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Biomedical subjects

J M Steinacker

Publications and source records attributed to J M Steinacker.

At least 37 records · Page 2Linked to original sources

Ultra-triathlon-related blood-chemical and endocrinological responses in nine athletes.

BACKGROUND: Objective of this study was to get more insight in hematology, biochemistry, and endocrinology of ultra-endurance exercise, to improve knowledge in this field, supplementation, and medical care of affected athletes. METHODS: A large body of individual hematological, biochemical, and endocrinological parameters was analyzed in the blood taken from ultra-athletes before and after completing the 1993 Colmar ultra triathlon covering 7.5 km swimming, 360 km cycling, and approximately 85 km running. PARTICIPANTS: Nine experienced ultra-athletes participated in the study. A follow-up was not possible since the athletes left Colmar within 24 hrs after the contest. RESULTS: The athletes finished the ultra-contest at rankings 4, 5, 7, 8, 9, 11, 18, 22, 23 in a total time between 23:38:53 and 27:54:30 hr:min:sec. Their final body mass (68.6 +/- 1 kg) was significantly lower than at baseline (71.9 +/- 4.2 kg). Non of the athletes made use of medical care. Data after this contest reflect mild hyponatremia, intravascular hemolysis, increased triglyceride turnover, acute-phase reaction, hyperaldosteronemia 2061 +/- 1013 pmol.L-1), hypercortisolemia 971 +/- 486 nmol.L-1), hyper-growth-hormonemia (median 6.8 ng.ml-1), hypoinsulinemia, hypo-free-testosteronemia (42 +/- 17 pmol.L-1), protein catabolism, depressed testicular function, oliguria, and muscle cell leakage. CONCLUSIONS: In our opinion, data presented do not reflect any acute health risks in healthy athletes who are well prepared and carefully supplied during such a contest.

Adult↗

Validation of the acetylene rebreathing method for measurement of cardiac output at rest and during high-intensity exercise.

The use of the acetylene rebreathing method to estimate cardiac output (CO) during high-intensity exercise, which may be influenced by recirculation of acetylene, has not been validated. This study was designed to validate the acetylene rebreathing method to measure CO during high-intensity exercise using the direct Fick method. CO was measured at rest and during exercise at 25%, 50%, 75% and 90% of the nine subjects' maximum oxygen uptake (VO2max) by the direct Fick and acetylene rebreathing method. CO measured by the acetylene rebreathing method correlated with work rate (r = 0.90, P < 0.01) and with oxygen uptake (r = 0.94, P < 0.01). The correlation coefficient of CO between both methods was r = 0.91 (P < 0.01). There was no significant difference in CO measured by each method at rest as well as at each work rate. The difference in CO between each method was greater at lower CO than at higher CO. At 90% of VO2max, the CO measured by acetylene rebreathing was nearly identical to that measured by the Fick method. It can be concluded that acetylene rebreathing for measurement of CO is valid not only at rest but also during exercise, especially during high-intensity exercise.

Acetylene↗

Effect of felodipine on regional blood supply and collateral vascular resistance in patients with peripheral arterial occlusive disease.

This double-blinded, randomized, placebo-controlled study was designed to investigate the acute effect of felodipine on regional blood supply and collateral vascular resistance in patients with peripheral arterial occlusive disease (PAOD). Thirty men with PAOD were treated with a single dose of 5 mg felodipine or placebo. Systolic blood pressure (SBP), Doppler ankle pressure (DAP), calf blood flow (CBF) by venous occlusion plethysmography and calf transcutaneous oxygen tension (tcpO2) were measured during a cycle ergometry. Felodipine reduced SBP significantly (from 149 to 136 mmHg, p < 0.05), while placebo did not. DAP increased slightly but not significantly in both groups. The pressure gradient between SBP and DAP fell significantly in the felodipine group (60 vs 39 mmHg, p < 0.01) but not in the placebo group (59 vs 56 mmHg). There was a trend for lower velocity in tcpO2 decrease during the stress test and higher velocity of tcpO2 increase during recovery from exercise in the felodipine group although the differences between both groups were not significant. In the felodipine group, CBF increased by 35.6% (p < 0.05) whereas it did not change in the placebo group. In conclusion, while lowering SBP, felodipine increased slightly, or at least maintained, the blood supply to the calves in PAOD patients, which probably results from reducing collateral vascular resistance.

