SEARCH · Search PubMed

Results for “Maintenance”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

SourceResearch connectionFrom yearThrough year

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 775 records · Page 43Linked to original sources

PubMed2006

DomainSieve: a protein domain-based screen that led to the identification of dam-associated genes with potential link to DNA maintenance.

MOTIVATION: The Dam methyltransferase (DamMT) activity, broadly distributed in association with restriction endonucleases, as part of the restriction-modification defense systems, has evolved to become intimately associated with essential biological functions in a few organisms. In Escherichia coli, DamMT is involved in multiple aspects of DNA maintenance, replication initiation, daughter chromosome segregation, DNA mismatch repair, gene expression control, etc. The participation of DamMT in such a diverse set of functions required that other genes adapted, or emerged through evolution, in response to the DamMT-induced modification of the genomic environment. One example is SeqA, a protein that senses the methylation status of the origin of replication of the chromosome to control the timing of replication initiation. Interestingly, seqA is only present in a few DamMT-specifying proteobacteria. This observation led us to hypothesize that other genes, specifying related functions, might also be found in these organisms. To test this hypothesis, we implemented a large-scale comparative genomic screen meant to identify genes specifying DNA methylation sensing domains, probably involved in DNA maintenance functions. RESULTS: We carried out a phylogenetic analysis of DamMT, identifying two contrasting behaviors of the protein. Based on this phylogeny, we defined precisely a set of genomes, in which the protein activity is likely to be involved in DNA maintenance functions, the 'resident' dam genomes. We defined a second set of genomes, in which DamMT is not resident. We developped a new tool, 'DomainSieve', in order to screen these two sets for protein domains that are strictly associated with 'resident' dam genomes. This approach was rewarding and generated a list of genes, among which some, at least, specify activities with clear linkage to DamMT-dependent DNA methylation and DNA maintenance. AVAILABILITY: DomainSieve is implemented as a web resource and is accessible at http://stat.genopole.cnrs.fr/ds/.

Algorithms↗

PubMed2004

Time modulated prefrontal and parietal activity during the maintenance of integrated information as revealed by magnetoencephalography.

Using magnetoencephalography, we investigated the spatiotemporal patterns of brain magnetic activity responsible for maintaining verbal and spatial information in either an integrated or an unintegrated fashion. Considering time dimension, we noted a greater activation of a fronto-parietal network in early latencies during the maintenance of integrated information, and a different pattern during the maintenance of unintegrated material, showing a greater activation in a fronto-posterior network in late latencies. The greater activation found in certain areas which are traditionally reported as being engaged in spatial working memory (i.e. superior frontal gyri, dorsolateral prefrontal cortex, superior and inferior parietal lobes) when subjects maintained integrated information could be explained by a greater weight of the spatial dimension. It is as if words somehow acquired a spatial attribute, thus exerting a greater load in a neural network specialized in spatial working memory. Alternatively, and not mutually exclusive, we also propose that during the maintenance of integrated information the allocation of cognitive resources is less interfering than during the maintenance of unintegrated information, making it easier.

Adult↗

PubMed1990

Enhanced myocardial salvage by maintenance of microvascular patency following initial thrombolysis with recombinant tissue plasminogen activator.

