A glycolytic metabolite bypasses "two-hit" tumor suppression by BRCA2.

Knudson's "two-hit" paradigm posits that carcinogenesis requires inactivation of both copies of an autosomal tumor suppressor gene. Here, we report that the glycolytic metabolite methylglyoxal (MGO) transiently bypasses Knudson's paradigm by inactivating the breast cancer suppressor protein BRCA2 to elicit a cancer-associated, mutational single-base substitution (SBS) signature in nonmalignant mammary cells or patient-derived organoids. Germline monoallelic BRCA2 mutations predispose to these changes. An analogous SBS signature, again without biallelic BRCA2 inactivation, accompanies MGO accumulation and DNA damage in Kras-driven, Brca2-mutant murine pancreatic cancers and human breast cancers. MGO triggers BRCA2 proteolysis, temporarily disabling BRCA2's tumor suppressive functions in DNA repair and replication, causing functional haploinsufficiency. Intermittent MGO exposure incites episodic SBS mutations without permanent BRCA2 inactivation. Thus, a metabolic mechanism wherein MGO-induced BRCA2 haploinsufficiency transiently bypasses Knudson's two-hit requirement could link glycolysis activation by oncogenes, metabolic disorders, or dietary challenges to mutational signatures implicated in cancer evolution.

Genetic Etiology of Nonsyndromic Hearing Loss in Hungarian Patients.

Hearing loss is the most prevalent sensory disorder worldwide. The majority of congenital nonsyndromic hearing loss (NSHL) cases are caused by hereditary factors. Previously, the majority of NSHL studies focused on the GJB2 gene; however, with the availability of next-generation sequencing (NGS) methods, the number of novel variants associated with NSHL has increased. The purpose of this study was to design effective genetic screening for a Hungarian population based on a pilot study with 139 NSHL patients. A stepwise, comprehensive genetic approach was developed, including bidirectional capillary sequencing, multiplex ligation-dependent probe amplification (MLPA), and an NGS panel of 108 hearing loss genes. With our results, a genetic diagnosis was possible for 92 patients. Sanger sequencing and MLPA identified the genetic background of 50% of these diagnosed cases, and the NGS panel identified another 16%. The vast majority (92%) of the diagnosed cases showed autosomal recessive inheritance and 76% were attributed to GJB2. The implementation of this stepwise analysis markedly increased our diagnostic yield and proved to be cost-effective as well.

Attenuated transcriptional response to pro-inflammatory cytokines in schizophrenia hiPSC-derived neural progenitor cells.

Maternal immune activation (MIA) during prenatal development is an environmental risk factor for psychiatric disorders including schizophrenia (SZ). Converging lines of evidence from human and animal model studies suggest that elevated cytokine levels in the maternal and fetal compartments are an important indication of the mechanisms driving this association. However, there is variability in susceptibility to the psychiatric risk conferred by MIA, likely influenced by genetic factors. How MIA interacts with a genetic profile susceptible to SZ is challenging to test in animal models. To address this gap, we examined whether differential gene expression responses occur in forebrain-lineage neural progenitor cells (NPCs) derived from human induced pluripotent stem cells (hiPSC) generated from three individuals with a diagnosis of schizophrenia and three healthy controls. Following acute (24 h) treatment with either interferon-gamma (IFNγ; 25 ng/µl) or interleukin (IL)-1ß (10 ng/µl), we identified, by RNA sequencing, 3380 differentially expressed genes (DEGs) in the IFNγ-treated control lines (compared to untreated controls), and 1980 DEGs in IFNγ-treated SZ lines (compared to untreated SZ lines). Out of 4137 genes that responded significantly to IFNγ across all lines, 1223 were common to both SZ and control lines. The 2914 genes that appeared to respond differentially to IFNγ treatment in SZ lines were subjected to a further test of significance (multiple testing correction applied to the interaction effect between IFNγ treatment and SZ diagnosis), yielding 359 genes that passed the significance threshold. There were no differentially expressed genes in the IL-1ß-treatment conditions after Benjamini-Hochberg correction. Gene set enrichment analysis however showed that IL-1ß impacts immune function and neuronal differentiation. Overall, our data suggest that a) SZ NPCs show an attenuated transcriptional response to IFNγ treatment compared to controls; b) Due to low IL-1ß receptor expression in NPCs, NPC cultures appear to be less responsive to IL-1ß than IFNγ; and c) the genes differentially regulated in SZ lines - in the face of a cytokine challenge - are primarily associated with mitochondrial, "loss-of-function", pre- and post-synaptic gene sets. Our findings particularly highlight the role of early synaptic development in the association between maternal immune activation and schizophrenia risk.

