Akzidentelle Quadrizepstenodese durch arthroskopische Kreuzbandplastik

Adjustable loop button fixations are commonly applied in anterior cruciate ligament (ACL) surgery. In the following case of a young female soccer player, the combination of soft tissue interposition and tunnel malplacement led to an accidental tenodesis of the quadriceps tendon. This resulted in a massive restriction of the joint function which was resolved by arthroscopic removal of the transplant and fixation. The patient gained full range of motion 8 weeks postoperatively.     

Effects of ivacaftor on severely ill patients with cystic fibrosis carrying a G551D mutation

BackgroundRecently, ivacaftor, a CFTR-potentiator, has been shown to be effective and safe in patients with cystic fibrosis carrying a G551D mutation and moderately impaired lung function. The objective of this retrospective study was to assess efficacy and safety of ivacaftor in severely ill patients with at least one G551D mutation.MethodsData from 14 patients with a FEV1 < 40% predicted who received ivacaftor on a “named patient program” base in Germany were analyzed.ResultsOne patient took ivacaftor at a lower than recommended dose due to abundant mucus and a feeling to “suffocate.” No additional severe adverse events were reported. One further patient stopped ivacaftor due to lung transplantation, one due to perceived poor effectiveness, one due to pregnancy, and one stopped standard therapy. The remaining patients took ivacaftor regularly and did not change other therapies. FEV₁ increased by more than 5 %predicted in 5 of the 14 patients from baseline (average FEV₁ during the year prior to ivacaftor). On average, FEV₁ increased significantly by 5.2 ± 5.6%predicted (p < 0.01). The relative improvement in FEV₁ was 19.7 ± 22.1%.ConclusionIvacaftor was effective in many patients with poor lung function. The response was, however, variable. Although the drug appeared safe for most of these patients, increased bronchial secretions may warrant intensified physiotherapy and intravenous antibiotic treatment when ivacaftor is initiated.     

Formation of the inner ear during embryonic and larval development of the cichlid fish (Oreochromis mossambicus)

Background: The vertebrate inner ear comprises mineralized elements, namely the otoliths (fishes) or the otoconia (mammals). These elements serve vestibular and auditory functions. The formation of otoconia and otoliths is described as a stepwise process, and in fish, it is generally divided into an aggregation of the otolith primordia from precursor particles and then a growth process that continues throughout life. Results: This study was undertaken to investigate the complex transition between these two steps. Therefore, we investigated the developmental profiles of several inner ear structural and calcium-binding proteins during the complete embryonic and larval development of the cichlid fish Oreochromis mossambicus in parallel with the morphology of inner ear and especially otoliths. We show that the formation of otoliths is a highly regulated temporal and spatial process which takes place throughout embryonic and larval development. Conclusions: Based on our data we defined eight phases of otolith differentiation from the primordia to the mature otolith.