Adult↗

Training and overtraining: an overview and experimental results in endurance sports.

Overtraining can be defined as "training-competition > > recovery imbalance", that is assumed to result in glycogen deficit, catabolic > anabolic imbalance, neuroendocrine imbalance, amino acid imbalance, and autonomic imbalance. Additional non-training stress factors and monotony of training exacerbate the risk of a resulting overtraining syndrome. Short-term overtraining called overreaching which can be seen as a normal part of athletic training, must be distinguished from long-term overtraining that can lead to a state described as burnout, staleness or overtraining syndrome. Persistent performance incompetence, persistent high fatigue ratings, altered mood state, increased rate of infections, and suppressed reproductive function have been described as key findings in overtraining syndrome. An increased risk of overtraining syndrome may be expected around 3 weeks of intensified/prolonged endurance training at a high training load level. Heavy training loads may apparently be tolerated for extensive periods of time if athletes take a rest day every week and use alternating hard and easy days of training. Persistent performance incompetence and high fatigue ratings may depend on impaired or inhibited transmission of ergotropic (catabolic) signals to target organs, such as: (I) decreased neuromuscular excitability, (II) inhibition of alpha-motoneuron activity (hypothetic), (III) decreased adrenal sensitivity to ACTH (cortisol release) and increased pituitary sensitivity to GHRH (GH release) resulting in a counter-regulatory shift to a more anabolic endocrine responsibility, (IV) decreased beta-adrenoreceptor density (sensitivity to catecholamines), (V) decreased intrinsic sympathetic activity, and (VI) intracellular protective mechanisms such as increased synthesis of heat-shock proteins (HSP 70) represent a complex strategy against an overload-dependent cellular damage.

Adrenal Glands↗

Lung diffusion capacity, oxygen uptake, cardiac output and oxygen transport during exercise before and after an himalayan expedition.

Studies were made of pulmonary diffusion capacity and oxygen transport before and after an expedition to altitudes at and above 4900 m. Maximum power (Pmax) and maximal oxygen uptake (VO2max) were measured in 11 mountaineers in an incremental cycle ergometer test (25W.min-1) before and after return from basecamp (30 days at 4900 m or higher). In a second test, cardiac output (Qc) and lung diffusion capacity of carbon monoxide (DL,cg) were measured by acetylene and CO rebreathing at rest and during exercise at low, medium and submaximal intensities. After acclimatization, VO2max and Pmax decreased by 5.1% [from 61.0 (SD 6.2) to 57.9 (SD 10.2) ml.kg-1, n.s.] and 9.9% [from 5.13 (SD 0.66) to 4.62 (SD 0.42) W.kg-1, n.s.], respectively. The maximal cardiac index and DL,cg decreased significantly by 15.6% [14.1 (SD 1.41) 1.min-1.m-2 to 11.9 (SD 1.44)1.min-1.m-2, P < 0.05] and 14.3% [85.9 (SD 4.36) ml.mmHg-1. min-1 to 73.6 (SD 15.2) ml.mmHg-1.min-1, P < 0.05], respectively. The expedition to high altitude led to a decrease in maximal Qc, oxygen uptake and DL,cg. A decrease in muscle mass and capillarity may have been responsible for the decrease in maximal Qc which may have resulted in a decrease of DL,cg and an increase in alveolar-arterial oxygen difference. The decrease in DL,cg especially at lower exercise intensities after the expedition may have been due to a ventilation-perfusion mismatch and changes in blood capacitance. At higher exercise intensities diffusion limitation due to reduced pulmonary capillary contact time may also have occurred.

