HNO-Praxis

Abstract Human induced pluripotent stem cells (hiPSCs) show great promise in the development of novel strategies to mitigate reproductive diseases and promote successful reproductive outcomes. Recently, a novel approach for the fast and efficient differentiation of ovarian support cells (OSCs) to generate a versatile platform for basic research and clinical applications was demonstrated. This study details the clinical process development and application of an OSC product, known asFertilo, to improve thein vitromaturation (IVM) of human oocytes, a method referred to as OSC-IVM. First, transcription factor (TF) mediated OSC differentiation using research-grade raw materials was shown to produce granulosa-like cells that improve the MII maturation rate of human oocytes. To support clinical application, several raw material upgrades were initiated, including substitution of the differentiation matrix with a higher-quality alternative, laminin-521, and the generation of a clinically suitable hiPSC seed bank and master cell bank. Single cell RNA sequencing of OSCs generated using the updated protocol for clinical translation demonstrated the consistency and reproducibility of cellular outcomes. Next, analytical release testing of the clinical product was performed and a murine oocyte maturation assay was developed to establish the potency of OSCs for use in OSC-IVM. Finally, the qualifiedFertiloproduct was applied in a two-phase longitudinal cohort analysis, with the results showing improvement in key outcomes compared to traditional IVM treatment. Our findings demonstrate the first-time clinical development and application of an hiPSC-derived product to improve reproductive outcomes after IVM and advance women’s health.

Currently, there is an intensive discussion about enhancing and expanding outpatient rhinosurgical procedures. Many questions about how to stratify into out- and inpatient procedures are still not sufficiently clarified. Particularly, the use of nasal packing materials is not adequately discussed. We performed a Germany-wide survey among otorhinolaryngologists regarding the use of nasal packing materials in sinonasal surgery. Additionally, we asked for any complication in relation to nasal packing. In 85,6% nasal packing was used for septal and turbinate surgery at least occasionally, in 44,2% always. In sinus surgery these numbers are 94,1% and 49%, respectively. Non-resorbable nasal packing materials were predominantly used.Most frequent complications were bleeding with nasal packing in situ (> 50% of respondents) and posterior dislocation (24% of respondents), requiring emergency treatment. Death was listed in 5 patients. One patient suffered from permanent brain damage due to hypoxia. Application of non-resorbable nasal packing materials with occlusion of the nasal cavity carry a substantial risk of complications, which necessitate emergency treatment, thus requiring inpatient care.

Graeber e Wengrow sustentam que grande parte da narrativa sobre a revolução neolítica e a revolução política retorna inadvertidamente às hipóteses de Rousseau. Especialistas sobre evolução social nutrem ainda a cândida convicção de que grupos diminutos de caçadores-coletores seriam a única forma possível de organização social horizontal e igualitária, bem como sustentam que a desigualdade social e política teria nascido com a revolução neolítica. O problema é que essa interpretação não encontra respaldo nos dados apresentados pela arqueologia contemporânea, já que sociedades de tamanho considerável de caçadores-coletores experimentaram esporadicamente tanto um modelo de organização horizontal quanto hierárquico. Ora, se a agricultura institui a desigualdade e a hierarquia, como é possível a desigualdade e a hierarquia terem historicamente aparecido, ao menos esporadicamente, milênios antes da introdução da agricultura no seio de povos caçadores-coletores?

Die COVID-19-Pandemie hält die Welt weiterhin mit steigenden Infektionszahlen in Atem. Gleichzeitig nehmen die Fälle der postviralen Riechstörung nach einer COVID-19 zu. Bei 5 bis 20% der Betroffenen persistiert ein Geruchsverlust nach 1 bis 2 Monaten. In einer multizentrischen Studie (n=652, davon 404 Frauen) wurden nicht sinunasale, erworbene Riechstörungen unterschiedlicher Ätiologie betrachtet: postviral 584 davon 490 nach COVID-19-Infektion, idiopathisch 28, traumatisch 40.

Die Effektivität eines iNFT mit VertiguardRT ist in klinischen Studien gut belegt. Dort erfolgte das iNFT in 12 Tagen (5 T. Training, 2 trainingsfreie T., 5 T. Training). Dieser Ablauf ist nicht ohne weiteres in den Praxisalltag und die Terminpläne der Patienten integrierbar. Ziel dieser Arbeit war es zu untersuchen, ob iNFT mit VertiguardRT unter praxisnahen und flexibleren Bedingungen erfolgreich sein kann.

Neurofibromatosis type 1 (NF1) is an autosomal dominant tumor predisposition syndrome that is also characterized by skeletal abnormalities. In the cranial region, skeletal dysplasia is observed that is associated with a characteristic peripheral nerve sheath tumor, the plexiform neurofibroma (PNF). The aim of the study was to determine PNF-associated skeletal asymmetries of the mid-skull and skull base as an indicator of local tumor development. The distances of the zygomatic arch, mastoid, and juga measurement points from the interorbital horizontal plane and median sagittal plane were examined on anterior-posterior cephalograms of 168 NF1 patients (females: 82, males: 86) and compared with the findings of a control group. A distinction was made as to whether the patients had developed a facial PNF. The distances of the measurement points from the reference planes differed between the patient and control group (p<0.05). Within the NF1 patients, differences between certain distances were noted when comparing patients with PNF and without PNF (p<0.05). In PNF patients, discrete changes in the skull contour were also detectable on the non-affected side (p<0.05). The caudal measurement point of the skull base showed no changes in the group comparison. The individually very variable facial PNF in NF1 is associated with deformations and misalignments of midfacial bones that follow a pattern quantifiable with cephalometric analysis.

We describe a sequential multistaining protocol for immunohistochemistry, immunofluorescence and CyTOF imaging for formalin-fixed, paraffin-embedded specimens (FFPE) in the formalin gas-phase (FOLGAS), enabling sequential multistaining, independent from the primary and secondary antibodies and retrieval. Histomorphologic details are preserved, and crossreactivity and loss of signal intensity are not detectable. Combined with a DAB-based hydrophobic masking of metal-labeled primary antibodies, FOLGAS allows the extended use of CyTOF imaging in FFPE sections.