's lymphoma. The c-Myc protein is normally degraded very rapidly with a half-life of 20 to 30 min. Here we demonstrate that proteolysis of c-Myc in vivo is mediated by the ubiquitin-proteasome pathway. Inhibition of proteasome activity blocks c-Myc degradation, and c-Myc is a substrate for ubiquitination in vivo. Furthermore, an increase in c-Myc stability occurs in mitotic cells and is associated with inhibited c-Myc ubiquitination. Deletion analysis was used to identify regions of the c-Myc protein which are required for rapid proteolysis. We found that a centrally located PEST sequence, amino acids 226 to 270, is necessary for rapid c-Myc degradation, but not for ubiquitination. Also, N-terminal sequences, located within the first 158 amino acids of c-Myc, are necessary for both efficient c-Myc ubiquitination and subsequent degradation. We found that c-Myc is significantly stabilized (two- to sixfold) in many Burkitt's lymphoma-derived cell lines, suggesting that aberrant c-Myc proteolysis may play a role in the pathogenesis of Burkitt's lymphoma. Finally, mutation of Thr-58, a major phosphorylation site in c-Myc and a mutational hot spot in Burkitt's lymphoma, increases c-Myc stability; however, mutation of c-Myc is not essential for stabilization in Burkitt's lymphoma cells.

The complete genome sequence of the Streptomyces temperate phage straight phiC31: evolutionary relationships to other viruses

The completed genome sequence of the temperate Streptomyces phage straight phiC31 is reported. straight phiC31 contains genes that are related by sequence similarities to several other dsDNA phages infecting many diverse bacterial hosts, including Escherichia, Arthrobacter, Mycobacterium, Rhodobacter, Staphylococcus, Bacillus, Streptococcus, Lactobacillus and Lactococcus. These observations provide further evidence that dsDNA phages from diverse bacterial hosts are related and have had access to a common genetic pool. Analysis of the late genes was particularly informative. The sequences of the head assembly proteins (portal, head protease and major capsid) were conserved between straight phiC31, coliphage HK97, staphylococcal phage straight phiPVL, two Rhodobacter capsulatus prophages and two Mycobacterium tuberculosis prophages. These phages and prophages (where non-defective) from evolutionarily diverse hosts are, therefore, likely to share a common head assembly mechanism i.e. that of HK97. The organisation of the tail genes in straight phiC31 is highly reminiscent of tail regions from other phage genomes. The unusual organisation of the putative lysis genes in straight phiC31 is discussed, and speculations are made as to the roles of some inessential early gene products. Similarities between certain phage gene products and eukaryotic dsDNA virus proteins were noted, in particular, the primase/helicases and the terminases (large subunits). Furthermore, the complete sequence clarifies the overall transcription map of the phage during lytic growth and the positions of elements involved in the maintenance of lysogeny.

The evolution of biofilms in venous access devices implanted in children with Wilms' tumour

Biofilms form on all implanted foreign materials. In venous access ports (VAPs), the biofilm with entrapped organisms may be the source of recurring bacteraemia. At present, little is known of the development of biofilms in VAPs. In this study light, scanning, and transmission electron microscopy were used to investigate the evolution of biofilms in VAPs implanted in 15 African children with Wilms' tumour. The VAPs were removed either emergently because of infection (n = 6) or blockage (n = 3), or electively at the end of chemotherapy (n = 6). Intact biofilms were obtained from lengths of the catheter attached to ports that had been in place for 11 days to 3 years. Each was prepared for light and electron microscopy. In infected ports, shortly after implantation biofilms were thin and comprised of apparently healthy erythrocytes (RBCs) and occasional platelets, leucocytes (WBCs), and bacteria enmeshed in a network of fibrin. Three weeks after implantation, RBCs had autolysed and large numbers of WBCs and bacterial colonies were present within and on the luminal surface. In 1 instance, the lumen of a VAP had been occluded by a "plug" of WBCs. In non-infected patients, the biofilms in long-standing VAPs were of varying thickness and primarily composed of an amorphous granular material. In most cases, healthy and necrotic bacteria were present both within the core and on the surface of the biofilms. The results suggest that while bacteria, per se, are an important factor, the presence and degradation of blood components may be an equally important factor in the development of biofilms in VAP catheters.