Acclimatization↗

Hypoxic ventilatory response during rest and exercise after a Himalayan expedition.

Hypoxic ventilatory response (HVR) was examined before and after acclimatization to high altitude. Transient hyperoxic switches according to Dejours's technique were used to examine the contribution of HVR to the hyperpnoea of increasing exercise intensities. Ten mountaineers were exposed to hypoxia (oxygen fraction in inspired gas. F1O2 = 0.11, 79 mmHg) before the expedition and after return from altitude (56 days, 30 days at 4900 m or higher). After 25-min breathing hypoxic gas, the subjects performed a maximal cycle ergometer test (increments 50 W per 5 min). Respired gases and ventilation (VE) were analysed breath-by-breath, partial pressure of oxygen (PO2) and oxygen saturation (SO2) were measured in capillary blood. The HVR was tested by switching two breaths to an F1O2 of 1.0. The nadir of VE after the switch was measured (decrease in ventilation, DVE). The HVR was expressed as the DVE at a PO2 of 40 mmHg (DVE40) and the DVE versus decrease of SO2 (DVE/[100-SO2]). The HVR estimated by DVE40 increased from 19.9 to 28.0 l.min-1 (median, P = 0.013). The HVR expressed as DVE (100-SO2) at rest was no different before and after acclimatization (0.89 and 0.86 l.min-1.%-1 respectively) and during exercise it did not change before the expedition (0.83 l.min-1. %-1). However, DVE/(100-SO2) increased significantly with exercise intensity after the expedition (1.61 l.min-1.% at 200 W). The changes of DVE versus SO2 as well as of DVE versus VE were steeper after the expedition than before. In summary, after return from 30 day at high altitude, an increased HVR was observed. The augmentation of HVR was evident at higher exercise intensities and we suggest that this reflects a change in sensitivity of the peripheral chemoreflex loop.

Acclimatization↗

Unaccustomed high-mileage vs intensity training-related changes in performance and serum amino acid levels.

To test the overtraining-related "imbalanced amino acid hypothesis" (19), the influence of an unaccustomed average 103 %.4 wk-1 increase in training mileage (ITV) on performance and on serum levels of individual amino acids (AAs) was examined in distance runners and controlled by an unaccustomed average 152%.4 wk-1 increase in tempo-pace and interval runs (ITI). Two mmol.l-1 lactate performance (2 LP) increased, 4 LP stagnated and total running distance (TD) decreased in the incremental test during ITV--which may indicate an ITV-dependent overtraining--in contrast to an ITI-related increase in 2 LP, 4 LP and TD. The summed serum AAs decreased in ITV (2744 +/- 534 vs 2933 +/- 663 umol.l-1; p < 0.05) in contrast to an ITI-related increase (3541 +/- 657 vs 3252 +/- 885 umol.l-1; p < 0.05) with an average 29% higher final summed AAs concentration during ITI (p < 0.05). During ITV 12 individual AAs decreased by 6-17%, 8 remained constant and 3 increased (Cys, Met, fTrp) by 6-19%, as opposed to an ITI-related increase in 16 AA by 6-55%. The observed ITV-related changes in serum AAs profile were smaller than after completing contests as a marathon, a 100 km-run or an ultra-triathlon. It may be concluded that the observed small changes in AAs profile or AAA/BCAA and AA/LNAA ratios only represent an epiphenomenon without recognizable influence on incremental test performance, since increases in fTrp/LNAA ratios (+28% in ITV vs +45% in ITI) were found to be related both to performance impairment (ITV) and improvement (ITI).

Adult↗

Comparison of whole-body thallium imaging with transcutaneous PO2 in studying regional blood supply in patients with peripheral arterial occlusive disease.

