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Biomedical subjects

R D Dickerman

Publications and source records attributed to R D Dickerman.

At least 37 records · Page 2Linked to original sources
PubMed2000

The upper range of lumbar spine bone mineral density? An examination of the current world record holder in the squat lift.

Weight-bearing exercise is known to improve bone mineral density, however, excessive forces exerted on the lumbar spine can be pathologic. Cadaveric studies have calculated a hypothetical "critical compression force" at which the lumbar spine would suffer collapse. In addition, recent studies have suggested that bone density correlates with strength. Thus far studies have failed to examine elite power athletes to determine the possible upper range for bone mineral density and critical compression force. Therefore, we recruited the current world record holder in the squat lift, with a record squat lift >469 kg, for an examination of lumbar spine bone mineral density. The subject had dual energy x-ray absorptometry (DEXA) and magnetic resonance imaging (MRI) performed of the lumbar spine. The subject also had serum chemistries, cell blood count and testosterone levels performed. DEXA scan revealed the highest bone mineral density reported to date. MRI revealed normal alignment, no evidence of disc herniation or compressive disc disease. There was no frank or neural foraminal canal stenosis. The estimated compressive force generated on his lumbar spine during the squat lift of > 469 kg doubles the previously reported critical compression force. This case study supports the previously described relationship between strength and bone density and redefines the upper limits of bone density in strength athletes.

Absorptiometry, Photon↗
PubMed2000

Middle cerebral artery blood flow velocity in elite power athletes during maximal weight-lifting.

Cerebral blood flow velocity (CBFV) has been shown to significantly increase during dynamic exercise (running) secondary to increases in cardiac output. Static exercise (weight-lifting) induces supraphysiological arterial pressures up to 450/380 mmHg, and thus may alter CBFV. Catastrophic brain injuries such as stroke, cerebral hemorrhage, subarachnoid hemorrhage, retinal hemorrhage and retinal detachment have been associated with weight-lifting. A recent study has shown that intra-ocular pressure (IOP), which is an indirect measure of intracranial pressure, elevates to pathophysiologic levels during weight-lifting. Recent CBFV studies instituting Valsalva have demonstrated decreases in CBFV from 21%-52%. To date, no studies have examined CBFV during maximal weight-lifting to elucidate the cerebrovascular responses to extreme pressure alterations. We recruited nine elite power athletes, including a multi-world record holder in powerlifting, for a transcranial Doppler study of middle cerebral artery blood flow velocity at rest and during maximal weight-lifting. All subjects' resting blood flow velocities were within normal ranges (mean 64.4 +/- 9.5 cm sec2). Blood flow velocities were significantly (p < 0.0001) decreased in all subjects during maximal lifting (mean 48.4 +/- 10.1 cm sec2). Linear regression analysis demonstrated a significant inverse linear relationship in the net change of blood velocities from rest to maximal lift for each subject (r = 0.8585, p < 0.001). This study demonstrates that blood flow velocities are significantly decreased during heavy resistance training. The drop in CBFV during weight-lifting was significantly less than previous Valsalva studies, which likely reveals the cardiovascular, baroreflex, and cerebrovascular system adaptations occurring in these elite power athletes.

Adult↗
PubMed1999

Intra-ocular pressure changes during maximal isometric contraction: does this reflect intra-cranial pressure or retinal venous pressure?

Recent publications have suggested that intra-ocular pressure (IOP) may be an indirect assessment of intra-cranial pressure (ICP). Both IOP and ICP have similar physiologic pressure ranges and similar responses to changes in intra-abdominal, intra-thoracic and aortic pressure. Previous studies have demonstrated the relationships between retinal arterial pressure and aortic pressure, intra-ocular pressure and retinal venous pressure, intra-cranial pressure and retinal venous pressure. Power athletes routinely utilize the Valsalva maneuver during weightlifting. In fact there are reports of stroke, cerebral hemorrhage, subarachnoid hemorrhage, conjunctival, foveal and retinal hemorrhage, retinal detachment, hiatal hernia and pneumothorax associated with weightlifting. These events are thought to occur secondary to the extreme pressure elevations that occur in the intra-abdominal, intra-thoracic, intra-cranial, intra-ocular and vascular compartments. To date no human studies have examined the IOP changes that may occur with heavy resistance exercise. Therefore, we recruited power athletes (n = 11), who had participated in prior studies, from the local metropolitan area. The athletes had blood pressure status, drug screening and medical histories performed during previous investigations. Intra-ocular pressure was measured by noncontact tonometry at rest and during maximal isometric contraction. All subjects resting IOP were within normal ranges (mean 13 +/- 2.8 mmHg). Intra-ocular pressures were significantly (p < 0.0001) elevated in each subject during maximal contraction (mean 28 +/- 9.3 mmHg). One subject's IOP reached 46 mmHg during maximal contraction. Linear regression analysis demonstrated a significant linear relationship (r = 0.62, p < 0.0001) in the net change of IOP from rest to maximal contraction for each subject. This study demonstrates that IOP elevates to pathophysiologic levels during resistance exercise. The findings of conjunctival hemorrhages in two subjects further supports IOP being reflective of retinal venous pressure. The enormous pressures generated by power athletes during weightlifting leads to elevations in ICP which obstruct venous outflow leading to hemorrhage and elevations in IOP. The question remains as to whether these intermittent bursts of elevated IOP can lead to long-term pathological sequelae.