Morphological aspects of microarterial anastomoses: a comparison of nylon with polydioxanone

The morphological appearance of longitudinally sectioned rat femoral arteries was determined in intact arteries and from 3 to 435 days after vessel division and anastomosis with either 9/0 gauge nylon or polydioxanone (PDS) in 26 animals. The purpose of the study was to establish the mechanisms and compare the quality of healing after microarterial anastomosis and to determine whether PDS was degraded before sufficient anastomotic healing had taken place. The results revealed that there was no difference in the process of healing or quality of anastomosis with either suture material. From 3 to 21 days post anastomosis, there was a progressive separation of the ends of vessels within the developing scar. Anastomotic patency was established and maintained at first by an adventitial overgrowth of fibroblasts and undifferentiated adventitial cells and later by the growth of a smooth myocyte scar that stretched between the cut ends of the vessel and over the intima in the form of elongated circumferential plaques. The vessel was morphologically healed by the 21st day. The sutures served little or no purpose in maintaining anastomotic integrity after the 5th day, being situated in the scar forming between the separating vessel ends. PDS was present within the vessel wall up to 120 days post anastomosis and was certainly intact at the time of morphological healing, suggesting that this material is safe as a microvascular suture.

The effects of hexane on rat myocardium: a morphometric and morphological study

Specimens from the left ventricular myocardium of 10 rats that had been exposed to subcutaneously administered hexane for 30 days were morphometrically and morphologically examined. Other than the presence of occasional necrotic fibres in hexane-treated animals, there was little difference in the histological appearance of myofibres in control or experimental specimens. There was a slight reduction in the average diameter of cardiac myofibres after exposure to hexane. Pathological ultrastructural changes of the myofibres were noted in the experimental and not in the control groups. Mitochondrial oedema and necrosis and myofilament disorganization and dissolution were significant changes noted in the experimental group. These pathological changes suggest that hexane, a constituent of glue and benzine, is cardiotoxic.

Serial morphological changes in primate skeletal myofibres after 3 hours of ischaemia and 24 hours of reperfusion

The sequential morphological changes occurring in skeletal myofibres after 3 hours' ischaemia and from 3 hours to 24 hours of reperfusion in vervet monkeys are described. Eight vervet monkeys were studied under general anaesthesia. A hind limb was exsanguinated and a tourniquet applied for 3 hours. Open muscle biopsy specimens were obtained from the tibialis anterior muscle before tourniquet application, just before tourniquet release and 3, 6, 12, 18 and 24 hours after tourniquet deflation. All specimens were prepared for transmission electron microscopy. After 3 hours of ischaemia and increasing periods of reperfusion, a small number of fibres showed progressive pathomorphological changes that eventually resulted in myofibre death. After initial glycogen loss and later intermyofibrillar oedema, the majority of myofibres returned to normal, while a group of fibres remained oedematous. The progressive morphological characteristics of reversibly injured myofibres undergoing repair and irreversible injured cells undergoing necrosis are described.

Alterations in the cytological composition of the juxta-scar villous mucosa after ulcer therapy with sucralfate or cimetidine

A comparative light-microscopic morphometric analysis of non-metaplastic mucosa obtained from the pretreatment juxta-duodenal ulcer (DU) villous mucosa of 10 patients and from the first part of the duodenum of 5 normal volunteers revealed a significant increase (P less than 0.01) in the number of goblet cells (GCs) per 100 microns of villous mucosa (GC/100 microns). Such an increase was thought to represent a mucoprotective response by the mucosa to the corrosive lumenal factors that may cause or maintain ulceration. A similar morphometric analysis was performed on the endoscopically healed juxta-scar villous mucosa of 11 patients successfully treated for 6 weeks with sucralfate (5 patients) or cimetidine (6 patients). After treatment with cimetidine, GC/100 microns was reduced to near-normal levels, whereas after sucralfate therapy it was significantly raised (P less than 0.05). The difference in GC/100 microns after treatment with either sucralfate or cimetidine was significant at the P less than 0.02 level. The apparent drug-mediated difference in the cytological composition of the healed mucosa was thought to be a function of the pharmacodynamic mechanisms of action of the two drugs in promoting DU healing. It is proposed that the retention of GC hyperplasia after curative therapy with sucralfate may predisposed patients so treated to extended periods of remission.

