Hypogonadism and anemia in an athlete.

We report the case of a highly trained endurance athlete (22-year-old) who developed anemia (Hb 9.5 mg/dl) over a period of 6 months. Iron deficient or haemolytic anemia, as well as chronic loss of blood, were excluded. Further, laboratory analyses revealed that this athlete exhibited very low levels of testosterone due to a partial hypogonadotropic hypogonadism. Following testosterone supplementation, red blood cell indices improved. Although hypogonadotropic hypogonadism is well known to be associated with reduced hematopoesis, it rarely causes anemia in athletes. This should be considered as a possible cause for anemia. Extreme training, unbalanced nutrition or the combination of both, have been shown to be causally involved in the development of secondary hypogonadotropic hypogonadism.

Clinical effectiveness of customised sport shoe orthoses for overuse injuries in runners: a randomised controlled study.

BACKGROUND AND OBJECTIVES: Treatment of chronic running-related overuse injuries by orthopaedic shoe orthoses is very common but not evidence-based to date. HYPOTHESIS: Polyurethane foam orthoses adapted to a participant's barefoot plantar pressure distribution are an effective treatment option for chronic overuse injuries in runners. DESIGN: Prospective, randomised, controlled clinical trial. INTERVENTION: 51 patients with running injuries were treated with custom-made, semirigid running shoe orthoses for 8 weeks. 48 served as a randomised control group that continued regular training activity without any treatment. MAIN OUTCOME MEASURES: Evaluation was made by the validated pain questionnaire Subjective Pain Experience Scale, the pain disability index and a comfort index in the orthoses group (ICI). RESULTS: There were statistically significant differences between the orthoses and control groups at 8 weeks for the pain disability index (mean difference 3.2; 95% CI 0.9 to 5.5) and the Subjective Pain Experience Scale (6.6; 2.6 to 10.6). The patients with orthoses reported a rising wearing comfort (pre-treatment ICI 69/100; post-treatment ICI 83/100) that was most pronounced in the first 4 weeks (ICI 80.4/100). CONCLUSION: Customised polyurethane running shoe orthoses are an effective conservative therapy strategy for chronic running injuries with high comfort and acceptance of injured runners.

Changes in blood lactate concentrations during different treadmill exercise test protocols.

AIM: The purpose of this study was to compare the blood-lactate and heart rate response of three treadmill tests and to define a conversion algorithm. METHODS: Subjects included 19 long-distance runners. The first two tests had increments of 2 km/h every 3 (test3m) or 5 minutes (test5m). The third test (testFm) consisted of four consecutive 2000m-runs. The calculated individual-anaerobic-threshold (IAT) from test3m was defined as speed at the third step of testFm, speed-increments between the four steps were 0.25 m/s. RESULTS: Lactate threshold (LT) did not show significant differences. Speed at IAT in test3m (15.09|*plusmn*|2.29 km/h) was significantly higher than in test5m (14.74|*plusmn*|2.22 km/h), heart rates were nearly identical. Speed and heart rate at 2 mmol/L showed no significant differences. At lactate concentrations of 3 and 4 mmol/L, running-speeds in test3m were significantly higher than in test5m and testFm. Heart rate were the same in test3m and test5m but significantly higher in testFm. CONCLUSION: Taking test3m as basis for determining endurance-performance, an adjustment of test5m can be made by adding 1.8 mmol/l instead of 1.5 mmol/l to the LT to derive the IAT. TestFm shows similar results as test5m, however, standardization is difficult due to variable increment durations.

Physical activity throughout life reduces the atherosclerotic wall process in the carotid artery.

