[Development and/or increase of rheumatoid nodules in RA patients following leflunomide therapy]. / Neuauftreten und/oder Zunahme von Rheumaknoten unter Leflunomidtherapie bei RA-Patienten.

This is the first description of the development of rheumatoid nodules in 3 rheumatoid arthritis patients following leflunomide therapy. The nodules were localized at typical sites with preference of the extensor side of hands and elbow. One nodule examined histologically revealed the typical architecture of RA nodules. In all 3 patients the time of onset of nodulosis was about 6 months after initiating the leflunomide therapy. In all 3 patients leflunomide was clinically efficacious concerning RA: remission or near remission was achieved. Due to the extent of nodulosis, the leflunomide therapy had to be stopped in 2 patients. Progression and acceleration of nodulosis is well known following MTX therapy in RA patients. It is caused by adenosine A1 receptor promotion of multinucleated giant cell formation by human monocytes. Leflunomide has no known influence on adenosine metabolism, so different pathogenetic mechanisms must be assumed for the induction of nodulosis by leflunomide.

[Ultrasound determination of sacral position in the frontal plane]. / Die sonographische Bestimmung der Kreuzbeinstellung in der Frontalebene.

AIM OF THE STUDY: The position of the sacrum in the frontal plane is important for the statics of the spine. The most common method of investigating the sacrum is its visualisation on an antero-posterior X-ray film. The aim of this study was to find a method of determining the position of the sacrum in the frontal plane by sonography. METHOD: Criteria for the correct image of the upper rim of the sacrum are presented and the procedure for measuring sacral tilt is introduced. The results of the sonographic measurements of 107 patients are compared with the results of X-ray measurements. The intraindividual differences are described and statistically evaluated. RESULTS: Almost 90% of the patients revealed a difference between the sonography and the radiology measurement of less than three millimeters. The overall sensibility was 80%. The specificity was 82%. The results were calculated for different age groups. They turned out to be better in children and adolescents than in adult patients. Obese adults had significantly worse results than patients with normal body weight. CONCLUSIONS: This study suggests that the method presented can help to provide reliable information on the position of the sacrum, especially in children and adolescents. By using sonography we can partly reduce the necessary X-ray exposure, especially in the diagnosis and treatment of leg length discrepancies.

Effects of egg yolk and salt on Micrococcaceae heat resistance.

The heat resistance and growth possibilities of various members of the Micrococcaceae in egg yolk and egg yolk with added salt were determined. Egg yolk alone protected members of the Micrococcaceae considerably against heat. Whereas in water Staphylococcus aureus S6 had a decimal reduction time (D) value of 66 s at 55 degrees C, its D value in egg yolk at the same temperature was 246 s. In salted egg yolk (water activity, 0.95), S. aureus S6 had a D value of 180 s at 66 degrees C and was largely inactivated during the pasteurization processes currently applied. Micrococcus saprophyticus and S. epidermidis (D value of each under the same conditions, 390 s) could survive such treatments to a certain extent and can thus spoil commercial egg yolk.

Heat inactivation of staphylococcus epidermidis at various water activities.

Members of the family Micrococcaceae play an important role in food spoilage and even in food poisoning. In contrast to members of the family Enterobacteriaceae, these bacteria can grow in media with low water activities. Therefore, the heat resistance of Staphylococcus epidermidis, a rather resistant member of the family Micrococcaceae, was studied at water activities between 0.87 and 1.00. The heat inactivation curves were clearly biphasic at all temperatures and water activities tested. Especially at low water activities, the D-values of the tail phase were extremely high (at 0.87 water activity, a D-value at 70 degrees C of 500 s was recorded).