Long-Term Effects of Specific Stabilizing Exercises for First-Episode Low Back Pain

Study Design. A randomized clinical trial with 1-year and 3-year telephone questionnaire follow-ups. Objective. To report a specific exercise intervention’s long-term effects on recurrence rates in acute, first-episode low back pain patients. Summary of Background Data. The pain and disability associated with an initial episode of acute low back pain (LBP) is known to resolve spontaneously in the short-term in the majority of cases. However, the recurrence rate is high, and recurrent disabling episodes remain one of the most costly problems in LBP. A deficit in the multifidus muscle has been identified in acute LBP patients, and does not resolve spontaneously on resolution of painful symptoms and resumption of normal activity. Any relation between this deficit and recurrence rate was investigated in the long-term. Methods. Thirty-nine patients with acute, first-episode LBP were medically managed and randomly allocated to either a control group or specific exercise group. Medical management included advice and use of medications. Intervention consisted of exercises aimed at rehabilitating the multifidus in cocontraction with the transversus abdominis muscle. One year and three years after treatment, telephone questionnaires were conducted with patients. Results. Questionnaire results revealed that patients from the specific exercise group experienced fewer recurrences of LBP than patients from the control group. One year after treatment, specific exercise group recurrence was 30%, and control group recurrence was 84% (P , 0.001). Two to three years after treatment, specific exercise group recurrence was 35%, and control group recurrence was 75% (P , 0.01). Conclusion. Long-term results suggest that specific exercise therapy in addition to medical management and resumption of normal activity may be more effective in reducing low back pain recurrences than medical management and normal activity alone. [Key Words: multifidus, low back pain, rehabilitation]

Tissue-specific induction of SOCS gene expression by PRL

The mechanisms whereby tissue sensitivity to PRL is controlled are not well understood. Here we report that expression of mRNA and protein for members of the SOCS/CIS/JAB family of cytokine signaling inhibitors is increased by PRL administration in ovary and adrenal gland of the lactating rat deprived of circulating PRL and pups for 24 h but not in mammary gland. Moreover, suckling increases SOCS mRNA in the ovary but not in the mammary gland of pup-deprived rats. Deprivation of PRL and pups for 48 h allows the mammary gland to induce SOCS genes in response to PRL administration, and this is associated with a decrease in basal SOCS-3 mRNA and protein expression to the level seen in other tissues, suggesting that SOCS-3 induced refractoriness related to filling of the gland. In reporter assays, SOCS-1, SOCS-3, and CIS, but not SOCS-2, are able to inhibit transactivation of the STAT 5-responsive beta -lactoglobulin promoter in transient transfection assays. Moreover, suckling results in loss of ovarian and adrenal responsiveness to PRL administered 2 h after commencement of suckling, as determined by STAT 5 gel shift assay. Immunohistochemistry was used to localize the cellular sites of SOCS-3 and CIS protein expression in the ovary and adrenal gland. We propose that induced SOCS-1, SOCS-3, and CIS are actively involved in the cellular inhibitory feedback response to physiological PRL surges in the corpus luteum and adrenal cortex during lactation, but after pup withdrawal, the mammary gland is rendered unresponsive to PRL by increased levels of SOCS-3.

Specific manipulative therapy treatment for chronic lateral epicondylalgia produces uniquely characteristic hypoalgesia

The treatment of lateral epicondylalgia, a widely-used model of musculoskeletal pain in the evaluation of many physical therapy treatments, remains somewhat of an enigma. The protagonists of a new treatment technique for lateral epicondylalgia report that it produces substantial and rapid pain relief, despite a lack of experimental evidence. A randomized, double blind, placebo-controlled repeated-measures study evaluated the initial effect of this new treatment in 24 patients with unilateral, chronic lateral epicondylalgia. Pain-free grip strength was assessed as an outcome measure before, during and after the application of the treatment, placebo and control conditions. Pressure-pain thresholds were also measured before and after the application of treatment, placebo and control conditions. The results demonstrated a significant and substantial increase in pain-free grip strength of 58% (of the order of 60 N) during treatment but not during placebo and control. In contrast, the 10% change in pressure-pain threshold after treatment, although significantly greater than placebo and control, was substantially smaller than the change demonstrated for pain-free grip strength. This effect was only present in the affected limb. The selective and specific effect of this treatment technique provides a valuable insight into the physical modulation of musculoskeletal pain and requires further investigation. (C) 2001 Harcourt Publishers Ltd.