BACKGROUND: Good cardiorespiratory fitness has been associated with a reduced risk for clinical events of atherosclerotic vascular diseases. It is still unclear how this relates to a slower progression of the early atherosclerosis wall process. METHOD: Using a dynamic model, we generated new parameters for describing the pathologic wall process in the carotid artery, based on an automatic layer detection system. In this study, we scrutinised the influence of two ultrasonographic parameters, intima-media thickness (IMT) and roughness, by comparing two groups: a healthy inactive group (PIP) (mean (SD) age 64.37 (5.10) years; n = 50) and a healthy lifelong physically active group (PA) (mean (SD) age 64.48 (3.45) years; n = 51). All subjects underwent a blood test, spiroergometry, echocardiography and carotid ultrasound examination. RESULTS: There was a significant difference in the well known risk factors for cardiovascular disease (for example, high density lipoprotein cholesterol, triglyceride) between groups. PIP compared to PA had a significantly higher roughness (PIP 0.073 (0.015) vs PA 0.065 (0.0156); p<0.01). No significantly higher IMT was found for PIP (PIP 0.89 (0.18) vs PA 0.90 (0.22); p = 0.63) compared to PA. In this cross sectional study of middle aged men, Vo(2)max was inversely associated with carotid atherosclerotic parameters. CONCLUSION: In this study, good cardiorespiratory fitness was associated with an increase of the proven risk factors and a reduction of atherosclerosis in the common carotid artery. Roughness seems to be significantly more sensitive than IMT for characterising the changes of the arterial wall. We suggest measuring roughness in addition to IMT to gain additional information about the atherosclerotic wall.

Computer-based quantification of the mean Achilles tendon thickness in ultrasound images: effect of tendinosis.

BACKGROUND: B-mode measurement of the sagital diameter of the Achilles tendon based on a manual tracing (MT) procedure is partly dependent on the subjectivity of the reader. The aim of this study is to establish a standardised automatic procedure to differentiate between normal and chronically degenerated tendons. For this comparison, the tracing results of the tendon boundaries of an automatic identification (AI) process, already established with the detection of intima-media thickness, are compared with computer-assisted MT. METHODS: The detection of the tendon boundaries was performed in 115 ultrasound images including the cranial border of the calcaneal tuberosity. The measured section (starting point 4 cm away from the anterior boundary of the calcaneal tuberosity) amounted to 3 cm, and was divided into three sub-segments (1 cm each). Intra- and inter-reader/observer variability for mean and maximum Achilles tendon thickness (ATT) with AI and MT were evaluated. A normal group and a group with clinically diagnosed chronic tendon degeneration had mean and maximum ATT readings compared. RESULTS: Using MT, the intra- and inter-reader variability was 3.0% and 6.8%, respectively, using AI the variability was 1.6% and 3.9%, respectively. Mean and maximum ATT were measured systematically lower by AI compared to MT in all regions by 0.4 mm. The AI procedure was most accurate in the second segment. The mean ATT and maximum ATT were correctly detected in 93.9% and 96.6% of the images. CONCLUSION: The AI procedure detected the ATT with a high level of precision in all three segments. The most robust measurement was reached in the second segment. It eliminates most of the inter-/intra-reader variability in ATT measurement using MT. We suggest this new method could be a new gold standard for quantification of chronic disorder in Achilles tendons.

External iliac artery occlusion in a young female cyclist.

After 8 years of high performance training in mountain biking, a top female athlete, aged 23, first complained of diffuse, exercise-induced pain in both thighs. Over a period of the next 4 years, a slight but continuous reduction in her performance was observed, despite having maintained her training regime during the first 2 years. Gradually, pain increased, at last occurring even when she climbed a few stairs. This led to a clinical, echo-Doppler, MR-angiographic and DS-angiographic examination, which showed a complete occlusion of the right iliac external artery with good collateralisation. The left external iliac artery evidenced only small intravascular lesions. Surgical treatment (endarterectomy plus patch angioplasty) eliminated the pain completely. Except for a lipoprotein (a) of 114 mg/dL, no other significant risk factors were found. The influence of a genetic (heterocygotic) low APC-ratio of 1.6 and free protein S of 53% is unclear. This is a typical case of a delayed diagnosis in an athlete. A complete occlusion of an external iliac artery is extremely seldom in young in female athletes. With no indication of a general atherosclerotic or inflammatory process nor congenital abnormalities, an exercise-induced, chronic traumatisation may have caused this pathological condition.

