Overtraining in elite athletes. Review and directions for the future

Overtraining is an imbalance between training and recovery. Short term overtraining or 'over-reaching' is reversible within days to weeks. Fatigue accompanied by a number of physical and psychological symptoms in the athlete is an indication of 'staleness' or 'overtraining syndrome'. Staleness is a dysfunction of the neuroendocrine system, localised at hypothalamic level. Staleness may occur when physical and emotional stress exceeds the individual coping capacity. However, the precise mechanism has yet to be established. Clinically the syndrome can be divided into the sympathetic and parasympathetic types, based upon the predominance of sympathetic or parasympathetic activity, respectively. The syndrome and its clinical manifestation can be explained as a stress response. At present, no sensitive and specific tests are available to prevent or diagnose overtraining. The diagnosis is based on the medical history and the clinical presentation. Complete recovery may take weeks to months.     

Facilitation and depression in the responses of spinal Renshaw cells to random stimulation of motor axons

1. We investigated the responses of cat lumbosacral Renshaw cells to pseudo-Poison stimulus sequences (of three different mean rates) delivered to motor axons in ventral roots or various muscle nerves. The Renshaw cell responses were evaluated by computation of peristimulus time histograms (PSTHs). 2. PSTHs computed with respect to all the stimuli showed, before the reference time, near-constant bin contents corresponding to the mean firing probability (rate), and an initial excitatory component (increase in discharge probability) after the reference time, followed by a small but longer-lasting reduction of firing rate. These two response components were strongly correlated linearly. It is suggested that the postexcitatory rate reduction is predominantly due to afterhyperpolarization. 3. In general, Renshaw cell responses to any stimulus in a stimulus train depended upon the stimulation history. In the averaged record, the response to the second of a pair of stimuli was affected by the first stimulus independently of intervening (random) stimuli. Very often, the second response showed a long-lasting depression (from 25 to greater than 250 ms). In a number of cases a briefer facilitating effect preceded the depression. 4. These conditioning effects were largely homosynaptic, i.e., confined to the particular input channel that was stimulated. This was shown by stimulating two different nerves (or nerve branches) with independent random patterns of similar mean rates and determining the cross-conditioning exerted by one input channel on the excitatory effects of the other. At small intervals between conditioning and test stimuli of some tens of milliseconds, a facilitatory effect could often be seen, which almost certainly reflected spatial summation. However, the subsequent depressant effect was largely accounted for by the postexcitatory rate reduction consequent to the conditioning stimulus in the parallel channel. Autoconditioning was still present. 5. The amount of facilitation and depression as well as their balance depended on the average Renshaw cell response. This in turn depended, at each mean stimulus rate, on the strength of synaptic coupling between an input channel and the cell, and on the mean stimulus rate, declining with an increase in mean rate. That is, the facilitation increased and the depression decreased with decreasing synaptic coupling and increasing mean stimulus rate. 6. Several factors may contribute to facilitation and depression; these are discussed with respect to their relative quantitative significance.(ABSTRACT TRUNCATED AT 400 WORDS)     

Structural muscle damage and muscle strength after incremental number of isometric and forced lengthening contractions

Summary Exercise-induced muscle damage is characterized by histological changes, like Z-line streaming, inflammatory response and decreased muscle function reflected in a prolonged decline in maximal isometric muscle strength after eccentric work. It is assumed that force decrement is mainly related to the amount of structural damage. However, the relationship between number of eccentric contractions, magnitude of structural damage and force decrement is not very well documented. Therefore we studied the effect of an increasing number of both isometric and eccentric (forced lengthening) contractions on histological parameters of muscle damage and maximal isometric force in an experimental in situ rat model. Tibialis anterior muscles of male Wistar rats were subjected to an increasing number of either isometric or eccentric contractions and were examined for histological markers of muscle damage. The present study shows that muscle damage increases progressively with the number of forced lengthening contractions. Maximal isometric torque was found to decline after both types of exercise. However, the decline after forced lengthening exercise was more pronounced. Only a weak relationship between percentage of histological muscle damage and isometric torque after forced lengthening contractions was found. The findings of the present study suggest that the decline in muscle force after eccentric exercise may partly be attributed to other factors than structural damage.     

