Background. Stroke occurs after coronary artery bypass grafting with an incidence ranging between 0.8% and 5.2%. To identify factors associated with stroke, we prospectively examined a study cohort ...and tested findings in an independent validation sample.
Methods. The study cohort comprised 456 patients undergoing coronary artery bypass grafting only, and the validation sample comprised 1,298 patients. Stroke was detected postoperatively by the study team and confirmed by neurologic consultation and computed tomographic scanning.
Results. Five factors taken together were correlated with stroke: previous stroke, presence of carotid bruit, history of hypertension, increasing age, and history of diabetes mellitus. The only significant intraoperative factor was cardiopulmonary bypass time. Probabilities were calculated, and patients were placed into low, medium, and high stroke-risk groups. In the validation sample, this model was able to rank the majority of patients with stroke into the high-risk group.
Conclusions. These five factors taken together can identify the risk of stroke in patients having coronary artery bypass grafting. Recognition of the high-risk group will aid studies on the mechanism and prevention of stroke by modification of surgical procedures or pharmacologic intervention.
(Ann Thorac Surg 1997;63:516–21)
The effect of vitamins and minerals supplementation (VTM) and/or two rates of body weight gain (GAIN) on bovine placental vascular development and angiogenic factors gene expression were evaluated in ...two experiments: In Exp. 1, crossbred Angus heifers (
= 34) were assigned to VTM/NoVTM treatments at least 71 days before breeding to allow changes in the mineral status. At breeding, through artificial insemination (AI), heifers were assigned to low-gain (LG) 0.28 kg/d or moderate-gain (MG) 0.79 kg/d treatments, resulting in NoVTM-LG (Control;
= 8), NoVTM-MG (
= 8), VTM-LG (
= 9), and VTM-MG (
= 9) until day 83 of gestation; In Exp. 2, crossbred angus heifers (
= 28), were assigned to control (CON;
= 12), receiving a basal total mixed ration (TMR) or TMR + VTM (VTM;
= 16) from breeding until parturition. Placentomes from Exp. 1 and cotyledons (COT) from Exp. 2 were evaluated by immunohistochemistry for COT vascular density area. COTs from Exp. 1 were evaluated for angiogenic factor (
-1,
-2,
2,
3,
1,
,
,
) gene expression. In Exp. 1, COT vascularity was not affected by the interaction of VTM and GAIN (
= 0.67) or the main effects of VTM (
= 0.50) and GAIN (
= 0.55). Likewise, angiogenic factors were not differentially expressed between treatments (
< 0.05). In Exp. 2, COT vascularity was greater in VTM vs. CON (
= 0.07). In conclusion, there is a suggested later-stage influence of vitamin and mineral supplementation on placental vascularity, emphasizing the importance of supplementation beyond early pregnancy.
We hypothesized that a standing flank ovariohysterectomy procedure could be developed in beef heifers that would provide high quality tissues for addressing critical questions during early pregnancy, ...while concomitantly keeping livestock stewardship a high priority. To test the hypothesis, we: 1) developed a standing flank ovariohysterectomy procedure for use in beef heifers, and 2) implemented this procedure in a cohort of heifers up to d 50 of pregnancy for tissue collections, documentation of post-surgical recovery, and assessment of feedlot finishing performance. Ovariectomy and cesarean section protocols are well established in research and veterinary medicine and were used as starting points for procedural development. Crossbred Angus heifers ( = 46; ∼ 15 mo of age; BW = 362.3 ± 34.7 kg) were used to develop this new surgical tissue collection technique. Heifers were subjected to the 5-d CO-Synch + CIDR estrous synchronization protocol so ovariohysterectomy occurred at d 16, 22, 28, 34, 40, and 50 of gestation. Key aspects of the standing flank ovariohysterectomy technique included 1) use of local anesthetic for a standing flank incision, 2) locate the uterine and ovarian arteries via blind palpation and ligate them through the broad ligament via an improved clinch knot, 3) cut the ovaries and uterus free from the broad ligament, 4) ligate the cervix and uterine branch of the vaginal artery, and 5) cut through the cervix and remove the reproductive tract. Surgical times, from skin incision to placement of the last suture, were influenced ( = 0.04) by stage of gestation. In pregnant heifers, time decreased from d 22 (120.0 ± 12.0 min) of gestation to d 40 (79.5 ± 12.0 min) of gestation; then increased at d 50 (90.5 ± 14.7 min) of gestation. Using this procedure, we obtained uterine, placental, and embryo/fetal tissues that had experienced limited hypoxia, little or no trauma, and thus were excellent quality for scientific study. All heifers recovered from surgery quickly and were moved to a finishing period. During the finishing period, ovariohysterectomized heifers had a DMI of 13.8 kg, gained 1.99 ± 0.35 kg/d, and had a G:F of 0.145 over 132-d. The standing flank ovariohysterectomy technique represents a new and viable model to economically obtain high quality tissues for investigating critical biological mechanisms during early pregnancy in beef heifers.