A new method of preoperative assessment of correct electrode array alignment based on post-operative measurements in a cochlear implanted cohort.

PURPOSE: During cochlear implantation surgery, a range of complications may occur such as tip fold-over. We recently developed a method to estimate the insertion orientation of the electrode array. The aim of the study was to determine the optimal angle of orientation in a cohort of cochlear implanted patients. METHODS: On eighty-five CT scans (80 uncomplicated insertions and 5 cases with tip fold-over), location of the electrode array's Insertion Guide (IG), Orientation marker (OM) and two easily identifiable landmarks (the round window (RW) and the incus short process (ISP)) were manually marked. The angle enclosed by ISP-RW line and the Cochlear™ Slim Modiolar electrode array's OM line determined the electrode array insertion angle. RESULTS: The average insertion angle was 45.0-47.2° ± 10.4-12° SD and was validated with 98% confidence interval. Based on the measurements obtained, patients' sex and age had no impact on the size of this angle. Although the angles of the tip fold-over cases (44.9°, 46.9°, 34.2°, 54.3°, 55.9°) fell within this average range, the further it diverted from the average it increased the likelihood for tip fold-over. CONCLUSION: Electrode array insertion in the individually calculated angle relative to the visible incus short process provides a useful guide for the surgeon when aiming for the optimal angle, and potentially enhances good surgical outcomes. Our results show that factors other than the orientation angle may additionally contribute to failures in implantation when the Slim Modiolar electrode is used.

Pediatric morphometric study to guide the optimized implantation of the Osia® 2 implant system.

PURPOSE: Continuous technological advances result in the availability of new bone conduction hearing implants, of which their suitability for pediatric patients is of major concern. The CochlearTMOsia® 2 is a new active osseointegrated steady-state implant system that uses digital piezoelectric stimulation to treat hearing loss. The implant in the United States was approved for patients aged 12 years and above, whereas the CE mark is independent of age, the only requirement is body weight of at least 7 kg. Therefore, further clinical studies are required to assess device characteristics in younger patients. The aim of our study was to perform a morphometric study among 5-12-year-old children, and to develop a surgical protocol for Osia 2 system implantation based on these findings. METHODS: We examined retrospectively cranial CT scans of 5-12-year-old patients from our clinical database. We measured the bone and soft-tissue thickness in the region of interest, and the position of the sigmoid sinus. 3D printed temporal bones were also used for planning. RESULTS: Soft-tissue thickness varied between 3.2 ± 0.5 mm and 3.6 ± 0.6 mm and bone thickness varied between 3.5 ± 1.1 mm and 4.7 ± 0.3 mm. The sigmoid sinus was located 1.3 ± 0.2 cm posterior to the ear canal, and the anterior distance was 4.8 ± 0.9 to 7.1 ± 1.1 mm. CONCLUSIONS: Our morphometric studies showed that patients aged 5-12 have different anatomical dimensions compared to adults, but that implantation of the Osia 2 system is feasible in these patients using an altered implant positioning recommended by our data. The Cochlear™ Osia® 2 is, therefore, an option for hearing rehabilitation in younger pediatrics.

Laser Writing of Scalable Single Color Centers in Silicon Carbide.

Single photon emitters in silicon carbide (SiC) are attracting attention as quantum photonic systems ( Awschalom et al. Nat. Photonics 2018 , 12 , 516 - 527 ; Atatüre et al. Nat. Rev. Mater. 2018 , 3 , 38 - 51 ). However, to achieve scalable devices, it is essential to generate single photon emitters at desired locations on demand. Here we report the controlled creation of single silicon vacancy (VSi) centers in 4H-SiC using laser writing without any postannealing process. Due to the aberration correction in the writing apparatus and the nonannealing process, we generate single VSi centers with yields up to 30%, located within about 80 nm of the desired position in the transverse plane. We also investigated the photophysics of the laser writing VSi centers and concluded that there are about 16 photons involved in the laser writing VSi center process. Our results represent a powerful tool in the fabrication of single VSi centers in SiC for quantum technologies and provide further insights into laser writing defects in dielectric materials.