Adult↗
PubMed1999

Pressure-overload-induced sliding hiatal hernia in power athletes.

Sliding hiatal hernias are a common condition thought to occur with increasing age secondary to a degenerative process. The incidence of sliding hiatal hernias in the general population is 0.5%. Although the prevalence in the Western world is thought to be significantly higher, with approximately 60% of geriatric patients in North America having a hiatal hernia on radiologic studies. Thus, the primary etiology of the sliding hiatal hernia is thought to be degeneration of the phrenoesophageal ligament. Most hiatal hernias occurring in young adults are idiopathic. There has been speculation of a stress-induced hiatal hernia from repeated episodes of elevated intra-abdominal pressure, and to date there is one report of a pressure-overload-induced hiatal hernia occurring in an elite body builder. The prevalence of hiatal hernia in young male power athletes has yet to be examined. Therefore, we examined eight male elite power athletes and seven male non-weightlifters, matched for age, via fluoroscopy with barium swallow to test the hypothesis that pressure overload can induce hiatal hernias in young adults.

Adult↗
PubMed1999

Anabolic steroid-induced hepatotoxicity: is it overstated?

OBJECTIVE: There have been numerous reports of hepatic dysfunction secondary to anabolic steroid use based on elevated levels of serum aminotransferases. This study was conducted to distinguish between serum aminotransaminase elevations secondary to intense resistance training and anabolic steroid-induced hepatotoxicity in elite bodybuilders. DESIGN: This was a case-control study of serum chemistry profiles from bodybuilders using and not using anabolic steroids with comparisons to a cohort of medical students and patients with hepatitis. PARTICIPANTS: The participants were bodybuilders taking self-directed regimens of anabolic steroids (n = 15) and bodybuilders not taking steroids (n = 10). Blood chemistry profiles from patients with viral hepatitis (n = 49) and exercising and nonexercising medical students (592) were used as controls. MAIN OUTCOME MEASURES: The focus in blood chemistry profiles was aspartate aminotransferase (AST), alanine aminotransferase (ALT), gamma-glutamyltranspeptidase (GGT), and creatine kinase (CK) levels. RESULTS: In both groups of bodybuilders, CK, AST, and ALT were elevated, whereas GGT remained in the normal range. In contrast, patients with hepatitis had elevations of all three enzymes: ALT, AST, and GGT. Creatine kinase (CK) was elevated in all exercising groups. Patients with hepatitis were the only group in which a correlation was found between aminotransferases and GGT. CONCLUSION: Prior reports of anabolic steroid-induced hepatotoxicity based on elevated aminotransferase levels may have been overstated, because no exercising subjects, including steroid users, demonstrated hepatic dysfunction based on GGT levels. Such reports may have misled the medical community to emphasize steroid-induced hepatotoxicity when interpreting elevated aminotransferase levels and disregard muscle damage. For these reasons, when evaluating hepatic function in cases of anabolic steroid therapy or abuse, CK and GGT levels should be considered in addition to ALT and AST levels as essential elements of the assessment.

Adult↗
PubMed1999

Subdural empyema complicating cerebrospinal fluid shunt infection.

Subdural empyema has not been reported previously as a complication of cerebrospinal fluid (CSF) shunt surgery. An infant submitted to CSF shunt insertion for congenital hydrocephalus developed subdural empyema after a failed attempt to treat a superficial scalp wound infection with oral antibiotics. Enterobacter cloacae was isolated from the empyema. Temporizing management of the preceding superficial wound infection with oral antibiotics probably was the cause of this exotic pathogen. The treatment of infected scalp wounds contiguous with shunt hardware must be surgical.

Empyema, Subdural↗
PubMed1998

Left ventricular wall thickening does occur in elite power athletes with or without anabolic steroid Use.

