Health News
Pumped-Up Octogenarians

Researchers are putting a new wrinkle on the stereotypical “muscle man,” giving seniors testosterone to build up strength.

WE USUALLY associate testosterone with pubescent boys and men in their prime. Now USC researcher Fred Sattler is evaluating just how important “the tough-guy hormone” is to the elderly – both men and women.
Scientists have long known that testosterone is the body’s most powerful regulator of muscle mass and strength. As testosterone levels decline in both genders over the course of a lifetime, muscle loss follows.
Skeletal muscle mass drops about 15 percent between the third and eighth decades of life, and as much as 30 percent afterward. This muscle loss, or sarcopenia, is responsible for much of senior citizens’ frailty, typically occurring in areas – the thighs, for example – that can impair the ability to walk, stand and climb stairs. And the deleterious effects don’t end there.
“When you have muscle loss, you lose strength and lose function,” says Sattler, a professor of medicine at the Keck School of Medicine of USC. “When you lose function, you lose independence. And with that, you can have depression and isolation.”
Sattler and post-doctoral colleague Todd Schroeder are looking at a potential way to battle this cycle: giving oral androgens (pill forms of testosterone) to elderly patients.
In the past, androgens have been administered by periodic injections, which were both painful and caused uneven hormone levels; or by skin patches, which sometimes caused rashes. Oral testosterone skirts these problems.
The goal, Sattler explains, is not to flood the system with an excess of androgen, but to return the body to a normal hormone level, such as would be found in a younger person.
In various studies at USC, Sattler is giving trial participants (men between 60 and 85) oral doses of androgens in the hopes of augmenting their muscle and strength. Women may be added later to one of the studies.
Androgen therapy may have other health benefits, such as increasing the body’s sensitivity to insulin, lowering cholesterol and reducing abdominal obesity. It might also help with mood and energy levels.
Study participant Warner “Dutch” Sturtevant, 73, doesn’t know if the pills he takes daily are medicine or a placebo, “but I do feel a little peppier,” he says – and he gained 5 pounds in nine weeks.

– Alicia Di Rado

Why Johnny Can’t Breathe
Smog is a major player in making kids miss school, a new USC preventive medicine study shows.

SCHOOL ABSENCES due to sore throats, coughs, asthma attacks and other respiratory complaints spike in the days following a significant rise in ozone in the

A modest increase in ozone is associated with an 83 percent jump in school absences.
air, according to a study by USC preventive medicine researchers.
Each increase of 20 parts per billion (ppb) of ozone – a common air pollutant – is associated with an 83 percent increase in absences due to respiratory illnesses, says lead researcher Frank Gilliland. Forß a school of 1,000 children, in which 30 children are typically out sick, this would mean a jump to 55 children staying home sick.
If each absence were two days long, the increase would result in an additional 50 days of missed classes per 1,000 students. “Because exposures at the levels observed in this study are common, the increases in school absenteeism from respiratory illnesses ... document an important adverse impact of ozone on children’s health and well-being,” Gilliland says.
The absenteeism study is part of a larger USC initiative known as the Children’s Health Study. Researchers have monitored levels of major pollutants in a dozen Southern California communities since 1993, while carefully tracking the respiratory health of more than 3,000 students.
For this study, they looked at school absences among 2,081 students in the fourth grade at 27 schools during a six-month period in 1996. They called parents after the absences to determine the reason kids had missed school and also tracked daily levels of air pollutants in the surrounding communities. The researchers found that a 20 ppb increase in ozone was associated with a 45 percent increase in absences due to upper respiratory illnesses and a 174 percent increase in lower respiratory illnesses. Effects of the pollution began three to five days after the exposure.
“A 20 ppb increase in ozone from day to day is not a big increase in Southern California,” says Gilliland, an assistant professor in the Keck School of Medicine of USC. On clear days, ozone can average 30 ppb in the Los Angeles basin, while levels on a smoggy day can exceed 100 ppb.
The study was published in the January issue of the journal Epidemiology.

– Alicia Di Rado

In praise of Pork Bellies
Tendon-Loving Care

The lowly swine may get little respect in the barnyard, but he’s winning new admirers among doctors and their patients who suffer from bad shoulders, damaged elbows and other joint problems.
USC orthopedists are using a patch made from pigs’ small intestines to improve healing of surgically repaired tendons.
The patches – commercially known as the Restore Orthobiologic Soft Tissue Implant – are meant to scaffold, or support, tendons while they heal.
Across the country, medical researchers are exploring a variety of uses for implants made from pig intestines, from treating cardiovascular lesions to stopping urinary incontinence. USC orthopedic surgeons – the only orthopedists in Southern California using the patch – are among the leaders in exploring its clinical uses for healing ligament, tendon and muscular problems.
“I use it in surgery if the damaged tendon looks tenuous or appears at risk of rupturing again,” says John M. Itamura, an orthopedic surgeon at the Keck School of Medicine of USC. Over time, the body creates new tissue around the area, absorbs the implanted patch and eliminates it through the urine in two to four months.
More than 30 of Itamura’s patients have received patches for rotator cuff or elbow problems. Though it is too early to assess results from the patch, Itamura has not yet seen any drawbacks.
Pig tissue – specifically the small intestinal submucosa that forms the middle layers of the intestinal wall – appears to have reviving properties. The material is a mixture of naturally occurring collagen, a key component of tendons and ligaments, as well as proteins.
Because the material has no cellular components, the body accepts it more readily with less risk of rejection. In contrast to mechanical devices, too, the patches seem to stimulate the growth of new blood vessels and are infection resistant.
Traditionally, surgeons have had to graft patients’ own tissue or donated tissue to reinforce lost or damaged tendons or ligaments. The new patches allow for reinforcing tendons without invasive removal of other tendons or ligaments.

– Alicia Di Rado
Of Good Cheer

Why does America love its cheerleaders so? Enquiring Scots want to know. In a feature article, the Glasgow Herald probed the enduring charm of organized sport’s perky pom-pom girls. While their prestige has taken a dip since the golden era of cheerleading – from high school royalty in the 1950s and 1960s to frequent objects of parody in recent decades – these peripatetic pepsters remain the darlings of Hollywood and Madison Avenue. “Cheerleaders are bundles of contradictions,” opined USC communications scholar Sarah Banet-Weiser, author of a book on the culture of beauty pageants. “And it’s a contradiction that’s sexy,” she told the Herald – sanctioned by the administration,
Photograph by Michele A.H. Smith / Suburbia illustration by Michael Klein / Population illustration by A.J. Garces