Review of electrode placement with the Slim Modiolar Electrode: identification and management.

Background - Several cochlear implant recipients experience functionality loss due to electrode array mal-positioning. The application of delicate perimodiolar electrodes has many electrophysiological advantages, however, these profiles may be more susceptible to tip fold-over. Purpose - The prompt realization of such complication following electrode insertion would be auspicious, thus the electrode could be possibly repositioned during the same surgical procedure. Methods - The authors present three tip fold-over cases, experienced throughout their work with Slim Modiolar Electrode implants. Implantations were performed through the round window approach, by a skilled surgeon. Standard intraoperative measurements (electric integrity, neural response telemetry, and electrical stapedial reflex threshold tests) were successfully completed. The electrode position was controlled by conventional radiography on the first postoperative day. Results - Tip fold-over was not tactilely sensated by the surgeon. Our subjects revealed normal intraoperative telemetry measurements, only the postoperative imaging showed the tip fold-over. Due to the emerging adverse perception of constant beeping noise, the device was replaced by a CI512 implant after 6 months in one case. In the two remaining cases, the electrode array was reloaded into a back-up sheath, and reinserted into the scala tympani successfully through an extended round window approach. Discussion - Future additional studies using the spread of excitation or electric field imaging may improve test reliability. As all of these measurements are still carried out following electrode insertion, real-time identification, unfortunately, remains questionable. Conclusion - Tip fold-over could be reliably identified by conventional X-ray imaging. By contrast, intraoperative electrophysiology was not sufficiently sensitive to reveal it.

Cell-based high-throughput compound screening reveals functional interaction between oncofetal HMGA2 and topoisomerase I.

HMGA2 is an important chromatin factor that interacts with DNA via three AT-hook domains, thereby regulating chromatin architecture and transcription during embryonic and fetal development. The protein is absent from differentiated somatic cells, but aberrantly re-expressed in most aggressive human neoplasias where it is causally linked to cell transformation and metastasis. DNA-binding also enables HMGA2 to protect cancer cells from DNA-damaging agents. HMGA2 therefore is considered to be a prime drug target for many aggressive malignancies. Here, we have developed a broadly applicable cell-based reporter system which can identify HMGA2 antagonists targeting functionally important protein domains, as validated with the known AT-hook competitor netropsin. In addition, high-throughput screening can uncover functional links between HMGA2 and cellular factors important for cell transformation. This is demonstrated with the discovery that HMGA2 potentiates the clinically important topoisomerase I inhibitor irinotecan/SN-38 in trapping the enzyme in covalent DNA-complexes, thereby attenuating transcription.

[Possibilities for residual hearing preservation with Nucleus CI532 Slim Modiolar electrode array. Case report]. / A maradványhallás megorzésének lehetoségei cochlearis implantáció során Nucleus CI532 Slim Modiolar elektródasorral.

During the rehabilitation of hearing-impaired patients, the preservation of residual acoustic hearing following cochlear implantation by minimizing the implantation trauma allows for improved hearing performance. To achieve this, minimally invasive, soft surgery methods and thinner, atraumatic electrodes were required. In our present study, we reported a case where Cochlear® Nucleus CI532 Slim Modiolar electrode was implanted in a patient with residual hearing. Our aim was to study the possible preservation of postoperative acoustic residual hearing by audiological monitoring. Since childhood, due to her congenital hearing loss, she has been wearing a conventional, airborne hearing correction device on both ears. Six months before cochlear implantation, we measured the progression on both sides of the hearing loss, so we decided to perform cochlear implantation. The patient had residual hearing on both ears prior to surgery thus the Cochlear® Nucleus CI532 Slim Modiolar Implant was used. The minimally invasive surgery was performed on the patient's right ear through the round window approach. Compared to the preoperative hearing threshold (average 85 dBHL) in the 4th postoperative week, an initial hearing threshold progression of 20-25 dBHL was observed between 0.25 and 1.0 kHz, while of 5-10 dBHL between 2.0-4.0 kHz. Hearing threshold measured in the 6th month showed a slight progression in the range above 1 kHz, but improved by the 12th month, to the results achieved at the 4th week. The effects of cochlear implantation on residual hearing have been studied in numerous studies, in which several key surgical and technical factors have been identified. Nucleus CI532 is a Slim Modiolar electrode profile that is close to the modiolus, so it is expected to have a lower endocochlear hydrodynamic load since it lies in the covering of the osseus spiral lamina, thus less influencing the dynamics of the basilar membrane. However, the perimodiolar location of the electrode array allows the adjacent nerve elements of the spiral ganglion to be stimulated with a lower electrical intensity and a reduced surface that may be neuroprotective. Preservation of acoustic residual hearing following cochlear implantation improves the patient's speech perception and the sound localization skills, particularly in difficult circumstances. Long-term residual hearing preservation may also be of great importance in the subsequent feasibility for regenerative procedures and drug treatments. Orv Hetil. 2018; 159(41): 1680-1688.