STUDY OBJECTIVE: The aim was to examine the value of a subthrombolytic maintenance infusion of recombinant double chain tissue plasminogen activator (BW t-PA, Duteplase) in preserving microvascular coronary flow following initial thrombolysis. DESIGN: Coronary arterial thrombi were induced by a copper coil (placed under fluoroscopic control) in the canine left anterior descending coronary artery. Complete vessel occlusion occurred within 10-15 min of coil placement. Following 90 min of thrombotic occlusion, animals received one of three treatments: group 1, vehicle 0.9% saline; group 2, t-PA 1.0 X 10(6) IU.kg-1.h-1 for 1 h; group 3, t-PA 1.0 X 10(6) IU.kg-1.h-1 for 1 h followed by 0.12 X 10(6) IU.kg-1.h-1 throughout the 2 h reperfusion period. Radiolabelled microspheres were administered to assess microvascular coronary flow at various time points throughout the experimental period. SUBJECTS: Experimental subjects were beagle dogs of either sex (n = 30), weight 8.9-14.3 kg. MEASUREMENTS AND MAIN RESULTS: Main vessel patency (assessed fluoroscopically) was achieved within 40.0(SEM 4.0) min and 37.0(3.1) min for group 2 and group 3 animals respectively. Group 1 animals did not reperfuse. Full microvascular coronary flow was achieved following the lytic infusion of t-PA. However, microvascular flow to the ischaemic zone was significantly reduced at the end of the 2 h reperfusion phase in group 2 animals despite "aggressive" anticoagulation with heparin throughout the reperfusion period: subendocardial flow decreased from 0.74(0.14) to 0.24(0.08) ml.min-1.g-1; subepicardial flow decreased from 0.82(0.13) to 0.36(0.09) ml.min-1.g-1, p less than 0.05. Microvascular coronary flow to the ischaemic zone was better preserved following the maintenance infusion of t-PA given throughout the reperfusion phase: subendocardial flow decreased from 0.95(0.07) to 0.50(0.10) ml.min-1.g-1; subepicardial flow decreased from 0.73(0.04) to 0.52(0.08) ml.min-1.g-1. Thrombolytic reperfusion led to salvage of the ischaemic myocardium, with infarct/risk ratio decreasing from 75.0(10.0)% in group 1 to 46.3(11.0)% in group 2, p less than 0.05. Further salvage of the ischaemic myocardium followed a lytic plus maintenance infusion of t-PA, with infarct/risk ratio decreasing to 35.5(6.7)% but this did not reach statistical significance. CONCLUSIONS: t-PA consistently achieved main vessel reperfusion within 40 min (mean) of instituting therapy in our model, leading to marked salvage of ischaemic myocardium. The data also suggest that maintenance infusion of t-PA helps preserve microvascular coronary flow throughout reperfusion and tends to reduce infarct size further.

Animals↗

PubMed1998

Components of the Ku-dependent non-homologous end-joining pathway are involved in telomeric length maintenance and telomeric silencing.

In the budding yeast, Saccharomyces cerevisiae, genes in close proximity to telomeres are subject to transcriptional silencing through the process of telomere position effect (TPE). Here, we show that the protein Ku, previously implicated in DNA double-strand break (DSB) repair and in telomeric length maintenance, is also essential for telomeric silencing. Furthermore, using an in vivo plasmid rejoining assay, we demonstrate that SIR2, SIR3 and SIR4, three genes shown previously to function in TPE, are essential for Ku-dependent DSB repair. As is the case for Ku-deficient strains, residual repair operating in the absence of the SIR gene products ensues through an error-prone DNA repair pathway that results in terminal deletions. To identify novel components of the Ku-associated DSB repair pathway, we have tested several other candidate genes for their involvement in DNA DSB repair, telomeric maintenance and TPE. We show that TEL1, a gene required for telomeric length maintenance, is not required for either DNA DSB repair or TPE. However, RAD50, MRE11 and XRS2 function both in Ku-dependent DNA DSB repair and in telomeric length maintenance, although they have no major effects on TPE. These data provide important insights into DNA DSB repair and the linkage of this process to telomere length homeostasis and transcriptional silencing.

Antigens, Nuclear↗

PubMed1984

Mutants of S. cerevisiae defective in the maintenance of minichromosomes.

We have isolated yeast mutants that are defective in the maintenance of circular minichromosomes. The minichromosomes are mitotically stable plasmids, each of which contains a different ARS (autonomously replicating sequence), a centrometeric sequence, CEN5, and two yeast genes, LEU2 and URA3. Forty minichromosome maintenance-defective (Mcm-) mutants were characterized. They constitute 16 complementation groups. These mutants can be divided into two classes, specific and nonspecific, by their differential ability to maintain minichromosomes with different ARSs. The specific class of mutants is defective only in the maintenance of minichromosomes that carry a particular group of ARSs irrespective of the centromeric sequence present. The nonspecific class of mutants is defective in the maintenance of all minichromosomes tested irrespective of the ARS or centromeric sequence present. The specific class may include mutants that do not initiate DNA replication effectively at specific ARSs present on the minichromosomes; the nonspecific class may include mutants that are affected in the segregation and/or replication of circular plasmids in general.

Chromosomes↗

PubMed2000

The Saccharomyces cerevisiae mre11(ts) allele confers a separation of DNA repair and telomere maintenance functions.

