A Study on the Safety of Hot Spring Bathing for Pregnant Women / 日本温泉気候物理医学会雑誌

  Pregnancy has been removed from the list of contraindications for hot spring bathing. Therefore, The Japanese Society of Balneology, Climatology and Physical Medicine has considered that it is necessary to conduct a joint research on the safety of hot spring bathing for pregnant women, publish the results extensively, and enlighten the public about this matter. Considering that only a small number of reports have been published in Japan about the safety of hot spring bathing for pregnant women, the Society has decided to study this subject.   Expectant and nursing mothers living in hot spring towns, such as Beppu and Ibusuki City, have responded to questions about the period between the early stages of pregnancy and delivery via a self-administered questionnaire; The questions included: 1) age when the pregnancy ended, 2) number of previous deliveries, 3) details of hot spring bathing　habits (whether they bathed in hot springs on a daily basis, how often they bathed during the different [early, middle, and late] stages of pregnancy, and whether they used hot spring baths attached to their homes or hot spring facilities away from their homes), and 4) whether they had pregnancy complications such as miscarriages (excluding those occurring in the early stages of pregnancy), premature delivery, threatened premature delivery, or toxemia of pregnancy/pregnancy-induced hypertension (edema, hypertension).  Total 1,721 responses were collected (86% reply rate). The mean participant age was 30.8 years. Importantly, there were 643 (37.6%) primigravid and 1,078 (62.4%) parous women. Age and gravidity were not associated with pregnancy complications. In the early and middle stages of pregnancy, there were no significant differences in the incidence of pregnancy complications between individuals who bathed ≥ once per week [hot spring bath (+)] group and those who bathed < once per week [hot spring bath (−)] group. In the late stages of pregnancy, the number of pregnancy complications were fewer in the hot spring bath (+) group (20.3%) than that in the hot spring bath (−) group (25.9%) (p = 0.028). In addition, there were no significant differences in the pregnancy complications between hot spring bathing (+) and hot spring bath (−) groups in the early and middle stages of pregnancy even if we focused on the homecoming pregnant women. Whereas, in the late stages of pregnancy, the number of pregnancy complications were fewer in the hot spring bath (+) group (13.0%) compared with the hot spring bath (−) group (24.5%) (p = 0.028) in the homecoming pregnant women.  This study has confirmed that daily hot spring bathing during pregnancy does not increase the incidence of pregnancy complications. Furthermore, it can be stated that the removal of “pregnancy” from the contraindications of hot spring bathing was appropriate.

Comparison of the Habit of Bathing between Japanese Living in Kyoto and Japanese Americans Living in Los Angeles / 日本温泉気候物理医学会雑誌

<p><b>Pur</b><b>pose:</b> Bathing habits are said to be affected by the country of residence. We investigated and compared bathing habits between Japanese living in Kyoto and Japanese Americans living in Los Angeles. </p><p><b>Methods:</b> 488 subjects living in Kyoto (Japanese) and 539 subjects living in Los Angeles (Japanese Americans) were enrolled. The survey items for bathing habits were as follows: frequency (times per week) and time (morning, afternoon, evening) of taking baths and showers, other styles of bathing, and bathing duration (both baths and showers). We performed a simple tabulation and cross tabulation, calculated 95% confidential intervals by simple tabulation, and compared the results using chi-square analysis. The survey was conducted in Los Angeles in October 2010 and in Kyoto in December 2013.</p><p><b>Results:</b> The percentage of subjects who took baths was 92.8% for Japanese and 56.0% for Japanese Americans. The frequency of taking a bath was 36.8 points higher for Japanese compared with Japanese Americans. The percentage of subjects who took showers was 71.7% for Japanese and 82.6% for Japanese Americans. The frequency of taking a shower was 10.9 points higher for Japanese Americans compared with Japanese. The most common response for frequency of bathing was “every day”, followed by “every other day” in both groups. The most common response for the time of taking a bath was “evening” in both groups. Among Japanese Americans, 21.8% took baths in the “morning”. Most Japanese indicated they took a shower “less than once a week” (48.0%), whereas most Japanese Americans took a shower “every day” (78%). The timing of taking a shower was in the “evening” for most Japanese, but in the “morning” or “evening” for most Japanese Americans. The most common response for bathing duration (both baths and showers) was “26-30 min” among Japanese and “6-10 min” among Japanese Americans.</p><p><b>Discussion:</b> For Japanese Americans, the purpose of bathing was suggested to be cleaning the body since their main style of bathing was taking showers of a short duration in the morning or evening. On the other hand, for Japanese, the purpose of bathing was thought to be cleaning and healing the body, but also maintaining health since their main style of bathing was taking baths of a long duration in the evening. We speculate that the country of residence affects bathing habits and that there are differences among people of the same race living in different countries.</p><p><b>Conclusion:</b> Bathing habits such as bathing style, the time of bathing and bathing duration were different between Japanese and Japanese Americans.</p>

