Leukemia inhibitory factor, LIF receptor, and gp130 in the mouse uterus during early pregnancy.

Leukemia inhibitory factor (LIF) has been shown to play an important role in the implantation of mouse blastocysts. The present study was designed to investigate the changes of LIF protein, LIF receptor, and gp130 in the mouse uterus during the early pregnancy. LIF protein and LIF receptor were at high levels in the mouse uterus near the time of ovulation and on day 4 of pregnancy. gp130 was highest on days 3 and 4 of pregnancy. Both LIF receptor and gp130 showed strong staining in the stroma of the day 5 uterus, at a time when LIF protein was low. The presence of LIF receptor and gp130 in the luminal epithelium on day 4 and in the stroma on day 5 may indicate the site of the high affinity LIF receptor. The coexistence of a high level of LIF protein, LIF receptor, and gp130 in the day 4 uterus is consistent with the previously observed high level of uterine LIF mRNA on the same day and the importance of LIF for the blastocyst implantation in mouse.

Early and late mortality of patients undergoing aortic valve replacement after previous coronary artery bypass graft surgery.

BACKGROUND: In a small number of patients who undergo coronary artery bypass graft surgery (CABG), a hemodynamically significant aortic valve lesion requiring aortic valve replacement (AVR) develops as they grow older. In a limited number of studies in small patient groups, high mortality has been shown in patients undergoing AVR after CABG. We undertook this study to determine the mortality risk factors for patients who undergo AVR after CABG procedures. METHODS AND RESULTS: The outcome of 104 patients treated at our institution between January 1983 and December 1993 was retrospectively reviewed. The initial surgery was CABG in all patients. The patient population included 86 men (83%) and 18 women (17%); their mean age was 67 years. Overall, 70% of patients had congestive heart failure, and 96% had multivessel coronary artery disease. The diagnosis was aortic stenosis in 68% of patients, aortic insufficiency in 16%, and combined aortic stenosis and aortic insufficiency in 16%. Postoperative complications included worsening congestive heart failure (35%), perioperative myocardial infarction (13%), and bleeding (28%). The early mortality was 14%, and the late mortality was 17% (mean follow-up, 35 months). The risk factors for early mortality were number of diseased vessels (P = .028), renal failure (0.000), and prior myocardial infarction (P = .028). A perioperative predictor of early mortality was cardiopulmonary bypass time (P = .000). The risk factors for late mortality included preoperative diabetes mellitus (P = .007), postoperative acute respiratory distress syndrome (P = .011), and ventricular arrhythmias (P = .0001). The survival at 1, 5, and 10 years was 96%, 75%, and 49%, respectively. CONCLUSIONS: Risk factors were identified for early and late mortality in patients undergoing AVR after previous CABG. Although early morbidity and mortality were high, the longterm outcome of the survivors was favorable.