[Regional distribution of the cochlear implant (CI) centers in Germany]. / Regionale Verteilung der Cochlea-Implantat (CI)-versorgenden Einrichtungen in Deutschland.

The treatment of patients with severe hearing loss or deafness with a cochlear implant (CI) represents a standard in Germany today. However, there is hardly any data on the current number of clinical CI centers (CI clinics) and their geographical distribution. The patient self-help organization, German Cochlear Implant Society (DCIG), and the German Society for Otorhinolaryngology, Head and Neck Surgery (DGHNO-KHC) have therefore initiated a survey to determine the regional distribution, the range of services, the consideration of existing quality standards and cooperation with patient self-help organizations of the individual clinical CI centers.For this purpose, a total number of 170 ENT departments or their directors (37 professors and 133 chief physicians), respectively, were contacted by e-mail and provided with a questionnaire. The survey took place from October 2019 to February 2020.Of the 170 departments contacted, 71 (41.8 %) took part in the survey. Of these, 70 departments (98.6 %) confirmed to perform CI surgeries. Thus, 41.8 % of all clinics contacted reported to perform CI surgeries (70 of 170 clinics), while this information was not available from 99 clinics. All 70 clinical CI centers (100 %) reported to conduct CI surgeries on adults, 60 centers (85.7 %) also on children (< 18 years). 36 departments (51.4 %) reported that the total number of CI surgeries at their facility in 2018 was more than 50. In 64 departments (91.4 %), the recommendations of the DGHNO-KHC on CI care (according to the White Paper CI care 2018) were followed. A collaboration between the department and patient self-help organization was confirmed by 67 institutions (95.7 %). The geographical distribution of the clinical CI centers showed a heterogeneous distribution pattern between the individual federal states and also within the respective federal state.The work presented here is a first assessment of the situation with regard to the regional distribution of clinical CI centers in Germany. A clustering of CI centers was noticeable in metropolitan areas, sometimes with several facilities in one city. The predominant attention to quality-related aspects, such as the consideration of the DGHNO-KHC white paper and the cooperation with patient self-help, is gratifying. The limitations of the study result from limited participation in the survey (41.8 % of the contacted clinics).

[Inpatient rehabilitation of adult CI users: Results in dependency of duration of deafness, CI experience and age]. / Stationäre Rehabilitationsmaßnahmen bei erwachsenen CI-Trägern: Ergebnisse in Abhängigkeit von der Dauer der Taubheit, Nutzungsdauer und Alter.

BACKGROUND: Cochlear implants (CI) have proven to be a highly effective treatment for severe hearing loss or deafness. Inpatient rehabilitation therapy is frequently discussed as a means to increase the speech perception abilities achieved by CI. However, thus far there exists no quantitative evaluation of the effect of these therapies. METHODS: A retrospective analysis of audiometric data obtained from 1355 CI users compared standardized and qualitative speech intelligibility tests conducted at two time points (admission to and discharge from inpatient hearing therapy, duration 3-5 weeks). The test battery comprised examination of vowel/consonant identification, the Freiburg numbers and monosyllabic test (65 and 80 dB sound pressure level, SPL, free-field sound level), the Hochmair-Schulz-Moser (HSM) sentence test in quiet and in noise (65 dB SPL speech level; 15 dB signal-to-noise ratio, SNR), and a speech tracking test with and without lip-reading. RESULTS: An average increase of 20 percentage points was scored at discharge compared to the admission tests. Patients of all ages and duration of deafness demonstrated the same amount of benefit from the rehabilitation treatment. After completion of inpatient rehabilitation treatment, patients with short duration of CI experience (below 4 months) achieved test scores comparable to experienced long-term users. The demonstrated benefit of the treatment was independent of age and duration of deafness or CI experience. CONCLUSION: The rehabilitative training program significantly improved hearing abilities and speech perception in CI users, thus promoting their professional and social inclusion. The present results support the efficacy of inpatient rehabilitation for CI recipients. Integration of this or similar therapeutic concepts in the German catalog of follow-up treatment measures appears justified.

The German Mouse Clinic: a platform for systemic phenotype analysis of mouse models.

