ABSTRACT
Purpose<br>To investigate the effect of CO<sub>2</sub>-inhalation on the cerebral circulation of CVA patients during artificial CO<sub>2</sub>-bathing, controlled examinations were made with <sup>99m</sup>Tc-hexamethyl propyleneamine oxime SPECT (hereinafter abbreviated as HM-PAO-SPELT).<br>Subject and Methods<br>HM-PAO-SPECT was conducted on four CVA patients without CO<sub>2</sub>-inhalation as a control. 0.5g of artificial CO<sub>2</sub>-bath tablet (Kao Bub<sup>®</sup>) was them added to 2<i>l</i> of hot tapwater at 40°C to provide an ordinary bathing concentration. The patients inhaled the CO<sub>2</sub> generated for 3min at a height of 20cm above the water level, which was immediately followed by HM-PAO-SPECT. Similar examinations were performed at a higher bathing concentration provided by adding 50g of artificial CO<sub>2</sub>-bath tablet (Kao Bub<sup>®</sup>) to 2<i>l</i> of water. To compare results with systemic circulation, blood pressure and blood gas were measured before and after the CO<sub>2</sub>-inhalation.<br>Results<br>HM-PAO-SPECT showed a remarkable increase in blood flow in two of the four patients when 0.5g of artificial CO<sub>2</sub>-bath tablet was used to provide an ordinary bathing concentration. At a concentration 100 times higher than ordinary concentration using 50g of artificial CO<sub>2</sub>-bath tablet, obvious increase in blood flow was found in three of the patients. At both concentrations, the remaining patient showed a decrease on blood flow, with no change in blood pressure or blood gas.<br>Discussion<br>CO<sub>2</sub> is considered as one of the most potent factors involved in cerebral blood flow. In these examinations, the effect of CO<sub>2</sub>-inhalation from artificial CO<sub>2</sub>-bath tablet in increasing blood flow was confirmed by means of HM-PAO-SPECT. Its usefulness was thus proven. The subject who showed a decrease in blood flow may have been in a period of steal phenomenon, or luxury perfusion, when he underwent the examination. Future studies must be performed on the relationship between the increase in blood flow and the improvement of symptom, timing of artificial CO<sub>2</sub> bathing, and between the effect of artificial bathing and the CO<sub>2</sub> concentration.
ABSTRACT
The effect of the artificial CO<sub>2</sub>-bathing on the blood pressure in patients with Parkinson's disease with autonomic disorder was investigated and the conclusions were obtained as follows;<br>1. Regardless of the extent of the autonomic disorder and the contents in the bath, the slight increase in the blood pressure was observed immediatly after the bathing.<br>2. Systolic blood pressure within 100-150mmHg before the bathing decreased gradually during the bathing and the degree of the decrease was proportional to the extent of the autonomic disorder. The variation of the blood pressere during the bathing was within 30mmHg.<br>3. Furthermore, when the artificial CO<sub>2</sub>-bathing liquid was used, the decrease in the blood pressure after the bathing was salient in proportion to the extent of the autonomic disorder and it was observed that the restoration of the blood pressure to the level before the bathing was remarkably delayed compared with the tap water bathing. This phenomenon was similar in patient with Shy-Drager syndrome characterized by severe autonomic disorder.<br>4. From the above results, it was suggested that the close management of the blood pressure and the attention to the change of position are necessary during and after the artificial CO<sub>2</sub>-bathing in patient with Parkinson's disease with severe autonomic disorders and patients with Shy-Drager syndrome.
ABSTRACT
The therapeutic effect of artificial CO<sub>2</sub> pack on pressure sores of five patients with neurological diseases was confirmed using an infrared thermometer.<br>The artificial CO<sub>2</sub> pack was prepared by dissolving a 5-g KAO-BABU tablet in 250ml of water at 50°C.<br>It was proven that the pressure sore recovered faster after treatment with artificial CO<sub>2</sub> hot-pack than that with plain water hot-pack.<br>In addition, the skin temperature in the area around the pressure sore became lower than the temperature just before the treatment presumably because of the steal phenomenon of blood flow under the skin.