Infants colonized with enterotoxin-producing staphylococci at 3 months display a decreased frequency of interferon-gamma-producing CD45RO lymphocytes upon stimulation with staphylococcal enterotoxin A at birth but not at 6 months of age.

The aim of the study was to elucidate the relationship between the cytokine response to staphylococcal enterotoxin A (SEA) at birth and subsequent staphylococcal colonization in the first months of life. In a cohort of 45 newborns, cord blood lymphocytes were stimulated with SEA (10 ng/ml) in vitro, re-stimulated with PMA (phorbol myristate acetate) and ionomycin at day 3 and assessed for CD45RO expression and cytokine generation by flow cytometry. The infants were classified into three groups according to nasal staphylococcal colonization and enterotoxin generation at 3 months: There were 16 infants with either no colonization or non-enterotoxin-producing staphylococci, 16 infants with enterotoxins B, C, D and E, and 13 infants colonized with SEA-producing staphylococci.

[Effectiveness of the back school. A review of the results of evidence-based evaluation].

Back schools are high frequency-low cost interventions. Their effectiveness has lately been regarded with skepticism. The variety of back school programs makes an over-all evaluation difficult.

[Injection therapy in lumbar syndromes].

Injection therapy as part of orthopaedic pain treatment is of major importance in sciatica. It helps to differentiate unclear complaints and allows a break through of the vicious circle of pain and muscle spasm. Pharmacological principles and possible complications have to be observed.

Effectiveness of the back school. A review of the results of evidence- based evaluation.

Back schools are high frequency-low cost interventions. Their effectiveness has lately been regarded with skepticism. The variety of back school programs makes an over-all evaluation difficult.

Medical training therapy in lumbar syndromes.

Chronic low back pain can be considered to be one of the most frequently treated and most costly diseases in modern industrial societies. Dysfunctions and imbalances of the spine-supporting muscles increase the risk of low back pain. Consequently preventive treatment and rehabilitation have to aim at preserving and restoring the full capacity of the spine-supporting muscles as well as training coordination and spine-friendly behaviour.

Injection therapy in lumbar syndromes.

Injectiontherapy as part of orthopaedic pain treatment is of major importance in sciatica. It helps to differentiate unclear complaints and allows a break through of the vitious circle of pain and muscle spasm. Pharmacological principals and possible complications have to be observed.

[A case report: ochronosis in combination with chondrocalcinosis].

We report the case of a 70 year old female patient suffering from Cox- and Gonarthrosis, a massive loss of function of the whole vertebral spine caused by a combination of Ochronosis and Chondrocalcinosis. The patient's anamnesis, the clinical findings and the pathology with the possible clinical manifestations are being described with a review on the existing literature.

[Relevance of preoperative nutritional therapy for postoperative outcome].

Several studies on preoperative artificial nutrition have shown beneficial effects only in severely malnourished patients (weight loss > 15% within short time, serum albumin < 2.8 g/dl). In this group of patients undergoing major gastrointestinal surgery, the postoperative complication rate was reduced to 40-60%.

The correlation between magnetic resonance imaging and the operative and clinical findings after lumbar microdiscectomy.

Fifty-four consecutive patients were studied prospectively with magnetic resonance imaging before microdiscectomy, and the findings correlated with clinical symptoms before and after operation. A sequestrated fragment was found in 59% of cases, a subligamentous disc sequestration in 25% and a disc protrusion in 16%. The levels operated on were L4/5-36%, L5/S1-62.

High prevalence of parkinsonism after occupational exposure to lead-sulfate batteries.

Seven of nine postal workers exposed to lead-sulfate batteries over a period of up to 30 years developed parkinsonian symptoms. One of the remaining two showed left-hand bradykinesia and one was not available for examination. The high prevalence and cause of parkinsonism in these patients remains unexplained.

Intravenously administered acetylsalicylic acid in combination with low-dose heparin in acute ischemic stroke: a safety analysis.

Although therapy with acetylsalicylic acid (aspirin, ASA) is well established in secondary prevention of stroke, efficacy and side effects of this substance in acute stroke treatment are undetermined. ASA may be useful in acute cerebral ischemia because of its potential to prevent thrombus propagation and neuronal damage. A total of 268 patients with an acute cerebral ischemia, who were admitted to our stroke unit within 24 hours after stroke, were treated with intravenously administered ASA (0.

[Intermediate-term follow-up of surgically managed tendinosis calcarea (calcifying subacromion syndrome--SAS) of the shoulder joint].

Purpose: Investigation of clinical und ultrasonographical results after operatively treated calcifying tendinitis.

Methods: 131 patients with calcifying tendinitis were treated by surgical decompression and, if necessary and possible, calcific deposit removal. 93% of these patients were clinically and ultrasonographically examined after an average time of 4 years and 5 months.