Quantitatively estimating functional reserve of blood supply to the legs in patients with peripheral arterial occlusive disease (PAOD) remains a clinical issue. This study was designed to investigate the regional blood supply to the legs in PAOD patients during exercise by use of thallium 201 (201Tl) whole-body imaging in comparison with transcutaneous PO2 (tcPO2) measurement. Thirty-three patients with PAOD and 10 subjects without PAOD (control) performed an incremental cycle ergometry (CE), while tcPO2 was continuously registered on the involved calf. In the last minute of exercise, 2 mCi of 201Tl was injected intravenously and the 201Tl whole-body images were taken immediately (stress) and four hours (redistribution) following stress with a dual-head camera system. Regional blood supply (RBS) (%) was calculated from the geometric mean counts of the region of interest divided by the total counts of the whole body. The performance of PAOD patients was reduced in doing CE, and tcPO2 fell distinctly in PAOD patients (from 51 to 19 mmHg) whereas it increased in controls (from 57 to 67 mmHg). The RBS in PAOD patients was obviously reduced in comparison with that of controls. While in controls the RBS of the calf (3.1%) at stress did not differ from that at redistribution (3.4%), in PAOD patients the redistribution RBS (2.8%) increased as compared with that of stress (1.5%). There was a hyperbolic relationship between stress RBS of the calf and the velocity of tcPO2 fall in PAOD patients during exercise test (velocity of tcPO2 fall = -0.032 + 0.39/RBS, r2 = 0.54, P < 0.05). In conclusion, the RBS determined by 201Tl whole-body imaging is comparable to the tcPO2 measurement in differentiating patients with PAOD from subjects without PAOD during exercise. Regional 201Tl uptake reflects regional blood supply in PAOD patients. There is a hyperbolic relationship between the RBS derived from 201Tl whole-body imaging and tcPO2 in PAOD patients during exercise, implying that in a critical ischemia the lower the RBS is, the more steeply the tcPO2 decreases.

Adult↗

Does the threshold of transcutaneous partial pressure of carbon dioxide represent the respiratory compensation point or anaerobic threshold?

On reaching the respiratory compensation point (RCP) during rapidly increasing incremental exercise, the ratio of minute ventilation (VE) to CO2 output (VCO2) rises, which coincides with changes of arterial partial pressure of carbon dioxide (PaCO2). Since PaCO2 changes can be monitored by transcutaneous partial pressure of carbon dioxide (PCO2,tc) RCP may be estimated by PCO2,tc measurement. Few available studies, however, have dealt with comparisons between PCO2,tc threshold (TAT) and lactic, ventilatory or gas exchange threshold (VAT), and the results have been conflicting. This study was designed to examine whether this threshold represents RCP rather than VAT. A group of 11 male athletes performed incremental exercise (25 W.min-1) on a cycle ergometer. The PCO2,tc at (44 degrees C) was continuously measured. Gas exchange was computed breath-by-breath and hyperaemized capillary blood for lactate concentration ([la-]b) and PaCO2 measurements was sampled each 2 min. The TAT was determined at the deflection point of PCO2,tc curve where PCO2,tc began to decrease continuously. The VAT and RCP were evaluated with VCO2 compared with oxygen uptake (VO2) and VE compared with the VCO2 method, respectively. The PCO2,tc correlated with PaCO2 and end-tidal PCO2. At TAT, power output [P, 294 (SD 40) W], VO2 [4.18 (SD 0.57) l.min.1] and [la(-)] [4.40 (SD 0.64) mmol.l-1] were significantly higher than those at VAT[P 242 (SD 26) W, VO2 3.56 (SD 0.53) l.min-1 and [la(-)]b 3.52 (SD 0.75), mmol.l-1 respectively], but close to those at RCP [P 289 (SD 37) W; VO2 3.97 (SD 0.43) l.min-1 and [la(-)]b 4.19 (SD 0.62) mmol.l-1, respectively]. Accordingly, linear correlation and regression analyses showed that P, VO2 and [la(-)]b at TAT were closer to those at RCP than at VAT. In conclusion, the TAT reflected the RCP rather than VAT during rapidly increasing incremental exercise.