The yeast Mre11 protein participates in important cellular functions such as DNA repair and telomere maintenance. Analysis of structure-function relationships of Mre11 has led to identification of several separation-of-function mutations as well as N- and C-terminal domains essential for Mre11 meiotic and mitotic activities. Previous studies have established that there is a strong correlation between Mre11 DNA repair and telomere maintenance functions and that Mre11-Rad50-Xrs2 complex formation appears to be essential for both of these activities. Here we report that the mre11(ts) allele, previously shown to cause temperature-dependent defects in DNA repair and meiosis, confers a temperature-independent telomere shortening, indicating that mre11(ts) is a separation-of-function mutation with respect to DNA repair and telomere maintenance. In a yeast two-hybrid system, Mre11(ts) fails to form a homodimer or interact with Rad50 and Xrs2 irrespective of experimental temperatures. These observations collectively suggest that the Pro(162)Ser substitution in Mre11(ts) confers a novel separation of Mre11 mitotic functions. Moreover, we observed that while overexpression of the 5'-3' exonuclease gene EXO1 partially complements the MMS sensitivity of mre11, rad50, and xrs2 null mutants, it has no effect on telomere shortening in these strains. This result provides additional evidence on possible involvement of distinctive mechanisms in DNA repair and telomere maintenance by the Mre11-Rad50-Xrs2 complex.

Alleles↗

PubMed1992

Maintenance requirements of Escherichia coli ATCC 25922 in the presence of sub-inhibitory concentrations of various antibiotics.

Escherichia coli ATCC 25922 was grown in minimal medium M63, with glucose 0.1 gL as limiting energy substrate, in the presence of sub-inhibitory concentrations of netilmicin, habekacin, tobramycin, dibekacin, amikacin, kanamycin, amoxycillin, ampicillin, cephalothin, cefoxitin and nalidixic acid. Maintenance requirements were determined with a simple relationship derived from batch growth curves. The apparent relationship between maintenance requirements and antibiotic concentration is an exponential increase, log m(c) = log mo + k.c, where m is maintenance, c antibiotics concentration, mo maintenance without antibiotics, and k a constant. Values for k were found to be in the range 0.5-2.0 mg-1.L.

Amikacin↗

PubMed1976

Maintenance requirement and energetic efficiency of lean and obese Zucker rats.

The body balance technique was used to determine the maintenance requirement and the energetic efficiency of 6-week-old male lean and obese Zucker rats. Fifteen lean and 15 obese rats were assigned to three groups of five each and fed three levels of food intake: ad libitum, 75% of ad libitum, and 50% of ad libitum, for a 4-week period. The obese rats consumed more food and gained significantly more weight than the lean rats. Obese rats utilized dietary energy more efficiently than lean rats but the opposite was true for dietary protein. The efficiency with which obese rats utilized metabolizable energy for gain was 36% compared with efficiency of utilization of metabolizable energy above maintenance for obese and lean were 51.4% and 21.4%, respectively. The maintenance requirement on the basis of metabolic body size for the obese and lean was calculated to be 122 and 130.5 kcal ME per day per kg.75 for the 4-week period. These results indicate that the energetic efficiency is higher in obese than in lean Zucker rats and suggest that the higher energetic efficiency is not the result of a significantly lower maintenance requirement.

Animals↗

PubMed1983

The nutritional value of a soy protein concentrate (STAPRO-3200) for long-term protein nutritional maintenance in young men.

Six healthy young male M.I.T. students participated in a metabolic study to assess the capacity of a soy protein concentrate (STAPRO-3200) to serve as the sole source of dietary protein for long-term maintenance of protein nutritional status. Following an initial 9-day period, during which the subjects received an egg-protein, formula diet supplying 1.5 g protein per kilogram per day, the soy protein was given at a level of 0.8 g protein (N X 6.25) per kilogram per day for 82 days. Throughout, nitrogen balances were measured, and at intervals of 3 to 4 weeks, blood chemistries were determined, and evaluations of physical performance were undertaken. In addition measurements were made of zinc absorption and balance and of iron absorption, with the aid of 70Zn and 58Fe. Mean nitrogen balances were slightly positive for all subjects and the protein source was judged to support adequately maintenance of protein nutritional status, confirmed by the absence of changes in relevant blood parameters and maintenance of performance in the exercise tests. Mean zinc absorption was 23% of intake and did not change during the 82-day soy period and crude zinc balances remained slightly positive throughout. Iron intake was solely from the soy concentrate, and each meal was supplemented with ascorbic acid. Iron absorption was highly variable between and within subjects, as determined by the stable isotope balance procedure. Associated with the withdrawal of blood for purposes of monitoring the subjects, serum ferritin declined indicating a reduction in iron stores. These blood changes were used to approximate iron absorption and it was estimated to be 16%. It is concluded that well-processed soy concentrate can serve as the sole source of nitrogen and essential amino acids for long-term maintenance in adult humans.

