Pregnancy outcomes after frozen-thawed single euploid blastocyst transfer following IVF cycles using GNRH agonist or HCG trigger for final oocyte maturation

To assess whether GnRH agonist trigger impacts the implantation potential of euploid embryos. Retrospective cohort study done at an academic IVF center evaluating frozen-thawed embryo transfer (FET) cycles in which single-euploid blastocysts were transferred between 2014 and 2019. All embryos were generated in an IVF cycle which used GnRHa or hCG trigger and then were transferred in a programmed or natural FET cycle. Only the first FET cycle was included for each patient. Primary outcome was ongoing pregnancy rate or live birth rate (OPR/LBR). Secondary outcomes were implantation rate (IR), clinical pregnancy rate (CPR), clinical loss rate (CLR), and multiple pregnancy rate (MPR). Logistic regression was performed to control for confounding variables. A p value of < 0.05 was considered statistically significant. Two hundred sixty-three FET cycles were included for analysis (GnRHa = 145; hCG = 118). The GnRHa group was significantly younger (35.2 vs. 37.5 years) and had higher AMH values (4.50 ng/ml vs. 2.03 ng/ml) than the hCG group, respectively (p < 0.05). There was no significant difference in OPR/LBR (64.1% (93/145) vs. 65.3% (77/118); p = 0.90) between the GnRHa and hCG groups, respectively. There was also no significant difference in IR, CPR, CLR, or MPR between groups. After controlling for confounding variables, the adjusted odds ratio for OPR/LBR was 0.941 (95% CI, 0.534–1.658); p = 0.83) comparing GnRHa to hCG. Pregnancy outcomes did not significantly differ when groups were stratified by age (< 35 vs. > 35 years old). Our findings confirm that euploid embryos created after hCG or GnRHa trigger have the same potential for pregnancy.     

Quantitative MRI of skeletal muscle in a cross‐sectional cohort of patients with spinal muscular atrophy types 2 and 3

The aim of this study was to document upper leg involvement in spinal muscular atrophy (SMA) with quantitative MRI (qMRI) in a cross‐sectional cohort of patients of varying type, disease severity and age. Thirty‐one patients with SMA types 2 and 3 (aged 29.6 [7.6‐73.9] years) and 20 healthy controls (aged 37.9 [17.7‐71.6] years) were evaluated in a 3 T MRI with a protocol consisting of DIXON, T2 mapping and diffusion tensor imaging (DTI). qMRI measures were compared with clinical scores of motor function (Hammersmith Functional Motor Scale Expanded [HFMSE]) and muscle strength. Patients exhibited an increased fat fraction and fractional anisotropy (FA), and decreased mean diffusivity (MD) and T2 compared with controls (all P < .001). DTI parameters FA and MD manifest stronger effects than can be accounted for the effect of fatty replacement. Fat fraction, FA and MD show moderate correlation with muscle strength and motor function: FA is negatively associated with HFMSE and Medical Research Council sum score (τ = ?0.56 and ?0.59; both P < .001) whereas for fat fraction values are τ = ?0.50 and ?0.58, respectively (both P < .001). This study shows that DTI parameters correlate with muscle strength and motor function. DTI findings indirectly indicate cell atrophy and act as a measure independently of fat fraction. Combined these data suggest the potential of muscle DTI in monitoring disease progression and to study SMA pathogenesis in muscle.     

A systematic review of prospective studies on attention problems and academic achievement

Polderman TJC, Boomsma DI, Bartels M, Verhulst FC, Huizink AC. A systematic review of prospective studies on attention problems and academic achievement. Objective: Our aim was to provide an overview of prospective studies that have addressed the association between attention problems (AP, i.e. symptoms of hyperactivity and inattentiveness) and academic achievement (AA). Method: We conducted a systematic search in the literature. Normal population studies and clinical studies were included. The methodological quality of each study was evaluated by objective criteria. A best evidence synthesis was used to determine the strengths of the association. Results: Sixteen studies were included. We found convincing evidence for a negative association between AP and AA. After controlling for intelligence, comorbidity, and socioeconomic status (SES), the association between the hyperactive symptoms of AP and AA was non‐significant in two studies. Conclusion: Children with AP are at risk for lower AA and subsequent adverse outcomes later in life. Interventions in affected children should focus on their behavioural and educational development.     

The human retinal stem niches could overlap a vascular anatomical pattern

<正>Stem cells are undifferentiated cells which have the unique potential to self-renew and to supply,via intermediate stages of transit amplifying cells(TACs),differentiated cells.Within the stem cell niches not only heterologous cells,but also differentiated progeny of stem cells provide regulation to the stem cells parents.Stem cells can differentiate in various cell types during tissue maintenance or repair.     