Plasma etomidate levels in mother and fetus

The most commonly used induction agent in anaesthesia for Caesarean section is still thiopentone. The increasing incidence of Caesarean section for delivery of premature babies from a hostile environment may call in question the assumption that the dose of thiopentone received by the neonate will not cause depression in the hours following birth. Previous studies on thiopentone for Caesarean section have shown inconsistency in umbilical vein/maternal vein ratios. We have studied plasma etomidate levels in maternal and umbilical blood at the time of delivery to see whether equilibrium occurs with this agent. We were able to demonstrate an umbilical/maternal vein etomidate ratio of 0.5 (SD 0.18), with no relation to time in the range encountered. Also, the uterine artery/uterine vein etomidate ratio was 0.86 (SD 0.33), suggesting that etomidate uptake into the fetus is effectively complete. Further, in all cases the neonatal plasma etomidate levels were less than half those measured at recovery of consciousness in adults in other studies, despite a larger induction dose than is usually used.

Alterations in the morphology of skeletal myofibres after 90 minutes of ischaemia and 3 hours of reperfusion

Morphometric, light and electron microscopic methods were employed to determine whether skeletal myofibres were damaged by 90 minutes of tourniquet-mediated ischaemia. Open biceps muscle biopsies were obtained before 90 minutes of upper limb tourniquet ischaemia in 5 Chacma baboons. Further biopsies were obtained just before tourniquet release in 2 animals and after 3 hours' reperfusion in the remaining 3 animals. Other than a slight reduction in myofibre diameter and the anaerobic depletion of intermyofibrillar glycogen, no pathological changes were noted in skeletal myofibres after ischaemia. However, after reperfusion there was myofibre enlargement, intermyofibrillar oedema, internalisation of nuclei, myofibrillar and mitochondrial disorganisation and dissolution, and Z-band streaming. These results show that reperfusion injury affects skeletal myofibres after 90 minutes of tourniquet-mediated ischaemia.

A histometric analysis of skeletal myofibers following 90 min of tourniquet ischemia and reperfusion

Routine tourniquet use causes sublethal hypoxic cellular injury and results in edema formation. Using a histochemical morphometric technique, edema caused by 90 min of tourniquet-induced ischemia and 3 hr of reperfusion is measured in the different muscle fibers of a primate model. The degree of cellular swelling is shown to be related to the fiber's metabolic dependence upon oxygen. After reperfusion, predominantly oxidative type 1 fibers show a 29% increase in diameter, P less than 0.0005, type 2a fibers which are both oxidative and glycolytic increase by 7%, P less than 0.005, and the glycolytic type 2b fibers increase by 5%, P less than 0.01. A 48% increase in interfiber distance occurs with reperfusion, P less than 0.01. By quantifying the different fibers' responses to ischemic injury, this method may be of use in investigating the pathophysiology and prevention of reperfusion injury and the post-tourniquet syndrome.

Disposition of propofol infusions for caesarean section

The disposition of propofol was studied in women undergoing elective Caesarean section. Indices of maternal recovery and neonatal assessment were correlated with venous concentrations of propofol. After induction of anaesthesia with propofol 2.0 mg.kg-1, ten patients received propofol 6 mg.kg-1.hr-1 with nitrous oxide 50 per cent in oxygen (low group) and nine were given propofol 9 mg.kg-1.hr-1 with oxygen 100 per cent (high group). Pharmacokinetic variables were similar between the groups. The mean +/- SD Vss = 2.38 +/- 1.16 L.kg-1, Cl = 39.2 +/- 9.75 ml.min-1.kg-1 and t1/2 beta = 126 +/- 68.7 min. At the time of delivery (8-16 min), the concentration of propofol ranged from 1.91-3.82 micrograms.ml-1 in the maternal vein (MV), 1.00-2.00 micrograms.ml-1 in the umbilical vein (UV) and 0.53-1.66 micrograms.ml-1 in the umbilical artery (UA). Neonates with high UV concentrations of propofol at delivery had lower neurologic and adaptive capacity scores 15 minutes later. The concentrations of propofol were similar between groups during the infusion but they declined at a faster rate in the low group postoperatively. Maternal recovery times did not depend on the total dose of propofol but the concentration of propofol at the time of eye opening was greater in the high group than the low group (1.74 +/- 0.51 vs 1.24 +/- 0.32 micrograms.ml-1, P less than 0.01). The rapid placental transfer of propofol during Caesarean section requires propofol infusions to be given cautiously, especially when induction to delivery times are long.

