Objective-Integrins are attractive therapeutic targets. Inhibition of integrin ␣ IIb ␤ 3 effectively blocks platelet aggregation.However, limitations with intravenous ␣ IIb ␤ 3 antagonists and failure of oral ␣ IIb ␤ 3 antagonists prompted doubts on the current concept of ligand-mimetic integrin blockade. Methods and Results-Evaluating P-selectin expression on platelets by flow cytometry, we report a mechanism of paradoxical platelet activation by ligand-mimetic ␣ IIb ␤ 3 antagonists and define three requirements: (1) Induction of ligand-bound conformation of ␣ IIb ␤ 3 , (2) receptor clustering, (3)

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Cochlear implantation has a remarkable impact on the social life, activities and self-esteem of each patient. In order to objectify this comprehensive effect the term quality of life has been introduced. Various questionnaires have been developed to assess the quality of life in such patients. In a review of the literature several generic and disease specific quality of life questionnaires were analyzed regarding the effect of cochlear implantation and changes over time after implantation. Numerous disease specific instruments show a considerable improvement in total scores and in several subcategories, but some generic instruments may not be sensitive enough to detect changes after cochlear implantation. Nevertheless a respectable number of sensitive and validated instruments are available for use in these patients. These instruments recognize substantial improvements after cochlear implantation in several aspects of quality of life including physical, social and psychological domains. Since quality of life questionnaires allow a comprehensive insight into patients' daily life and activities, quality of life measurements are an essential addition to speech perception tests to quantify the outcome after implantation. The measurement of cochlear implant related quality of life states an important instrument to provide information about the outcome of technical improvements, different treatment and rehab strategies in future.