Reproducibility of post-exercise lactate and anaerobic threshold.

To test the effect of previous strenuous training on lactate (LA) formation and on changes of lactate threshold (AT) values, a group of seven male athletes aged 26.3 +/- 9.2 years, height 184 +/- 6.2 cm, body weight 79.3 +/- 8.1 kg, percentage of body fat 8.8 +/- 3.7 and VO2 max 56.2 +/- 5.4 ml/kg were examined on a treadmill to the maximum in the morning after 2 days of rest, and after 2 consecutive days of strenuous training. The subjectively perceived rate of fatigue (SPF) in the morning prior to the exercise test was assessed by means of a 5-grade score. The values of LA max, AT, and SPF on day 1 were 11.06 +/- 2.4 mmol/l, 3.5 +/- 0.4 m/s, and 0.6 +/- 0.4, respectively. The corresponding values on day 2 were 8.8 +/- 1.7 mmol/l, 4.0 +/- 0.3 m/s, and 2.0 +/- 0.5, respectively. The values on day 3 were 8.6 +/- 1.1 mmol/l, 4.1 +/- 0.4 m/s, and 2.1 +/- 0.7, respectively. Statistically significant differences on the 1st day were found in LA max, AT, and SPF compared with days 2 and 3. No significant differences were found between the values for the 2nd and 3rd days. AT values for day 1 were significantly lower than those for days 2 and 3. A significantly higher level of SPF in the morning prior to the test procedure was observed on days 2 and 3 compared with day 1. The AT and SPF values for days 2 and 3 showed no significant difference.(ABSTRACT TRUNCATED AT 250 WORDS)

[Aseptic complications in total alloarthroplasty of the hip joint (author's transl)]. / Aseptische Komplikationen bei der Totalalloarthroplastik am Hüftgelenk.

A perfect technic of implantation is the fundamental factor to guarantee a postoperative course free of complications. The position of the prosthesis and a high initial stability are important factors, too. In the OHH 1 561 patients were given 1 973 cemented total endoprostheses from 1968 to 1978. From 1975 to 1980, an additional number of 212 total endoprostheses without cement (ceramic prostheses) were implanted. The following aseptic complications were most common: (1) loosening, (2) luxation, (3) fractures of the shaft of the prosthesis, (4) bursting of the femur-shaft, (5) protrusio acetabuli, and (6) periarticular deposition of calcium. The rate of complications in cemented total endoprostheses was 2.7%, in cement-free endoprostheses 5.7%. In 10.3% of the cemented endoprostheses early complications were observed; among the patients with cement-free endoprostheses there occurred one luxation and one fatal case (pulmonary embolism). Late complications of the cemented endoprostheses were seen in 8%; among the cement-free endoprostheses 4 loosenings of the acetabulum, 3 loosenings of the shaft, 1 protrusio acetabuli and 1 fracture of the ceramic neck were found. 77.5% of the patients, with cemented prostheses judged their ability to walk as much improved, compared to the previous state. In 15.7% the results were unchanged, in 6.7% the state had deteriorated. Among the patients with cement-free endoprostheses 61% considered their walking ability to be much better, 29% moderately improved and 8.5% unchanged. 1% felt worse than before surgical treatment.

[Thermography in osteosyntheses and total endoprostheses of the knee joint with and without infection (author's transl)]. / Thermographie bei Osteosynthesen und Totalendoprothesen des Kniegelenkes mit und ohne Infektion.

Thermography supplies information on the radiation temperature and hence on the blood supply in the body surface area. Together with the clinical findings this can contribute towards the recognition and recording of infections. During the normal course of a cure following osteosynthesis, the radiation temperature rose moderately up to +2 C degrees and returned to normal after 4 to 6 weeks. In case of infections, however, hyperthermia was very pronounced. Hyperthermia did not rise above +2 degrees C in case of mechanical loosening of an alloarthroplastic knee joint substitute. However, in infections temperature rises up to +44 degrees C were seen. Hence, thermography can supply additional pointers for further therapeutic approach.

Sex-dependent changes in plasma globulins in women and men exposed to heat stress.

Healthy, sedentary women and men, aged 20 to 30 years, were exposed to the same degree of intermittent heat stress in a sauna bath. Blood samples were taken immediately before and at various intervals after heat exposure. The concentrations and intravascular masses of IgG, IgA, IgM, alpha1-antitrypsin, transferrin and alpha2-macroglobulin were determined by the radial immunodiffusion technique and by the measurement of plasma volume. Losses in body weight and plasma volume were lower in women than in men. The globulin concentrations increased significantly in both sexes after heat exposure. The sum of the masses of individual globulins increased only in women, a change interpreted as globulin shifts from the interstitial into the vascular space. Whereas it is unlikely that sex-dependent differences in these shifts are due to changes in vascular permeability, it seems that the protein composition of the lymphatic fluid entering the vascular space plays an important role in these shifts.

The influence of heat stress on plasma volume and intravascular proteins in sedentary females.

