ABSTRACT
Facial form depends on the precise positioning of cartilage, bone, and tooth fields in the embryonic pharyngeal arches. How complex signaling information is integrated to specify these cell types remains a mystery. We find that modular expression of Forkhead domain transcription factors (Fox proteins) in the zebrafish face arises through integration of Hh, Fgf, Bmp, Edn1 and Jagged-Notch pathways. Whereas loss of C-class Fox proteins results in reduced upper facial cartilages, loss of F-class Fox proteins results in distal jaw truncations and absent midline cartilages and teeth. We show that Fox proteins are required for Sox9a to promote chondrogenic gene expression. Fox proteins are sufficient in neural crest-derived cells for cartilage development, and neural crest-specific misexpression of Fox proteins expands the cartilage domain but inhibits bone. These results support a modular role for Fox proteins in establishing the competency of progenitors to form cartilage and teeth in the face.
Subject(s)
Body Patterning , Cartilage/embryology , Cartilage/metabolism , Forkhead Transcription Factors/metabolism , Tooth/embryology , Tooth/metabolism , Animals , Body Patterning/genetics , Bone and Bones/metabolism , Branchial Region/metabolism , Cell Proliferation/genetics , Cell Survival/genetics , Chondrogenesis/genetics , Face , Forkhead Transcription Factors/genetics , Gene Expression Regulation, Developmental , Mutation/genetics , Neural Crest/cytology , Signal Transduction , Skull/cytology , Zebrafish/embryology , Zebrafish Proteins/metabolismABSTRACT
PURPOSE: We aimed to investigate the angiogenic balance in fresh compared to frozen embryo transfers, and among neonates with adverse perinatal outcomes. METHODS: This was a retrospective cohort study. All IVF cycles resulting in a singleton live birth at a university academic fertility center from January 1, 2011, to December 31, 2013, were examined. Concentrations of sFLT-1 and PlGF were measured in previously frozen serum specimens collected during early gestation at approximately 5 weeks gestation. Patients completed an electronic survey to detail perinatal outcome. RESULTS: We identified 152 singleton live births (103 fresh, 49 frozen). Demographic characteristics were similar between the two groups. Ratios of sFlt-1:PlGF were not different between fresh and frozen transfers. Neonates from fresh cycles had a mean birth weight 202 g lighter (p = 0.01) than frozen cycles, after adjusting for gestational age. Among babies born with poor perinatal outcomes, there was a difference in sFlt-1:PlGF ratios after adjusting for race. In non-Asians, infants born small for gestational age (SGA) (< 10th percentile) had significantly higher sFLT-1:PLGF ratio, median ratio (0.21 vs 0.12, p = 0.016). CONCLUSIONS: Fresh transfers were associated with lower birth weight infants compared to frozen transfers. While there was no difference in sFlt-1:PlGF ratios between fresh and frozen transfers, these ratios were significantly lower in SGA infants, suggesting an imbalance in angiogenic markers during placentation.
Subject(s)
Cryopreservation , Embryo Transfer , Fertilization in Vitro/methods , Infant, Small for Gestational Age/blood , Infertility, Female/physiopathology , Placenta Growth Factor/blood , Vascular Endothelial Growth Factor Receptor-1/blood , Adult , Birth Weight , Female , Gestational Age , Humans , Infant, Newborn , Live Birth , Pregnancy , Pregnancy Outcome , Retrospective StudiesABSTRACT
PURPOSE: Prior studies suggest that pregnancy outcomes after autologous oocyte cryopreservation are similar to fresh in vitro fertilization (IVF) cycles. It is unknown whether there are differences in pregnancy and perinatal outcomes between cryopreserved oocytes and cryopreserved embryos. METHODS: This is a retrospective cohort study comparing pregnancy and perinatal outcomes between oocyte and embryo cryopreservation at a university-based fertility center. We included 42 patients and 68 embryo transfers in patients who underwent embryo transfer after elective oocyte preservation (frozen oocyte-derived embryo transfer (FOET)) from 2005 to 2015. We compared this group to 286 patients and 446 cycles in women undergoing cryopreserved embryo transfer (frozen embryo transfer (FET)) from 2012 to 2015. RESULTS: Five hundred fourteen transfer cycles were included in our analysis. The mean age was lower in the FOET vs FET group (34.3 vs 36.0 years), but there were no differences in ovarian reserve markers. Thawed oocytes had lower survival than embryos (79.1 vs 90.1%); however, fertilization rates were similar (76.2 vs 72.8%). In the FOET vs FET groups, clinical pregnancies were 26.5 and 30%, and live birth rates were 25 and 25.1%. Miscarriages were higher in the FET group, 8.1 vs 1.5%. There were no differences in perinatal outcomes between the two groups. The mean gestational age at delivery was 39.1 vs 38.6 weeks, mean birth weight 3284.2 vs 3161.1 gms, preterm gestation rate 5.9 vs 13.4%, and multiple gestation rate 5.9 vs 11.6%. CONCLUSIONS: In our study, live birth rates and perinatal outcomes were not significantly different in patients after oocyte and embryo cryopreservation.
Subject(s)
Birth Rate , Cryopreservation/methods , Embryo Transfer/methods , Oocytes/physiology , Adult , Birth Weight , Cohort Studies , Female , Fertilization in Vitro , Gestational Age , Humans , Infant, Newborn , Infertility, Female/therapy , Infertility, Male/therapy , Male , Pregnancy , Pregnancy Outcome , Retrospective StudiesABSTRACT
STUDY DESIGN: A retrospective, single-center review of all spinal deformity surgeries at the authors' institution. OBJECTIVES: To determine the most sensitive physical examination finding as a test for motor deficits after spinal deformity surgery. BACKGROUND: Despite both reported false negatives of neuromonitoring and the potential for development of delayed deficits, the literature has paid relatively little attention to the postoperative evaluation and monitoring of neurologic integrity after correction of spinal deformity. METHODS: A retrospective, single-center review of 1,274 consecutive spinal deformity surgeries from 2003 to 2011 was performed. Patients with limited neurologic function or an inability to undergo an examination preoperatively were excluded. A total of 1,023 patients were included in the analysis. Records were analyzed for postoperative motor deficit. RESULTS: A total of 12 patients had a motor deficit in the perioperative period. Eight had a deficit on the immediate postoperative exam; 6 had absent ankle dorsiflexion and 2 had weak ankle dorsiflexion; And 4 developed a delayed motor deficit: 3 with absent ankle dorsiflexion and 1 with weak ankle dorsiflexion. There were no cases of a motor deficit in which ankle dorsiflexion was not weak or absent. Of the 12 patients with a deficit, 8 had complete loss of motor function. Of the 4 patients with incomplete neurologic injury, loss of ankle dorsiflexion was the only common physical examination finding. In this review, ankle dorsiflexion was 100% sensitive (12 of 12) and 100% specific (1,011 of 1,011) for neurologic injury. CONCLUSIONS: Ankle dorsiflexion was the most sensitive test for lower extremity motor function after spinal deformity surgery, both for immediate and delayed deficits. Without testing ankle dorsiflexion specifically, neurologic motor deficits may be missed.