Adult↗

Unaccustomed high mileage compared to intensity training-related neuromuscular excitability in distance runners.

The influence of a 4-week unaccustomed average 103% mileage increase (ITV, increase in training volume; n = 8; average baseline mileage 85.9 km.week-1, final mileage 174.6 km.week-1) on performance and neuromuscular excitability (NME) was tested in experienced distance runners and controlled 1 year later by a 4-week unaccustomed average 152% increase in tempo-pace and interval-runs (ITI, increase in training intensity; n = 9; baseline 9 km.week-1 final 22.7 km.week-1) with an average total mileage of 61.7 km.week-1 (week 1) to 84.7 km.week-1 (week 4). Seven athletes participated in ITV as (week 4). Seven athletes participated in ITV as well as in ITI. During incremental treadmill test performance at a lactate concentration of 2 mmol.1-1 (2 LP) increased, and at 4 mmol.1-1 (4 LP) performance did not change, whereas total running distance (TD) during the incremental test decreased in ITV compared to an increase in 2 LP, 4 LP and TD during ITI which may indicate that there was an ITV-related overtraining. The NME of the reference muscles vastus medialis and rectus femoris deteriorated in ITV (day 28 compared to 0) compared to constant values during ITI, reflecting an ITV-related overload of neuromuscular structures.

Adult↗

Serum amino acid concentrations in nine athletes before and after the 1993 Colmar ultra triathlon.

The amino acid imbalance hypothesis should explain the fatigue originating in the brain during sustained exercise or over-training as a branched-chain (BCAA)/aromatic amino acids (AAA) imbalance with increased brain tryptophan uptake and 5-hydroxytryptamine synthesis. The serum amino acid profile was determined in 9 ultra-triathletes before and after completing the 1993 Colmar ultra-triathlon to additionally analyse the extent of this amino acid imbalance during such an extreme prolonged contest lasting more than 23 hours. The summed serum concentration of 25 amino acids decreased by 18% from 3962 +/- 846 to 3255 +/- 694 umol.l-1 likely reflecting a catabolic state of the organism with a decrease in 18 individual amino acids by 9-56%, an increase in cystine (+38%), methionine (+24%), tyrosine (+10%), phenylalanine (+12%), free tryptophan (+74%), and constant glutamine, leucine and total tryptophan levels. Since plasma volume increased by approximately 7.6% with a 3.3 kg body mass decrease in the athletes during the ultra triathlon, a decrease in intra-cellular water with an extra-cellular fluid increase is hypothesized. This decrease in cellular hydration state is seen as a protein-catabolic signal.

Adult↗

Transcutaneous oxygen tension and Doppler ankle pressure during upper and lower body exercise in patients with peripheral arterial occlusive disease.

The effects of upper and lower body exercise on blood supply to the lower extremities were investigated in patients with peripheral arterial occlusive disease (PAOD) by measurements of transcutaneous oxygen tension (tcPO2) and Doppler ankle pressure (DAP). Twenty patients with PAOD (PAOD group) and 10 subjects without PAOD (control group) performed treadmill test (TT), recumbent cycle ergometry (CE), and rowing ergometry (RE) with a fixed seat. The tcPO2 was registered on the calf and DAP was measured at the end of each step of CE and RE. The walking distance in TT of the control group was not limited (> 1000 m), whereas that of the PAOD group was 161 m in median. In the control group there was no significant difference of performance between CE (125 +/- 33 W) and RE (111 +/- 24 W), whereas in the PAOD group, performance was lower in CE (72 +/- 31 W) than in RE (102 +/- 28 W) (P < 0.01). DAP of controls increased during both CE (136 to 165 mmHg) and RE (170 to 213 mmHg), whereas the DAP of the PAOD group decreased during CE (from 85 to 44 mmHg) and remained relatively constant during RE (113 to 101 mmHg). In controls, tcPO2 did not distinctly change during TT (70 to 66 mmHg) and increased during CE (58 to 73 mmHg) and RE (69 to 82 mmHg), whereas in the PAOD group, tcPO2 decreased during TT (66 to 33 mmHg) and CE (50 to 22 mmHg) and remained almost unchanged in RE (64 to 60 mmHg). A hyperbolic relationship was found between tcPO2 and DAP. In conclusion, during upper body exercise, blood supply to the lower extremities in patients with PAOD was not affected, whereas lower body exercise led to exhaustion of the functional reserve of blood supply. Because of a hyperbolic relationship between tcPO2 and DAP, tcPO2 remained relatively constant if blood supply was sufficient, but in disturbed blood supply a small change of DAP was accompanied by a great change of tcPO2. Therefore, in critical ischemia the change of tcPO2 was more sensitive than that of DAP.