Changes of HSP72-expression in leukocytes are associated with adaptation to exercise under conditions of high environmental temperature.

Overexpression of the heat shock protein HSP72 provides thermotolerance. We asked if two consecutive endurance runs 1 week apart (CR1, CR2) and additional environmental heat stress affect HSP72-expression in leukocytes of nonheat-acclimated endurance athletes. Twelve subjects were allocated randomly into two groups. Group HH completed both runs at 28 degrees C ambient temperature, and group NH performed CR1 at 18 degrees C and CR2 at 28 degrees C. HSP72-expression was determined by flow cytometry and RT-PCR before and 0, 24, and 48 h after exercise. Additionally, post-exercise cells were exposed to in vitro heat shock (HS; 2 h, 42 degrees C). The prolonged, high HSP72 protein level after CR1 in HH compared with NH may reflect thermotolerance induced by endurance exercise at high ambient temperature. Adaptation of cardiocirculatory/thermoregulatory capacity after CR2 in HH went along with a more rapid down-regulation of HSP72 compared with CR1. HSP72 mRNA demonstrated temperature-related changes after exercise. The reduced HS response in vitro after CR2 may represent exercise-related adaptation mechanisms. HSP72 concentrations in leukocytes may indicate previous exercise- and temperature-related stress conditions and adaptation in immunocompetent cells.

Expression of the antioxidant stress protein heme oxygenase-1 (HO-1) in human leukocytes.

Inducible heme oxygenase (HO-1) is an antioxidant stress protein, that is mainly induced by reactive oxygen species (ROS), cytokines and hyperthermia. By using flow cytometry the present investigation demonstrated a rise in the cytoplasmic expression of HO-1 in lympho- (L), mono- (M) and granulocytes (G) of 9 endurance-trained male subjects after a half marathon run. The expression was more pronounced in M (median: 98.3% HO-1 positive cells/4.31 mfc) and G (94.8%/1.93 mfc) than in L (80.1%/1.51 mfc) when measured 3 h post-exercise. Additionally the exercise protocol caused a rise in the plasma levels of myeloperoxidase, TNF alpha and interleukin-8 (IL-8), indicating an inflammatory response. We could detect a correlation between IL-8 and HO-1, directly after exercise, that was apparent in G (r = 0.67, p < .05) and L (r = 0.80, p < .05), but did not reach significance in M (r = 0.65, p = 0.06). An additional detection of HO-1 at rest in 12 untrained subjects showed a higher baseline expression of HO-1 compared to the athletes. The regulatory pathways leading to an increased expression of HO-1 after endurance exercise are not completely clear, but a causal involvement of a cytokine-mediated generation of ROS must be discussed. We supposed that the down-regulation of the baseline expression of HO-1 in athletes reflects an adaptional mechanism to regular exercise training.

Physical exercise-induced expression of inducible nitric oxide synthase and heme oxygenase-1 in human leukocytes: effects of RRR-alpha-tocopherol supplementation.

This study evaluated the effects of RRR-alpha-tocopherol (500 IU/day, 8 days) on in vivo cytokine response and cytoplasmic expression of inducible nitric oxide synthase (iNOS) and the antioxidant stress protein heme oxygenase-1 (HO-1) in human leukocytes after exhaustive exercise. Thirteen men were investigated in a double-blind, placebo-controlled, cross-over study with a wash-out period of 28 days. The exercise procedure consisted of an incremental treadmill test followed by a continuous run until exhaustion at 110% of the individual anaerobic threshold (total duration 28.5 +/- 0.8 min). HO-1 and iNOS protein were assessed in mono- (M), lympho-, and granulocytes (G) using flow cytometry. Plasma interleukin-6 (IL-6) and IL-8 were measured by ELISA. IL-6 rose significantly whereas IL-8 did not exhibit significant changes after exercise. Changes of IL-6 were not affected by RRR-alpha-tocopherol. Exercise induced an increase of iNOS protein primarily in M and G. A small, but significant, increase of HO-1 protein was measured in M and G. RRR-alpha-Tocopherol did not show any significant effects on cytoplasmic expression of iNOS and HO-1 at rest and after exercise. In conclusion, exhaustive exercise induces expression of iNOS and HO-1 in human leukocytes by a mechanism that is not sensitive to RRR-alpha-tocopherol supplementation.