Horseshoe kidneys and their wide-ranging anatomy present a unique test to the open surgical approach for repair of abdominal aortic aneurysms. Endovascular options are currently the desired strategy ...for treatment of abdominal aortic aneurysms and offer multiple advantages when horseshoe kidneys are present. Even so, the challenging nature of these patients demands a high degree of caution and planning. This case details a patient with horseshoe kidney who underwent percutaneous endovascular aneurysm repair for an abdominal aortic aneurysm and developed isthmus infarction early in the postoperative period with an uneventful subsequent recovery. Here we report what we believe is the first successfully described percutaneous endovascular aneurysm repair to treat a patient with horseshoe kidney.
Sex steroids are important regulators of angiogenesis and growth in reproductive tissues, including the placenta. In experiment (exp.) 1, to examine the expression of a suite of sex steroid receptors ...throughout early pregnancy, maternal (caruncular CAR) and fetal (fetal membranes FM) placental tissues were collected on days 14 to 30 after mating and on day 10 after estrus (nonpregnant controls). In exp. 2, to examine the hypothesis that assisted reproductive technology would affect the expression of the same suite of sex steroid receptors, pregnancies were achieved through natural mating (NAT) or transfer of embryos from natural mating (NAT-ET), in vitro fertilization (IVF), or in vitro activation (IVA), and CAR and FM were collected on day 22. In exp. 1, for CAR messenger RNA (mRNA) expression of estrogen receptors (ESR) 1 and 2, nuclear (n) progesterone receptors (PGR) and membrane (m) PGRα, β, and γ were affected (P < 0.02) by pregnancy stage, as were ESR1, nPGR, and mPGRα, β, and γ for FM (P < 0.03). In exp. 2, for CAR, mRNA expression of ESR1 and nPGR was decreased (P < 0.001) in NAT-ET, IVF, and IVA groups compared with NAT. For FM, mRNA expression of ESR1 tended to be greater (P = 0.10) in the IVA group compared with NAT and NAT-ET, and GPER1 was greater (P < 0.05) in NAT-ET and IVF compared with NAT. These data establish the normal pattern of sex steroid receptor mRNA expression in maternal and fetal placenta during early pregnancy in sheep, and in addition, suggest that altered expression of placental sex steroid receptors may be an early event leading to poor placental vascularization and growth after assisted reproductive technology.
•Uteroplacental expression of sex steroid receptors was examined in early pregnancy.•Uteroplacental sex steroid receptor expression changed dramatically throughout early pregnancy.•Uteroplacental sex steroid receptor expression was affected by assisted reproductive techniques.•Uteroplacental sex steroid receptor expression may play an important role pregnancy establishment.•Altered uteroplacental sex steroid receptor expression may underlie negative consequences of ART.