Weketrema gen.n., a new genus for Weketrema hawaiiense (Yamaguti, 1970) comb. n. (Digenea : Lecithasteridae) recently found in Australian marine fishes

A new genus, Weketrema, is erected in the family Lecithasteridae for the species hitherto known as Lecithophyllum hawniiense. Weket, ema hawaiiense (Yamaguti, 1970) comb, n. is redescribed from Scolopsis bilineatus (Bloch) (Perciformes: Nemipteridae) from Lizard Island and Heron Island, Queensland, Plectorhinchus gibbosus (Lacepede) (Perciformes: Haemulidae) from Heron Island and Cheilodactylus nigripes Richardson (Perciformes: Cheilodactylidae) and Latridopsis forsteri (Castelnau) (Perciformes: Latridae) from Stanley, northern Tasmania. The new genus is distinguished from related members of the family Lecithasteridae by its complete lack of a sinus-sac. Although placed in the subfamily Lecithasterinae pro tem, its true subfamily position is not entirely clear. Comment is made on its unusual distribution, both in terms of zoogeography and hosts.

Tormopsolus attenuatus n. sp (Digenea : Acanthocolpidae) from Seriola hippos (Perciformes : Carangidae), Western Australia, with some observations on the relationships in the genus

A new acanthocolpid, Tormopsolus attenuatus n. sp., is described from the carangid Seriola hippos from waters off the coast of SW Australia. A cladistic analysis of the genus using 31 morphological and metrical characters indicates that the closest species is T. asiatica Parukhin, 1976 status amend. (previously T. orientalis asiatica). T. attenuatus differs from T. asiatica in its smaller overall dimensions, more attenuated outline, relatively shorter post-testicular region, vitelline interruption at the level of the ovary, papillae on the oral sucker and, possibly, much longer genital atrium. Other similar species, T. orientalis Yamaguti, 1934 and T. medius Reimer, 1983, differ in having interruptions of the vitelline fields at the level of both testes and at the level of the ovary.

Lecithophyllum kitrii n. sp (Digenea : Lecithasteridae) from Australian coral reef fishes of the genus Siganus

Lecithophyllum kitrii n. sp. is described from Siganus punctatus and S. lineatus off Heron Island on the southern Great Barrier Reef, Australia. It differs from most other species in the genus in its elongate pars prostatica and globular sinus-sac, and from all other species in having the seminal vesicle almost always entirely in the hindbody.

Comparison of competitively primed and conventional allele-specific nucleic acid amplification

A simulation of competitively primed allele-specific DNA amplification has been constructed and its behavior examined, This has shown that when the ratio of the amount of homoduplex misprime product to the total amount of amplimer is low, it increases by approximately one-fourth of the mispriming frequency with each doubling of the total amount of amplimer, When the ratio is high acid reverse mispriming becomes significant, it asymptotes toward a value

Four new species of Macropodinium (Ciliophora : Litostomatea) from Australian wallabies and pademelons

