Influence of Full-body Water Immersion on Esophageal Motor Function and Intragastric Pressure

BACKGROUND/AIMS: In Japan, it is customary to take a daily bath during which the body is immersed in water to the neck. During full-body immersion, hydrostatic pressure is thought to compress the chest and abdomen, which might influence esophageal motor function and intra-gastric pressure. However, whether water immersion has a significant influence on esophageal motor function or intragastric pressure has not been shown. The aim of this study was to clarify the influence of full-body water immersion on esophageal motor function and intragastric pressure. METHODS: Nine healthy male volunteers (mean age 40.1 +/- 2.8 years) were enrolled in this study. Esophageal motor function and intragastric pressure were investigated using a high-resolution 36-channel manometry device. RESULTS: All subjects completed the study protocol. Intragastric pressure increased significantly from 4.2 +/- 1.1 to 20.6 +/- 1.4 mmHg with full-body water immersion, while the lower esophageal high pressure zone (LEHPZ) value also increased from 20.5 +/- 2.2 to 40.4 +/- 3.6 mmHg, with the latter being observed regardless of dietary condition. In addition, peak esophageal peristaltic pressure was higher when immersed as compared to standing out of water. CONCLUSIONS: Esophageal motor function and intragastric pressure were altered by full-body water immersion. Furthermore, the pressure gradient between LEHPZ and intragastric pressures was maintained at a high level, and esophageal peristaltic pressure was elevated with immersion.

Factors Supporting Continuation of Recuperation at Home of a Respirator Wearing Patient / 日本農村医学会雑誌

Two years have passed since a patient who started to use the respirator for a tuberculosis sequela and chronic respiratory failure at home. During this period, the patient got several short-term admissions into the hospital. After his first discharge, the patient and his family felt anxiety about recupration at home. It was the first time for us to provide home care services to a respirator wearing patient. However, the shift to recuperation at home was realized as an understanding was reached between physicians who decided upon care home and the patient's wife who wished “to live with the husband together”. The patient is now playing a role as a father and as a husband, and he is leading a full life. In this study, the personal and familial circumstances of the patient, decision-making about home care and community support were analized. We coucluded that there were several important factors for successful recuperation at home:specification of contents of concrete medical support to a patient and a family;an immediate suitable action at the time of change of a patient's condition;taking periodic rests of a patient and a family;and a good family relationship.