23 untrained femal subjects underwent a standardised thermal dehydration. Plasma volume (PV), hematocrit (HCT), total intravascular protein concentration (TPC), albumin concentration (AC), total globulin concentration (TGC) were determined before, immediately, 90 min and 180 min after the heat stress. The intravascular protein masses (IPM) were calculated from PV and protein concentration. In comparison to men the loss of body weight and PV was smaller. Consequently the TPC does not increase to the same amount in men. A tendency for a diminution of IPM could be observed but this shift was not significant, compared to males. According to these findings the colloid osmotic capacity remained on a relatively high level. Opposite to men the IPM of globulins increased in females after thermal dehydration.

Changes in muscle action potentials of patients with diseases of motor units following the infusion of a peptide fragment of ACTH.

The polypeptides ACTH and ATCH4-10 (OI 63) witha sequence of amino acids H-Met-Glu-His-Phe-Arg-Trp-Gly-OH, have similar stimulating effects on motor units in lower mammals. Their actions differ primarily in that ACTH4-10 is not corticotropic. Since the corticotropic action of ACTH frequently presents a problem during its clinical use in treatment of motor unit diseases, the action of ACTH4-10 was studied in two patients with muscular atrophy. Prior to administration of ACTH4-10, stimulation of M. oppenens pollicis through the median nerve evoked muscle action potentials in both patients which progressively declined in amplitude. This decline was not observed subsequent to the infuscion of ACTH4-10 (3, 6 and 15 mg). The effect lasted partially in excess of at least 2 h. It is suggested that ACTH4-10 produces this effect by direct action on a peripheral component of the motor unit and/or indirectly by an action on the central nervous system.

Plasma volume, albumin and globulin concentrations and their intravascular masses. A comparative study in endurance athletes and sedentary subjects.

Plasma volume, hematocrit, intravascular protein concentration, colloid osmotic pressure and the intravascular mass of proteins were measured in 49 sedentary subjects and 40 endurance athletes (long-, middle distance runners, cyclists). The plasma volume in sedentary subjects was 42.7(35.8-51.7) ml/kg body weight (BW) as compared to 54.6(46.7-65.9) ml/kg BW in athletes. The protein concentrations were 71.0 (66.5-77.1) g/l in sedentary subjects and 69.0 (64.8-75.2) g/l in athletes. The respective numbers for the hematocrit were 44.6 (40.1-49.25)% and 42.8 (38.2-49.6)%, for the colloid osmotic pressure 38.0 (36.0-40.5) cm H2O (n=35) and 30.0 (25.0-34.4) cm H2O (n=31), for the intravascular mass of proteins 3.09 (2.45-4.01) g/kg BW and 3.75 (3.31-4.67) g/kg BW. All differences were statistically significant at least on the 5% level. The physiological consequences for athletes of having a lower hematocrit and lower protein concentration but a higher intravascular mass of proteins (+22%) for their waterbalance as well as for their dietary protein intake are discussed. Endurance exercise stimulates mainly the synthesis of albumin and globulins produced by the liver resulting in an expansion of the PV. The protein synthesis of the RES does not seem to respond to exercise stimulus.

Peptide enhancement of neuromuscular function: animal and clinical studies.

Evidence is presented for an extra-adrenal effect of ACTH and ACTH analogs on muscle action potentials (APs), contractions and fatigue in in situ experiments. ACTH, alphaMSH, betaMSH and ACTH 4-10 increase the amplitude of APs and contractions and decrease fatigue in intact, hypophysectomized and in adrenalectomized rats, subjected to repetitive indirect stimulation (supermaximal strength, 5/sec or 10/sec for 30 min). Elevation of endogenous ACTH resulting from adrenalectomy or cold stress, or both, has the same effect as ACTH administration. ACTH peptides are most effective in depressed physiological conditions e.g. following hypophysectomy. As the effect of ACTH 4-10 is abolished after section of the motor nerve, it is inferred that this peptide may affect central motor neurons. Preliminary observations from clinical studies with ACTH 4-10 in patients with muscle disease, in whom a pathological decline in amplitude of a short series of evoked muscle APs was prevented by peptide administration, also indicate a possible action of this peptide on central nervous system neurons.

[Pulmonary function tests and spiroergometric parameters during rehabilitation of patients with idiopathic scoliosis (fusion of the spine with Harrington rod and training) (author's transl)]. / Lungenfunktionswerte und spiroergometrische Parameter während der Rehabilitation von Patienten mit idiopathischer Skoliose (Fusionsoperation der WS nach Harrington und Training)

11 female patients with idiopathic scoliosis underwent spinal fusion surgery after Harrington. Additionally the patients were exercised before and after surgery by a special program. During the period of rehabilitation the usual spirographic measurements were carried out and some spiroergometric parameters were measured at standardized ergometric work loads. The diminished vital capacity and the practically normal forced vital capacity were not changed significantly, but the maximum voluntary ventilation was enhanced distinctly. The resting heart rate, primarily far above normal level, decreased significantly at the end of the exercise period and approached normal range. Maximum heart rate corresponded always to the mean values of normal subjects. Instead of a nearly constant increased minute volume of respiration, respiratory frequency and specific ventilation (respiratory equivalent) the maximum 0-2 uptake and maximum 0-2 puls increased significantly. These changes can be explained by an improvement of the uneven distribution of perfusion and ventilation, due to the combined surgical and exercise treatment.