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The purpose of this paper is to investigate whether the presence of a nasogastric tube (NGT) for feeding has an impact on the nasal colonization by Staphylococcus aureus. Three groups of frail elderly were examined: 76 patients fed by NGTs and 52 orally fed patients in skilled nursing wards, and 33 orally fed patients in regular nursing wards. Samples from the nasal and oral cavities were cultured for S. aureus and susceptibility testing for oxacillin was performed. The prevalence of S. aureus (either oxacillin-susceptible or oxacillin-resistant) in the NGT-fed group was not significantly different to that in the two orally fed groups nor the nostril in which the NGT was placed. A significant correlation in colonization was found between the two nares and between the nares and oral cavity in the same patient (r > 0.45, P < 0.005) for both oxacillin-susceptible and oxacillin-resistant S. aureus. The presence of NGTs for feeding in elderly frail patients is not associated with higher rates of S. aureus colonization in the nares or oral cavity.

Behçet's disease is a chronic inflammatory disorder characterized by the triad of oral and genital ulcers and ocular lesions. One of the most life-threatening manifestations results from involvement of the central nervous system, presenting as necrotising meningo-encephalitis, most typically affecting the brain stem, internal capsula and basal brain ganglia. We report on a young Caucasian mate with Behçet's disease (HLA B 51+) and recurrent uveitis, who presented with acute neurologic involvement under CyA therapy 5 years after first diagnosis. At the time of admission MRI showed two high intensity lesions in the brain stem on T1 weighted images enhanced with Gd-DTPA, reflecting active inflammation. Shortly after admission the CyA treatment was stopped and a therapy with high dose steroids and chlorambucil, starting with a dose of 2 mg daily was initiated. This led to improvement of neurologic symptoms, also documented by brain stem evoked potentials and investigations of cerebrospinal fluid, as well as of ophtalmologic symptoms within few days of treatment. Steroids were reduced to a maintenance dose of 12 mg Prednyliden daily. The brain MRI taken 8 weeks after onset of chlorambucil treatment showed the same lesions in the brain stem, with low intensity in the T1 weighted images an no longer enhanced Gd-DTPA uptake. Chlorambucil dose was reduced to 2 mg every second day after 8 months. There was no exacerbation in the follow-up of 12 months. We conclude that a 6-week Chlorambucil therapy consisting of 2 mg/p.o./d led to remission of neurologic involvement firstly evolving under CyA-medication which suggests superiority of chlorambucil as a treatment modality in neurologic as well as ophtalmologic features of the disease.

Pustulotic arthroosteitis is characterized by the association of inflammatory and hyperostotic skeletal changes, primarily of the anterior chest wall, and chronic recurrent skin lesions of the palms and soles known as pustulosis palmaris et plantaris. Since its first description by Sonozaki in 1981 in Japan, it has also been reported by several European authors and become widely accepted as a separate entity within the spectrum of the seronegative spondylarthropathies. In this report, we describe 11 cases seen in our clinic in the years 1985 to 1992. Course and severity of the disease varied greatly among individual patients. In four of them a difference of up to 6 years between the onset of skin and skeletal symptoms were noted. Besides chronic recurrent nonspecific osteomyelitis in two cases, neither an association to other rheumatic or dermatologic diseases nor to HLA-B27 could be found. Corticosteroids, non-steroidal anti-inflammatory drugs, immunosuppressive agents, and antibiotics were all used with uncertain therapeutic success. Based on these data, we suppose that pustulotic arthroosteitis is more common in Germany than previously thought, and has to be considered as an important differential diagnosis of sternoclavicular arthritis. In a review of the available literature, the current opinions on nomenclature, etiology, pathogenesis, and treatment are discussed.

Two isolates of Pleurotus ostreatus from North America and one from Germany are interbreedable. Under identical conditions at low temperatures, their fruiting bodies are hard to distinguish. However, shape and colour and several other characters vary with culture conditions. The American stocks fruit well at temperatures from 4 to 24 °C, the German ones only below 15 °C. Four types of hybrids between German and American Pleupotus were obtained: i) The whole fruiting process is temperature sensitive as in German Pleurotus. ii) It proceeds at 4-24 °C as in American stocks, iii) Fruiting initiation is insensitive but sporophore development is sensitive to elevated temperatures, iv) Primordia formation and initial sporophore development depend on temperatures below 15 °C, but pileus expansion and spore discharge continue above 20 °. The involvement of separate genes for the single developmental steps and the use of temperature sensitivity for commercial varieties are discussed. One sporeless strain, "F42x11", with considerable fruiting bodies has been obtained. In intrastock di-mon-matings this character was dominant.

Extracts from fruit bodies ofPleurolus orAgaricus promoted fructification ofPleurotus mycelium. This was visible in regular primordia formation 7-10 days after application of extract to the mycelium and in higher sporophore weights.After fractionating the extracts by ultra- and gel-filtration a marked stimulation of sporophore weights was detectable only in fractions of lower molecular weight. The number of primordia, however, was also increased by compounds of high molecular weight, but not by protein alone.With increasing dilution of the extracts the weight of fruit bodies decreased more rapidly than the number of primordia.40 mg of L-asparagine or equimolar amounts of urea showed an effect similar to that of the extract from 1 g fruit body. Suggars gave no reaction.Sporophore initiation and fruit body growth are supposed to be two different processes inPleurotus as well as inAgaricus bisporus.Methods for detecting a hypothetical sporophore inducer and an inhibitor are discussed.