Absorption↗

PubMed1998

Obese gene expression in porcine adipose tissue is reduced by food deprivation but not by maintenance or submaintenance intake.

The relationship between obese gene expression and energy intake was determined in pigs of various body weights. With ad libitum consumption, expression increased (P < 0.001) with body weight from 55 to 163 kg. Obese mRNA relative abundance was correlated with fat mass (r = 0.74, P < 0.0001) and percentage of fat (r = 0.72, P < 0. 0001). Obese expression was also evaluated at 159 kg (initial weight) and ad libitum, maintenance or 23% of maintenance intake for 28 d. Obese mRNA was independent of treatment (P > 0.78) despite considerable weight differences. Obese mRNA abundance was then compared at 136 kg (initial weight) and ad libitum or maintenance intake for 3 or 28 d. Abundance was not influenced by either duration of treatment or intake, despite a small increase (P < 0.01) in serum nonesterified fatty acids (NEFA) and a reduction (P < 0.02) in insulin attributable to maintenance intake. Finally, mRNA abundance was determined at 60 and 136 kg and conditions of food deprivation or ad libitum intake for 3 d. Food deprivation reduced (P < 0.01) serum insulin and increased (4- to 5-fold) NEFA concentrations. Obese mRNA abundance was greater (P < 0.01) in the heavier pigs and was reduced (P < 0.01) by food deprivation. We conclude that obese mRNA abundance in pigs correlates with fat mass and percentage of body fat under conditions of ad libitum intake. Furthermore, obese mRNA abundance is reduced by food deprivation, whereas lesser degrees of intake restriction do not change obese mRNA abundance, even when accompanied by appreciable weight loss.

Adipose Tissue↗

PubMed2004

The content and comprehensiveness of hepatitis C education in methadone maintenance and drug-free treatment units.

Although drug users are at elevated risk for hepatitis C virus (HCV) infection, many are uniformed or misinformed about the virus. Drug treatment programs are uniquely situated to provide comprehensive risk-modifying educational programs for decreasing HCV transmission, a strategy advocated in the most recent National Institutes of Health Consensus Development Conference Statement on the Management of Hepatitis C. Given the large proportion of patients that inject drugs in methadone maintenance treatment programs and the high prevalence of HCV among drug injectors, we compared a nationwide sample (N = 246) of methadone maintenance treatment programs and drug-free programs regarding the content and comprehensiveness of HCV education. All of these programs provide HCV education to at least some of their patients. Results indicated that, compared to drug-free programs, methadone maintenance treatment programs cover a significantly greater number of HCV-related topics, and that a significantly greater proportion of the methadone programs cover specific topics (e.g., how to avoid transmitting HCV, the importance of testing for HCV, treatment options if HCV positive). Of special concern is that fewer than three quarters of the drug-free programs address what to do if co-infected with human immunodeficiency virus (HIV) and HCV and how to maintain health if HCV positive, and only about half of the drug-free and methadone maintenance treatment programs educate HCV-positive patients about the importance of obtaining vaccinations for hepatitis A and B. Drug treatment programs need to educate patients about the proactive steps these individuals can take to deal with HCV, provide critically needed HCV services, and encourage patients to make full use of these services.

Analgesics, Opioid↗

PubMed1996

Role of maintenance oral dexamethasone in prophylaxis of delayed emesis caused by moderately emetogenic chemotherapy.

BACKGROUND: Although usually a problem of cisplatin-based chemotherapy, delayed emesis can cause severe distress in patients treated with cyclophosphamide. Dexamethasone has been shown to be effective in the control of cisplatin-induced delayed emesis, but its role against the delayed problem in patients treated with cyclophosphamide has not been demonstrated. Our study was conducted to evaluate the effect of dexamethasone in delayed emesis induced by cyclophosphamide. PATIENTS AND METHODS: Ninety-eight patients were given i.v. granisetron and i.v. dexamethasone before chemotherapy, and randomised to receive either oral dexamethasone 4 mg twice daily as maintenance or no maintenance. RESULTS: Ninety-four patients were evaluable. Of those given maintenance oral dexamethasone, 57% had complete and 30% had major control of delayed emesis, versus 33% and 15%, respectively, of patients who did not receive maintenance. Side effects are mainly constipation and headache. CONCLUSION: The results shows that oral dexamethasone is an effective agent against cyclophosphamide-induced delayed emesis.

Administration, Oral↗

PubMed1995

Maintenance and growth respiration of the aboveground parts of young field-grown hinoki cypress (Chamaecyparis obtusa).