First-pass effect of an intravenous bolus of [13C]bicarbonate displayed breath-by-breath.

The dilution of an intravenous bolus dose of [13C]bicarbonate is used as an estimate for the metabolic rate under certain conditions. It is a consistent finding in all studies that the total amount of intravenous [13C]bicarbonate cannot be recovered as breath 13CO2. In this study, we used a breath-by-breath analysis of 13CO2 to depict the washout of 13CO2 at a high temporal resolution to analyze the extent to which a probable first-pass effect is responsible for the reduced recovery. Eight healthy men were tested at seated rest and with bicycle exercise at a constant load relative to 40 and 75% maximal O2 consumption VO2 max). [13C]bicarbonate (0.0125 g/kg body wt) was administered as an intravenous bolus in each test. Respiratory mass spectrometry was used to derive the course of the end-tidal 13CO2-to-12CO2 ratio from the breath-by-breath data. Approximately 2 min after 13C administration, the washout curve could be fitted well by a two-exponential curve describing a two-compartment mammillary model. Immediately after administration of the bolus dose, an excess peak in the end-tidal 13CO2-to-12CO2 ratio appeared. This peak could not be included in the two-exponential fitting. The area under the first peak resulted in 3.8 +/- 1.3% of the total [13C]bicarbonate dose at rest, 11.5 +/- 2.9% at moderate exercise (40% VO2 max), and 16.9 +/- 4.0% at intensive exercise (75% VO2 max). The first-pass effect had an increasing impact of up to about two-thirds of the lacking bicarbonate with higher exercise intensity. The "loss" of tracer via this first-pass effect must be considered when the results of studies with parenteral administration of [13C]bicarbonate are considered, especially when it is given as a bolus dose and during exercise.

Transcriptional and translational regulation of heat shock proteins in leukocytes of endurance runners.

Heat shock proteins (HSP) represent cell-protective and antioxidant systems that may be induced by reactive oxygen species, cytokines, and hyperthermia. In the present study, we evaluated the influence of heavy endurance exercise and training on HSP27 and HSP70 in peripheral leukocytes of 12 athletes (before and at 0, 3, and 24 h after a half-marathon) and 12 untrained controls on protein and mRNA levels by flow cytometry and RT/PCR, respectively. HSP transcripts increased significantly immediately after acute exertion accompanied by elevated levels of corresponding proteins. HSP protein expression remained high until 24 h postexercise. Significant increases of plasma interleukin-8, myeloperoxidase, and creatine kinase occurred after exercise. Basal HSP expression was usually lower in trained compared with untrained subjects. Applying in vitro heat shock to resting blood samples of all subjects significantly stimulated HSP mRNA, showing higher increases in trained individuals. The exercise-induced alterations indicate that immunocompetent cells became activated. In addition to heat stress, other exercise-associated stress agents (oxidants, cytokines) may have also participated in stimulation of HSP expression in leukocytes. The expression pattern of HSP due to training status may be attributed to adaptive mechanisms.

Antioxidant intervention does not affect the response of plasma erythropoietin to short-term normobaric hypoxia in humans.

