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Vinaya Manchaiah,1–4 Ilmari Pyykkö,5 Jing Zou,5,6 Hilla Levo,7 Erna Kentala7 1Department of Speech and Hearing Sciences, Lamar University, Beaumont, TX, USA; 2Department of Behavioural Sciences and Learning, The Swedish Institute for Disability Research, Linköping University, Linköping, Sweden; 3Audiology India, Mysore, 4Department of Speech and Hearing, School of Allied Health Sciences, Manipal University, Manipal, Karnataka, India; 5Department of Otolaryngology, Hearing and Balance Research Unit, University of Tampere, Tampere, Finland; 6Department of Otolaryngology-Head and Neck Surgery, Center for Otolaryngology-Head & Neck Surgery of Chinese PLA, Changhai Hospital, Second Military Medical University, Shanghai, China; 7Department of Otolaryngology, University of Helsinki, Helsinki, Finland Objectives: To facilitate self-help, the Finnish Ménière’s Federation (FMF) provides various kinds of support to persons with Ménière’s disease (MD), which includes patient magazines (PM) and Internet-based peer support (iPS). The current study aimed to evaluate the benefits reported by MD patients in terms of PM and iPS.Method: The study used a cross-sectional survey design with a mixture of structured and open-ended questions administered online. A sample of 185 patients from the FMF membership database provided complete data.Results: Ninety-two percent of the respondents rated PM as useful, or very useful. The main benefits of PM included: information on the disease and complaints, information about elements of peer support program, patient’s experience with useful positive case studies, relevant news on MD, and information of activity of the FMF. Of the 185 persons, 68 reported that they did not have a need for peer support as their disease was either in silent phase or did not cause any annoyance. The main reasons for nonuse were: mild disease, personal reasons, and problems in using. Regarding the benefits of iPS, 75% of recent and 64% of chronic MD patients said that they would benefit from such a program. The main benefits of iPS included: reliable information on the disease and its management, peer support useful for coping with the disease, information about managing MD symptoms, information about managing attitude, and information about therapy. Moreover, the study identified different groups of individuals, which included: nonusers of support from patient organizations, those who used the support but did not feel they benefited, and those who used and also benefited from such programs.Conclusion: The current study results provide some information about the preferences of MD patients regarding different forms of support and could certainly prove helpful while developing wider support strategies. Keywords: Ménière’s disease, chronic condition, peer support, self-help, self-management

Eeva Tuunainen,1 Jyrki Rasku,1 Pirkko Jäntti,2 Päivi Moisio-Vilenius,3 Erja Mäkinen,3 Esko Toppila,4 Ilmari Pyykkö1 1Department of Otolaryngology, Section of Hearing and Balance Research Unit, University of Tampere and University Hospital of Tampere, Finland; 2Department of Geriatric Medicine, Hatanpää City Hospital, Tampere, Finland; 3Koukkuniemi Residential Home, Tampere, Finland; 4Finnish Institute of Occupational Health, Helsinki, Finland Purpose: To evaluate whether rehabilitation of muscle force or balance improves postural stability and quality of life (QoL), and whether self-administered training is comparable with guided training among older adults residing in an institutional setting. Patients and methods: A randomized, prospective intervention study was undertaken among 55 elderly patients. Three intervention groups were evaluated: a muscle force training group; a balance and muscle force training group; and a self-administered training group. Each group underwent 1-hour-long training sessions, twice a week, for 3 months. Postural stability was measured at onset, after 3 months, and after 6 months. Time-domain-dependent body sway variables were calculated. The fall rate was evaluated for 3 years. General health related quality of life (HRQoL) was measured with a 15D instrument. Postural stability was used as a primary outcome, with QoL and falls used as secondary outcomes. Results: Muscle force trainees were able to undertake training, progressing towards more strenuous exercises. In posturography, the number of spiky oscillations was reduced after training, and stationary fields of torque moments of the ankle increased, providing better postural stability in all groups; in particular, the zero crossing rate of weight signal and the number of low variability episodes in the stabilogram were improved after training. While no difference was found between different training groups in posturography outcomes, a reduction of fall rate was significant in only the guided training groups. A significant part of the variability of the QoL could be explained by the posturography outcome (46%). However, the outcome of training was associated with a reduced QoL. Conclusion: Even moderate or severely demented residents could do exercises in five-person groups under the supervision of a physiotherapist. An improvement in postural stability was observed in all training groups, indicating that even self-administered training could be beneficial. Posturography outcome indicated that training alters the postural strategy by reducing the oscillatory fluctuations of body sway signal. However, only guided training tended to reduce falls. Short training intervention programs may decrease QoL by changing the elderly's daily routine and making it more active and exhausting. Keywords: force and balance training, falls, time-domain body sway analysis, psychological consequences

Sanjeev Ranjan,1 Rohit Sood,1 Jozsef Dudas,2 Rudolf Glueckert,2 Anneliese Schrott-Fischer,2 Soumen Roy,2 Ilmari Pyykkö,3 Paavo KJ Kinnunen11Helsinki Biophysics and Biomembrane Group, Department of Biomedical Engineering and Computational Science, Aalto University, Espoo, Finland; 2Department of Otorhinolaryngology, Innsbruck Medical University, Innsbruck, Austria; 3Department of Otolaryngology, University of Tampere Medical School, Tampere, FinlandBackground: The neurotrophic receptor tyrosine kinase B (TrkB) has diverse signaling roles in neurons and tumor cells. Accordingly, its suppressive targeting is of interest in neuroblastoma and other tumors, whereas its role in improving survival is focused in neurons. Here we describe targeting of TrkB-binding peptide-conjugated liposomes (PCL) to the TrkB-expressing mouse macrophage-like cell line RAW264, and to all-trans-retinoic acid-treated neuron-like TrkB+ SH-SY5Y human neuroblastoma cells.Methods: Binding and internalization of PCL was monitored by flow cytometry and confocal fluorescence microscopy.Results: Internalization of TrkB-targeted PCL by RAW264 cells was enhanced and faster when compared with PCL having the corresponding scrambled peptide. Likewise, binding and augmented uptake were confirmed for TrkB+ SH-SY5Y cells, with targeted PCL appearing in the cytoplasm after 20 minutes of incubation.Conclusion: We demonstrate here the feasibility of targeting liposomes to TrkB-expressing cells by 18-mer peptides, promoting cellular uptake (at least partly into endosomes) via receptor-mediated pathways.Keywords: liposomes, targeting, tyrosine kinase B, peptide

Ya Zhang1, Weikai Zhang1*, Alexander H Johnston2*, Tracey A Newman3, Ilmari Pyykkö1, Jing Zou1 1Department of Otolaryngology, University of Tampere, Medical School, Tampere, Finland; 2Centre for Biological Sciences, 3Clinical Neurosciences, University of Southampton, Southampton, UK*These authors are co-contributorsAbstract: Polymersomes are nanosized vesicles formed from amphiphilic block copolymers, and have been identified as potential drug delivery vehicles to the inner ear. The aim of this study was to provide targeting to specific cells within the inner ear by functionalizing the polymersome surface with Tet1 peptide sequence. Tet1 peptide specifically binds to the trisialoganglioside clostridial toxin receptor on neurons and was expected to target the polymersomes toward the cochlear nerve. The Tet1 functionalized PEG-b-PCL polymersomes were administered using routine drug delivery routes: transtympanic injection and cochleostomy. Delivery via cochleostomy of Tet1 functionalized polymersomes resulted in cochlear nerve targeting; in contrast this was not seen after transtympanic injection.Keywords: nanoparticles, peptide, round window membrane, nerve fibers, spiral ganglion cell, drug delivery