[Risk analysis of gastroenterological endoscopies by routine data using the example of endoscopic retrograde cholangio-pancreatography (ERCP)].

Background: The present study evaluates the analysis of routine data within quality control management by means of ERCP in a tertiary center over five years.

Methods: In a retrospective study, we analyzed pseudonymized routine administrative data according § 21 KHEntgG. These data can be tracked with regard to specific indicators for all hospitals and after data revocation for each individual hospital.

Anatomy of the Eustachian Tube.

The eustachian tube consists of 2 compartments: the Rüdinger's safety canal and the auxiliary gap. It is surrounded by a cartilaginous wall on the craniomedial side and a membranous wall on the inferolateral side. The eustachian tube cartilage is firmly attached to the skull base by the lateral and the medial suspensory ligaments, which are separated by the medial Ostmann fat pad.

First clinical experiences with a direct acoustic cochlear stimulator in comparison to preoperative fitted conventional hearing aids.

Objective: Patients with moderate-to-severe mixed hearing losses (MHLs) are hard to provide sufficient benefit with currently available conventional hearing aids. Here, the long-term safety of a direct acoustic cochlear stimulator (DACS) and the effectiveness compared with conventional "high-performance" hearing aids were investigated.

Study Design: Prospective, within patient reference, nonrandomized, interventional multicenter clinical study performed at these 3 centers: Medical University Hannover, University of Heidelberg, and Helios Hospital Krefeld.

Audiometric characteristics of two Dutch families with non-ocular Stickler syndrome (COL11A2).

Objective: To evaluate hearing impairment and cochlear function in non-ocular Stickler syndrome.

Study Design: Multifamily study.

Patients & Methods: Ten patients from two different families with non-ocular Stickler syndrome (Stickler syndrome type 3) were included.

Virtual reality: a new paranasal sinus surgery simulator.

Objectives/hypothesis: Virtual surgical training systems are of growing value. Current prototypes for endonasal sinus surgery simulation are very expensive or lack running stability. No reliable system is available to a notable number of users yet.

NY-CO-58/KIF2C is overexpressed in a variety of solid tumors and induces frequent T cell responses in patients with colorectal cancer.

NY-CO-58/KIF2C has been identified as a tumor antigen by screening antibody responses in patients with colorectal cancer. However, expression had not consequently been examined, and nothing was known about its ability to induce spontaneous T cell responses, which have been suggested to play a role in the development of colorectal cancer. We analyzed 5 colorectal cancer cell lines, and tumor samples and adjacent healthy tissues from 176 patients with epithelial cancers for the expression of NY-CO-58/KIF2C by RT-PCR and Western Blot.

Individual models for virtual bone drilling in mastoid surgery.

Segmented training cases for virtual simulation of bone-drilling interventions in middle ear surgery have proven to be helpful in learning about surgical anatomy of the temporal bone. The anatomy of the mastoid shows a high degree of variability, however, and the aim of this study was to evaluate whether individual virtual models could be created within an affordable timeframe, and to what extend they reflected natural individual anatomy during virtual mastoid surgery. Automatic segmentation schemes were used, and these reduced the time required to create individual models on the basis of DICOM CT scans to less than 5 minutes.

Chemokine CXCL13 is overexpressed in the tumour tissue and in the peripheral blood of breast cancer patients.

The abilities of chemokines in orchestrating cellular migration are utilised by different (patho-)biological networks including malignancies. However, except for CXCR4/CXCL12, little is known about the relation between tumour-related chemokine expression and the development and progression of solid tumours like breast cancer. In this study, microarray analyses revealed the overexpression of chemokine CXCL13 in breast cancer specimens.

Using a virtual reality temporal bone simulator to assess otolaryngology trainees.

Objective: The objective of this study is to determine the feasibility of computerized evaluation of resident performance using hand motion analysis on a virtual reality temporal bone (VR TB) simulator. We hypothesized that both computerized analysis and expert ratings would discriminate the performance of novices from experienced trainees. We also hypothesized that performance on the virtual reality temporal bone simulator (VR TB) would differentiate based on previous drilling experience.

Expression of cancer-testis antigens as possible targets for antigen-specific immunotherapy in head and neck squamous cell carcinoma.