[High resolution 20 MHz ultrasound diagnosis in dermatology for noninvasive imaging of malignant melanomas].

For years, high-resolution b-scan ultrasound is a well established technique in dermatology regarding the preoperative determination of thickness of skin tumors like malignant melanoma or basal cell carcinoma. Most tumors appear as echopoor areas in high-frequency sonography. Until today, a differentiation between skin tumors by means of high-frequency ultrasound is not possible.

Reversible urinary retention as the main symptom in the first manifestation of a syringomyelia.

A neurogenic bladder is seldom described as the first manifestation of syringomyelia. A patient is reported with an extensive syrinx along the entire spinal cord and a Chiari type I malformation, who experienced dysaesthesia and weakness during shooting practice and presented with urinary retention.

[Intraindividual reproducibility of ultrasound detection of gastrobiliary motility parameters and CCK incretion after a standardized, liquid, fat-containing test meal].

Aim And Methods: Gastric emptying, antral mobility, fasting gallbladder volumes, gallbladder emptying rates, and CCK incretion following a standardized liquid fatty meal were investigated in 14 healthy young volunteers (seven women and seven men) on two separate study days. In the seven young women, taking oral contraceptives, one study day was in the oestrogen phase and the other in the gestagen phase of their menstrual cycle.

Results: There was good intraindividual reproducibility of the different sonographic gastrobillary motility parameters and the postprandial CCK incretion in both sexes (coefficients of reliability between 0.

[Synovial hemangioma as a rare differential diagnosis of juvenile hemarthrosis. Therapy by laser ablation].

We report the case of multiple hemangiomas in the left knee of a young female. The hemangiomas were ablated by holmium yag-laser. Arthroscopic versus open surgery procedures in the therapy of synovial hemangiomas will be discussed.

[High resolution computerized tomography of the temporal bone in mandibulofacial dysostosis].

High resolution CT (HR-CT) scanning of the temporal bone was performed in three patients with a fully expressed mandibulofacial dysostosis for preoperative assessment of temporal bone abnormalities. The external auditory canal was absent in five of six ears. Scans revealed a dysplastic middle ear cleft with dysplastic and partly dislocated ossicles.

[Visual evaluation of conventional roentgen pictures and dual x-ray absorptiometry in the diagnosis of osteopenia].

Routine radiographs and PA dual x-ray absorptiometry (DXA) of the lumbar spine were performed in 253 patients. A T-score of -2SD (approximately 20% reduction from young normal bone mineral density (BMD)) as measured by DXA, was used as threshold for the diagnosis of osteopenia. A lumbar spine index (LSI) as proposed by Barnett and Nordin was assessed by one radiologist.

Epidemiology of invasive Haemophilus influenzae disease in a German city.

This study was done to analyze the epidemiology of invasive Haemophilus influenzae disease in Bochum city area. Forty-eight children with invasive Haemophilus influenzae infections were treated at the University Children's Hospital in Bochum during the study period from January 1971 to June 1992. Clinical manifestations included meningitis (n = 34), epiglottitis (n = 8), pneumonia (n = 2), bacteremia (n = 2), cellulitis (n = 1) and osteomyelitis (n = 1).

Sonographic quantification of the type IV reaction after intradermal application of recall antigens.

20-MHz B-scan high-resolution sonography permits non-invasive, two-dimensional visualisation of micromorphological structures in vivo, and allows precise measurement of the depth and extent of inflammatory skin lesions. In 50 patients, the reactions following intradermal application of 8 recall antigens to the volar forearm were evaluated clinically and sonographically at various times (0, 24, 48, 72 h). In 30 patients, one of the inflammatory papules was excised after 48 h for complete histological work-up (serial sections) and subsequent comparison with the sonographic image.

[Therapy of post-herpetic neuralgia. Pain therapy using an anti-varicella zoster immunoglobulin].

After remission of the dermatological symptoms of herpes zoster infection, post-zoster neuralgia (PZN) can persist or recur for months and years. Most frequently, satisfactory therapy of PZN is not possible. During recent years the persistence of viruses on the surface of neuronal cells has been discussed as the possible reason for chronic pain.

[The so-called post-discotomy syndrome--failure of intervertebral disk surgery?].

The Post-discectomy-Syndrome (PDS) is a clinical entity with various components from individual disposition, sequelae of the underlying disc degeneration and of the operation, as well. These include local back pain, persisting (poly-)radicular pain and facet irritation with pseudoradicular irradiation due to segmental instability, epidural scarring and local arachnoiditis. Diagnosis has to focus on separation from failed-back-surgery-syndromes (FBSS) with single components like insufficient discal or bony decompression or segmental instability.