Reports on the occurrence of left ventricular wall thickening in resistance-trained athletes have rejected the possibility for this physiological adaptation to occur without concomitant anabolic steroid abuse. Others have concluded short bursts of arterial hypertension that occur with maximal weight lifting are not sufficient to induce left ventricular wall thickening, and left ventricular wall thickness >/=13 mm should not be found in pure resistance-trained athletes. Therefore, we examined 4 elite resistance-trained athletes by two-dimensional echocardiography. In addition, we retrospectively examined the individual left ventricular dimensions of 13 bodybuilders from our previous echocardiographic studies. All 4 elite resistance-trained athletes had left ventricular wall thicknesses beyond 13 mm. One of the elite bodybuilders has the largest left ventricular wall thickness (16 mm) ever reported in a power athlete. Retrospectively, 43% of the drug-free bodybuilders and 100% of the steroid users had left ventricular wall thickness beyond the normal range of 11 mm. In addition, 1 drug-free subject and 3 steroid users were beyond the critical mark of 13 mm. No subjects demonstrated diastolic dysfunction. In contrast to previous reports, we have demonstrated that left ventricular wall thicknesses >/=13 mm can be found routinely in elite resistance-trained athletes. The use of anabolic steroids concomitant with intensive resistance exercise does appear to augment left ventricular size without dysfunction. Anabolic steroids may accelerate left ventricular wall thickening indirectly by increasing strength, thus augmenting the pressor response.

Adult↗
PubMed1997

Neuroendocrine-associated behavioral patterns in the male Asian elephant (Elephas maximus).

Steroid-responsive behaviors have been reported in various species; however, the reports thus far on the male Asian elephant (bull) during musth are few in number and most have been conducted on single captive animals for short time periods. The purpose of this investigation was to perform a longitudinal study on steroid-responsive behavior in 3 male Asian elephants from a captive herd of 11 male Asian elephants in Nepal. Male Asian elephants were 18, 25, and 43 years old. The animals had serum collected for 11 months and were observed on a daily basis for aggressive behavior according to the Species Survival Plan (SSP) collection protocol on SSP data sheets. Testosterone (T) and dihydrotestosterone (DHT) were measured in each animal by radioimmunoassay. Testosterone levels rose during musth 26-fold compared to nonmusth, and DHT was elevated 12-fold in musth. Maximal aggressive behavior episodes occurred during peak elevations of T and DHT, with correlation coefficients of 0.82 and 0.89, respectively. Therefore, we suggest that the aggressive episodes are dependent on elevated circulating androgens acting on androgen-responsive neural tissues.

Animals↗
PubMed1997

Left ventricular size and function in elite bodybuilders using anabolic steroids.

OBJECTIVE: To investigate the relationship between resistance training, anabolic steroid use, and left ventricular function. DESIGN: Sixteen competitive bodybuilders were recruited for an echocardiography study. SETTING: University of North Texas Health Science Center (Fort Worth, TX, U.S.A.); the cardiologist and technician were blinded as to subjects' drug status. SUBJECTS: Eight competitive heavyweight drug-free (DF) bodybuilders and eight competitive heavyweight body-builders on self-directed regimens of anabolic steroids. RESULTS: Average body mass indexes (BMI; kg/m2) for the drug-user (DU) and DF groups were not significantly different (34.1 +/- 2.8 and 32.0 +/- 4.3, respectively). Increases in left ventricular posterior wall and ventricular septal thickness were apparent in the DU group (p < 0.05). The ratio of echocardiographic findings to BMI revealed a significantly smaller left ventricular end-diastolic dimension (LVDEd/BMI; p < 0.05) in the DU group. The smaller LVDEd in DUs is coupled with a significantly disproportionate septal and posterior wall thickness in DUs when indexed to body mass compared to DFs. There was no direct evidence of diastolic dysfunction detected by mitral inflow velocity patterns. CONCLUSION: Anabolic steroids may potentiate concentric left ventricular hypertrophy with decreasing ventricular compliance without affecting cardiac function.

Adult↗
PubMed1997

Peripheral neuropathy and testosterone.

A 265 lb. (body mass index, 38.1) male elite bodybuilder suffered focal muscle atrophy that developed in his right vastus lateralis muscle within a month following a painful self-administered injection of testosterone. The subject did not lose any sensory or motor function immediately after the injection; however after several days to weeks, muscle atrophy and paresthesia ensued. The subject had an obvious atrophic zone in the right vastus lateralis muscle with approximately 40% loss of strength when compared to the left leg. In our view, the neuropraxia developed from direct neurotoxic effect of androgens or pressure exerted upon the nerve following injection of a bolus of liquid. This report is indicative of the many potential dangers associated with unsupervised androgen use which may include androgens as potential neurotoxins.

Adult↗