Steroid Cell Tumour in Pregnancy: Reflection on a Rare Case and Review of the Literature.

There are only a few cases of steroid cell tumours that have been described in the literature. Here, we present an exceptionally rare case of a steroid cell tumour arising from the ovary in early pregnancy.

[Traumatic physeal separations of the distal tibia. Occurrence, forms, treatment strategies]. / Traumatische Wachstumsfugenlösungen der distalen Tibia. Aufkommen, Formen, Behandlungsstrategien.

Traumatic physeal separations (SH I/II) of the lower extremities are rare. Complications are reported in 2.2-39.6%. The current study is intended to provide recent data concerning epidemiology and treatment decisions in physeal separation of the distal tibia. All patients who suffered a physeal separation of the distal tibia in a 36-month period were included in a multicenter study. Age, gender, mechanism of injury, classification, therapeutic decision, and early complications were recorded online. There were 150 cases (64.6% male, 35.4% female, average age 11.8 years). The most frequent mechanism of injury was sportive activity (42%); 76% of cases needed reduction. Antecurvation was tolerated up to 10° (p=0.0021) and valgus up to 7° (p=0.0155). Tolerance ranges up to 5° of retrocurvation and varus were not statistically significant. The investigation confirmed epidemiological data of former studies. For the first time data concerning the treatment reality of physeal separations of the distal tibia were recorded. They consistently follow the recommendations of the appropriate literature.

[Necrotizing fasciitis caused by group G streptococci]. / Nekrotisierende Fasziitis durch Gruppe-G-Streptokokken.

Necrotizing fasciitis is a soft tissue infection which is highly lethal. Its lethality can only be reduced by early diagnosis and radical débridement. A delayed diagnosis will result in streptococcal toxic shock syndrome. Any surgery neglecting radical débridement up to amputation is inadequate and cannot reduce lethality. This paper reports on two cases of necrotizing fasciitis of the leg caused by group G streptococci.

Positron emission tomography (PET) in the urooncological evaluation of the small pelvis.

Positron emission tomography (PET) with the use of ((18)F)2-fluoro-D: -2-desoxyglucose (FDG) has been investigated to be a highly sensitive and specific imaging modality in the diagnostic of primary and recurrent tumors and in the control of therapies in numerous non-urologic cancers. The aim of this review is to validate the significance of PET as a diagnostic tool in malignant urological tumors of the small pelvis. A systematic review of the current literature concerning the role of PET for malignant prostate, testicular and bladder tumors was carried out. The data indicate no additional role for PET in comparison with conventional imaging in tumor detection and local staging for prostate, bladder or testicular cancer. Tumor recurrence in prostate cancer seems to be more effectively identified with acetate and choline than with FDG, but this effect is more pronounced with higher PSA values. The value of PET in the identification of metastatic disease in either tumor entity can not be finally outlined as the clinical data are partly missing, controversial or in the process of evaluation. FDG-PET can be regarded as accepted imaging modality in the restaging of seminomatous germ cell tumors after chemotherapy.

[Simultaneous rupture of a patellar tendon and contralateral quadriceps tendon]. / Gleichzeitige Patella- und kontralaterale Quadrizepssehnendurchtrennung.

The simultaneous bilateral rupture of the quadriceps tendon is a rare injury; only occasional reports exist about the bilateral simultaneous rupture of the patellar tendon. Degenerative changes of the tendon due to drugs or diseases lead to the rupture. We describe two cases of simultaneous rupture of the patellar and contralateral quadriceps tendons; only one patient had special risks. We report the management of therapy and the functional results using the Lysholm score and Knee Rating Scale.

Comparative study of root-canal preparation using Lightspeed and Quantec SC rotary NiTi instruments.