A universal method for determining the detergent effect of surfactants.

Surfactants are indispensable in industrial applications today due to their wetting, emulsifying, dispersing, cleansing, and detergent properties. The use of surfactants extends from the cosmetic industry to the petroleum industry and beyond. Their characteristics and effectiveness can be assessed through various standardized tests, and based on these methods, their applications can be determined. However, there is a lack of a universally applicable testing method for one crucial and complex property: the detergent effect. The detergent effect refers to the removal of unwanted contaminants from a solid surface. However, cleaning is not solely attributed to the surfactant but to the appropriate combination of various factors, whose synergistic effect reduces surface contamination. The most significant factors influencing detergent effect include the characteristics and nature of the contaminants, properties of the cleaning solution (surfactant concentration and composition, water hardness, enzymes, etc.), temperature, washing time, and hydrodynamic conditions. Additionally, the presence of electrolytes, pH of the cleaning solution, and detergent foaming properties may also play important roles. Our goal was to develop a detergent effect testing methodology that is not specific to any particular application domain but offers a straightforward and easy-to-implement solution for comparing the detergent effect of various types of surfactants.•The study presents a method for determining detergent effect of surfactants.•The method is universal and suitable for the evaluation of any type of surfactant.•The method is low-cost and easy to perform.

An improved method for determining the water number for surfactants.

Surfactants have a significant role in everyday life and various industries. Their amphipathic nature significantly influences their properties, functions, and applicability. The ratio of water and oil solubility is characterized by the HLB value (hydrophilic-lipophilic balance) or the closely related water number. A determination of the water number of surfactants represents the amount of water that a surfactant can incorporate into a microemulsion. The results of measuring the water number provide information about the hydrophilic properties of the surfactant in question. Understanding the water number helps determine the applicability of surfactants. From the water number of surfactants, conclusions can be drawn about the HLB value of the particular surfactant, providing further insights into its properties. Although a well-established method for determining water number has long been available, it has been revealed that many of the auxiliary substances and chemicals used in this process have severe health-damaging effects, leading to their discontinuation in routine laboratory use. Our goal was to find a solvent combination that would be suitable for the water number determination method. Additionally, we aimed to investigate solvents that are environmentally and human-biologically less harmful, easily and affordably obtainable.•The study presents a method for determining the water number of surfactants.•The method is straightforward to execute and free from harmful solvents.•By improving the method, we enhanced the reliability of the examination.

Analysis of nucleic acid chaperoning by the prion protein and its inhibition by oligonucleotides.

Prion diseases are unique neurodegenerative illnesses associated with the conversion of the cellular prion protein (PrP(C)) into the aggregated misfolded scrapie isoform, named PrP(Sc). Recent studies on the physiological role of PrP(C) revealed that this protein has probably multiple functions, notably in cell-cell adhesion and signal transduction, and in assisting nucleic acid folding. In fact, in vitro findings indicated that the human PrP (huPrP) possesses nucleic acid binding and annealing activities, similarly to nucleic acid chaperone proteins that play essential roles in cellular DNA and RNA metabolism. Here, we show that a peptide, representing the N-terminal domain of huPrP, facilitates nucleic acid annealing by two parallel pathways nucleated through the stem termini. We also show that PrP of human or ovine origin facilitates DNA strand exchange, ribozyme-directed cleavage of an RNA template and RNA trans-splicing in a manner similar to the nucleocapsid protein of HIV-1. In an attempt to characterize inhibitors of PrP-chaperoning in vitro we discovered that the thioaptamer 5'-GACACAAGCCGA-3' was extensively inhibiting the PrP chaperoning activities. At the same time a recently characterized methylated oligoribonucleotide inhibiting the chaperoning activity of the HIV-1 nucleocapsid protein was poorly impairing the PrP chaperoning activities.