Recent research has demonstrated that reactive oxygen species (ROS) participate in intracellular signaling processes initiated during hypoxia. We investigated the role of ROS in the response of plasma erythropoietin (Epo) to short-term normobaric hypoxia in humans. Twelve male subjects were exposed twice to 4 h of normobaric hypoxia (H; inspired oxygen fraction 12.5%) with a period of 6 wk between both experiments (H1 and H2). With the use of a randomized placebo-controlled crossover design, the subjects received orally a combination of the antioxidants all-rac-alpha-tocopherol (800 mg/day for 3 wk) and alpha-lipoic acid (600 mg/day for 2 wk) or placebo before H1 and H2, respectively. Three weeks before H1, the subjects underwent one control experiment in normoxia (N; inspired oxygen fraction 20.9%) without any treatment. Serum alpha-tocopherol was significantly higher after treatment with antioxidants compared with placebo. Capillary Po(2) declined during H without significant differences between antioxidants and placebo. Plasma peroxide levels were lower under antioxidant treatment but not affected by hypoxia. The response of Epo to H did not show significant differences between antioxidant [maximum increase (means, 95% confidence interval): +121%, +66 to +176%] and placebo conditions (+108%, +68 to +149%). Similarly, hypoxia-induced increase of Epo corrected for diurnal variations, as revealed during N, did not differ between antioxidants and placebo. Individual variability of Epo in response to H was not related to the individual degree of hypoxemia during H. Our results do not support the assumption that ROS play a major modulating role in the response of Epo to short-term normobaric hypoxia in humans.

Free radicals and oxidative stress in exercise--immunological aspects.

Reactive oxygen (ROS) and nitrogen species (RNS) are continuously generated in the biological system and play an important role in a variety of physiological and pathological processes. There is evidence that physical exercise augments the generation of ROS/RNS. The present review discusses and compares insights into the generation and function of ROS/RNS such as superoxide, hydrogen peroxide, hypochloric acid, and nitric oxide released by leukocytes in response to exercise. Emphasis is placed on: (a) mechanisms and regulation of ROS/RNS generation in immunocompetent cells with respect to acute exercise and regular training; (b) damaging effects of ROS/RNS in terms of oxidative stress which may be causally involved in features such as exercise-induced damage to muscle tissue and leukocyte DNA; (c) (immuno-) modulating effects of ROS/RNS which include activation of transcription factors; (d) responses of antioxidant stress proteins to acute exercise and regular training; and (e) effects of antioxidants on exercise-induced changes in immune function. Available data suggests that ROS/RNS are involved in the inflammatory response to heavy exercise and therefore exert damaging effects. Several immune functions are influenced by actions of ROS/RNS, and it is hypothesized that adaption to regular training is also modulated in part by free radicals. Furthermore, regular training seems to reduce the capacity of leukocytes for oxidant release and leads to an adaptation of antioxidative mechanisms, which may contribute to a limitation of exercise-induced oxidative stress.

The long-term involution of physiological cardiomegaly and cardiac hypertrophy.

The long-term involution of physiological cardiomegaly and cardiac hypertrophy. Med. Sci. Sports Exerc., Vol. 21, No. 3, pp. 244-249, 1989. Forty-five former athletes in endurance disciplines, primarily Olympic medalists and World Cup, European Cup, and German champions, for whom results of an exercise ECG and radiological heart volume measurement were available from their active competitive phase, were examined. The study protocol included clinical examination, laboratory controls, resting and exercise ECG, determination of cardiac volume, and one- and two-dimensional echocardiographic examination. Of the 45 former athletes contacted, 38 appeared for examination. Of these, four presented with heart disease (two with infarction, one with aortic stenosis, and one with arrhythmia). The remaining 34 were divided into groups of still active (more than 300 kcal.wk-1) and inactive (less than 300 kcal.wk-1) athletes. The interval between the first and second examination averaged 23 yr. The active former athletes showed a weight increase of 5.2% (P less than 0.01) and a reduction of 14% in ergometric performance (P less than 0.02). The inactive group had a marked weight increase of 17.4% (P less than 0.001); the ergometric performance was lowered by 20% (P less than 0.001). The absolute heart size had decreased in the active group by 6.1% (NS) and the relative heart size by 10.7% (P less than 0.005); the corresponding values in the inactive group were 4.5% (NS) and 18% (P less than 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)

Physical fitness influences water turnover and body water changes during trekking.

