Steroids and the reversal of age-associated changes in myelination and remyelination.

The myelin sheaths that surround all but the smallest diameter axons within the mammalian central nervous system (CNS) must maintain their structural integrity for many years. Like many tissues, however, this function is prone to the effects of ageing, and various structural anomalies become apparent in the aged CNS. Similarly, the regenerative process by which myelin sheaths, lost as a consequence of exposure to a demyelinating insult, are restored (remyelination) is also affected by age. As animals grow older, the efficiency of remyelination progressively declines. In this article, we review both phenomena and describe how both can be partially reversed by steroid hormones and their derivatives.

Concomitant therapy with anxiolytics or hypnotics and maintenance of initial SSRI therapy.

We conducted a retrospective analysis to evaluate the relationship between anxiolytic or hypnotic therapy and maintenance of therapy with selective serotonin reuptake inhibitors (SSRIs). Subjects were 654 patients who received anxiolytics or hypnotics early in SSRI therapy (study group ) and 15,172 patients who did not (controls). Maintenance of SSRI therapy was evaluated during the 6 months after start of therapy and included days of initial SSRI therapy and rates of discontinuation, defined as a break of more than 30 days. Rates of discontinuation in study and control groups (84% and 77%, p=0.001) and average days of initial SSRI therapy (77 and 94 days, p<0.0001) were statistically different. Thus patients receiving anxiolytic or hypnotics in the first 60 days of therapy were less likely to continue initial SSRI therapy.

The effectiveness of an early active intervention program for workers with soft-tissue injuries. The Early Claimant Cohort Study.

STUDY DESIGN: A prospective cohort of approximately 1600 injured workers off work because of soft-tissue musculoskeletal problems was followed for 1 year through a series of structured telephone interviews. OBJECTIVE: To determine the effectiveness of a Workers' Compensation Board-sponsored early, active, exercise and education program based in the community in comparison to "usual" care. SUMMARY OF BACKGROUND DATA: The program established in 1990 was available in more than 100 clinics. Results from an earlier pilot study indicated lower overall claims costs for workers attending the program compared with non-attenders. METHODS: Subjects were recruited at the time of Workers' Compensation Board claim registration. Routinely collected data and self-reported responses to demographic, quality-of-life, functional status, pain, recovery expectations, and workplace response to injury questions were used to determine selection factors for community clinic attendance. Economic and non-economic outcomes were compared for clinic attenders and non-attenders. RESULTS: For the 885 male and female new back problem cases in the study, overall clinic attenders were not systematically different from non-attenders at baseline. Analysis of duration of benefits showed no significant difference between attenders and non-attenders, although health care costs for clinic attenders were significantly higher. Functional status, health-related quality-of-life, and pain measures all improved significantly throughout time for both groups, bit there were no statistically significant differences in rate of improvement. CONCLUSION: There was no advantage from the program compared with usual care on the outcomes measured-a finding consistent with recent studies that examined the longer-term effectiveness of other interventions in the first few weeks of back pain symptoms.

"She looked at me crazy": escalation of conflict through telegraphed emotion.

This exploratory study investigated a feature of adolescent social interaction that can quickly initiate or escalate conflict: telegraphed emotion (a specific emotion conveyed through a subset of its expressive components or through a brief, extreme display of the complete expression; Shields & Maybury, manuscript in preparation). In the form of "the look," telegraphed emotion conveys intensely felt, yet controlled, affect. Using focus groups, teenage females were asked to define the look and to discuss its use, such as who employs it, when it is used, and the consequence of using the look. They reported that the look has different meanings depending on whether it is directed at a friend or a nonfriend, and whether it is used by females or males. With friends, the purpose is to communicate anger, sadness, or disgust; with nonfriends, it indicates disgust or anger, but within a framework of asserting power or status. The look often results in escalation of conflict, especially a verbal or physical fight. These findings are discussed, and the implications for investigating and preventing adolescent interpersonal conflict are explored.

Fear of male homosexuality: cardiac responses of low and high homonegative males.