Aboveground respiration of five 8-year-old trees of field-grown hinoki cypress (Chamaecyparis obtusa (Sieb. et Zucc.) Endl.) was nondestructively measured at monthly intervals over 1 year with an enclosed standing tree method. The relationship between monthly specific respiration rate and monthly mean relative growth rate at the individual tree level was described by a linear equation. During the dormant season, respiration was used mainly for maintenance purposes, whereas during the growing season, more than 40% of the respiration was used for growth purposes, i.e., 60 to 70% in May. We conclude that annual maintenance and growth respiration of a tree are directly proportional to the aboveground phytomass and its annual increment, respectively. The maintenance coefficient was estimated to be 0.504 +/- 0.039 (SE) kg kg(-1) year(-1), indicating that the amount respired for maintaining already existing phytomass was equivalent to about half of the existing phytomass. The growth coefficient was estimated to be 0.772 +/- 0.043 (SE) kg kg(-1), indicating that the amount respired for constructing new phytomass was equivalent to about three-fourths of the annual phytomass increment. The annual stand maintenance and growth respiration were, respectively, 8.8 Mg ha(-1) year(-1) for an aboveground biomass of 17.4 Mg ha(-1) and 5.0 Mg ha(-1) year(-1) for an annual stand aboveground biomass increment of 6.5 Mg ha(-1) year(-1). About two-thirds of the total respiration was used to maintain already existing biomass, and about one-third was used to construct new biomass.

Journal Article↗

PubMedDate not supplied

Stem maintenance and construction respiration in Pinus ponderosa grown in different concentrations of atmospheric CO(2).

To determine whether long-term growth in enriched CO(2) atmospheres changes the woody tissue respiration component of aboveground carbon budgets, we measured woody tissue respiration of stems of 3-year-old ponderosa pine (Pinus ponderosa Laws.) grown in ambient (350 ppm) or twice ambient (700 ppm) atmospheric CO(2) concentrations in open-top field chambers located in Placerville, CA. Total respiration rate was measured by gas exchange, and construction respiration was calculated from the construction cost, percent carbon of stem samples and relative growth rate. Maintenance respiration was determined as the difference between total and construction respiration. The Q(10) of respiration was greater in stems grown in elevated CO(2) than in stems grown in ambient CO(2) (2.20 versus 1.67). As a result, mean daily respiration per unit volume of wood modeled for the month of September was greater in trees growing in elevated CO(2) than in ambient CO(2) (46.75 versus 40.45 mol m(-3) day(-1)). These effects of atmospheric CO(2) concentration were not the result of differences in relative growth rate. Calorimetric analyses of woody tissue construction cost indicated no difference between treatments; however, trees in the elevated CO(2) treatment showed a 1% lower carbon concentration than trees in the ambient CO(2) treatment. Estimates of construction respiration did not differ between treatments, confirming that the treatment differences in mean daily respiration rate were attributable to the maintenance component. Under future predicted atmospheric conditions, changes in the maintenance respiration of woody tissue may lead to an increase in the respiration component of whole-plant carbon budgets of ponderosa pine. Our results suggest that potential increases in the maintenance component of stem respiration should be considered when modeling the response of forest stand growth to enriched CO(2) atmospheres.

Journal Article↗

PubMed1998

Effect of nitrogen on the seasonal course of growth and maintenance respiration in stems of Norway spruce trees.

To determine effects of stem nitrogen concentration ([N]) on the seasonal course of respiration, rates of stem respiration of ten control and ten irrigated-fertilized (IL), 30-year-old Norway spruce trees (Picea abies (L.) Karst.), growing in northern Sweden, were measured on seven occasions from June 1993 to April 1994. To explore sources of seasonal variation and mechanisms of fertilization effects on respiration, we separated total respiration into growth and maintenance respiration for both xylem and phloem bark. Stem respiration increased in response to the IL treatment and was positively correlated with growth rate, volume of living cells and stem nitrogen content. However, no significant effect of IL treatment or [N] in the living cells was found for respiration per unit volume of live cells. Total stem respiration during the growing season (June to September) was estimated to be 16.7 and 29.7 mol CO(2) m(-2) for control and IL-treated trees, respectively. Respiration during the growing season accounted for approximately 64% of total annual respiration. Depending on the method, estimated growth respiration varied between 40 and 60% of total respiration during the growing season. Between 75 and 80% of the live cell volume in the stems was in the phloem, and phloem maintenance accounted for about 70% of maintenance respiration. Because most of the living cells were found in the phloem, and the living xylem cells were concentrated in the outer growth rings, we concluded that the best base for expressing rates of stem growth and maintenance respiration in young Norway spruce trees is stem surface area.

