[Adherence to Phase III Cardiac Rehabilitation Programs: A Prospective, Randomized Comparison between a Conventionally Conducted Program and a Tai Chi-Based Program]. / Adhärenz in Herzgruppen: Ein prospektiver, randomisierter Vergleich einer konventionell durchgeführten Herzgruppe zu einer Tai-Chi-Herzgruppe.

INTRODUCTION: In patients with cardiac diseases, lifestyle changes such as an increase in physical activity are recommended to prevent further cardiac events. In Germany this is possible by attending outpatient heart groups. A problem inherent in these programs is the lack of adherence since more than two thirds of patients stop attending cardiac rehabilitation programs after six months. An alternative to the conventional implementation of heart groups is Tai Chi, which was found to improve adherence to cardiac rehabilitation programs in international studies. METHODS: Patients were randomly assigned to a conventional heart group or a heart group with Tai Chi exercises. At the beginning of the study, a medical history was taken and physical and instrumental tests were carried out, including an assessment of anxiety/depression (HADS questionnaire) and physical well-being (SD-12). Follow-up tests were performed every three months. RESULTS: Patients were 62.6 ±â€Š8.5 years old, the mean BMI was 28.6 ±â€Š62 kg/m(2), and the proportion of women was 29.8 %. The groups were different in terms of age (conventional heart group: 65.0 ±â€Š7.5; Tai Chi group: 59.9 ±â€Š8.9 years). Therefore, age-adjusted analyses were performed in addition to the planned analyses. Regarding the primary endpoint of the study, there was no difference between the groups. After twelve months, 50 % of subjects were active in the Tai Chi group and 48 % in the conventional heart group (odds ratio 0.92, p = 0.891). After adjustment for age by logistic regression, the odds ratio was 0.47 (p = 0.285). Furthermore, both the participation period in weeks (Tai Chi group: 43.3 ±â€Š26.0; conventional group: 45.5 ±â€Š24.2, p = 0.766) and the participation rate (Tai Chi group: 66.8 ±â€Š19.2 % Tai Chi, conventional group: 76.3 ±â€Š16.5 %, p = 0.074) did not differ between the two groups. A further analysis showed a non-significant trend for improvement of anxiety, depression and physical well-being in the Tai Chi group compared with the conventional group. CONCLUSION: The insight gained in international studies regarding a better adherence to Tai Chi-guided prevention programs was not transferable to heart group participants from Germany. However, there was a trend regarding a better mental condition in the Tai Chi group.

[Malignant meningeal "histiocytosis"]. / Meningeale maligne "Histiozytose".

Two cases of patients with unusual pleomorphic tumors in the meninges are reported. Histologically and immunohistologically, the tumor cells may be histiocytic in appearance. Computed tomography and magnetic resonance imaging scans, however, revealed no lesions in the parenchyma or in the meninges. The cytological examination of the cerebrospinal fluid revealed only a light lymphocytic reaction without tumor cells in both cases and thus led to misinterpretations as meningoencephalitis. One patient presented psychiatric symptoms. Related clinical problems and the possible histogenesis of the tumors are discussed.

[Gastric carcinoid in chronic atrophic gastritis with hypergastrinemia]. / Karzinoid des Magens bei chronisch-atrophischer Gastritis mit hypergastrinämie.

A 51 year-old woman with vomitus, intermittent epigastric pain and heartburn had chronic sideropenic anemia. Gastroscopy revealed a subcardial, submucosal tumor. The tumor was removed totally by endoscopic polypectomy. Histologically it was identified as a carcinoid. The endocrinologic examination showed hypergastrinemia caused by chronic atrophic gastritis. The association of this gastric carcinoid with chronic atrophic gastritis type A, hypergastrinemia, hyperplasia of the gastrin-producing antral cells and micronodular hyperplasia of endocrine cells in the gastric fundus, confirms the hypothesis about the pathogenesis of these extremely rare gastric tumors.

[Carcinoid tumor of the esophagus. A rare differential diagnosis in submucosal esophageal tumor]. / Karzinoid des Osophagus. Eine seltene Differentialdiagnose submuköser Osophagustumoren.