PURPOSE: This study was performed to assess water turnover and changes of body water during a trekking tour at moderate altitude. METHODS: Fifteen healthy normally trained adults participated in a 7-d backpack trek tour in the Swiss Alps (total walking distance: 120.5 km; cumulated altitude difference: 6990 m (uphill) and 7550 m downhill; lowest point: 1285 m; highest point: 3317 m). Total body water and water turnover were measured using deuterium dilution and elimination (oral load of 0.33 g 99.8% D2O per kg body weight, overnight equilibration period, pre- and postdose saliva samples immediately before and after sleep, analysis of D2O concentrations in saliva using Fourier-transform infrared spectroscopy, CV < 1%). Physical training state was assessed after the tour using the lactate-exercise intensity relationship obtained by performing 50-W increments every 3 min on a cycle ergometer. RESULTS: Body water decreased from the evening of day 0 to the evening of day 4 (from 45.3 +/- 7.3 L to 43.4 +/- 7.6 L, P < 0.05), and did not significantly decrease (43.5 +/- 7.9 L) until the evening of day 5 (maximum of trekking exercise intensity). Mean daily water turnover was 5.7 +/- 1.8 L x d(-1) corresponding to 78.7 +/- 17.5 mL x kg(-1) x d(-1). Body water changes and water turnover were significantly related to the exercise intensity obtained at the lactate threshold as well as at the level of 4 mM lactate. CONCLUSIONS: This correlation may be in part explained by differing glycogen content of muscle tissue.

Autonomic imbalance hypothesis and overtraining syndrome.

PURPOSE: The parasympathetic, Addison type, overtraining syndrome represents the dominant modern type of this syndrome. Beside additional mechanisms, an autonomic or neuroendocrine imbalance is hypothesized as underlying. METHODS/RESULTS: Several findings support this thesis. During heavy endurance training or overreaching periods, the majority of findings give evidence of a reduced adrenal responsiveness to ACTH. This is compensated by an increased pituitary ACTH release. In an early stage of the overtraining syndrome, despite increased pituitary ACTH release, the decreased adrenal responsiveness is no longer compensated. The cortisol response decreases. In an advanced stage of overtraining syndrome, the pituitary ACTH release also decreases. In this stage, there is additionally evidence for decreased intrinsic sympathetic activity and sensitivity of target organs to catecholamines. This is indicated by decreased catecholamine excretion during night rest, decreased beta-adrenoreceptor density, decreased beta-adrenoreceptor-mediated responses, and increased resting plasma norepinephrine levels and responses to exercise. However, this complete pattern is only observed subsequent to high-volume endurance overtraining at high caloric demands. CONCLUSION: The described functional alterations of pituitary-adrenal axis and sympathetic system can explain persistent performance incompetence in affected athletes.

Bilateral segmental dystonia in a professional tennis player.

Dystonias occur frequently as repetitive movements, persistent elevations of muscle tone, or tonic contortions, whereby the cause is assumed to be an impairment of basal ganglia function. Focal dystonias are especially known in musicians, although little is reported on focal dystonias in athletic stress. The present case report describes the case of a 34-yr-old professional tennis player with bilateral segmental dystonia. The symptoms were expressed in involuntary movements when he intended to hit the ball and in a progredient tremor, initially in one hand, later in both, making him unable to write. The altered mobility during athletic stress was confirmed by video analysis, the altered innervation with excessive, uncoordinated impulse influx by means of electromyography during sport-type specific stress, and writing incapacity during a writing test. The symptoms abated under therapy with trihexyphenidyl-HCL, so that the patient has been able to work as a tennis coach with improved athletic performance for the past 3 yr. It is concluded that the various forms of dystonia should be included in the differential diagnosis of impaired coordinative movements under athletic exercise, especially of the upper extremities.

Reciprocal strength ratio in shoulder abduction/adduction in sports and daily living.