Males with high negative attitudes toward male homosexuality are often referred to in research as homophobics, yet it is unknown whether high homonegative males actually exhibit physiological responses characteristic of phobics. In a series of studies, heart rate was monitored in males with high or low negative attitudes toward male homosexuality as they viewed slides of landscapes and slides depicting explicit sexual activity. If high homonegativity is equivalent to homophobia, high homonegative males should exhibit heart rate acceleration to slides of male-male sexual activity, but, like low homonegative males, deceleration to all other slide types. Significant group effects were obtained only in the pilot study. Examination of individual response patterns in the pilot study and the two subsequent studies showed that high homonegative attitudes were necessary but not sufficient for heart rate acceleration to male-male slides. Results confirm the existence of the phobic type of heart rate acceleratory pattern among some, but not all, high homonegative males.

Is awareness of bodily change in emotion related to awareness of other bodily processes?

To what extent is reported attentiveness to bodily responses in emotion predicted by a general disposition to be attentive to one's normal, nonemotive bodily processes? University undergraduates (373 women and 167 men) completed the modified Autonomic Perception Questionnaire (APQ-R; Mandler, Mandler, & Uviller, 1958; Shields, 1984) for one of two target emotions, anger and transient anxiety, and the Body Awareness Questionnaire (BAQ; Shields, Mallory, & Simon, 1989), a measure of attentiveness to nonemotive bodily processes. In addition, the Body subscale, part of a Love Symptom Checklist concerning symptoms of romantic love was completed by 246 of these subjects. We predicted that the two measures of attentiveness to bodily response in emotion would be more strongly related to each other than to the BAQ. Significant low positive correlations between APQ-R and BAQ scores were obtained for each sex for both anger and anxiety. Correlations between the Body subscale and the APQ-R were high, positive, and significant, but correlations with the BAQ were near zero. Hierarchical multiple regression analyses showed that of the three variables entered (subject sex, Body subscale scores, and BAQ scores), the greatest change in explained APQ-R variance was accounted for by the Body subscale scores. This pattern of results was replicated in a second study of 56 women and 42 men. Results are discussed with reference to detected arousal in emotion and beliefs about emotion symptoms.

The Body Esteem Scale: multidimensional structure and sex differences in a college population.

Norms and reliability and validity data are presented for an objectively scored Body Esteem Scale. Factor analysis of the scale revealed that body esteem is a multidimensional construct which differs for males and females. For males, the body esteem dimensions dealt with physical attractiveness, upper body strength, and physical condition. For females, the dimensions dealt with sexual attractiveness, weight concern, and physical condition. The three aspects of males' body esteem were more highly intercorrelated than those of the females, indicating a greater degree of body esteem differentiation for females than for males.

Schwann cell remyelination is restricted to astrocyte-deficient areas after transplantation into demyelinated adult rat brain.

The ability to generate large numbers of Schwann cells from a peripheral nerve biopsy makes them potential candidates for the clinical application of cell transplantation to enhance remyelination in human demyelinating disease. Transplant-derived Schwann cell remyelination has previously been demonstrated in the spinal cord but not for demyelinated axons in the brain, a more likely site for initial clinical intervention. We have transplanted Schwann cells from male neonatal rat sciatic nerves into ethidium bromide-induced areas of demyelination in the deep cerebellar white matter of adult female rats. The extent of Schwann cell remyelination 28 days after transplantation was significantly increased in lesions that received direct injections of Schwann cells compared with non-transplanted lesions. Using in situ hybridisation to identify the rat Y chromosome, transplanted male cells were found to co-localise with the P0 immunoreactive area of Schwann cell remyelination. Combined immunohistochemistry and in situ hybridisation confirmed that many remyelinating Schwann cells were transplant-derived. P0 immunoreactivity and transplanted male cells were found in GFAP-negative, astrocyte-free areas. Transplanted Schwann cells were not identified outside of transplanted lesions, nor did they did not contribute to remyelination of a lesion at a distance from the site of transplantation. Our findings indicate that demyelinated axons in the adult brain can be remyelinated by transplanted Schwann cells but that migration and remyelination are restricted to areas from which astrocytes are absent.

Characterisation of inflammatory cells associated with "idiopathic retroperitoneal fibrosis".