Investigation of Vegetable Oils and Their Derivatives for the Synthesis of Extreme Pressure Additives.

The harmful effects of wear can be reduced through proper lubrication of the frictional parts. When exposed to excessive loads, the lubricant film is displaced from the surfaces, and even the adhesive lubricant layer may rupture. Additives known as Extreme Pressure (EP) are frequently incorporated into lubricants to minimise wear and avert seizures under high temperature and pressure. Mechanistically, these additives generate a film on the surface through chemisorption. These additives are extensively applied in various lubricants, with the largest quantities being employed in metalworking fluids and lubricating greases. Sulfurized vegetable oils and their derivates can be used as EP additives for lubricants. To conduct the investigations, sulfurized additives were synthesized using different vegetable-based oils and fatty acid esters, and alpha-olefins. In this study, the Four-ball test results were compared to gain a more accurate comprehension of how various raw-material-based additives influence wear and friction. The goal was to select raw materials that could be used with favorable results for the production of EP additives. The objective was to achieve a minimum Four-ball weld load parameter of 2000 N. The experiments revealed that the functional impacts of the synthesized samples are dependent on the type of raw materials employed. Based on the experimental data and the stated criteria, the examined raw materials were found to be suitable for the synthesis of EP additives.

Fuzziness in the core of the human pathogenic viruses HCV and HIV.

Nucleocapsid proteins are the molecular jacks-of-all-trades of small RNA viruses because they play pivotal roles in viral genomic RNA selection and packaging, regulate genome replication and virus budding and at the same time orchestrate a complex, dynamic interaction network with host cell proteins contributing to viral persistence and pathogenecity. These promiscuous interactions are made possible by the intrinsic flexibility of viral nucleocapsid proteins, facilitating either simultaneous or sequential binding to a plethora of structurally unrelated substrates, resulting in flexible, ever-changing multiprotein, RNA-protein and lipid-protein complexes during the viral replicative cycle. In this chapter, we examine the flexibility and multifunctionality of the assemblages formed by the nucleocapsid proteins of two important human pathogens, hepatitis C virus and human immunodeficiency virus.

Optical Microscopy Systems for the Detection of Unlabeled Nanoparticles.

Label-free detection of nanoparticles is essential for a thorough evaluation of their cellular effects. In particular, nanoparticles intended for medical applications must be carefully analyzed in terms of their interactions with cells, tissues, and organs. Since the labeling causes a strong change in the physicochemical properties and thus also alters the interactions of the particles with the surrounding tissue, the use of fluorescently labeled particles is inadequate to characterize the effects of unlabeled particles. Further, labeling may affect cellular uptake and biocompatibility of nanoparticles. Thus, label-free techniques have been recently developed and implemented to ensure a reliable characterization of nanoparticles. This review provides an overview of frequently used label-free visualization techniques and highlights recent studies on the development and usage of microscopy systems based on reflectance, darkfield, differential interference contrast, optical coherence, photothermal, holographic, photoacoustic, total internal reflection, surface plasmon resonance, Rayleigh light scattering, hyperspectral and reflectance structured illumination imaging. Using these imaging modalities, there is a strong enhancement in the reliability of experiments concerning cellular uptake and biocompatibility of nanoparticles, which is crucial for preclinical evaluations and future medical applications.

Biocompatible poly(ethylene succinate) polyester with molecular weight dependent drug release properties.