Samples of Macropodinium spp. were collected from 3 new macropodid species: from 21 of 28 (75%) black-striped wallabies (Macropus dorsalis); 10 of 11 (91%) swamp wallabies (Wallabia bicolor); and 22 of 43 (51%) Tasmanian pademelons (Thylogale billardierii). The examination of ciliate morphology by silver impregnation and scanning electron microscopy led to the redescription of the genus Macropodinium and the description of 4 new species: Ma. tricresta sp. nov. and Ma. spinosus sp. nov. from M. dorsalis; Ma. maira sp. nov. from T. billardierii; and M. bicolor sp. nov. from W. bicolor; each species was strictly host specific. Cellular orientation was reinterpreted on the basis of vestibular morphology and it is concluded that Macropodinium spp. are laterally rather than dorso-ventrally compressed. The striated groove is thus dorso-ventral rather than lateral. Oral ciliation consisted of up to three bands: an adoral band composed of oblique kineties; a vestibular band of longitudinal kineties; and a preoral band of longitudinal kineties. Somatic ciliation occurred in two longitudinal bands: a dense band composed of several parallel kineties on the left side of the dorso-ventral groove; and a sparse band composed of a single kinety on the right internal side of the dorso-ventral groove. Few structures were homologous to those of other litostome ciliates, and thus the relationship of Macropodinium to other litostomes cannot yet be clearly defined.

The upper Paleozoic miospore genus Spelaeotriletes Neves and Owens, 1966, and constituent Gondwanan species

The upper Paleozoic miospore genus Spelaeotriletes Neves and Owens, 1966 is reviewed as a morpho-taxonomic entity and vis-a-vis other similarly constructed (pseudosaccate) genera - Geminospora Balme, 1962, Grandispora Hoffmeister, Staplin, and Malloy, 1955, Rhabdosporites Richardson, 1960, and Retispora Staplin, 1960. Detailed studies of numerous, mainly topotype specimens of Spelaeotriletes ybertii (Marques-Toigo, 1970) Playford and Powis, 1979 from the Lower Permian of Uruguay result in its re-diagnosis, in conjunction with a survey of its exclusively Gondwanan occurrences, particularly in South American strata extending from the Upper Carboniferous (Westphalian) into the Lower Permian, and also in Australian strata of approximately equivalent age. The characteristics of other species of Spelaeotriletes reported from upper Paleozoic deposits of Gondwana are discussed, as are their temporal representations in various broad regions of the supercontinent (South America, North Africa, Australia). These species include two, perhaps three, that, like Spelaeotriletes triangulus/arenaceus, are known also from Euramerica - S. balteatus (Playford, 1963) Higgs, 1996, S. pretiosus (Playford, 1964) Utting, 1987, and possibly S. owensii Loboziak and Alpern, 1978. Other species, such as S. benghaziensis Loboziak and Clayton, 1988, S. giganteus Loboziak and Clayton, 1988, and S. vibrissus Playford and Satterthwait, 1988, have, on present knowledge, exclusively Gondwanan occurrences. S. queenslandensis Jones and Truswell. 1992, known only from Upper Carboniferous strata of northeastern Australia, is formally reassigned on sculptural grounds to Grandispora. Not unexpectedly in a paleogeographic perspective, North Africa and South America are more closely allied with each other than with Australia in terms of shared species of Spelaeotriletes. (C) 2001 Elsevier Science Ltd. All rights reserved.

A new genus of viviparous gyrodactylid (Monogenea) from the Great Barrier Reef, Australia with descriptions of seven new species