PURPOSE: Functionally, the shoulder is considered a ball joint, whereby high mobility is attended by low stability. Therefore, muscular balance is decisive for stability. Altered strength ratios are frequently described as "muscular dysbalances" and considered one of the causes of shoulder pathologies, whereby objective quantification is difficult. METHODS: In order to quantify physiological muscle balance, the strength ratio of shoulder abduction/adduction (AB/AD) was determined in 166 untrained men (UM) concentrically at 60 degrees.s-1 (LIDO-Active). The influence on this norm of one-sided (25 high-performance (TPH), 18 leisure tennis players (TPL)) and two-sided athletic exercise (32 gymnasts (GY)), altered daily exercise (11 paraplegics with paralysis time < 4 months (PP), 11 paraplegics with paralysis time > 2 yr (PU)), and a combination of altered daily exercise and athletic activity (16 trained paraplegics (PT)) was examined (ANOVA, alpha = 0.05). RESULTS: Determination of the AB/AD quotient in UM was 0.82. Shoulder stress in sports led to a decrease in quotients compared with UM because of a relatively increased torque in AD (P < 0.01). At the beginning of a paraplegia, the quotient of AB/AD is elevated (P < 0.05). This altered ratio decreases with duration of paralysis (PU) and athletic activity (PT). CONCLUSION: With increased shoulder stress, the altered strength ratios reflect specific requirements of the performance attained. However, the importance of muscular dysbalances for the onset of shoulder complaints must be considered more important than their influence on athletic performance capacity.

Predicting competition performance in long-distance running by means of a treadmill test.

PURPOSE: The purpose of this study was to examine the power of 16 parameters beside the individual anaerobic threshold (IAT) in predicting performance in various competition distances. METHODS: This study examined 427 competitive runners to test the prediction probability of the IAT and other parameters for various running distances. All runners (339 men, 88 women; ages, 32.5 +/- 10.14 yr; training, 7.1 +/- 5.53 yr; training distance, 77.9 +/- 35.63 km.wk-1) performed an increment test on the treadmill (starting speed, 6 or 8 km.h-1; increments, 2 km.h-1; increment duration, 3 min to exhaustion). The heart rate (HR) and the lactate concentrations in hemolyzed whole blood were measured at rest and at the end of each exercise level. The IAT was defined as the running speed at a net increase in lactate concentration 1.5 mmol.L-1 above the lactate concentration at LT. RESULTS: Significant correlations (r = 0.88-0.93) with the mean competition speed were found for the competition distances and could be increased using stepwise multiple regression (r = 0.953-0.968) with a set of additional parameters from the training history, anthropometric data, or the performance diagnostics. CONCLUSIONS: The running speed at a defined net lactate increase thus produces an increasing prediction accuracy with increasing distance. A parallel curve of the identity straight lines with the straight lines of regression indicates the independence of at least a second independent performance determining factor.

HSP expression in human leukocytes is modulated by endurance exercise.

PURPOSE: Temperature increase, oxidative stress, and inflammatory reactions after endurance exercise were expected to stimulate the synthesis of heat shock proteins (HSP) in peripheral blood leukocytes. Furthermore, it was of interest whether regular endurance training influences HSP expression. METHODS: The expression of HSP27, HSP60, HSP70, constitutive HSC70, and HSP90 in the cytoplasma and surface of lymphocytes, monocytes, and granulocytes of 12 trained athletes was analyzed by flow cytometry before and after (0, 3, and 24 h) a half marathon. Twelve untrained persons at rest were included as control. RESULTS: After the race, there was a significantly greater percentage of leukocytes expressing cytoplasmic HSP27, HSP60, and HSP70 (P < 0.01), whereas HSC70 and HSP90 remained unchanged. The fluorescence intensity increased significantly in monocytes for HSP27 (0 and 3 h) and HSP70 (0, 3, and 24 h) and in granulocytes, only 24 h postexercise for HSP70. The percent values of trained athletes at rest were significantly lower compared with untrained persons (P < 0,01). CONCLUSIONS: Strenuous exercise increased HSP expression in blood immediately after the run, indicating a protective function of HSP in leukocytes of athletes to maintain function after heavy exercise. The downregulation of HSP-positive cells in trained athletes at rest seems to be a result of adaptation mechanisms to regular endurance training.