A morphological control for ventricular pathology in man: a morphometric and morphologic assessment of LV myofibres in secundum ASD

Ethical considerations preclude the biopsy of normal human myocardium. As a consequence, morphological investigations of diseased human heart muscle are hampered by a lack of suitable normal control tissue. The left ventricular (LV) myocardium of patients with isolated secundum atrial septal defect (ASD) is considered to be normal. This study was designed to investigate the possibility that the fine-structure of LV myofibres in hearts with ASD could be used as normal controls for myofibre pathomorphology. Wedge biopsies from the LV of four adults undergoing elective surgery for the repair of ASD were examined by light and electron microscopy. Bivariant myofibre morphometry showed that the LV myocardium of one specimen was 'normal' while three specimens exhibited varying degrees of hypertrophy. There was a correlation between the diameter (FD) and morphology of individual myofibres within and between specimens. In general, myofibres with FD less than 25 microns were similar in fine-structural appearance to those described as morphologically normal in animal models whereas those with FD greater than 25 microns exhibited hypertrophic features that increased in 'severity' with increase in myofibre size. It is proposed that although the LV myocardium in ASD may be mildly hypertrophied, myofibres with FD less than 25 microns are probably normal and may be used as fine-structural controls for myofibre pathomorphology in hearts suspected of disease.

Obstetric epidural analgesia with mixtures of bupivacaine, adrenaline and fentanyl

We performed a double-blind comparison of six solutions for epidural analgesia in 90 healthy Chinese women with uncomplicated pregnancies. Patients were randomly allocated to receive 10 ml bupivacaine 0.125% or 0.25% plain, bupivacaine 0.125% with adrenaline 1.25 micrograms/ml, bupivacaine 0.25% with adrenaline 2.5 micrograms/ml or the latter two solutions with added fentanyl 50 micrograms. Analgesia was unsatisfactory in 30% of the bupivacaine 0.125% groups without fentanyl. The addition of adrenaline, compared with bupivacaine 0.25% plain, gave faster onset and longer duration of analgesia (p less than 0.05) which was similar to that found in both fentanyl groups. There were no differences in method of delivery or neonatal Apgar scores among groups. The least concentrated mixture that gave the best analgesia was the combination of bupivacaine 0.125% with adrenaline 1.25 micrograms/ml and fentanyl 50 micrograms.

The addition of fentanyl to epidural bupivacaine in first stage labour

Epidural analgesia was studied in 100 healthy Chinese women with uncomplicated pregnancies in first stage labour. Patients were randomly allocated to receive 8 ml of one of the following five solutions: bupivacaine 0.125% with fentanyl 50 micrograms or fentanyl 100 micrograms, bupivacaine 0.25% plain, bupivacaine 0.25% with fentanyl 50 micrograms or fentanyl 100 micrograms. There was no difference in quality of analgesia among groups as measured by the reduction of visual analogue pain scores 20 minutes after the epidural dose. The duration of analgesia was similar among groups with the overall median duration being 105 minutes. There was no difference in method of delivery or neonatal Apgar scores. The least concentrated mixture providing good quality analgesia for the first stage of labour was the combination of bupivacaine 0.125% with fentanyl 50 micrograms.

Propofol infusion anaesthesia for caesarean section

Two propofol infusion regimens and a standard general anaesthetic were compared in thirty Chinese women undergoing elective Caesarean section. After induction of anaesthesia with propofol 2 mg.kg-1, ten patients received propofol 6 mg.kg-1.hr-1 and nitrous oxide 50 per cent in oxygen while ten were given propofol 9 mg.kg-1.hr-1 with 100 per cent oxygen. The other ten patients received thiopentone 4 mg.kg-1 and nitrous oxide 50 per cent in oxygen with enflurane one per cent. Maternal recovery times and psychomotor performance were recorded. Neonates were assessed by Apgar scores, neurologic and adapative capacity scores (NACS) and umbilical cord blood gas analysis. Haemodynamic changes were similar immediately following induction but the low propofol infusion group had the best haemodynamic stability subsequently. Recovery times were fastest in the low-infusion group but there were no differences in later postbox testing. Neonatal Apgar scores and umbilical blood gas analysis were similar but NACS at two hours were poorer in the high infusion group. A propofol infusion coupled with nitrous oxide appears to be a satisfactory technique for Caesarean section.

