[Knee school as a secondary preventive approach : The sustainable treatment of occupational gonarthrosis]. / Das Kniekolleg als sekundärpräventiver Ansatz : Die nachhaltige Behandlung berufsbedingter Gonarthrose.

BACKGROUND: 2-6 months after successful medical rehabilitation in gonarthrosis, the positive effects remit without the implementation of adequate aftercare strategies. OBJECTIVES: A prospective comparative study aimed to investigate whether and to what extent the sustainability model of knee school for the secondary preventive treatment of occupational gonarthrosis is able to maintain positive treatment effects in the medium term. MATERIAL AND METHODS: A total of 292 male employees from the building trade went through the three-week phase 1 of the biopsychosocial knee college with a focus on ergonomics and muscle strength training. In the following 12 months (Phase 2), the participants were contacted several times by telephone in order to motivate them to continue the training. While 178 employees voluntarily and locally continued their training in selected fitness centers with financial support (VG 1), and 38 employees opted for an individual home program (VG 2), 76 participants stopped all training (KG). RESULTS: After Phase 1, all groups showed significant improvements in the parameters mobility, as well as stretch ability and strength endurance of the thigh muscles, complaints of the knee and quality of life. While the parameters in VG 1 continued to develop positively after 12 months, the measured values in VG 2, with the exception of muscle strength, moderately remitted. By contrast, a significant decline in the measurement values partly below the status quo ante was observed for the KG. CONCLUSIONS: As part of the aftercare, financially supported training in a fitness center with accompanying regular telephone contacts for male construction workers with knee discomforts shows positive effects if the participation is voluntary. Organized training in the fitness center is superior to individual home programs.

The influence of thyroid and testicular hormones on globule leucocytes in the rat duodenal crypt epithelium.

The globule leucocyte is a cell with a wide distribution in the digestive, respiratory, biliary, urinary and genital tract epithelia of homeotherms. It occurs in the crypts of the rat small intestine and within the epithelium on the villous bases but not on the remainder of the villi. A characteristic feature of this cell is the presence of acidophilic cytoplasmic granules, 0.5 to a few micrometers in diameter. The nucleus resembles that of intraepithelial intestinal lymphocytes. In this investigation, a quantitative study was made of the effect of thyroidectomy and/or castration on the number of globule leucocytes in the duodenal crypts of immature and adult rats. In sham-operated rats, globule leucocytes were rare, occurring with a frequency of 1 or 2 per 1,000 epithelial cells. After thyroidectomy, they increased to 14--20 per 1,000 epithelial cells. Castration did not influence the number of globule leucocytes but resulted in an increase in the number, size and acidophilia of their cytoplasmic granules. In immature rats, but not in adults, castration combined with thyroidectomy enhanced the effect of thyroidectomy, increasing globule leucocyte number to 32 per 1,000 epithelial cells. Treatment of thyroidectomized-castrates with thyroxine, initiated 38 days after operation, reduced the crypt globule leucocyte population to normal, whereas treatment with testosterone did not. Growth hormone failed to influence the elevated number of globule leucocytes in thyroidectomized rats, suggesting that this action of thyroxine was not mediated via an influence on growth hormone release. Because of their similar nuclear morphology, intraepithelial crypt lymphocytes were also counted and there was no obvious relationship in the fluctuations of these two cell populations. It is suggested that the greater number of crypt globule leucocytes in thyroid deficiency may reflect changes in the intestinal secretory immunoglobulin system and this is being investigated, beginning with a study of the distribution of IgE.