Comparison of the Habit of Bathing between Japanese Living in Kyoto and Japanese Americans Living in Los Angeles / 日本温泉気候物理医学会雑誌

Purpose: Bathing habits are said to be affected by the country of residence. We investigated and compared bathing habits between Japanese living in Kyoto and Japanese Americans living in Los Angeles. Methods: 488 subjects living in Kyoto (Japanese) and 539 subjects living in Los Angeles (Japanese Americans) were enrolled. The survey items for bathing habits were as follows: frequency (times per week) and time (morning, afternoon, evening) of taking baths and showers, other styles of bathing, and bathing duration (both baths and showers). We performed a simple tabulation and cross tabulation, calculated 95% confidential intervals by simple tabulation, and compared the results using chi-square analysis. The survey was conducted in Los Angeles in October 2010 and in Kyoto in December 2013.Results: The percentage of subjects who took baths was 92.8% for Japanese and 56.0% for Japanese Americans. The frequency of taking a bath was 36.8 points higher for Japanese compared with Japanese Americans. The percentage of subjects who took showers was 71.7% for Japanese and 82.6% for Japanese Americans. The frequency of taking a shower was 10.9 points higher for Japanese Americans compared with Japanese. The most common response for frequency of bathing was “every day”, followed by “every other day” in both groups. The most common response for the time of taking a bath was “evening” in both groups. Among Japanese Americans, 21.8% took baths in the “morning”. Most Japanese indicated they took a shower “less than once a week” (48.0%), whereas most Japanese Americans took a shower “every day” (78%). The timing of taking a shower was in the “evening” for most Japanese, but in the “morning” or “evening” for most Japanese Americans. The most common response for bathing duration (both baths and showers) was “26-30 min” among Japanese and “6-10 min” among Japanese Americans.Discussion: For Japanese Americans, the purpose of bathing was suggested to be cleaning the body since their main style of bathing was taking showers of a short duration in the morning or evening. On the other hand, for Japanese, the purpose of bathing was thought to be cleaning and healing the body, but also maintaining health since their main style of bathing was taking baths of a long duration in the evening. We speculate that the country of residence affects bathing habits and that there are differences among people of the same race living in different countries.Conclusion: Bathing habits such as bathing style, the time of bathing and bathing duration were different between Japanese and Japanese Americans.

Comparison of the Habit of Bathing between Japanese Living in Kyoto and Japanese Americans Living in Los Angeles / 日本温泉気候物理医学会雑誌

<p><b>Purpose:</b> Bathing habits are said to be affected by the country of residence. We investigated and compared bathing habits between Japanese living in Kyoto and Japanese Americans living in Los Angeles. </p><p><b>Methods:</b> 488 subjects living in Kyoto (Japanese) and 539 subjects living in Los Angeles (Japanese Americans) were enrolled. The survey items for bathing habits were as follows: frequency (times per week) and time (morning, afternoon, evening) of taking baths and showers, other styles of bathing, and bathing duration (both baths and showers). We performed a simple tabulation and cross tabulation, calculated 95% confidential intervals by simple tabulation, and compared the results using chi-square analysis. The survey was conducted in Los Angeles in October 2010 and in Kyoto in December 2013.　</p><p><b>Results:</b> The percentage of subjects who took baths was 92.8% for Japanese and 56.0% for Japanese Americans. The frequency of taking a bath was 36.8 points higher for Japanese compared with Japanese Americans. The percentage of subjects who took showers was 71.7% for Japanese and 82.6% for Japanese Americans. The frequency of taking a shower was 10.9 points higher for Japanese Americans compared with Japanese. The most common response for frequency of bathing was “every day”, followed by “every other day” in both groups. The most common response for the time of taking a bath was “evening” in both groups. Among Japanese Americans, 21.8% took baths in the “morning”. Most Japanese indicated they took a shower “less than once a week” (48.0%), whereas most Japanese Americans took a shower “every day” (78%). The timing of taking a shower was in the “evening” for most Japanese, but in the “morning” or “evening” for most Japanese Americans. The most common response for bathing duration (both baths and showers) was “26-30 min” among Japanese and “6-10 min” among Japanese Americans.</p><p><b>Discussion:</b> For Japanese Americans, the purpose of bathing was suggested to be cleaning the body since their main style of bathing was taking showers of a short duration in the morning or evening. On the other hand, for Japanese, the purpose of bathing was thought to be cleaning and healing the body, but also maintaining health since their main style of bathing was taking baths of a long duration in the evening. We speculate that the country of residence affects bathing habits and that there are differences among people of the same race living in different countries.</p><p><b>Conclusion:</b> Bathing habits such as bathing style, the time of bathing and bathing duration were different between Japanese and Japanese Americans.</p>

