Small Bowel Obstruction in the Virgin Abdomen.

This article highlights the quagmire of the surgeon who encounters a small bowel obstruction in the absence of previous abdominopelvic surgery. Historic literature implies urgent surgical intervention is required; however, there is no current standard of care to guide management. Key principles of general surgery apply, and definitive management is based on the provider's clinical judgment after synthesizing key clinical history and additional diagnostic imaging studies.

Acclimatization of low altitude-bred deer mice ( Peromyscus maniculatus) to high altitude.

A colony of deer mice subspecies ( Peromyscus maniculatus sonoriensis) native to high altitude (HA) has been maintained at sea level for 18-20 generations and remains genetically unchanged. To determine if these animals retain responsiveness to hypoxia, one group (9-11 wk old) was acclimated to HA (3,800 m) for 8 wk. Age-matched control animals were acclimated to a lower altitude (LA; 252 m). Maximal O2 uptake (V̇o2max) was measured at the respective altitudes. On a separate day, lung volume, diffusing capacity for carbon monoxide (DLCO), and pulmonary blood flow were measured under anesthesia using a rebreathing technique at two inspired O2 tensions. The HA-acclimated deer mice maintained a normal V̇o2max relative to LA baseline. Compared with LA control mice, antemortem lung volume was larger in HA mice in a manner dependent on alveolar O2 tension. Systemic hematocrit, pulmonary blood flow, and standardized DLCO did not differ significantly between groups. HA mice showed a higher postmortem alveolar-capillary hematocrit, larger alveolar ducts, and smaller distal conducting structures. In HA mice, absolute volumes of alveolar type I epithelia and endothelia were higher whereas that of interstitia was lower than in LA mice. These structural changes occurred without a net increase in whole-lung septal tissue-capillary volumes or surface areas. Thus, deer mice bred and raised to adulthood at LA retain phenotypic plasticity and adapt to HA without a decrement in V̇o2max via structural (enlarged airspaces, alveolar septal remodeling) and nonstructural (lung expansion under hypoxia) mechanisms and without an increase in systemic hematocrit or compensatory lung growth. NEW & NOTEWORTHY Deer mice ( Peromyscus maniculatus) are robust and very active mammals that are found across the North American continent. They are also highly adaptable to extreme environments. When introduced to high altitude they retain remarkable adaptive ability to the low-oxygen environment via lung expansion and remodeling of existing lung structure, thereby maintaining normal aerobic capacity without generating more red blood cells or additional lung tissue.

The relationship between cardiopulmonary size and aerobic performance in adult deer mice at high altitude.

Deer mice (Peromyscus maniculatus sonoriensis) populations in the White Mountains of Eastern California are found across a substantial range of partial pressures of oxygen (PO2). Reduction in PO2 at high altitude can have a negative impact on aerobic performance. We studied plastic changes in organ mass and volume involved in aerobic respiration in response to acclimation to high altitude, and how those changes are matched with aerobic performance measured by VO2,max. Adult deer mice born and raised at 340 m were acclimated at either 340 or 3800 m for a period of 9 weeks. Lung volume increased by 9% in mice acclimated to high altitude. VO2,max was also significantly higher under hypoxic conditions after high altitude acclimation compared with controls. Body mass-corrected residuals of VO2,max were significantly correlated with an index of cardiopulmonary size (summed standardized residuals of lung volume and heart mass) under both hypoxic and normoxic conditions. These data show that phenotypic plasticity in lung volume and heart mass plays an important role in maintaining aerobic performance under hypoxic conditions, and accounts for up to 55% of the variance in aerobic performance.

A phylogenetic approach to total evaporative water loss in mammals.

Maintaining appropriate water balance is a constant challenge for terrestrial mammals, and this problem can be exacerbated in desiccating environments. It has been proposed that natural selection has provided desert-dwelling mammals physiological mechanisms to reduce rates of total evaporative water loss. In this study, we evaluated the relationship between total evaporative water loss and body mass in mammals by using a recent phylogenetic hypothesis. We compared total evaporative water loss in 80 species of arid-zone mammals to that in 56 species that inhabit mesic regions, ranging in size from 4 g to 3,500 kg, to test the hypothesis that mammals from arid environments have lower rates of total evaporative water loss than mammals from mesic environments once phylogeny is taken into account. We found that arid species had lower rates of total evaporative water loss than mesic species when using a dichotomous variable to describe habitat (arid or mesic). We also found that total evaporative water loss was negatively correlated with the average maximum and minimum environmental temperature as well as the maximum vapor pressure deficit of the environment. Annual precipitation and the variable Q (a measure of habitat aridity) were positively correlated with total evaporative water loss. These results support the hypothesis that desert-dwelling mammals have lower rates of total evaporative water loss than mesic species after controlling for body mass and evolutionary relatedness regardless of whether categorical or continuous variables are used to describe habitat.

