RESUMEN
The ulcer of the foot induced by arteriosclerotic obstruction (ASO) is poor prognosis that often comes to amputation. In the meantime, the CO<sub>2</sub> warm water is reported with that it has the powerful vasodilator action. In this research, it was made that the effects for the foot ulcer using the high concentration CO<sub>2</sub> warm water bathing was examined to be a purpose.<br>The subjects are the 49 cases (average 66-years, male: female=20: 29) degree of Fontaine II-IV. We prepared high concentrated CO<sub>2</sub> warm water in approx. 1, 000ppm at 38— technically utilizing an artificial gas-permeable dialysis membrane (MRE-SPA, Mitsubishi Rayon Engineering Co., Ltd.). Using the partial bathing with this CO<sub>2</sub> warm water, the progress was observed on the improvement of foot ulcer in the bathing of 10min. as the period, and of 1-2time/day. In addition, the peripheral tissue bloodflow and the transcutaneous oxygen partial pressure in dorsum pedis during the warm water bathing were observed.<br>The obvious improvement on each case of ulcer was confirmed within several months. The peripheral tissue blood flow (before bathing 1.1±0.5<i>ml</i>/min/100g) was increased after 1min and it rose to 4.4±1.8 after 10min from the beginning to bathing (p<0.01). Afterwards, it immediately returned to the previous value after the end. In the meantime, though the transcutaneous oxygen partial pressure was 40.7±18.3mmHg prior to the bathing, it increases after 10min with 50.7±18.2mmHg (p<0.05), and it was maintained at 50.3±20.8mmHg in 20min after bathing (p<0.01). And, in each Fontaine groups it significantly increase with the peripheral tissue bloodflow and the transcutaneous oxygen partial pressure.<br>As a conclusion, the partial bathing of the foot with high concentration CO<sub>2</sub> warm water is effective as the therapy for the foot ulcer caused by ASO. The mechanism indicated that the rise of transcutaneous oxygen partial pressure and peripheral tissue bloodflow was concerned without relating to the seriousness of ASO.
RESUMEN
Effects of cold and warm water bathing of hemiplegic lower limb on its isokinetic muscle strength were studied in 12 chronic stroke patients (9 males and 3 females, 53.3±14.2 yo, Ueda's grading 8.5±1.6 Grade).<br>Measurements of the isokinetic muscle strength of the knee flexion/extension were repeated three times; 1) after sitting for 10min at room temperature (21-22°C) as a control, 2) after cold water bathing (18°C) of hemiplegic lower limb for 5min, 3) after warm water bathing (41°C, 700ppm artificial CO<sub>2</sub> bath) of hemiplegic lower limb for 10min. The measurements were performed, using Cybex 6000 (Cybex international Co) at velocities of 60, 120, 180 and 240°/sec. Artificial CO<sub>2</sub> bath was prepared by dissolving Kao Babu (Kao Co) in 41°C warm water.<br>Peak torque of the knee flexions at any velocity decreased significantly after cold water bathing and imcreased after warm water bathing. Change in the maximum power and total work were similar to that of the peak torque. The muscle strength of the knee extension were not changed by neither cold nor warm water bathing.<br>The correlation coefficient between Ueda's Grade and its isokinetic muscle strength ranged from 0.3 to 0.6 and significantly improved after warm water bathing at velocity of 120 (°/second) in flexion. Warm water bathing might make it easy to exert their muscle strength at 120°/sec in flexion corresponding to their severity of their hemiplegia.<br>Regarding to the influence of spasticity, patients with no ankle clonus or pseudoclonus showed a tendency to increase in muscle strength of flexion and extension after warm water bathing. In patients with evident clonus, a tendency to decrease on extension and increase on flexion was seen after warm water bathing.<br>Further studies on the effects of warm water bathing of partial and full immersion in the treatment for spasticity of hemiplegic limb would contribute to stroke rehabilitation.
RESUMEN
The effect of Artificial CO<sub>2</sub>-bathing was compared with that of placebo bathing on patients with rheumatoid arthritis (RA). A large tablet containing sodium bicarbonate and citric acid, which is called Bub, was used to make CO<sub>2</sub> gas as it dissolves in water bath. A placebo tablet, which is quite same in the appearance, has the substrate only and makes no gas. So the trial was performed by single blind method.<br>Forty two RA patients (definite or classical) were tested by single bathing and other 40 RA patients, by serial bathing of 30 days (once a day). After a single bathing grip strength of the patients increased significantly in both groups, but more significantly in Bub group (p<0.01 vs p<0.05). The joint tenderness also reduced significantly after a single bathing in both groups, almost equally. However plasma β endorphin levels were little changed after single bathing in both groups.<br>By serial bathing of 30 days, Lansbury's activity index, ADL score, and pain score were all changed insignificantly in each group. However Bub group showed a tendency to improve in the 3 parameters, whereas placebo group did a tendency to deteriorate.<br>From the above results it was considered that artificial CO<sub>2</sub>-bathing may exert more beneficial effects on RA patients, as compared with plain water bathing.
RESUMEN
Actual changes in tissue partial pressures of each gas and tissue perfusion with serial artificial CO<sub>2</sub> bathing were evaluated by means of medical mass spectrometry using 5 rabbits.<br>An artificial CO<sub>2</sub> bath was prepared by adding “BUB”-KAO, a 50g sodium hydrogencarbonate and succinic acid tablet producing fine CO<sub>2</sub> bubbles in water of constant temperature 20-litre tub at 36-37°C.<br>Regional tissue perfusion volume was determined on the basis of a clearance curve for Argon tissue partial pressure which was monitored by an on-line computer system with mass spectrometry.<br>Increase in subcutaneous tissue PCO<sub>2</sub> changed from 27% to 10%, and in PO<sub>2</sub> from 12% to 5% on average by serial bathing every day for 4 weeks, on the other hand tissue perfusion volume was increased in 3 out of 5 cases; from 20.85±3.56 (X±SE) m<i>l</i>/100g/min, SD=6.71, p<0.05 to 25.23±8.00 (X±SE) m<i>l</i>/100g/min, SD=6.96, p<0.05.<br>CO<sub>2</sub> has been shown to be locally absorbed through the skin resulting in the elevation of subcutaneous tissue CO<sub>2</sub> partial pessure which decreases depending on the tissue perfusion irrespective of metabolic processes. It is, therefore, assumed that the elimination of absorbed constituents by serial bathings is not caused by a decrease in the percutaneous absorption rate but an increase in washing out rate by the improved tissue perfusion.