Non-Functioning Adrenocortical Carcinoma Presenting as Retroperitoneal Hemorrhage With Early Metastasis.

Adrenocortical cancer is a rare neoplasm with varied clinical presentation and overall poor outcome. This should be managed with timely intervention at highly specialized centers. Our aim is to report this rare case presentation of large non-functional adrenocortical cancer, complicated by spontaneous rupture while awaiting workup leading to life-threatening hemorrhage. Despite successful emergency radical surgical management and achieving negative margins, the patient developed early recurrence as intra-abdominal metastasis within two months. This can likely be attributed to the aggressive nature of the tumor as indicated by the high Ki-67 index or spillage of the tumor cells following spontaneous rupture. We recommend managing these non-functioning adrenocortical cancers as early as possible at highly specialized centers with reference to published standard guidelines.

Erythema Dyschromicum Perstans After Adalimumab Treatment.

Tumor necrosis factor (TNF) is a cytokine that regulates immunity by binding to the cytokine receptor (TNFR), which has a role in treating inflammatory, neoplastic, and autoimmune diseases. Medications, including etanercept, infliximab, and adalimumab, are examples of TNF-alpha blockers. Adalimumab is a fully human immunoglobulin monoclonal antibody approved for use in the treatment of psoriasis, psoriatic arthritis, rheumatoid arthritis, inflammatory bowel disease, and hidradenitis suppurativa according to the American College of Rheumatology. However, there are few reports of cases where its administration was associated with skin reactions. In the present paper, we report a case of a psoriatic male patient who developed a cutaneous reaction of the face following treatment with adalimumab.

Non-surgical treatment of mandibular fractures--survey of 28 patients.

Between January 1996 and January 2001 28 patients (nine females, nineteen males) with 35 fractures were treated by observation and soft diet only. Patients with isolated high condylar neck fractures were not included. The mean age at time of trauma was 35.6 years (5/80). Only patients with normal occlusion and radiologically undisplaced fractures were included. The follow-up time was 15 weeks on average (8/33). The patients did not undergo any active treatment. They just received the instruction to reduce mouth opening and to take a soft diet for 4 weeks. During the first 2 weeks after the trauma the patients were seen twice a week. Follow-up X-rays were performed after 4 and after 8 to 12 weeks. As a preemptive therapy antibiotics (amoxicillin plus clavulanic acid 2 x 1g/day) were given for 5 days. Spontaneous healing of all fractures was observed. In two patients a tooth had to be removed out of the fracture line. One patient complained about an occlusal problem after 1 week. In his case intermaxillary fixation was installed for 2 weeks. For forensic reasons the patients have to be fully informed about possible complications before indicating this type of management. Patient selection is crucial and requires a highly experienced surgeon. Patient inconvenience due to frequent consultations must be taken into consideration. This type of treatment can be recommended only in selected cases.

Physico-chemical and technological studies on sugar beet roots.

The morphological and chemical characteristics of ten varieties of sugar beet roots were evaluated during the season of 1996-1997. The best morphological characteristics were found in Top, Ito and Pamela varieties. The highest expected technological yield of sugar was found in Pamela and Top. The chemical constituents of different varieties of sugar-beet roots showed significant differences. The suitability of sugar beet juice for preparing beet syrup as a new product was also evaluated and compared with sugar cane syrup. Purified beet-syrups concentrated under vacuum or under atmospheric pressure showed more stability during storage than sugar cane syrup. The effect of storage conditions (at cold storage and at room temperature) and packaging materials (glass and polyethylene high-density bottles) on properties of beet-syrup and sugar cane syrup were also studied.

[Bone defect filling material in jaw bones using tricalcium phosphate]. / Knochendefektfüllungen in den Kieferknochen mit Tricalciumphosphat.

Our experience shows that resorbable Beta-Tricalcium-phosphate is a useful alternative as filling material for cystic defects of the maxilla and mandible. It proves to be biocompatible and causes no immunologic reactions. Granulate has been used in 51 patients, in most cases it was Tricalciumphosphate. In three patients it had to be removed. Radiologically as well as histologically it was shown that resorption of Tricalciumphosphate takes place and that is replaced by osseous integration.