Cold acclimation in Peromyscus: individual variation and sex effects in maximum and daily metabolism, organ mass and body composition.

We studied metabolic and organ mass responses to thermal acclimation (7 weeks at 5 degrees C or 23 degrees C) in deer mice, Peromyscus maniculatus. Cold acclimation resulted in significantly higher maximal oxygen consumption in thermogenesis (V(O(2)max)) and daily mean oxygen consumption (V(O(2)mean)), an increase in the mass of most visceral organs, a lower absolute body fat and a marginally significant increase in hematocrit. The mass of digestive organs and body fat content differed significantly between sexes. Acclimation effects on fat content were more pronounced in females. Variation in heart and lung mass was positively correlated with V(O(2)max) and V(O(2)mean), while body fat content was negatively correlated with both traits. Nonetheless, a large fraction of the metabolic difference between cold- and warm-acclimated groups remained unexplained. Associations between traits at lower levels of biological organization measured here and whole-organism energetics remained consistent across acclimation temperatures, except for the correlation between kidney mass and V(O(2)mean), which was positive and significant in cold acclimation and negligible following warm acclimation. We conclude that: (1) V(O(2)max) and V(O(2)mean) share a common physiological basis that remains overall the same across acclimation regimes; (2) changes in these traits are associated primarily with changes in heart mass; and (3) male and female deer mice respond differently to thermal acclimation, possibly due to differences in reproductive allocation.

Contribution of shivering and nonshivering thermogenesis to thermogenic capacity for the deer mouse (Peromyscus maniculatus).

Small mammals that are active all year must develop ways to survive the cold winters. Endotherms that experience prolonged cold exposure often increase their thermogenic capacity. Thermogenic capacity incorporates basal metabolic rate (BMR), nonshivering thermogenesis (NST), and shivering thermogenesis (ST). Increasing the capacity of any of these components will result in increased thermogenic capacity. It is often thought that NST should be the most plastic component of thermogenic capacity and as such is the most likely to increase with cold acclimation. We used deer mice to test this hypothesis by acclimating 27 animals to one of two temperatures (5 degrees or 22 degrees C) for 8 wk. We then measured and compared values for thermogenic capacity--BMR, ST, and NST--between the two groups. Thermogenic capacity and NST increased by 21% and 42%, respectively, after cold acclimation. Neither BMR nor ST showed any change after acclimation. Therefore, it appears that deer mice raise their thermogenic capacity in response to prolonged cold by altering NST only.

Development partly determines the aerobic performance of adult deer mice, Peromyscus maniculatus.

Previous studies suggest that genetic factors and acclimation can account for differences in aerobic performance (V(O(2)max)) between high and low altitude populations of small mammals. However, it remains unclear to what extent development at different oxygen partial pressures (P(O(2))) can affect aerobic performance during adulthood. Here we compared the effects of development at contrasting altitudes versus effects of acclimation during adulthood on V(O(2)max). Two groups of deer mice were born and raised for 5 weeks at one of two altitudes (340 and 3800 m above sea level). Then, a subset of each group was acclimated to the opposite altitude for 8 weeks. We measured V(O(2)max) for each individual in hypoxia (P(O(2))=13.5 kPa, 14% O(2) at 3800 m) and normoxia (P(O(2))=20.4 kPa, 21% O(2) at 340 m) to control for P(O(2)) effects. At 5 weeks of age, high altitude born mice attained significantly higher V(O(2)max) than low altitude born mice (37.1% higher in hypoxia and 72.1% higher in normoxia). Subsequently, deer mice acclimated for 8 weeks to high altitude had significantly higher V(O(2)max) regardless of their birth site (21.0% and 72.9% difference in hypoxia and normoxia, respectively). A significant development x acclimation site interaction comparing V(O(2)max) in hypoxia and normoxia at 13 weeks of age suggests that acclimation effects depend on development altitude. Thus, reversible plasticity during adulthood cannot fully compensate for developmental effects on aerobic performance. We also found that differences in aerobic performance in previous studies may have been underestimated if animals from contrasting altitudes were measured at different P(O(2)).