AIM: To compare several parameters of root-canal preparation using two different rotary nickel-titanium (NiTi) instruments: Lightspeed (Lightspeed Inc, San Antonio, TX, USA) and Quantec SC (Tycom, Irvine, USA). METHODOLOGY: Fifty extracted mandibular molars with root-canal curvatures between 20 degrees and 40 degrees were embedded into a muffle system. All root canals were prepared to size 45 followed by a stepback in 1-mm increments to size 70 (Lightspeed) or 45 (Quantec SC), using a high-torque motor at 1300 or 350 r.p.m. respectively. In both groups, irrigation was performed with 2 mL NaOCl (3%) after each instrument size. RC-Prep (Premier, PA, USA) was used as a chelating agent. The following parameters were evaluated: straightening of curved root canals, postoperative root-canal diameter, working safety (instrument fractures, perforations, apical blockages, loss of working length (WL)), cleaning ability and working time. Cleanliness of the root-canal walls was investigated under SEM using 5-score indices for debris and smear layer. Statistical analysis was performed using the Wilcoxon's test (P < 0.05) for straightening and Fisher's exact test (P < 0.05) for comparison of cross-sections, contact between pre- and postoperative diameter, root-canal cleanliness and working time. RESULTS: Both NiTi systems maintained the curvature well: the mean degree of straightening was 1.8 degrees for Lightspeed and 1.7 degrees for Quantec SC; differences were not significant. Procedural incidents occurred with Quantec SC in 12 root canals (three fractures, four apical blockages and five cases of loss of WL), preparation with Lightspeed resulted in five fractures, one apical blockage and five cases of loss of WL (11 incidents). Following preparation with Lightspeed, 55.5% of the root canals had a round diameter, 25% an oval and 19.5% an irregular diameter; Quantec SC preparations resulted in a round diameter in 51.5%, oval shape in 33.3% and irregular cross-sections in 15.2% of the cases. Mean working time was similar for Quantec SC (161 s) and Lightspeed (155 s); the difference was not significant. For debris, Lightspeed and Quantec achieved 64 and 63% for scores 1 and 2, respectively. For smear layer, Lightspeed and Quantec achieved only 13.3 and 27.4% for scores 1 and 2, respectively. Differences were not significant for either debris or smear layer. CONCLUSIONS: Both systems respected original root-canal curvature well and prepared acceptable diameter forms. The cleaning ability was judged not satisfactory for both systems. Both systems showed deficiencies in working safety.

4-Hydroxynonenal induces dysfunction and apoptosis of cultured endothelial cells.

Lipolytic products of triglyceride-rich lipoproteins, i.e., free fatty acids, may cause activation and dysfunction of the vascular endothelium. Mechanisms of these effects may include lipid peroxidation. One of the major and biologically active products of peroxidation of n-6 fatty acids, such as linoleic acid or arachidonic acid, is the aldehyde 4-hydroxynonenal (HNE). To study the hypothesis that HNE may be a critical factor in endothelial cell dysfunction caused by free fatty acids, human umbilical endothelial cells (HUVEC) were treated with up to160 microM of linoleic or arachidonic acid. HNE formation was detected by immunocytochemistry in cells treated for 24 h with either fatty acid, but more markedly with arachidonic acid. To study the cellulareffects of HNE, HUVEC were treated with different concentrations of this aldehyde, and several markers of endothelial cell dysfunction were determined. Exposure to HNE for 6 and 9 h resulted in increased cellular oxidative stress. However, short time treatment with HNE did not cause activation of nuclear factor-kappaB (NF-kappaB). In addition, HUVEC exposure to HNE caused a dose-dependent decrease in production of both interleukin-8 (IL-8) and intercellular adhesion molecule-1 (ICAM-1). On the other hand, HNE exerted prominent cytotoxic effects in cultured HUVEC, manifested by morphological changes, diminished cellular viability, and impaired endothelial barrier function. Furthermore, HNE treatment induced apoptosis of HUVEC. These data provide evidence that HNE does not contribute to NF-kappaB-related mechanisms of the inflammatory response in HUVEC, but rather to endothelial dysfunction, cytotoxicity, and apoptotic cell death.