Systematische Analyse der Lesbarkeit von Patienteninformationstexten auf Internetseiten deutscher nichtuniversitärer HNO-Kliniken

Background

Besides their function as one of the main contact points, websites of hospitals serve as medical information portals. All patients should be able to understand medical information texts; regardless of their literacy skills and educational level. Online texts should thus have an appropriate structure to ease their comprehension.

Materials and methods

Patient information texts on every German nonuniversity ENT hospital website (n?=?125) were systematically analysed. For ten different ENT topics a representative medical information text was extracted from each website. Using objective text parameters and five established readability indices, the texts were analysed in terms of their readability and structure. Furthermore, we stratified the analysis in relation to the hospital organisation system and geographical region in Germany.

Results

Texts from 142 internet sites could be used for the definite analysis. On average, texts consisted of 15 sentences and 237 words. Readability indices congruously showed that the analysed texts could generally only be understood by a well-educated or even academic reader.

Conclusion

The majority of patient information texts on German hospital websites are difficult to understand for most patients. In order to fulfil their goal of adequately informing the general population about disease, therapeutic options and the particular focal points of the clinic, a revision of most medical texts on the websites of German ENT hospitals is recommended.     

Expression von Zell-Zell-Adhäsionsproteinen im Gehörgangscholesteatom

BACKGROUND: External auditory canal cholesteatoma (EACC) is a rare entity in otolaryngology, which is histomorphologically identical with middle ear cholesteatoma. The cause of EACCt is, however, still not clear. The aim of this study was to describe the expression of beta-catenin, MMP-2, and MMP-9 in EACC matrix compared to the normal auditory meatal skin (AMS). METHODS: Thirteen specimens were obtained during surgical procedure. EACC and AMS specimens were immunostained with antibodies for beta-catenin, MMP-2, and MMP-9. RESULTS: Only the basal layers of the EACC specimens were positive for beta-catenin. The suprabasal layers showed diminished or negative immunostaining for beta-catenin. In all layers, AMS was homogeneously positive for beta-catenin. In contrast, the immunostaining for the gelatinases was equally increased in all layers of EACC, whereas AMS was weekly positive. CONCLUSION: The reduced immunoreactivity for beta-catenin may have been present because of the lessened cell-cell adhesion in the suprabasal layers of EACC. The increased expression of the metalloproteinases might point at an increased lack of integrity of EACC matrix. Recent studies revealed a balance between disintegrating and stabilising factors in normal tissue, which is disturbed in inflamed and neoplastic tissue. In EACC matrix, an imbalance of these factors, represented by reduced beta-catenin and increased gelatinase expression, is possible. Increased desquamation, the accumulation of keratin debris, and loss of tissue-stability support our findings.     

Ueber Bildung von breiten Condylomen im äusseren Gehörgang

Ohne Zusammenfassung     

Ein Fall von Aspergillus nigricans im äussern Gehörgang

Ohne Zusammenfassung     

Zur Casuistik von Eremdkörpern im äusseren Gehörgang

Ohne Zusammenfassung     

Störungen im Gleichgewichtsapparat bei Fällen von Explosionsschwerhörigkeit

Ohne Zusammenfassung     

Vier Fälle von Caries im Mittelohr bei Vorlagerung des Sinus transversus

Ohne Zusammenfassung(Am 6. März 1888 von der Redaction übernommen.)     

Kochleaimplantate im Felsenbeinpräparat

Background

For the functional outcome after cochlear implant surgery, the electrode position is of essential importance. Therefore, radiological techniques to localize the electrode within the cochlea are becoming increasingly important. In our study, we used multi-slice computed tomography (CT) to find radiological criteria to allocate the electrode within the cochlea.

Methods

Ten Nucleus 24 RCA electrodes were implanted into isolated human temporal bones using an extended cochleostomy and the Advance Off-Stylet technique. Five electrodes were implanted into the scala tympani and five into the scala vestibuli. After implantation, the temporal bones were blinded to the radiologist, and 64-slice CT scans were performed and analysed.

Results and conclusions

In all 10 cases, the surgical positioning of the electrode was equal to the radiological analysis of the CT scans. Radiological criteria were found that permit correct identification of the electrode within the cochlea. We think that this technique is sufficient for most questions concerning quality control and is widely available.     

Die klinische Bedeutung von Pulsveränderungen im Verlauf komplizierter und nichtkomplizierter otitischer Erkrankungen

Ohne ZusammenfassungMit 10 Kurven     

Osteosynthese im Gesichtsschädelbereich

Background

The favorable properties of silicon nitride (Si₃N₄) ceramic, such as high stability and biocompatibility suggest its biomedical use as an implant material. The aim of this study was to test its suitability for osteosynthesis.

Materials and methods

A Si₃N₄ prototype minifixation system was manufactured and implanted for osteosynthesis of artificial frontal bone defects in three minipigs. After 3 months, histological sections, CT and MRI scans were obtained. Finite element modeling (FEM) was used to simulate stresses and strains on Si₃N₄ miniplates and screws to calculate survival probabilities.

Results

Si₃N₄ miniplates and screws showed satisfactory intraoperative workability. There was no implant loss, displacement or fracture. Bone healing was complete in all animals and formation of new bone was observed in direct contact to the implants.

Conclusions

Si₃N₄ ceramic showed a good biocompatibility outcome both in vitro and in vivo. This ceramic may serve as biomaterial for osteosynthesis, e.g. of the midface including reconstruction of the floor of the orbit and the skull base. Advantages compared to titanium are no risk of implantation to bone with mucosal attachment, no need for explantation, no interference with radiological imaging.     

Die Bedeutung des SISI-Tests im Rahmen der Begutachtung von Lärmschwerhörigkeiten

Background and objective. Proof of cochlear hearing loss is an essential prerequisite for the diagnosis of noise deafness. For this purpose, the Königsteiner instruction leaflet (Königsteiner Merkblatt) recommends among other items the SISI test. Patients/methods. The results of the SISI test at 1 and 4 kHz were analysed for 100 expert opinions of noise (200 ears). Results. 10% of the subjects showed at 1 and 4 kHz a positive and 44% a negative result. At 1 kHz, 46% indicated a negative result and at 4 kHz a positive result. In the group with a negative SISI test at both frequencies, 74% demonstrated characteristics of pseudohypacusis. There was no correlation between a retrocochlear hearing disorder and a negative SISI test. Conclusions. Our analysis demonstrated that the negative SISI test is more often evidence of pseudohypacusis rather than a retrocochlear disorder. Consequently, the validity of a negative SISI test is limited.     

Temporäre Recurrensschädigungen im Tierexperiment

Zusammenfassung In einer Versuchsreihe werden bei Katzen temporäre mechanische Schädigungen durch Klemme und Ligatur am N. recurrens einer Seite gesetzt und der weitere Verlauf durch direkte Laryngoskopie klinisch am Erfolgsorgan beobachtet. Hierbei findet sich, daß im Verlauf von 3 bis 4 Wochen unter ständiger endoskopischer Kontrolle wieder völlige restitutio eintritt. Die gesetzten frischen Schädigungen am Nerven und der Restitutionszustand werden histologisch untersucht. Dabei zeigt sich, daß trotz des nicht geringen Traumas, wie z. B. Ligatur, die Veränderungen sich nur in Markscheidenschädigungen zeigen. Die Neurofibrillen zeigen nur geringe Veränderungen.     

Zwei physiologisch-akustische Vorträge,gehalten auf der 73. Versammlung deutscher Naturforscher und Aerzte zu Hamburg im September 1901

Ohne Zusammenfassung