80. Geburtstag Professor Dr. Günter Stüttgen

Ohne Zusammenfassung     

Dusch-PUVA: Eine neue M?glichkeit für die lokale PUVA-TherapiePhototoxizit?t in Abh?ngigkeit von Duschzeit, Duschtemperatur und Hauttyp Phototoxizit?t in Abh?ngigkeit von Duschzeit, Duschtemperatur und Hauttyp

Die Bade-PUVA ist ein seit Jahren etabliertes Therapieverfahren bei verschiedenen Dermatosen, insbesondere der Psoriasis. Als Alternative in der lokalen PUVA-Therapie wurde unter Verwendung von 3,4,5-Trimethylpsoralen (TMP) kombiniert mit einer UVA-Bestrahlung (315–400 nm) eine Dusch-PUVA entwickelt, bei der die Haut des Patienten mit Ausnahme des Kopf-Hals-Bereiches mit Psoralen-haltigem Duschwasser (TMP-Konzentration 0,27 mg/l) kontinuierlich benetzt wird. Vorteile, die eine solche Dusch-PUVA bietet, sind Raum-, Zeit- und Kostenersparnis sowie die geringere k?rperliche Belastung bei aufrechter Haltung des Patienten im Vergleich zur Ganzk?rper-Bade-PUVA. Wirksamkeit und Praktikabilit?t der Dusch-PUVA wurden an gesunden Probanden anhand der Minimalen Phototoxischen Dosis (MPD) geprüft in Abh?ngigkeit von der Temperatur des Duschwassers (33–38 °C), der Duschzeit (5–10 min) sowie der UVA-Bestrahlungsdosis (0,06–1,0 J/cm²). Zus?tzlich wurde der Verlauf der Photosensitivit?t auf TMP-behandelter Haut bis 4 h nach dem Duschen untersucht. Mit einer TMP-Konzentration von 0,27 mg/l im Duschwasser wurde eine MPD erreicht, die für Hauttyp I–II zwischen 0,125–0,375 J/cm² und für Hauttyp III–IV zwischen 0,375– 1,0 J/cm² lag. Phototoxische Reaktionen wurden bei einer Duschzeit von 5–10 min und einer Wassertemperatur von 33–38 °C beobachtet. Dabei korrelierte die Wassertemperatur umgekehrt proportional mit der MPD, jedoch zeigten sich kaum Unterschiede zwischen einer Duschzeit von 5 und 10 min. Die Photosensitivit?t persistierte bis zu 2 h nach dem Duschen. Die minimalen phototoxischen Reaktionen bei Dusch-PUVA unter Anwendung von 3,4,5-Trimethylpsoralen entsprechen unter Berücksichtigung des jeweiligen Hauttyps denen einer Bade-PUVA. Diese ersten Untersuchungsergebnisse bilden die Grundlage für die fachgerechte Anwendung der Dusch-PUVA und für die Erarbeitung von therapeutischen Modalit?ten.     

Rapid endothelialization of microporous vascular prostheses covered with meshed vascular tissue: a preliminary report

The aim of our study was to induce rapid endothelialization of vascular prostheses which replace malfunctioning blood vessels. We developed a technique of meshing a section of autologous arterial or venous tissue, wrapping it around a porous vascular prosthesis and fixing it with a running suture. This combination was used to replace a 1 cm segment of rat abdominal aorta. The implanted specimens were harvested after 8, 16, 24 or 135 d and evaluated for cellular ingrowth and endothelial coverage with light and scanning electron microscopy. All grafts were patent when harvested. Cells of the meshed tissue were observed to migrate through the pores in the prosthetic wall to cover the luminal surface. The presence of meshed vascular tissue around the prosthesis resulted in complete endothelialization within 24 d and sometimes within 8 d after implantation. This endothelial layer is still present after 135 d. In control prostheses without meshed vascular tissue, complete endothelialization takes at least 42 d. We conclude that the application of meshed vascular tissue around porous vascular prostheses results in patent prostheses with a rapidly formed and long-term surviving endothelium layer.     

Bone augmentation after soft‐tissue expansion using hydrogel expanders: effects on microcirculation and osseointegration

Objectives: The success of bone augmentation, for example of the alveolar ridge, might be endangered by dehiscence of the soft tissue that covers the augmented bone. Soft‐tissue coverage can be achieved without tension through pre‐augmentation tissue expansion with hydrogel expanders. We used a periosteal chamber to study the influence of tissue expansion on microcirculation and osseointegration in an in vivo animal model. Material and methods: Sixteen isogeneic Lewis rats were randomised into two groups. Additional eight animals served as donors of isogeneic bone grafts (Group 3, n=8). The bone grafts were harvested and implanted into Group 1 animals (n=8) (without tissue expansion) and Group 2 animals (after tissue expansion). In Group 2 (n=8), hydrogel expanders were inserted subperiosteally at the site to be augmented for 21 days. We used intravital microscopy to monitor microcirculation in vivo for 19 days after implantation. Specimens from both groups were evaluated histologically. Results: During the entire study period, functional microvessel density in the region above the augmentation material was significantly higher after previous tissue expansion (P>0.05). Both groups showed physiological microcirculation around the augmentation material. Histology revealed bone osseointegration of the bone graft in the group with tissue expansion and the presence of connective and granulation tissue in the group without tissue expansion. Conclusions: Pre‐augmentation soft‐tissue expansion with hydrogel expanders leads to higher functional microvessel density in the tissue above the augmentation material and thus, to more rapid osseointegration. The use of hydrogel expanders appears to increase the probability of success, especially of pre‐implant bone augmentation. To cite this article:
von See C, Gellrich N‐C, Jachmann U, Laschke MW, Bormann KH, Rücker M. Bone augmentation after soft‐tissue expansion using hydrogel expanders: effects on microcirculation and osseointegration.
Clin. Oral Impl. Res. 21 , 2010; 842–847
doi: 10.1111/j.1600‐0501.2009.01847.x