Effect of number of motile, frozen-thawed boar sperm and number of fixed-time inseminations on fertility in estrous-synchronized gilts.

There are advantages for use of frozen-thawed boar sperm (FTS) as a tool for preservation and transfer of valuable genetic material, despite its practical limitations. It was hypothesized that increasing the number of motile FTS and number of fixed-time artificial inseminations (AI) would improve pregnancy rate and litter size. Semen from six boars was frozen in 0.5mL straws at 500x10(6)cells/mL. Gilts approximately 170 days of age, were induced into estrus with PG600 and synchronized using MATRIX (synthetic progestagen). Following last feeding of MATRIX (LFM), gilts were checked twice daily for estrus. At onset of estrus, gilts were randomly assigned in a 3x2 factorial treatment design to receive 1x10(9) motile FTS (n=19), 2x10(9) motile FTS (n=19), 4x10(9) motile FTS (n=19) in a single AI at 32h after onset of estrus, or 1x10(9) motile FTS (n=18), 2x10(9) motile FTS (n=17), or 4x10(9) motile FTS (n=19) in each of the two AI at 24 and 32h following onset of estrus. Ultrasonography was performed at 12h intervals after estrus to estimate time of ovulation. Reproductive tracts were collected 28-34 days following AI. Estrus occurred at 139+/-2h (mean+/-SE) after LFM and ovulation at 33+/-1h following onset of estrus. Dose and number of inseminations did not interact or individually influence pregnancy rate at slaughter (73+/-4.2%) or numbers of normal fetuses (10.8+/-0.5). However, number of fetuses tended (P=0.14) to increase with double AI but not with dose. Boar did not affect pregnancy rate but did affect number of normal fetuses and embryonic survival (P<0.01). Longer intervals from insemination to ovulation reduced pregnancy rate (P<0.05), number of normal fetuses (P<0.001), and embryonic survival (P<0.01). Ovarian abnormalities at slaughter were associated with reduced pregnancy rate (P<0.001). The results of this experiment indicate that a double insemination using 2x10(9) motile sperm would produce the greatest number of piglets with fewest numbers of frozen sperm used, while double AI with 1x10(9) motile sperm would be most practical for pig production with limited genetic resources. Fertility was also influenced by boar, interval from insemination to ovulation, and gilt ovarian abnormalities.

Wingspan in-stent restenosis and thrombosis: incidence, clinical presentation, and management.

OBJECTIVE: Wingspan (Boston Scientific, Fremont, CA) is a self-expanding stent designed specifically for the treatment of symptomatic intracranial atheromatous disease. The current series reports the observed incidence of in-stent restenosis (ISR) and thrombosis on angiographic follow-up. METHODS: A prospective, intent-to-treat registry of patients in whom the Wingspan stent system was used to treat symptomatic intracranial atheromatous disease was maintained at five participating institutions. Clinical and angiographic follow-up results were recorded. ISR was defined as stenosis greater than 50% within or immediately adjacent (within 5 mm) to the implanted stents and absolute luminal loss greater than 20%. RESULTS: To date, follow-up imaging (average duration, 5.9 mo; range, 1.5-15.5 mo) is available for 84 lesions treated with the Wingspan stent (78 patients). Follow-up examinations consisted of 65 conventional angiograms, 17 computed tomographic angiograms, and two magnetic resonance angiograms. Of these lesions with follow-up, ISR was documented in 25 and complete thrombosis in four. Two of the 4 patients with stent thrombosis had lengthy lesions requiring more than one stent to bridge the diseased segment. ISR was more frequent (odds ratio, 4.7; 95% confidence intervals, 1.4-15.5) within the anterior circulation (42%) than the posterior circulation (13%). Of the 29 patients with ISR or thrombosis, eight were symptomatic (four with stroke, four with transient ischemic attack) and 15 were retreated. Of the retreatments, four were complicated by clinically silent in-stent dissections, two of which required the placement of a second stent. One was complicated by a postprocedural reperfusion hemorrhage. CONCLUSION: The ISR rate with the Wingspan stent is higher in our series than previously reported, occurring in 29.7% of patients. ISR was more frequent within the anterior circulation than the posterior circulation. Although typically asymptomatic (76% of patients in our series), ISR can cause neurological symptoms and may require target vessel revascularization.

Endovascular treatment of paraclinoid aneurysms: experience with 73 patients.

OBJECTIVE: Aneurysms arising from the internal carotid artery in close relation to the clinoid process have been called paraclinoid aneurysms. The surgical management of these aneurysms poses technical challenges, and such patients are frequently referred for endovascular treatment. We reviewed our experience with endovascular coil embolization of paraclinoid aneurysms to evaluate the safety and efficacy of this treatment modality. METHODS: From December 1993 to May 2002, 70 patients underwent endovascular procedures with detachable coils for 73 paraclinoid aneurysms (8 ruptured, 65 unruptured) at the University of Pittsburgh Medical Center and the University of Texas Southwestern Medical Center. A retrospective review of the medical records, outpatient charts, and operative reports was performed. Angiographic outcome was determined at the end of each procedure and by review of follow-up angiograms. Clinical assessments and outcomes are reported according to the Glasgow Outcome Scale (GOS). RESULTS: Immediate angiographic outcomes for 73 paraclinoid aneurysms demonstrated complete occlusion in 53 (72.6%), near-complete occlusion in 6 (8.2%), and partial occlusion in 14 (19.2%). Nine aneurysms required more than one coiling session to complete treatment; 8 of these aneurysms required two sessions and 1 required four, for a total of 84 endovascular procedures. Follow-up angiograms could be obtained in 49 patients with 52 paraclinoid aneurysms. During the follow-up period, 6 aneurysms demonstrating partial occlusion and 3 demonstrating near-complete occlusion showed spontaneous progression of thrombosis to complete occlusion. Twelve aneurysms initially demonstrating complete occlusion (5 aneurysms), near-complete occlusion (3 aneurysms), or partial occlusion (4 aneurysms) showed coil compaction requiring retreatment. Of these 12 aneurysms that demonstrated coil compaction, 3 were treated with surgery and 9 with coil repacking. The final angiographic outcomes, determined on the last available follow-up angiograms of 49 aneurysms, excluding 3 surgically clipped aneurysms, showed complete occlusion in 43 (87.8%), near-complete occlusion in 3 (6.1%), and partial occlusion in 3 (6.1%). The angiographic follow-up period ranged from 4 to 54 months (mean, 13.9 mo). Morbidity and mortality rates related to 84 endovascular procedures were 8.3 and 0%, respectively. There were no recurrent or new subarachnoid hemorrhages in 63 patients in whom clinical follow-up could be performed during a mean clinical follow-up period of 14.4 months. The final clinical outcomes demonstrated a GOS score of 5 (good recovery) in 56 patients (88.9%), a GOS score of 4 (moderate disability) in 2 (3.2%), and a GOS score of 3 (severe disability) in 1 (1.6%). Four patients (6.3%) died of unrelated causes. The average period of hospitalization was 17.8 days in patients with acutely ruptured aneurysms and 3.5 days in patients with unruptured or retreated aneurysms. CONCLUSION: The results of this study indicate that endovascular treatment is a safe and effective therapeutic alternative in ruptured and unruptured paraclinoid aneurysms. The endovascular treatment may also confer a positive impact in terms of the length of hospital stay.