Effect of adrenaline on venous plasma concentrations of bupivacaine after interpleural administration

Bupivacaine 2.5 mg kg-1 (0.5 ml kg-1 of 0.5% solution), with or without adrenaline 5 micrograms ml-1, was administered by interpleural injection to 12 patients after elective cholecystectomy. Noncompartmental analysis indicated that the addition of adrenaline had no effect on total body clearance, apparent volume of distribution at steady state or elimination half-life of bupivacaine. However, peak plasma concentrations were lower in the adrenaline group (mean (SD) [range]: 2.57 (0.61) [1.52-3.11] vs 3.22 (0.27) [2.84-3.53] micrograms ml-1, P less than 0.05) and the time to maximum concentration was delayed (median [range]: 25 [15-30] vs 15 [10-20] min, P less than 0.05). Analgesia was variable and no differences were detected between the two groups. The addition of adrenaline appears prudent to minimize possible bupivacaine toxicity.

The haemodynamic effects of propofol and thiopentone for induction of caesarean section

Forty Chinese women for elective caesarean section received either propofol 2 mg.kg-1 or thiopentone 4 mg.kg-1 for induction of general anaesthesia. Systolic, mean and diastolic arterial pressures and heart rate were recorded non-invasively every minute for ten minutes. Post-induction arterial pressures were similar to pre-induction values with no differences between thiopentone and propofol. Following intubation, the rise in systolic arterial pressure was greater in the thiopentone group, 32.1 mmHg (SD 23.7) compared with the propofol group, 17.4 mmHg (SD 23.8), (P less than 0.05). In the thiopentone group, arterial pressures were slower in returning to baseline values. Heart rate was initially elevated in both groups to the same degree. At caesarean section, induction with propofol causes less variation in arterial pressure than thiopentone. Hypotension is probably prevented by the coincident stimulus of rapid sequence induction. Neonatal Apgar scores were similar between the two groups.

Maternal and fetal levels of propofol at caesarean section

Twenty women were given a bolus induction of propofol 2.0 mg.kg-1 for elective caesarean section. Induction to delivery times ranged from five to fourteen minutes. At delivery the maternal venous (MV) concentrations of propofol ranged from 0.53 to 1.48 micrograms.ml-1 umbilical vein (UV) 0.39 to 1.4 micrograms.ml-1 and umbilical artery (UA) 0.34 to 0.68 micrograms.ml-1 MV propofol concentrations were always higher than corresponding UV concentrations. The mean (95% confidence interval) UV/MV ratio was 0.65 (0.56-0.74) and the mean UA/UV ratio was 1.07 (0.99-1.15). Neither ratio was shown to be correlated with induction to delivery time. Distribution of propofol is rapid across the placenta and in the fetus. Apgar scores were higher with shorter incision to delivery times but were not correlated to umbilical levels of propofol.

Pharmacokinetics of propofol in women undergoing elective caesarean section

We have compared the pharmacokinetics of a bolus induction dose of propofol 2 mg kg-1 in 10 Chinese women undergoing elective Caesarean section with those in six non-pregnant Chinese women having laparoscopic sterilization. Blood propofol concentrations were measured using high pressure liquid chromatography with fluorimetric detection. Pharmacokinetic data were analysed by a model independent method based on statistical moment theory. Data from the laparoscopy group also underwent compartmental analysis, which produced similar kinetic results. Non-compartmental analysis estimated that the women undergoing Caesarean section had a similar elimination half-life (mean 81.27 (SD 18.87) min) and apparent volume of distribution at steady state (2.66 (0.63) litre kg-1) as non-obstetric patients (99.45 (29.40) min and 3.36 (1.87) litre kg-1). Clearance was more rapid in the Caesarean section group (39.32 (8.07) ml min-1 kg-1 vs 29.40 (8.72) ml min-1 kg-1) (P less than 0.05). The increased total body clearance may result from blood loss and delivery of the fetus and placenta at operation, although an increase in extrahepatic clearance is also possible.