Production of prostaglandin E2 in monocytes stimulated in vitro by Chlamydia trachomatis, Chlamydophila pneumoniae, and Mycoplasma fermentans

Chlamydia trachomatis (CT) as well as Chlamydophila pneumoniae (CP) cause chronic inflammatory diseases in humans. Persistently infected monocytes are involved in the pathogenesis by inducing mediators of inflammation. An in vitro system of chlamydial persistence in human peripheral blood monocytes (HPBM) was used to investigate prostaglandin E(2) (PGE(2)) production and the expression of the key enzyme for prostaglandin production, cyclooxygenase-2 (COX-2). PGE(2) production was determined by PGE(2)-ELISA of HPBM-culture supernatants. Cox-2 mRNA expression was measured by real-time RT-PCR of total RNA isolated from HPBM. Both, CT and CP, stimulated PGE(2) production of HPBM in vitro. Equivalent numbers of CT per host cell induced a higher PGE(2)-response compared to CP. The amount of synthesized PGE(2) depended on the chlamydial multiplicity of infection (MOI). Even at an MOI of 10 the amount of CT- and CP-induced prostaglandin, respectively, was lower than the amount of prostaglandin induced by E. coli lipopolysaccharide (LPS) at a concentration of 10microg/ml. In contrast to stimulation with LPS, Chlamydia-induced PGE(2) production as well as cox-2 mRNA decreased after day 1 post infection (p.i.). These data indicate that Chlamydia stimulate PGE(2) production in human monocytes. Since Chlamydia are often contaminated by mycoplasma, the influence of mycoplasma on the prostaglandin production was investigated additionally. Mycoplasma fermentans (MF) also stimulated PGE(2) production. The co-infection of mycoplasma and Chlamydia resulted in an additive effect in the production of PGE(2). Thus it is important to use host cells and Chlamydia free of mycoplasma contamination for the analysis of Chlamydia-induced prostaglandin production.     

Description of a hybridoma bank towards Bordetella pertussis toxin and surface antigens

This paper describes the development of a murine bank of monoclonal antibodies against Bordetella pertussis toxin, filamentous hemagglutinin (FHA), pili, lipopolysaccharide (LPS), or outer membrane proteins (OMPs). Subunits S1, S2, S3 of pertussis toxin (PT) bound immunoglobulins and glycoproteins such as fetuin and haptoglobin in an unspecific manner. The specificity of monoclonal antibodies towards subunits S1, S2, S3 or S4 of PT could be demonstrated by using purified immunoglobulins or their Fab2 fragments. A set of FHA-specific monoclonal antibodies could be differentiated on the basis of their binding to the various breakdown products present in FHA preparations. Pili-specific monoclonal antibodies reacted with either native pili or denatured pilin, and both demonstrated serotype specificity. Monoclonal antibodies to Bordetella pertussis OMPs were directed to either the virulent phase-regulated trypsin-sensitive, detergent-extractable OMPs 92 kDa, 32 kDa, and 30 kDa or the non-virulent phase-expressed, not-trypsin sensitive OMPs 38 kDa, 33kDa, and 18 kDa.     

Pulse oximetry--principle and first experiences during anesthesia

Oximetry is a photometric method for simple, non-invasive, and continuous measurement of the O2 saturation (SaO2). The addition of the word "pulse" indicates that, directed by a photo-electric plethysmogram, measurements are only performed during arterial pulsations. It appears from our first experiences with pulse oximetry during anesthesia that each decrease in SaO2 is indicated quickly and reliably. From a practical point of view it is important that the apparatus is connected quickly and easily, and that the O2 saturation is monitored continuously, also in those periods when normally no blood samples are taken. An additional advantage is that by means of the plethysmogram the circulation is also monitored.     

First-pass lung uptake and pulmonary clearance of propofol: assessment with a recirculatory indocyanine green pharmacokinetic model

BACKGROUND: The principal site for elimination of propofol is the liver. The clearance of propofol exceeds hepatic blood flow; therefore, extrahepatic clearance is thought to contribute to its elimination. This study examined the pulmonary kinetics of propofol using part of an indocyanine green (ICG) recirculatory model. METHODS: Ten sheep, immobilized in a hammock, received injections of propofol (4 mg/kg) and ICG (25 mg) via two semipermanent catheters in the right internal jugular vein. Arterial blood samples were obtained from the carotid artery. The ICG injection was given for measurement of intravascular recirculatory parameters and determination of differences in propofol and ICG concentration-time profiles. No other medication was given during the experiment, and the sheep were not intubated. The arterial concentration-time curves of ICG were analyzed with a recirculatory model. The pulmonary uptake and elimination of propofol was analyzed with the central part of that model extended with a pulmonary tissue compartment allowing elimination from that compartment. RESULTS: During the experiment, cardiac output was 3.90+/-0.72 l/min (mean +/- SD). The blood volume in heart and lungs, measured with ICG, was 0.66+/-0.07 l. A pulmonary tissue compartment of 0.47+/-0.16 l was found for propofol. The pulmonary first-pass elimination of propofol was 1.14+/-0.23 l/min. Thirty percent of the dose was eliminated during the first pass through the lungs. CONCLUSIONS: Recirculatory modeling of ICG allows modeling of the first-pass pulmonary kinetics of propofol concurrently. Propofol undergoes extensive uptake and first-pass elimination in the lungs.