[Cochlear implantation in a girl with 7q-microdeletion syndrome]. / Cochleaimplantatversorgung eines Mädchens mit 7q-Mikrodeletionssyndrom.

One of the rare genetic diseases with sensory hearing loss is the microdeletion 7q syndrome. First described in the 1990s, only 7 cases of patients with this disease are described in the literature. Although this mutation is not well known, otological treatment is necessary if the DFNA5 gene is affected. A mutation in this gene leads to progressive hearing loss. Affected children therefore need regular evaluation of their hearing to ensure adequate treatment with hearing aids at early stages. We now present a case of an affected child with sensory hearing loss, mental retardation and anogenital malformations. In the following we describe the course of disease and possible treatment options. We especially describe the possibility of cochlear implantation. We can show with this case report that, even though massive mental retardation is shown, cochlear implantation is useful in this patient. Associated disabilities as cardiac and pulmonary problems may occur and should be treated before cochlear implantation. This is the first report of cochlear implantation in a child affected with microdeletion 7q syndrome.

Biological therapies in otology.

Hearing loss is present in millions of people worldwide. Current treatment for patients with severe to profound hearing loss consists of cochlear implantation. Providing the cochlear nerve is intact, patients generally benefit greatly from this intervention, frequently achieving significant improvements in speech comprehension. There are, however, some cases where current technology does not provide patients with adequate benefit. Ongoing research in cell transplantation and gene therapy promises to lead to new developments that will improve the function of cochlear implants. Translation of these experimental approaches is presently at an early stage. This review focuses on the application of biological therapies in severe hearing loss and discusses some of the barriers to translating basic scientific research into clinical reality. We emphasize the application of these novel therapies to cochlear implantation.

[Biological therapies in otology. German version]. / Biologische Therapien in der Otologie.

Millions of people worldwide suffer from hearing loss. Current treatment for patients with severe to profound hearing loss consists of cochlear implants. Providing the cochlear nerve is intact, patients generally benefit enormously from this intervention, frequently achieving significant improvements in speech comprehension. There are, however, some cases where current technology does not provide patients with adequate benefit. New therapeutic concepts based on cell transplantation and gene therapy are developing rapidly, at least in the research sector. Compared to the wealth of basic research available in this area, translation of these new experimental approaches into clinical application is presently at a very early stage. The current review focuses on translatable treatment concepts and discusses the barriers that need to be overcome in order to translate basic scientific research into clinical reality. Furthermore, the first examples of clinical application of biological therapies in severe hearing loss are presented, particularly in connection with cochlear implants.

Efficacy of topically delivered moxifloxacin against wound infection by Pseudomonas aeruginosa and methicillin-resistant Staphylococcus aureus.

Wound infection is a common risk for patients with chronic nonhealing wounds, causing high morbidity and mortality. Currently, systemic antibiotic treatment is the therapy of choice, despite often leading to several side effects and the risk of an insufficient tissue penetration due to impaired blood supply. If systemically delivered, moxifloxacin penetrates well into inflammatory blister fluid, muscle, and subcutaneous adipose tissues and might therefore be a possible option for the topical treatment of skin and infected skin wounds. In this study, topical application of moxifloxacin was investigated in comparison to mupirocin, linezolid, and gentamicin using a porcine wound infection and a rat burn infection model. Both animal models were performed either by an inoculation with methicillin-resistant Staphylococcus aureus (MRSA) or Pseudomonas aeruginosa. Wound fluid, tissue, and blood samples were taken, and bacterial counts as well as the moxifloxacin concentration were determined for a 14-day follow-up. A histological comparison of the rat burn wound tissues was performed. Both strains were susceptible to moxifloxacin and gentamicin, whereas mupirocin and linezolid were effective only against MRSA. All antibiotics showed efficient reduction of bacterial counts, and except with MRSA, infected burn wounds reached bacterial counts below 10(5) CFU/g tissue. Additionally, moxifloxacin was observed to promote wound healing as determined by histologic analysis, while no induction of bacterial resistance was observed during the treatment period. The use of topical antibiotics for the treatment of infected wounds confers many benefits. Moxifloxacin is therefore an ideal candidate, due to its broad antibacterial spectrum, its high efficiency, and its potential to promote wound healing.

[Application of muscle relaxants in Germany. A survey of German anaesthesia departments]. / Anwendung von Muskelrelaxanzien in Deutschland. Eine Umfrage an Deutschen Anästhesieeinrichtungen.

AIM: The aim of this study was to evaluate the use and application of muscle relaxants and neuromuscular monitoring in Germany. METHODS: A total of 2,996 questionnaires were sent out to the heads of German anaesthesia departments and private anaesthesia practices. The questions covered frequency of muscle relaxants used,how they were used, and neuromuscular monitoring. Influences on the way muscle relaxants were used could be derived from the desire for specific properties of a muscle relaxant, the desire for different monitoring conditions and from the size of the institution. We correlated these features with application practice using logistic regression analyses. RESULTS: Of the 2,996 questionnaires 2,058 could be analysed (68.6%). Amongst those were 102 level one hospitals (5%) and 903 private practices (44%). The replies from 350 (17%) departments were based on surveyed data, 1,613 (78.5%) were based on estimations. The desire for certain properties of muscle relaxants correlated with the use in practice, as were the desire for a non-depolarizing replacement for succinylcholine, the size of the department and the frequency of use of neuromuscular monitoring. Over 50% of all German anaesthesia departments limited the use of muscle relaxants to three. The use of laryngeal masks reduced the use of muscle relaxants. CONCLUSIONS: The survey regarding use of muscle relaxants in Germany could for the first time give an overview on the use of anaesthesia-specific substances in Germany. From the different frequencies of use and use modalities,conclusions could be drawn towards a standard of application for the year 2000. Changes in this standard would raise the need for further trend surveys. The methods of statistical analysis and survey evaluation can be used as a base for further surveys.

Invasion of the vertebrate skin by cercariae of Trichobilharzia ocellata: penetration processes and stimulating host signals.

The penetration of Trichobilharzia ocellata cercariae into the skin of their duck hosts was described using electron microscopy and histology. The behavior patterns of the cercariae on their exposure to human skin differed only little from those known for Schistosoma mansoni cercariae. After their attachment to living human skin the cercariae crept to wrinkles within a mean of 8 s, and full penetration was achieved within a mean of 4.0 min (83 s to 13.3 min). Tail shedding occurred as early as within a mean of 6.5 s of the first penetration attempts. It was supported by a muscular sphincter at the cercarial hindbody. The skin-surface stimuli for cercarial penetration were contained in the lipid fraction of the duck and human skin surface; hydrophilic components were effective only in some T. ocellata isolates. The penetration-stimulating components of duck-skin lipids were exclusively free fatty acids with the same chemical characteristics known to stimulate penetration of Schistosoma species. Skin-surface lipids of the abnormal human host, with their higher fatty acid contents, stimulated higher cercarial penetration rates than did skin lipids of the natural duck host. Fatty acids as penetration stimuli may offer advantages for T. ocellata cercariae by increasing the specificity for an invasion of terrestrial vertebrates, which is additionally determined by cholesterol and ceramides as signals for attachment and enduring contact behavior.