Herein, we present a dataset based on the RNA-Seq analysis of liver tissue from bovine female fetuses at day 83 of gestation. The findings were reported in the main article, “Periconceptual maternal ...nutrition affects fetal liver programming of energy- and lipid-related genes” 1. These data were generated to investigate the effects of periconceptual maternal vitamin and mineral supplementation and rates of body weight gain on the transcript abundance of genes associated with fetal hepatic metabolism and function. To this end, crossbred Angus beef heifers (n = 35) were randomly assigned to 1 of 4 treatments in a 2 × 2 factorial design. The main effects tested were vitamin and mineral supplementation (VTM or NoVTM – at least 71 days pre-breeding to day 83 of gestation) and rate of weight gain (low (LG – 0.28 kg/d) or moderate (MG – 0.79 kg/d) – from breeding to day 83). The fetal liver was collected on day 83 ± 0.27 of gestation. After total RNA isolation and quality control, strand-specific RNA libraries were prepared and sequenced on the Illumina® NovaSeq 6000 platform to generate paired-end 150-bp reads. After read mapping and counting, differential expression analysis was performed with edgeR. We identified 591 unique differentially expressed genes across all six vitamin-gain contrasts (FDR ≤ 0.1). To our knowledge, this is the first dataset investigating the fetal liver transcriptome in response to periconceptual maternal vitamin and mineral supplementation and/or the rate of weight gain. The data described in this article provides genes and molecular pathways differentially programming liver development and function.
Abstract
The hypothesis of this experiment was that increasing the inclusion level of distiller’s dried grains with solubles (DDGS) in the diets would decrease semen quality but have no negative ...effects on growth performance. Following the removal of DDGS from the diet, it was hypothesized that the ram lambs would recover and become reproductively sound, independent of treatment. To test this hypothesis, Suffolk and Hampshire ram lambs (n = 112) were allocated to 4 treatments (n = 4 pens per treatment; 7 rams per pen) in a completely randomized design. Dietary treatments were 60% corn, 25% oats, and 15% commercial lamb pellet (CON), 15% of the ration as DDGS substituted for corn (% DM basis; 15DDGS), 30% of the ration as DDGS substituted for corn (% DM basis; 30DDGS), and 45% of the ration as DDGS substituted for corn (% DM basis; 45DDGS). Lambs were fed for 112 d on their respective treatment, after which they were placed on the CON ration until day 168. Lambs were weighed on consecutive d at the beginning (days 0 and 1) and end (days 167 and 168) of the study. Scrotal circumference was measured on all lambs on days 84, 112, 140, and 168. Semen samples were collected on a subset of 64 rams (4 rams per pen) to evaluate semen quality on days 84, 112, 140, and 168. Blood samples were collected on the same subset of rams every 14 d throughout the study. A quadratic effect on BW on day 112 and overall BW (P = 0.03 and P = 0.005, respectively), ADG on day 112 and overall ADG (P = 0.02 and P = 0.02, respectively), DMI (P = 0.007) on day 112, and a cubic effect (P = 0.05) for overall G:F were observed. Overall and day 168 scrotal circumference had a quadratic (P = 0.05) response. A linear increase in spermatozoa concentration on day 168 was observed (P = 0.03) as DDGS concentration increased in the treatment diets, although rams in this stage of the study were no longer receiving DDGS. Overall, testosterone concentrations exhibited a linear decrease (P = 0.005) as DDGS increased in the diet. The linear increase (P = 0.04) on day 168 in morphologically normal sperm as DDGS increased in the diets indicated that all rams, regardless of treatment, would have passed a reproductive soundness exam. In the current study, no negative effects were observed in lamb feedlot or reproductive traits due to increasing DDGS in the diet, indicating that DDGS may be included at levels up to 45% of growing lamb diets.