In a 63-yr-old male endoscopy revealed an occlusive submucosal tumor in the upper esophagus. The surgically enucleated tumor was identified histologically and immunohistochemically as a carcinoid. The tumor had no endocrine activity. The localisation of these tumors in the esophagus is an extremely rare condition.

[Successful antibiotic treatment of a pulmonary infection with Nocardia asteroides (biovariety A3)]. / Erfolgreiche antibiotische Behandlung einer pulmonalen Infektion mit Nocardia asteroides (Biovarietät A3).

An open lung biopsy in a 67-year-old man revealed nocardiosis as the cause of a treatment-resistant pulmonary infection. His resistance had been weakened by a non-Hodgkin lymphoma, polychemotherapy and long-term steroid medication. The nocardiosis was cured by a 26-day high-dosage regimen of imipenem and amikacin in combination. A six-month period of co-trimoxazole followed to ensure treatment success. Nocardia asteroides (biovariety A3) was found to be the causative organism, the second time that this has been described as cause of a human infection.

[Rupture of the distal biceps tendon]. / Die Ruptur der distalen Bizepssehne.

Eight avulsions of the distal biceps tendon were operatively treated between 1982 and 1985. The operative procedure and results of subsequent investigations are described. The problems of correlation between injury and trauma and its assessment by histological observations are discussed. The clinical results have been good. So we can recommend the operative method according to Platt.

Chemical changes of human knee joint menisci in various stages of degeneration.

Human knee joint menisci graded according to degenerative alterations were submitted to chemical analysis. Normal menisci contained 72% water, 0.12% DNA, 22% collagen, and 0.8% total glycosaminoglycans with the following glycosaminoglycan distribution pattern: 40% chondroitin 6-sulphate, 10-20% chondroitin 4-sulphate, 20-30% dermatan sulphate, and 15% keratan sulphate. The water content increased with increasing degeneration, whereas the collagen and glycosaminoglycan contents decreased with relative increase of chondroitin 6-sulphate.

Knee joint meniscal degeneration as it relates to tissue fiber structure and mechanical resistance.

Histological examination of knee joint meniscectomy specimens revealed previously undescribed basophilic spindle shaped structures. This study was done to explore their structure, to discuss potential mechanisms for their development and to establish diagnostic criteria. --4000 surgical specimens were examined. The intercellular substance of the cartilage was studied by means of mucopolysaccharide histochemical and polarisation optical methods. The three-dimensional fiber construction was examined stereometrically by means of a procedure derived from the universal stage method of the mineralogists. The spindle-shaped structures seem to be a sign of reduced mechanical tissue resistance. They are performed but become visible during meniscal degeneration. The mechanically efficient element of the menisci is a triple dimensional network of collagen fibers. Longitudinal fibers assure the tension resistance of the tissue. Transverse and diagonal fiber bundles tie the longitudinal fibers together. They act as tension rods. Therefore, compression resistance results. Meniscal degeneration mainly takes place in the tension rod fibers. Therefore, degenerated menisci tend to burst longitudinally. The condition of tension rod fibers in important as an indicator of mechanical resistance of the cartilage. It is a parameter for the assessment of meniscal damage.

The bivalence of juxtaglomerular cells in the maturing rat kidney. A comparative study of secretory and contractile potential.

A comparative immunofluorescence and light microscopical study of the three cell types of the juxtaglomerular apparatus (pure muscle cells, pure granular cells and mixed cells) was performed on the growing and maturing kidney of the rat. Mixed cells, containing contractile protein and secretory granules, are detectable on the first postnatal day in about one third of the JGAs. From the third week, the number of bivalent cells increases, while the proportion of pure muscle or pure granular cells decreases. Morphological and functional maturation, achieved by 3 to 4 weeks, is associated with increasing numbers of bivalent cells and a shift in the main site of renin production from the inner to the outer cortical zone. The divergent internal structure of JGA cell types expresses the range of varied differentiation expressed by one cell line. Pure muscle or granular cells are at the extremes of the range and mixed cells take up an intermediate position.