S1-5The effects of Waon therapy for patients with chronic pain and fibromyalgia / 日本温泉気候物理医学会雑誌

<b>Objectives: </b>Many patients with chronic pain and fibromyalgia (FM) consult health care clinics continually, and move from hospital to hospital without gaining pain relief. In some patients, prolonged refractory pain affects their daily life and social function despite various treatments. The purpose of this study was to clarify the effects of Waon therapy in patients with chronic pain and FM.<BR><b>Patients and Methods: </b><BR><b>Study A:</b> 46 patients with chronic pain were assigned to Waon therapy group (n = 22) or non-Waon therapy group (n = 24). All patients were admitted to our hospital for 5 weeks. In non-Waon therapy group, cognitive behavior therapy (CBT), rehabilitation, and exercise therapy were performed during hospitalization. Waon therapy was started 2 weeks after admission in addition to CBT, rehabilitation, and exercise therapy. And the therapy was performed for 4 weeks. Pain was evaluated by the visual analog scale (VAS). Pain behavior was assessed based on the 11 items and the number per day was counted. Anger score was evaluated using the mentral complaints in the Cornell Medical Index. The degree of satisfaction with treatment was evaluated at discharge. <BR><b>Study B: </b>12 patients who fulfilled the FM criteria of the American College of Rheumatology. All patients received 20 sessions of Waon Therapy at our outpatients clinic. The VAS pain scale and the Fibromyalgia Impact Questionnaire (FIQ), Profile of Mood State (POMS) were evaluated before and after 10 and 20 sessions of Waon Therapy. <BR><b>Results: </b><BR><b>Study A: </b>The differences in number of pain behavior and anger scores before and after treatment were significantly larger in Waon therapy group than those in non-Waon therapy group. The treatment was rated as ‘satisfactory’ or ‘very satisfactory’ by 55% in non-Waon-therapy group and 82% in Waon Therapy group. <BR><b>Study B: </b>The VAS pain scores and FIQ scores were improved after the 10 and 20 sessions of Waon therapy. In the POMS, depression and anger, anxiety, confusion scales were sigificantly decresed and vigor score was elevated. <BR><b>Conclusion:</b> Waon therapy may be a promising method for treatment of chronic pain and fibromyalgia.

02-2Preventive effect of thermal therapy on heart failure due to pressure overload / 日本温泉気候物理医学会雑誌