The objectives were to examine effects of dietary Se supplementation and nutrient restriction during defined periods of gestation on maternal adaptations to pregnancy in primigravid sheep. Sixty-four ...pregnant Western Whiteface ewe lambs were assigned to treatments in a 2 x 4 factorial design. Treatments were dietary Se adequate Se (ASe; 3.05 μg/kg of BW) vs. high Se (HSe; 70.4 μg/kg of BW) fed as Se-enriched yeast, and plane of nutrition control (C; 100% of NRC requirements) vs. restricted (R; 60% of NRC requirements. Selenium treatments were fed throughout gestation. Plane of nutrition treatments were applied during mid (d 50 to 90) and late gestation (d 90 to 130), which resulted in 4 distinct plane of nutrition treatments treatment: CC (control from d 50 to 130), RC (restricted from d 50 to 90, and control d 90 to 130), CR (control from d 50 to 90, and restricted from d 90 to 130), and RR (restricted from d 50 to 130). All of the pregnant ewes were necropsied on d 132 ± 0.9 of gestation (length of gestation almost equal to145 d). Nutrient restriction treatments decreased ewe ADG and G:F, as a result, RC and CR ewes had similar BW and maternal BW (MBW) at necropsy, whereas RR ewes were lighter than RC and CR ewes. From d 90 to 130, the HSe-CC ewes had greater ADG (Se x nutrition; P = 0.05) than did ASe-CC ewes, whereas ADG and G:F (Se x nutrition; P = 0.08) were less for HSe-RR ewes compared with ASe-RR ewes. The CR and RR treatments decreased total gravid uterus weight (P = 0.01) as well as fetal weight (P = 0.02) compared with RC and CC. High Se decreased total (g; P = 0.09) and relative heart mass (g/kg of MBW; P = 0.10), but increased total and relative mass of liver (P less-than or equal to 0.05) and perirenal fat (P less-than or equal to 0.06) compared with ASe. Total stomach complex mass was decreased (P < 0.01) by all the nutrient restriction treatments, but was reduced to a greater extent in CR and RR compared with RC. Total small intestine mass was similar between RC and CC ewes, but was markedly reduced (P < 0.01) in CR and RR ewes. The mass of the stomach complex and the small and large intestine relative to MBW was greater (P = 0.01) for RC than for CR ewes. Increased Se decreased jejunal DNA concentration (P = 0.07), total jejunal cell number (P = 0.03), and total proliferating jejunal cell number (P = 0.05) compared with ASe. These data indicate that increased dietary Se affected whole-body and organ growth of pregnant ewes, but the results differed depending on the plane of nutrition. In addition, the timing and duration of nutrient restriction relative to stage of pregnancy affected visceral organ mass in a markedly different fashion.
The objectives of this study were to evaluate effects of maternal dietary restriction and Se supply on angiogenic factor mRNA expression in intestinal and mammary tissues, and jejunal crypt cell ...proliferation and vascularity in late-term fetal intestines. In Exp. 1, pregnant ewe lambs (n = 32; initial BW = 45.6 ± 2.3 kg) were allotted randomly to 1 of 4 treatments. Treatments (initiated d 50 ± 5 of gestation) were control (3.5 μg of Se·kg of BW⁻¹·d⁻¹), Se-wheat (75 μg of Se·kg of BW⁻¹·d⁻¹), selenate (Se3; providing 75 μg of Se·kg of BW⁻¹·d⁻¹), selenate (Se15; providing 375 μg of Se·kg of BW⁻¹·d⁻¹). Diets (DM basis) were similar in CP (15.5%) and ME (2.68 Mcal/kg). In Exp. 2, pregnant ewe lambs (n = 36; initial BW 53.8 ± 1.3 kg) were allotted randomly to treatments in a 2 x 2 factorial arrangement. Factors were nutrition (control, 100% of requirements vs. restricted nutrition, 60% of controls) and dietary Se (adequate Se; 6 μg of Se·kg of BW⁻¹·d⁻¹ vs. high Se; 80 μg of Se·kg of BW⁻¹·d⁻¹). Selenium treatments were initiated 21 d before breeding, and nutritional treatments were initiated on d 64 of gestation. Diets (DM basis) were 16% CP and 2.12 Mcal/kg of ME. In Exp. 1, Se15 increased (P = 0.07) vascular endothelial growth factor (VEGF) mRNA expression, whereas Se supplementation decreased (P = 0.06) kinase insert domain receptor (KDR) mRNA in maternal mucosal scrape on d 134 of gestation. Expression of VEGF mRNA was decreased by Se (P = 0.10) in fetal jejunum. In mammary tissue, fms-related tyrosine kinase 1 and KDR mRNA were greater in Se-wheat compared with Se3, and KDR expression was increased (P = 0.10) in Se15 compared with Se3. In Exp. 2, dietary restriction increased (P less-than or equal to 0.07) expression of mRNA for VEGF, fms-related tyrosine kinase 1, KDR, neuropilin 1, neuropilin 2, and hypoxia-inducible factor 1, α subunit in mucosal scrapes from maternal jejunum. In fetal jejunum, soluble guanylate cyclase, was decreased (P = 0.01) by maternal dietary restriction from d 64 to 135 of gestation. Total microvascularity in fetal jejunum was reduced (P = 0.002) by maternal dietary restriction. Mammary gland expression of VEGF, neuropilin 1, angiopoietin receptor (endothelial tyrosine kinase), and endothelial nitric oxide synthase 3 increased (P less-than or equal to 0.09), whereas angiopoietin 1 decreased (P = 0.05) due to nutrient restriction. Data indicate that expression of angiogenic factors and receptors in maternal intestine, mammary gland, and fetal jejunum are responsive to maternal nutrition and likely explain observed changes in tissue vascularity.