Deer mouse aerobic performance across altitudes: effects of developmental history and temperature acclimation.

Aerobic physiology at high altitudes has been studied in many animals. Prior work on laboratory-bred deer mice (a species with a wide altitudinal range) showed depression of aerobic capacity at high altitude, even after acclimation. However, wild deer mice show no reduction in thermogenic performance at high altitude, and performance limits seem to be due to physiological and anatomical adjustments to environmental temperature and not to oxygen availability. We asked whether across-altitude performance differences exist in deer mice after accounting for temperature acclimation (approximately 5 degrees and 20 degrees -25 degrees C) and prenatal and neonatal development altitude (340 vs. 3,800 m). We measured maximal thermogenic oxygen consumption (VO2sum) in cold exposure and ran mice on a treadmill to elicit maximal exercise oxygen consumption (VO2max). We found a 10% reduction in VO2max at 3,800 m compared with that at 340 m; thus, the mice were able to compensate for most of the 37% reduction in oxygen availability at the higher altitude. Development altitude did not affect VO2max. There was no effect of test altitude or development altitude on VO2sum in warm-acclimated animals, but both test and development altitude strongly affected VO2sum in cold-acclimated mice, and compensation for hypoxia at 3,800 m was considerably less than that for exercise.

Effects of three simultaneous demands on glucose transport, resting metabolism and morphology of laboratory mice.

In nature, animals must successfully respond to many simultaneous demands from their environment in order to survive and reproduce. We examined physiological and morphological responses of mice given three demands: intestinal parasite infection with Heligmosomoides polygyrus followed by caloric restriction (70% of ad libitum food intake versus ad libitum for 10 days) and/or cold exposure (5 degrees C vs. 23 degrees C for 10 days). We found significant interactions between these demands as well as independent effects. Small intestine structure and function changed with demands in both independent and interactive ways. Body mass decreased during caloric restriction and this decrease was greater for cold-exposed than warm-exposed mice. In ad libitum fed mice, body mass did not change with either cold exposure or parasite infection but body composition (fat versus lean mass of whole body or organs) changed with both demands. Generally, organ masses decreased with caloric restriction (even after accounting for body mass effects) and increased with cold exposure and parasite infection whereas fat mass decreased with both caloric restriction and parasite infection. Mass adjusted resting metabolic rate (RMR) increased with cold exposure, decreased with caloric restriction but, unlike previous studies with laboratory mice, did not change with parasite infection. Our results demonstrate that the ability of mice to respond to a demand is influenced by other concurrent demands and that mice show phenotypic plasticity of morphological and physiological features ranging from the tissue level to the level of the whole organism when given three simultaneous demands.

Aerobic performance of wild-derived house mice does not change with cold exposure or intestinal parasite infection.

Aerobic performance is affected by numerous endogenous and exogenous factors. We investigated the effects of ambient temperature and parasite infection on resting metabolism and maximal exercise-induced oxygen consumption in wild-derived house mice (Mus musculus). We also collected preliminary data for effects of lactation on these measures of aerobic performance. Mice were experimentally infected with a naturally occurring intestinal nematode (Heligmosomoides polygyrus) and then exposed to cold temperatures for 10 d or allowed to mate and reproduce. Wild-derived house mice did not change their resting metabolism with H. polygyrus infection or cold exposure, which is in stark contrast to similar studies with laboratory mice. Preliminary data also showed no effect of lactation on aerobic performance. Similarly, maximal exercise-induced oxygen consumption and hematocrit and hemoglobin were unaffected by all experimental treatments. We conclude that resting metabolism, maximal oxygen consumption, and hematology of wild-derived house mice are unaffected by exogenous (temperature) and endogenous (H. polygyrus) demands and, therefore, wild-derived mice respond to these demands without incurring potential costs associated with changes in aerobic performance.

Morphological plasticity varies with duration of infection: evidence from lactating and virgin wild-derived house mice (Mus musculus) infected with an intestinal parasite (Heligmosomoides polygyrus; Nematoda).