Acanthoplacatus gen. nov., a new genus of viviparous gyrodactylid, is described from the rns and skin of siganid fishes from the Great Barrier Reef, Australia. The genus is characterized by a muscular, tube-like haptor with 16 marginal hooks on the posterior margin. The ventral lobe of the haptor is located anteriorly relative to the dorsal lobe and contains a pair of hamuli and a ventral bar with posteriorly-projecting ventral bar membrane. A dorsal bar is absent. Five pairs of posterior gland cells surround the posterior terminations of the gut. The male copulatory organ is a muscular, non-eversible bulb with several spines around the distal opening. Species of Acanthoplacatus have a bilateral excretory system consisting of six pairs of flame cells and a pair of excretory bladders. Seven new species are described: Acanthoplacatus adlardi sp. nov. and A. amplihamus sp. nov. from Siganus punctatus (Forster, 1801), A. brauni sp. nov. from S. corallinus (Valenciennes, 1835), A. parvihamus sp. nov. from S. vulpinus (Schlegel and Mueller, 1845), A. puelli sp. nov. from S. puellus Schlegel, 1852, A. shieldsi sp. nov. from S. lineatus (Valenciennes, 1835) and A. sigani sp. nov. from S. fuscescens (Houttuyn, 1782). Species can be discriminated by shape and size of the hamuli, marginal hooks and ventral bar and by male copulatory organ sclerite morphology. Three species (A. brauni sp. nov., A. shieldsi sp. nov. and A. sigani sp. nov.) were assessed for seasonal variation of sclerite size. Ten of thirteen morphological characters showed seasonal variation in size for at least one of the species. The characters were longer in winter except dorsal root tissue cap width. Only one character, marginal hook length, showed significant seasonal variation for all three species. Species of Acanthoplacatus were observed to attach using only the marginal hooks and the role of hamuli in attachment is unclear. The dorsal rn of the host is the preferred site for most species but the anal fin, caudal fin and body surfaces are preferred by some species. Prevalences for species range from 57 to 100%.

Targeting of EBNA1 for rapid intracellular degradation overrides the inhibitory effects of the Gly-Ala repeat domain and restores CD8+T cell recognition

Epstein-Barr virus (EBV)-encoded nuclear antigen 1 (EBNA1) includes a unique glycine-alanine repeat domain that inhibits the endogenous presentation of cytotoxic T lymphocyte (CTL) epitopes through the class I pathway by blocking proteasome-dependent degradation of this antigen. This immune evasion mechanism has been implicated in the pathogenesis of EBV-associated diseases. Here, we show that cotranslational ubiquitination combined with N-end rule targeting enhances the intracellular degradation of EBNA1, thus resulting in a dramatic reduction in the half-life of the antigen. Using DNA expression vectors encoding different forms of ubiquitinated EBNA1 for in vivo studies revealed that this rapid degradation, remarkably, leads to induction of a very strong CTL response to an EBNA1-specific CTL epitope. Furthermore, this targeting also restored the endogenous processing of HLA class I-restricted CTL epitopes within EBNA1 for immune recognition by human EBV-specific CTLs. These observations provide, for the first time, evidence that the glycine-alanine repeat-mediated proteasomal block on EBNA1 can be reversed by specifically targeting this antigen for rapid degradation resulting in enhanced CD8+ T cell-mediated recognition in vitro and in vivo.

Adoptive transfer of autologous Epstein-Barr virus-specific cytotoxic T cells for nasopharyngeal carcinoma

Tumor cells from NPC patients are regularly and latently infected with EBV. To examine whether the virus serves as target for immune intervention of the cancer, we determined levels of EBV-specific CTLp in peripheral blood from NPC patients, long-term survivors of the cancer and healthy subjects. CTLp levels of test subjects varied between 3-3,000/10(6) PBMCs. The plasma EBV burden increased when the CTLp level fell below 150, whereas the EBV burden of PBMCs was not correlated with CTLp level. Compared with healthy carriers, CTLp levels of patients were lower and varied over a wider range, between 3-1,500/10(6) PBMCs. The quantitative immune deficit was probably attributed to the tumor because, first, CTLp in survivors was restored to levels similar to those in healthy carriers after the tumor had been successfully treated. Second, the CTLp level changed as disease progressed, being lower in local disease, increased in locoregional disease and decreased again when the tumor metastasized. Based on these findings, 4 patients with advanced disease were infused with 5 x 10(7)-3 x 10(8) autologous EBV CTLs. The treatment was safe and unaccompanied by inflammatory or other complications, but whether it improved tumor control could not be discerned from the large tumor bulk. Nevertheless, the treatment regularly increased CTLp levels of patients, maintained it at higher levels for protracted periods and, in 3 patients, restored host surveillance of EBV replication, reducing the plasma EBV burden. Taken together, these results provided a rationale to further explore EBV as a target of immune intervention of NPC. (C) 2001 Wiley-Liss, Inc.