In the present study, we demonstrate that well-known molecular weight-dependent solubility properties of a polymer can also be used in the field of controlled drug delivery. To prove this, poly(ethylene succinate) (PES) polyesters with polycondensation time regulated molecular weights were synthesized via catalyst-free direct polymerization in an equimolar ratio of ethylene glycol and succinic acid monomers at 185 °C. DSC and contact angle measurements revealed that increasing the molecular weight (Mw, 4.3-5.05 kDa) through the polymerization time (40-80 min) increased the thermal stability (Tm= ∼61-80 °C) and slightly the hydrophobicity (Θw= ∼27-41°) of the obtained aliphatic polyester. Next, this biodegradable polymer was used for the encapsulation of Ca2+ channel blocker Nimodipine (NIMO) to overcome the poor water solubility and enhance the bioavailability of the drug. The drug/ polymer compatibility was proved by the means of solubility (δ) and Flory-Huggins interaction (miscibility) parameters (χ). The nanoprecipitation encapsulation of NIMO into PES with increasing Mw resulted in the formation of spherical 270 ± 103 nm NIMO-loaded PES nanoparticles (NPs). Furthermore, based on the XRD measurements, the encapsulated form of NIMO-loaded PES NPs showed lower drug crystallinity, which enhanced not only the water solubility but even the water stability of the NIMO in an aqueous medium. The in-vitro drug release experiments demonstrated that the release of NIMO drug could be accelerated or even prolonged by the molecular weights of PES as well. Due to the low crystallinity of PES polyester and low particle size of the encapsulated NIMO drug led to enhance solubility and releasing process of NIMO from PES with lower Mw (4.3 kDa and 4.5 kDa) compared to pure crystalline NIMO. However, further increasing the molecular weight (5.05 kDa) was already reduced the amount of drug release that provides the prolonged therapeutic effect and enhances the bioavailability of the NIMO drug.

Cell line specific alterations in genes associated with dopamine metabolism and signaling in midbrain dopaminergic neurons derived from 22q11.2 deletion carriers with elevated dopamine synthesis capacity.

Microdeletions at the 22q11.2 locus are associated with increased risk for schizophrenia. Recent work has demonstrated that antipsychotic naïve 22q11.2 carriers display elevated levels of dopamine synthesis capacity (DSC) as assessed by 18F-DOPA PET imaging. While this is consistent with a role for abnormal dopamine function in schizophrenia, it is unclear what molecular changes may be associated with this neuro-imaging endophenotype, and moreover, if these alterations occur independently of clinical presentation. We therefore conducted a pilot study in which we generated human induced pluripotent stem cells (hiPSCs) from two 22q11.2 deletion carriers with elevated DSC in vivo, but distinct clinical presentations. From these and neurotypical control lines we were able to robustly generate midbrain dopaminergic neurons (mDA-neurons). We then assessed whether genes associated with dopamine synthesis, metabolism or signaling show altered expression between genotypes and further between the 22q11.2 deletion lines. Our data showed alterations in expression of genes associated with dopamine metabolism and signaling that differed between the two 22q11.2 hiPSC lines with distinct clinical presentations. This reinforces the importance of considering clinical, genetic and molecular information, when possible, when choosing which donors to generate hiPSCs from, to carry out mechanistic studies.

Packaging of HCV-RNA into lentiviral vector.

The advent of infectious molecular clones of Hepatitis C virus (HCV) has unlocked the understanding of HCV life cycle. However, packaging of the genomic RNA, which is crucial to generate infectious viral particles, remains poorly understood. Molecular interactions of the domain 1 (D1) of HCV Core protein and HCV RNA have been described in vitro. Since compaction of genetic information within HCV genome has hampered conventional mutational approach to study packaging in vivo, we developed a novel heterologous system to evaluate the interactions between HCV RNA and CoreD1. For this, we took advantage of the recruitment of Vpr fusion-proteins into HIV-1 particles. By fusing HCV Core D1 to Vpr we were able to package and transfer a HCV subgenomic replicon into a HIV-1 based lentiviral vector. We next examined how deletion mutants of basic sub-domains of Core D1 influenced HCV RNA recruitment. The results emphasized the crucial role of the first and third basic regions of D1 in packaging. Interestingly, the system described here allowed us to mobilise full-length JFH1 genome in CD81 defective cells, which are normally refractory to HCV infection. This finding paves the way to an evaluation of the replication capability of HCV in various cell types.

Detection of "tip fold-over" of the cochlear implant electrode array with transimpedance matrix (TIM) measurement / Az elektródasor visszatekeredésének kimutatása transzimpedanciamátrix (TIM)-vizsgálattal cochlearis implantátumban.