During ureterolysis in a patient with "idiopathic retroperitoneal fibrosis", fresh samples of peri-ureteric and peri-aortic tissue were obtained. An abdominal CT scan confirmed the peri-aortic distribution of the inflammation associated with advanced abdominal aortic atherosclerosis. Histology confirmed the presence of fibrosis and a variable chronic inflammatory cell infiltrate. Monoclonal antibodies were used to identify the inflammatory cells. B and T lymphocytes were present with the majority of T lymphocytes of the T helper phenotype. The majority of lymphocytes and macrophages and most vascular endothelial cells were HLA-DR positive. Ki67 and BerH2 staining was found in B cells and T helper cells, indicating that these cells were proliferating and activated. These findings compare with the characterisation of inflammatory cells associated with "inflammatory aneurysms" and with the inflammatory cells present in the spectrum of inflammation seen as a complication of advanced atherosclerosis--conditions known as "chronic peri-aortitis". It is suggested that our findings support the view that idiopathic retroperitoneal fibrosis represents clinical chronic peri-aortitis seen in an undilated aorta.

Remyelination occurs as extensively but more slowly in old rats compared to young rats following gliotoxin-induced CNS demyelination.

Age is one of the many factors that influence remyelination following CNS demyelination, although it is not clear whether it is the extent or rate of remyelination that is affected. To resolve this issue we have compared remyelination in young and old adult rat CNS following gliotoxin-induced demyelination. Remyelination of areas of ethidium bromide-induced demyelination in the caudal cerebellar peduncle reached completion by 4 weeks in young adult rats (2 months) but was not complete until 9 weeks in old adult rats (9-12 months). We have also shown that remyelination of lysolecithin-induced demyelination in the spinal white matter of old adult rats (18 months) can be extensive, with longer survival times (8 weeks) than have previously been examined. Thus, it is the rate rather than the extent of remyelination that changes in the ageing CNS. These results have important implications for understanding the mechanisms of remyelination, indicating that remyelination need not occur rapidly for it to be extensive. The capacity for the process of remyelination to continue over many weeks must also be borne in mind when assessing remyelination-enhancement strategies either by transplantation or promotion of endogenous mechanisms.

Southern bean mosaic virus RNA remains associated with swollen virions during translation in wheat germ cell-free extracts.

L-[35S]Methionine-labeled translation complexes were prepared by incubating either swollen intact southern bean mosaic virus (SBMV) particles or unencapsidated SBMV RNA in a wheat germ extract. The complexes were analysed by sucrose gradient centrifugation and by electron microscopy and dot blot hybridization of fractions from these gradients. In these complexes, 80 S ribosomes appeared to be associated with intact or near intact particles, suggesting that SBMV particles disassemble only after their RNA has initiated translation. This is in contrast to some other isometric viruses, such as turnip yellow mosaic virus, which appear to release their RNA rapidly prior to translation.

Systemic progesterone administration results in a partial reversal of the age-associated decline in CNS remyelination following toxin-induced demyelination in male rats.

In order to establish the effects of systemically administered progesterone on central nervous system (CNS) remyelination, a toxin-induced model of CNS demyelination was used in which the rate of remyelination is age-dependent. The rapid remyelination in young adult rats allowed an assessment of potential adverse effects of progesterone while the slow remyelination in older adult rats allowed an assessment of its potentially beneficial effects. There was no significant difference in the rate of remyelination between young control and treated animals. However, a modest but significant increase in the extent of oligodendrocyte remyelination in response to progesterone (and a comparable significant decrease in the proportion of axons that remained demyelinated) was observed in older rats 5 weeks after lesion induction. We also found a significant increase in the proportion of Schwann cell remyelinated axons between 3 and 5 weeks after lesion induction that was not apparent in the control animals. These results indicate that progesterone does not inhibit CNS remyelination and that it has a positive modulating effect on oligodendrocyte remyelination in circumstances where it is occurring sub-optimally.

Upper limb work-related musculoskeletal disorders among newspaper employees: cross-sectional survey results.

At a metropolitan newspaper office in Canada with extensive video display terminal (VDT) use, researchers carried out a survey (n = 1,007, 84% response) to establish baseline prevalence of work-related musculoskeletal disorders (WMSDs) and to identify demographic, postural, task, and psychosocial factors associated with WMSD symptoms. One-fifth of the respondents reported moderate or worse upper limb pain recurring at least monthly or lasting more than a week over the previous year. Logistic regression showed that employees who faced frequent deadlines and high psychological demands (fast work pace and conflicting demands), had low skill discretion and social support, spent more time keyboarding, or who had their screen in a non-optimal position were more likely to report moderate to severe symptoms. Women reported significantly higher levels of symptoms than men.