Peripubertal ewe lambs (44.3 ± 1.1 kg of initial BW) were used in a 2 x 3 factorial design to test the effects of plane of nutrition (diet) and stage of gestation on maternal visceral tissue mass, ...intestinal cellularity, crypt cell proliferation, and jejunal mucosal vascularity. Singleton pregnancies to a single sire were established by embryo transfer, and thereafter ewes were offered a control (Control) or high (High) amount of a complete diet (2.84 Mcal/kg and 15.9% CP; DM basis) to promote slow or rapid maternal growth rates. After d 90 of gestation, feed intake of the Control group was adjusted weekly to maintain BCS and meet the increasing nutrient demands of the gravid uterus. Ewes were slaughtered at 50 d (n = 6 Control; n = 5 High), 90 d (n = 8 Control; n = 6 High), or 130 d (n = 8 Control; n = 6 High) of gestation. Ewes were eviscerated and masses of individual organs were recorded. The jejunum was sampled and processed for subsequent analyses. Final ewe BW for Control-fed ewes was similar at d 50 and 90 and increased (P = 0.10) from d 90 to 130 (46.0, 48.9, and 58.2 ± 1.6 kg, respectively), whereas final BW increased (P less-than or equal to 0.01) throughout gestation in High-fed ewes (58.3, 68.8, and 81.1 ± 1.6 kg, respectively). Relative jejunum mass (g/kg of maternal BW) was greater (P = 0.003) in Control-fed ewes compared with High-fed ewes and tended (P = 0.11) to decrease from d 50 to 130. There were diet x stage of gestation interactions (P less-than or equal to 0.08) for ileum and small intestinal total and relative weights. Ileum mass (g/kg of maternal BW) in Control-fed ewes was less (P = 0.07) compared with High-fed ewes at d 50, was equal (P = 0.19) to High-fed ewes at d 90, and was greater (P = 0.02) than High-fed ewes at d 130. Small intestine mass (g/kg of maternal BW) was similar between Control- and High-fed ewes at d 50 and 90, but Control-fed ewes had greater (P = 0.01) mass at d 130. Jejunal RNA and protein concentrations were less (P less-than or equal to 0.07) and DNA was unaffected (P = 0.43) in Control-fed compared with High-fed ewes. Stage of gestation did not affect jejunal RNA, DNA (mg/g), or protein concentrations. Jejunal cellular proliferation was not affected by diet or stage of gestation. In jejunal mucosal tissue, capillary number decreased, whereas capillary surface density and area per capillary increased (P = 0.01) with advancing pregnancy (d 50 vs. d 130), but were independent of diet. Data indicated that intestinal mass as a proportion of maternal BW declined in overnourished, gestating ewe lambs. This response was more pronounced during late gestation and is likely explained by the increasing maternal BW and adiposity rather than by the changing cellularity or cell proliferation.
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