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Introduction: Medication-related osteonecrosis of the jaw (MRONJ) is a serious complication in patients receiving antiresorptive medication, such as bisphosphonates and denosumab, for different oncologic and non-oncologic diseases. Here, we report a case of MRONJ in a patient treated with tocilizumab, a humanized anti-interleukin-6 receptor antibody that effectively treats moderate to severe rheumatoid arthritis in adults.Case description: A 45-year-old female patient diagnosed with severe rheumatoid arthritis, who had been undergoing intravenous tocilizumab therapy for three years without history of bisphosphonate use, was referred to our department. Four weeks previously, several teeth in the maxilla and mandible were removed under local anesthesia by her dentist. Two weeks after the extractions, she felt pain in both jaws. We diagnosed wound dehiscence and delayed healing of the alveolar bone after the tooth extractions. Digital volume tomography showed persistent dry alveolar sockets. The patient underwent surgical debridement of necrotic bone, and intravenous antibiotics were administered in hospital. Five months later, wound dehiscence reoccurred in the same regions. Histopathological analysis of bone biopsies revealed a diagnosis of MRONJ. Four months later, wound dehiscence occurred in the left maxillary alveolar ridge, and local bone resection was performed under antibiotic treatment. Twenty-four months after the last surgery, wound dehiscence had healed completely without signs of recurrence.Discussion: Osteomyelitis of the jaw in patients treated with tocilizumab has not been reported often. This case confirms the potential role of this interleukin-6 receptor inhibitor in the pathogenesis of MRONJ and shows that patients who receive tocilizumab with MRONJ-like symptoms should be closely monitored. The pathomechanism of MRONJ under tocilizumab therapy remains unclear, so dental practitioners, maxillofacial surgeons, and rheumatologists should look for signs of MRONJ in patients receiving tocilizumab to prevent MRONJ onset.

The contribution of the Junkerherrschaft, the Prussian manorial system east of the river Elbe, to the modernization of Germany in the late nineteenth century has been an ongoing subject of historical debate for decades. By discussing a series of articles by William Hagen, the author challenges Hagen's thesis, according to which landlords as well as their subject peasants benefitted from changes within the Prussian manorial system of the seventeenth century, a mutually satisfactory bargain, in the course of which the peasants accepted a higher rate of labour services for a reduction in rental dues. Hagen's argument, that the decrease in rents and the increase in labour services meant an advantage for both peasants and landlords is dismantled by Rebel, who by reevaluating and reinterpreting Hagen's own evidence sketches a picture of drastic disadvantages which the peasants had to face under the new arrangement of increased labor services. Applying Eric Wolf's model of historical social relations, Rebel then sets out to show the effect of these developments in the sphere of family formation of the aristocratic dynasty and the peasant household. Dictated by the labor need of the manorial estates the latter are forced to constitute themselves in pseudo- and ad-hoc-families, which have to make unending choices of exclusion and dispossession of „uneconomical" and marginal family members. According to Rebel a pattern is developing, a hidden war between those who like the aristocracy form dynastic families and those who like the peasants cannot form families that last.

The article opens a debate on a book by John Komlos dealing with the economic history of the eighteenth-century Habsburg Monarchy. Rebel discusses Komlos' approach in regard to his concept of the Industrial Revolution and an ,,anthropometric history", which he classifies as „neoclassical" and „neo- Malthusian". Both Komlos' empirical basis - the height measurement of Austrian recruits - and his approach of establishing a correlation between physical height and national income are seen as problematic. The validity of some of the regional samples as well as the resulting calculations are questioned. Rebel doubts Komlos' thesis of a nutritional crisis of the population as a possible cause of the economic measures by the Austrian government which prepared the way for the lndustrial Revolution. Consequently this concept, which Komlos claimed to be a general model for world development, is rejected by Rebel also as a pattern of industrialization.