The German Mouse Clinic (GMC) is a large scale phenotyping center where mouse mutant lines are analyzed in a standardized and comprehensive way. The result is an almost complete picture of the phenotype of a mouse mutant line--a systemic view. At the GMC, expert scientists from various fields of mouse research work in close cooperation with clinicians side by side at one location. The phenotype screens comprise the following areas: allergy, behavior, clinical chemistry, cardiovascular analyses, dysmorphology, bone and cartilage, energy metabolism, eye and vision, host-pathogen interactions, immunology, lung function, molecular phenotyping, neurology, nociception, steroid metabolism, and pathology. The German Mouse Clinic is an open access platform that offers a collaboration-based phenotyping to the scientific community (www.mouseclinic.de). More than 80 mutant lines have been analyzed in a primary screen for 320 parameters, and for 95% of the mutant lines we have found new or additional phenotypes that were not associated with the mouse line before. Our data contributed to the association of mutant mouse lines to the corresponding human disease. In addition, the systemic phenotype analysis accounts for pleiotropic gene functions and refines previous phenotypic characterizations. This is an important basis for the analysis of underlying disease mechanisms. We are currently setting up a platform that will include environmental challenge tests to decipher genome-environmental interactions in the areas nutrition, exercise, air, stress and infection with different standardized experiments. This will help us to identify genetic predispositions as susceptibility factors for environmental influences.

Desensitization of the bradykinin-induced rise in intracellular free calcium in cultured endothelial cells.

We studied the cellular mechanism involved in the desensitization of cultured endothelial cells to bradykinin. Bradykinin (10 nmol/l) evoked a rise in the intracellular free calcium concentration [( Cai2+]), measured with the fluorescent probe indo-1, from 137 +/- 30 (+/- SEM) to 623 +/- 101 nmol/l. Cells were desensitized to bradykinin by repetitive stimulation with the peptide over 10 min, after which they no longer responded to bradykinin. However, purinergic stimulation with ATP (10 mumol/l) elicited the same increase in [Cai2+] in endothelial cells desensitized to bradykinin as in cells never exposed to bradykinin. The initial peak of [Cai2+] after stimulation with bradykinin or ATP was not affected by removal of extracellular calcium ions, indicating mobilization of Ca2+ from intracellular stores. Since GTP-binding proteins (G-proteins) are probably involved in the receptor-mediated stimulation of endothelial cells, we also tested the effects of sodium fluoride (NaF), a reported direct stimulator of G-proteins, on endothelial [Cai2+]. NaF (5 mmol/l) increased [Cai2+] to 412 +/- 88 nmol/l in control cells and was equally effective in cells desensitized to bradykinin. We conclude that the homologous desensitization to bradykinin does not occur at the level of intracellular signal transduction but at the level of membrane receptors.

Phase-randomized laser illumination for microscopy.

A simple apparatus is described that phase randomizes the output of a continuous argon ion laser, so that it may be used as a source of high intensity, monochromatic light for microscopy. The phase-randomizing device can be used with any laser, polarized or unpolarized, and of any desired power output and wavelength, including dye lasers for spectral studies. The randomizing system can be adapted to any light microscope and any optical system including bright-field, phase-contrast, Nomarski differential-interference, dark-field, and split-beam interference systems such as the Jamin-Lebedeff System. It can be used for a variety of photometric and photographic studies. The 514-nm wavelength appears to be relatively harmless to a variety of cells.

Evaluation of driving-while-intoxicated programs; some methodological considerations.

Some methodological problems encountered in evaluating the effectiveness of driving-while-intoxicated programs are discussed.

Direct test of the positive pressure gradient theory of pseudopod extension and retraction in amoebae.

When one pseudopod of an amoeba is sucked into a capillary connected to a partial vacuum and subjected to a pressure reduction of 30 to 35 centimeters of water, extension of other pseudopods, exposed to atmospheric pressure, is not prevented. This result is interpreted to mean that cytoplasmic streaming cannot be the result of a positive pressure gradient generated along the length of the stream, for if it were, streaming would have reversed its direction under the applied pressure gradient of opposite sign and supposedly greater magnitude.