<b>Introduction:</b> Long-term cardiac hypertrophy causes heart failure. One of the mechanisms of this transition from hypertrophy to heart failure is collapse of hypoxic response and angiogenesis. Heat shock protein 27 (HSP27) was found to act as an anti-apoptotic protein and its phosphorylation is responsible for the protection of cells against heat stress. HSP27 has been reported to regulate p53 expression, which contributes to down-regulate angiogenic factors through hypoxia inducible factor-1α(HIF-1α). We have reported that thermal therapy, namely Waon therapy, improves cardiac and vascular function in patients with chronic heart failure. However, the effect of this therapy on cardiac hypertrophy due to pressure overload is unknown. The purpose of this study is to investigate the effects and mechanisms of thermal therapy (Waon therapy) on the transition from cardiac hypertrophy to heart failure after pressure overload.<BR><b>Methods:</b> Cardiac hypertrophy was induced by transverse aortic constriction (TAC) in C57BL/6 mice. At 2 weeks after TAC, all mice were examined by echocardiography and showed left ventricular hypertrophy. Then, mice were randomly divided into thermal therapy or untreated group. Thermal therapy group received thermal therapy using an experimental far infrared ray dry sauna, which elevates the core temperature by 1 degree Celsius for 30 minutes, daily for 4 weeks. Sham operated mice were used as control. At 6 weeks after TAC, we measured body weight, heart rate and blood pressure before sacrifice, and eviscerated heart and leg muscle. Western blot analysis of p53, phosphorylated HSP27, HIF-1α and vascular endothelial growth factor (VEGF) was performed using extracted protein form heart.<BR><b>Results: </b>At 6 weeks after TAC, body weight, heart rate and blood pressure did not differ in three groups. Echocardiography showed that left ventricular fractional shortening of thermal therapy group was significantly larger than that of untreated group (Sham vs. Untreated vs. Thermal; 50.0±1.7 vs. 36.7±1.3 vs. 46.2±0.5, P<0.01, n=6 each). Heart weight/tibia length ratio of thermal therapy group was significantly smaller than that of untreated group (6.7±0.1 vs. 9.7±0.5 vs. 7.9±0.2, P<0.01, n=9 each). Western blot showed that thermal therapy increased phosphorylation of HSP27 and reduced p53. Thermal therapy also increased HIF-1α and VEGF at 6 weeks after TAC. Capillary/myofiber ratio was larger in thermal therapy group than that in untreated group (1.71±0.05 vs. 2.04±0.04 vs. 2.41±0.10, P<0.01, n=4 each).<BR><b>Conclusion:</b> Thermal therapy, namely Waon therapy, prevented the transition from cardiac hypertrophy to heart failure induced by pressure overload in mice. As the mechanism, thermal therapy amplified the phosphorylation of HSP27 and inhibited p53, increased HIF-1α and VEGF, and then increased angiogenesis.

02-2 Preventive effect of thermal therapy on heart failure due to pressure overload / 日本温泉気候物理医学会雑誌

Introduction: Long-term cardiac hypertrophy causes heart failure. One of the mechanisms of this transition from hypertrophy to heart failure is collapse of hypoxic response and angiogenesis. Heat shock protein 27 (HSP27) was found to act as an anti-apoptotic protein and its phosphorylation is responsible for the protection of cells against heat stress. HSP27 has been reported to regulate p53 expression, which contributes to down-regulate angiogenic factors through hypoxia inducible factor-1α(HIF-1α). We have reported that thermal therapy, namely Waon therapy, improves cardiac and vascular function in patients with chronic heart failure. However, the effect of this therapy on cardiac hypertrophy due to pressure overload is unknown. The purpose of this study is to investigate the effects and mechanisms of thermal therapy (Waon therapy) on the transition from cardiac hypertrophy to heart failure after pressure overload. Methods: Cardiac hypertrophy was induced by transverse aortic constriction (TAC) in C57BL/6 mice. At 2 weeks after TAC, all mice were examined by echocardiography and showed left ventricular hypertrophy. Then, mice were randomly divided into thermal therapy or untreated group. Thermal therapy group received thermal therapy using an experimental far infrared ray dry sauna, which elevates the core temperature by 1 degree Celsius for 30 minutes, daily for 4 weeks. Sham operated mice were used as control. At 6 weeks after TAC, we measured body weight, heart rate and blood pressure before sacrifice, and eviscerated heart and leg muscle. Western blot analysis of p53, phosphorylated HSP27, HIF-1α and vascular endothelial growth factor (VEGF) was performed using extracted protein form heart. Results: At 6 weeks after TAC, body weight, heart rate and blood pressure did not differ in three groups. Echocardiography showed that left ventricular fractional shortening of thermal therapy group was significantly larger than that of untreated group (Sham vs. Untreated vs. Thermal; 50.0±1.7 vs. 36.7±1.3 vs. 46.2±0.5, P<0.01, n=6 each). Heart weight/tibia length ratio of thermal therapy group was significantly smaller than that of untreated group (6.7±0.1 vs. 9.7±0.5 vs. 7.9±0.2, P<0.01, n=9 each). Western blot showed that thermal therapy increased phosphorylation of HSP27 and reduced p53. Thermal therapy also increased HIF-1α and VEGF at 6 weeks after TAC. Capillary/myofiber ratio was larger in thermal therapy group than that in untreated group (1.71±0.05 vs. 2.04±0.04 vs. 2.41±0.10, P<0.01, n=4 each). Conclusion: Thermal therapy, namely Waon therapy, prevented the transition from cardiac hypertrophy to heart failure induced by pressure overload in mice. As the mechanism, thermal therapy amplified the phosphorylation of HSP27 and inhibited p53, increased HIF-1α and VEGF, and then increased angiogenesis.