Adult↗

Pulmonary mechanics and entrainment of respiration and stroke rate during rowing.

During rowing, the respiratory musculature is confronted with dual demands: assisting the propulsive force generation and as the effector for ventilatory control. We determined the pulmomechanical and breathing pattern features of rowing-induced hyperpnea in five national class rowers (18 years old). Each subject performed incremental exercise on a mechanically braked rowing ergometer. Power was increased by 50 W each 3 min, from 150 W to 350 W. Breathing was through a low-resistance, ultrasonic flow-sensing device. Respired gas concentrations were measured by mass spectrometry. Intrapleural pressure (Pp1) was monitored by an esophageal balloon. Ventilation (VE) increased by increasing tidal volume (VT) at constant breathing frequency (fb). Above approximately 701.min-1 there was little change in VT and further increase in VE was dominated by fb. Two breathing patterns were identified: (1) one expiration per stroke and one inspiration during recovery and (2) one complete breath during stroke and one breath during recovery. Stroke frequency (fs) and fb increased in concert, i.e., all subjects entrained their breathing. Pp1 indicated dynamic airway compression during exhalation at high work rates and also that VT did encroach upon the flat part of the compliance curve. With the constrained VT, the demand for increased fb to effect the hyperpneic response at high work rates may result in an entrainment of the stroke frequency to that of breathing.

Adolescent↗

Metabolic and hormonal reactions during training in junior oarsmen.

This study evaluated strain reactions in young athletes (mean age: 17.6 years). Of 35 male rowers, 21 were selected by rowing ergometer tests to take part in a 26-day training camp before the World Championships in 1989. Blood samples were obtained in the morning of the day after rowing ergometer tests and on the 16th and 26th day. Cortisol (C), testosterone (T), sexual-hormone-binding globulin (SHBG), urea and creatine kinase (CK) were determined in serum and free testosterone (FT) was calculated. In the nonselected rowers C was 10% higher, FT 20% lower, and CK 42% higher compared to the selected rowers. During training, C was related to the intensity of training. It remained constant in phase 1 (12 days, increased volume of training) and increased in phase 2 (10 days, decreased volume and higher intensity). FT decreased in phase 1 and increased in phase 2. Urea showed a close relationship to training volume. CK levels decreased during the training volume. CK levels decreased during the training period as an adaptation to the training. Despite a high training load, there were no indications of overstrain reactions in these young athletes.

Adolescent↗

Performance and blood lactate on Gjessing and Concept II rowing ergometers.

The Gjessing (GE) and the wind resistance (Concept II, CII) rowing ergometers were compared in 11 trained subjects during incremental exercise. Maximum power was 255 (200-370) W on GE, but 294 (204-393) W in CII (median and range, p < 0.05). If power was directly measured by a strain gauge and a displacement transducer in the CII, a 5.1% (3.2%-7.8%) higher maximum performance was obtained (314 [223-413] W, p < 0.05). Maximum stroke rates were higher in GE (33 [27-37]/min) than in CII (29 [24-35]/min, NS). Blood lactate increased faster with work rate and lactic anaerobic threshold was therefore lower in GE. Blood lactate was higher for every heart rate for GE compared to CII. This suggests higher anaerobic effort in GE rowing.

Adult↗