Összefoglaló. Bevezetés: Az elmúlt években a cochlearis implantátum a súlyos halláskárosodás vagy a teljes siketség rutinszeru és hatékony kezelési eszközévé vált. Korunk egyik leggyakrabban használt és leghatékonyabb újítása a cochlearis implantációban a perimodiolaris vékony elektródasorok alkalmazása. A cochlea középtengelyét, a modiolust szorosan ölelo atraumatikus elektródasor igen meggyozo eredménnyel bizonyítja népszeruségét, mind az elektrofiziológiai mérések során, mind az akusztikus hallás megorzése terén nyújtott teljesítményével. Ugyanakkor igen kevés publikáció írja le az elektródasor nem megfelelo helyzetének elofordulási gyakoriságát, pontosabban a visszatekeredését a csúcsi szakaszon. Célkituzés: Tanulmányunk célja olyan szoftveres technika, a transzimpedancia-mátrix (TIM) beillesztése a rutin intraoperatív elektrofiziológiai mérési metodikák közé, amely képes objektív diagnosztikai lehetoséget biztosítani ahhoz, hogy korán felismerhessük a cochlearis implantátum elektródasorán keletkezett hurkot. Módszer: Hároméves kisgyermek kétoldali cochlearis implantációját követoen, posztoperatív röntgenfelvételen a bal oldalon az elektródasor megfelelo pozíciója figyelheto meg, míg a jobb oldalon az intracochlearis elektródasor végének visszatekeredése igazolódott. Képalkotó vizsgálatot követoen elektrofiziológiai metódusként TIM-vizsgálatot végeztünk. Az eljárás során a méroeszköz a kijelölt stimuláló elektródákon 1 V nagyságrendu feszültséget közöl állandó áramerosség mellett a cochlea közel eso struktúrái felé. Méroelektródák segítségével regisztráljuk a szöveteken mérheto feszültséget, majd transzimpedancia-mátrixszá alakítjuk a mért értékeket. Eredmények: Az elektródasor visszatekeredése, amelyet korábban radiológiai vizsgálattal igazoltunk, az objektív elektrofiziológiai mérések segítségével is jól azonosítható, és a vizsgálatok szoros párhuzamot mutatnak. Következtetés: Az elektródák helyzetének megjelenítésére szolgáló standard radiológiai képalkotási technikák kiegészíthetok, illetve kiválthatók egyszeruen elvégezheto, hatékony, objektív elektrofiziológiai vizsgálatokkal. Intraoperatíven, még a sebzárás elott kimutatható, ha az elektródasor nem megfelelo helyzetbe került, így csökkenthetjük a radiológiai vizsgálatokkal járó sugárterhelés és annak finanszírozási problémáját. Orv Hetil. 2021; 162(25): 988-996. INTRODUCTION: In recent years, the cochlear implant has become a routine and effective treatment tool for severe hearing loss and total deafness. One of the commonly used and effective innovations of our time in cochlear implantation is the perimodiolar thin electrode array. The atraumatic electrode array, which closely embraces the central axis of the cochlea (modiolus), has served its popularity with very convincing results, with its performance in both electrophysiological measurements and acoustic hearing preservation. However, very few publications describe the frequency of improper positioning of the electrode array, which is known as 'tip fold-over'. OBJECTIVE: The aim of our study is to incorporate a software technique, the transimpedance matrix (TIM), into routine intraoperative electrophysiological measurement methodologies to provide a potential objective diagnostic opportunity for early detection of tip fold-over of the electrode array. METHOD: Following bilateral cochlear implantation of a three-year-old child, postoperative radiography showed the correct position of the electrode array on the left side, while tip fold-over of the intracochlear electrode array was detected on the right side. Following imaging, a TIM study was performed as an electrophysiological method. During the procedure, the measuring device transmits a voltage of the order of 1 V to the nearby structures of the cochlea at a constant current at the designated stimulus electrodes. Measuring electrodes were used to register the voltage measured on the tissues, and then converted into a TIM. RESULTS: Electrode tip fold-over was previously diagnosed by radiological examination, while it can also be diagnosed by objective electrophysiological measurements now, and these two tests correlate well. CONCLUSION: Standard radiological imaging techniques for electrode positioning can be supplemented or replaced by easy-to-perform, effective objective electrophysiological studies. Tip fold-over can be detected intraoperatively, even before wound closure, if the electrode array is in the wrong position, thus reducing the radiation exposure associated with radiological examinations as well as reducing relevant costs. Orv Hetil. 2021; 162(25): 988-996.