With chronic parasite infection, host response to the parasite may change throughout the duration of the infection as the host progresses from the acute to the chronic phase. We investigated the effects of parasite infection ranging in duration from 30 to 120 days on host morphology both alone and in combination with lactation by using captive wild-derived house mice (Mus musculus) experimentally infected with a naturally occurring intestinal nematode (Heligmosomoides polygyrus). We found that some changes in host morphology were greatest at 30-60 days post-infection (e.g. spleen mass) followed by a decline towards the control state whereas other morphological changes were greatest at 90-120 days post-infection (e.g. small intestine mass) after a relatively steady increase with infection duration. For all infection durations, the morphological responses to parasite infection were similar for virgin and lactating mice (except for lean body mass). After accounting for changes in body mass with lactation, lactating mice increased organs of the gastrointestinal tract as well as liver and kidney but had less body fat than virgin mice. This is the first study to demonstrate that morphological plasticity of mice parasitized by H. polygyrus varies with infection duration and that this variation is generally similar for lactating and virgin mice.

Cold-acclimation in Peromyscus: temporal effects and individual variation in maximum metabolism and ventilatory traits.

Thermal acclimation in small endotherms provides an excellent model for the study of physiological plasticity, as energy requirements can be easily manipulated and the results are relevant for natural conditions. Nevertheless, how physiology changes throughout acclimation, and how individuals vary in their response to acclimation, remain poorly understood. Here we describe a high temporal-resolution study of cold acclimation in the deer mouse Peromyscus maniculatus. The experimental design was based on repeated measures at short intervals throughout cold acclimation, with controls (maintained at constant temperature) for measurement artifacts. We monitored body mass, maximum metabolic rate in cold exposure and ventilatory traits (respiratory frequency, tidal and minute volume and oxygen extraction) for 3 weeks at 23 degrees C. Then, half of the individuals were held for 7 weeks at 5 degrees C. Body mass was differently affected by cold acclimation depending on sex. Maximal metabolism ((O(2)max)) increased significantly during the first week of cold acclimation, "overshot" after 5 weeks and dropped to a plateau about 34% above control values at week 7. Similarly, ventilatory traits increased during cold acclimation, though responses were different in their kinetics and magnitude. Body mass, maximum metabolism, and most ventilatory traits were repeatable after 7 weeks in control and cold-acclimated animals. However, repeatability tended to be lower in the cold-acclimated group, especially while animals were still acclimating. Our results show that acclimation effects may be under- and/or overestimated, depending on when trials are performed, and that different traits respond differently, and at different rates, to acclimation. Hence, future studies should be designed to ensure that animals have attained steady-state values in acclimation experiments.

Age and aerobic performance in deer mice.

Age impacts the phenotype of all multicellular animals, but lifetime changes in physiological traits are poorly understood for all but a few species. Here, we describe a cross-sectional study of age effects on body composition, aerobic performance and ventilation in deer mice Peromyscus maniculatus. This species lives considerably longer in captivity (in excess of 5 years) than most laboratory rodents, and the adaptational biology of its aerobic physiology is well studied. Our deer mice grew throughout life, and, as is typical for mammals, their basal metabolic rate (BMR) and maximal oxygen consumption in exercise ((VO(2)max)) and thermogenesis ((VO(2)sum)) increased as power functions of mass. Age did not affect BMR, but we found abrupt decreases in growth rate, (VO(2)max) and (VO(2)sum) at approximately 485 days of age, and the mass-adjusted maximal aerobic performance of old mice (5 years of age) was 20% ((VO(2)max)) to 35% ((VO(2)sum)) less than that of young animals. Breathing frequency (f) and oxygen extraction (E(O(2))) also declined with age but did not change abruptly. However, there were no consistent age-related changes in tidal volume (V(T)) or minute volume ((Vmin)) after accounting for the effects of mass and (VO(2)sum). Age influenced several aspects of body composition (lean and fat mass). However, these changes were insufficient to explain the age-related declines in aerobic performance, suggesting that mass-specific oxidative capacity of lean tissue decreased with age. The performance changes we found could engender substantial reductions in the mobility and thermal tolerances of old deer mice. However, very few wild mice are likely to survive to ages where substantial performance decreases occur, so these declines are probably not subjected to strong selection in natural populations.