Cancer-Testis (CT) antigens are by definition expressed in tumor but not in healthy tissue except testis and might represent ideal targets for antigen-specific immunotherapy. Here, we present the first comprehensive analysis of CT antigen expression in patients with head and neck squamous cell carcinoma (HNSCC). Tumor samples (N = 51), and adjacent healthy tissue from patients with HNSCC were analyzed for the expression of 23 genes designated CT antigens using RT-PCR.

Pathophysiology of the Eustachian tube--relevant new aspects for the head and neck surgeon.

Objectives: The impact of cranio-maxillofacial procedures upon Eustachian tube function is still largely unknown. The aim of this presentation is to depict new aspects of Eustachian tube function and to demonstrate its importance to cranio-maxillofacial surgery.

Methods: Two different groups of patients were examined both clinically and by MRI of the Eustachian tube region.

Mice with altered KCNQ4 K+ channels implicate sensory outer hair cells in human progressive deafness.

KCNQ4 is an M-type K+ channel expressed in sensory hair cells of the inner ear and in the central auditory pathway. KCNQ4 mutations underlie human DFNA2 dominant progressive hearing loss. We now generated mice in which the KCNQ4 gene was disrupted or carried a dominant negative DFNA2 mutation.

Computer-based anatomy a prerequisite for computer-assisted radiology and surgery.

Rationale And Objectives: The aim of the study is to show the possibilities opened up by three-dimensional (3D) computer-based models of the human body for education in anatomy, training of radiological and endoscopic examinations, and simulation of surgical procedures.

Materials And Methods: Based on 3D data sets obtained from the Visible Human and/or clinical cases, virtual body models are created that provide an integrated spatial and symbolic description of the anatomy by using interactive color/intensity-based segmentation, ray casting visualization with subvoxel resolution, a semantic network for knowledge modeling, and augmented QuickTime VR (Apple Computer, Inc, Cupertino, CA) movies for presentation.

Results: From these models, various radiological, endoscopic, or haptic manifestations of the body can be derived.

[Histomorphological study of experimentally induced canalolithiasis].

Free otoconia in the posterior semicircular canal (pSCC) are regarded as the main reason for benign paroxysmal positional vertigo. We investigated the distribution of otoconia in the membranous labyrinth of guinea pigs (n = 34) after a defined rotatory/angular kinetic acceleration. The angular kinetic energy of the rotatory experiment produced a dislocation of the otoconia and sometimes of the complete gelatinous otolithic membrane of the utricular and saccular macula.

In vitro isolation and cell culture of vestibular inner ear melanocytes.

Introduction: Melanocytes of the membranous labyrinth of the inner ear have been described morphologically in various contexts. Nature and functions of these cells are as yet not completely clear, even though several hypotheses exist regarding the same. The limited knowledge is due in part to a lack of methods regarding in vitro cell culture.

[Influence of botulinum toxin on myogenous facial pain].

Objective: Can chronic pain of the masticatory muscles be positively affected by low dose injection of botulinum toxin (BTX-A)?

Methods: Twenty patients suffering chronic myofacial pain were questioned and examined after injection of 25-50 U Dysport into the affected muscles over a period of 8 weeks.

Results: Four weeks after injection of BTX-A patients reported a significant reduction of pain (p <0.001, paired t-test.

[G-DRG System 2005. Analysis and evaluation of significant changes from the viewpoint of HNO medical science].

With the release of the new Global Case Agreement by Self Administration in Public Health on the 16 September 2004, the adjustment of the G-DRG System for the year 2005 was completed. Otorhinolaryngology, and head and neck surgery face several changes in the fields of diagnosis and procedural coding (ICD-10-GM 2005, OPS-301 2005), G-DRG case allocation, and extra reimbursements for special interventions. Despite some considerable improvements, substantial problems remain unsolved.

Restoration of hearing by hearing aids: conventional hearing aids - implantable hearing aids - cochlear implants - auditory brainstem implants.

Aim of this report is to explain the current concept of hearing restoration using hearing aids. At present the main issues of conventional hearing aids are the relative benefits of analogue versus digital devices and different strategies for the improvement of hearing in noise. Implantable hearing aids provide a better sound quality and less distortion.

Laryngeal morphometry with a new laser 'clip on' device.

Background And Objectives: Qualitative laryngoscopic investigations belong to diagnostic routine in laryngology. Nevertheless, quantitative morphometric measurements of intralaryngeal structures have been difficult by now.

Study Design/material And Methods: The development of a two-point-light projection method for endolaryngeal measurements that works with a double reflecting mirror and green laser light is shown.