Journal Article↗

PubMed1999

Direct inhibition of maintenance respiration in western hemlock roots exposed to ambient soil carbon dioxide concentrations.

Root respiration often exhibits a direct and immediate decline with increasing concentrations of ambient soil carbon dioxide concentration ([CO(2)]), and recent evidence suggests this decline may be attributable to a decline in maintenance respiration within the root. If true, this concept could provide a clue to the biochemical process underlying respiratory inhibition as well as improve our knowledge of the timing and degree to which this inhibition occurs in nature. To test the hypothesis that maintenance respiration exhibits a direct, negative response to increasing [CO(2)], we measured total respiration in intact root systems of western hemlock (Tsuga heterophylla (Raf.) Sarg.) seedlings grown at different relative growth rates and exposed to soil [CO(2)]s ranging from 91 to 7008 &mgr;mol mol(-1). Analysis of covariance was used to separate maintenance from total respiration. Total respiration declined exponentially with increasing [CO(2)]. Maintenance respiration, which comprised 85% of total respiration over all treatments, also declined exponentially with increasing [CO(2)]. Growth respiration was not inhibited at any [CO(2)]. These findings may explain why roots of some fast-growing species do not show [CO(2)] inhibition.

Journal Article↗

PubMed2003

Maintenance of mouse male germ line stem cells in vitro.

The proliferation and differentiation of a stem cell are regulated intrinsically by the stem cell and extrinsically by the stem cell niche. Elucidation of regulatory mechanisms of spermatogonial stem cells (SSCs), the stem cell of the postnatal male germ line, would be facilitated by in vitro studies that provide a defined microenvironment reconstituted ex vivo. We analyzed the effect of in vitro environment on the maintenance of adult and immature SSCs in a 7-day culture system. Although the number of adult and immature SSCs decreased in a time-dependent manner, nearly one in four stem cells (24%) could be maintained in vitro for 7 days. Stem cell maintenance was enhanced by coculture with OP9 bone marrow stroma or L fibroblast cell lines, addition of glial cell line-derived neurotrophic factor, or utilization of specific culture medium. In contrast, coculture with TM4 or SF7 Sertoli cell lines and addition of activin A or bone morphogenetic protein 4 (BMP4) reduced stem cell maintenance in vitro. Only 4% of the stem cells remained when cultured with TM4 cells or activin A, and 6% remained when cultured with SF7 cells or BMP4. These results lead to the hypothesis that suppression of germ cell differentiation improves in vitro maintenance of SSCs by interrupting the unidirectional cascade of spermatogenesis and blocking stem cell differentiation.

Animals↗

PubMed2006

Titration of propofol for anesthetic induction and maintenance guided by the bispectral index: closed-loop versus manual control: a prospective, randomized, multicenter study.

BACKGROUND: This report describes a closed-loop titration of propofol target control infusion based on a proportional-differential algorithm guided by the Bispectral Index (BIS) allowing induction and maintenance of general anesthesia and compares this to manual propofol target control infusion. METHODS: One hundred sixty-four patients scheduled to undergo elective minor or major surgery were prospectively randomized in a multicenter study into the closed-loop (n = 83) or manual target control infusion group (n = 81). The goal was to reach a BIS target of 50 during induction and to maintain it between 40 and 60 during maintenance. For both groups, remifentanil target control infusion was adjusted manually, and ventilation was without nitrous oxide. RESULTS: Closed-loop control was able to provide anesthesia induction and maintenance for all patients. During induction, propofol consumption was lower in the closed-loop group (1.4 +/- 0.5 vs. 1.8 +/- 0.6 mg/kg; P < 0.0001), but the duration was longer (320 +/- 125 vs. 271 +/- 120 s; P < 0.0002). Adequate anesthesia maintenance, defined as the BIS in the range of 40-60, was significantly higher in the closed-loop group (89 +/- 9 vs. 70 +/- 21%; P < 0.0001), with a decrease of the occurrence of BIS less than 40 (8 +/- 8 vs. 26 +/- 22%; P < 0.0001). Time from discontinuation of propofol infusion to tracheal extubation was shorter in the closed-loop group (7 +/- 4 vs. 10 +/- 7 min; P < 0.017). Unwanted somatic events and hemodynamic instability were similar. CONCLUSION: Automatic control of consciousness using the BIS is clinically feasible and outperforms manual control.

Adult↗