S1-5 The effects of Waon therapy for patients with chronic pain and fibromyalgia / 日本温泉気候物理医学会雑誌

Objectives: Many patients with chronic pain and fibromyalgia (FM) consult health care clinics continually, and move from hospital to hospital without gaining pain relief. In some patients, prolonged refractory pain affects their daily life and social function despite various treatments. The purpose of this study was to clarify the effects of Waon therapy in patients with chronic pain and FM. Patients and Methods: Study A: 46 patients with chronic pain were assigned to Waon therapy group (n = 22) or non-Waon therapy group (n = 24). All patients were admitted to our hospital for 5 weeks. In non-Waon therapy group, cognitive behavior therapy (CBT), rehabilitation, and exercise therapy were performed during hospitalization. Waon therapy was started 2 weeks after admission in addition to CBT, rehabilitation, and exercise therapy. And the therapy was performed for 4 weeks. Pain was evaluated by the visual analog scale (VAS). Pain behavior was assessed based on the 11 items and the number per day was counted. Anger score was evaluated using the mentral complaints in the Cornell Medical Index. The degree of satisfaction with treatment was evaluated at discharge. Study B: 12 patients who fulfilled the FM criteria of the American College of Rheumatology. All patients received 20 sessions of Waon Therapy at our outpatients clinic. The VAS pain scale and the Fibromyalgia Impact Questionnaire (FIQ), Profile of Mood State (POMS) were evaluated before and after 10 and 20 sessions of Waon Therapy. Results: Study A: The differences in number of pain behavior and anger scores before and after treatment were significantly larger in Waon therapy group than those in non-Waon therapy group. The treatment was rated as ‘satisfactory’ or ‘very satisfactory’ by 55% in non-Waon-therapy group and 82% in Waon Therapy group. Study B: The VAS pain scores and FIQ scores were improved after the 10 and 20 sessions of Waon therapy. In the POMS, depression and anger, anxiety, confusion scales were sigificantly decresed and vigor score was elevated. Conclusion: Waon therapy may be a promising method for treatment of chronic pain and fibromyalgia.

Using problem-based learning tutorials to enhance the effectiveness of clinical clerkships / 医学教育

Background: Although problem–based learning （PBL） tutorials have widely been used in many medical schools, they are rarely used to enhance the effectiveness of clinical clerkships.<br>Methods: We used a questionnaire survey to evaluate the effectiveness of PBL tutorials during the clinical clerkships of 5th–year medical students.<br>Results: Of the 91 students, 90％ answered that PBL tutorials during clinical clerkships were considerably useful, and 94％ favored using PBL tutorials during clinical clerkships. All responses to the open–ended question regarding the usefulness of PBL tutorials stated that PBL tutorials were more useful during clinical clerkships than in the 2nd to 4th years. Many students felt that PBL tutorials helped them understand the processes of clinical reasoning and decision–making.<br>Conclusion: PBL tutorials increase the effectiveness of clinical clerkships, and, at the same time, the experiences of clinical clerkships increase the effectiveness of PBL tutorials.

The Effect of Waon Therapy on Failed Myocardium and Ischemic Limb via Heat Shock Proteins / 日本温泉気候物理医学会雑誌

 Waon therapy uses a far infrared-ray dry sauna, which is evenly maintained at 60°C and differs from the traditional sauna. The patients were placed in a 60°C sauna system for 15 minutes, in which the deep-body temperature has increased by 1.0 to 1.2°C. Then, after leaving the sauna, they underwent bed rest with a blanket to keep them warm for an additional 30 minutes. All patients were weighed before and after the therapy, and they drank some water at the end of Waon therapy to compensate for weight lost due to perspiration and prevent the dehydration.<br> We have previously reported that Waon therapy improves the cardiac and vascular endothelial function in patients with chronic heart failure (CHF) and the limb ischemia and symptoms in patients with arteriosclerosis obliterans (ASO). As underlying molecular mechanisms, we demonstrated that Waon therapy upregulates nitric oxide (NO) and endothelial NO synthase (eNOS), which would improve vascular endothelial and cardiac function in TO-2 cardiomyopathic hamsters and augment ischemia-induced angiogenesis. In order to investigate the mechanism of Waon therapy, we examined the effect of Waon therapy on heat shock proteins (Hsp) in failed myocardium and ischemic limb. Hsp are stress response proteins that can be induced by stress signals, including thermal stimulation. Hsp function as chaperones to assist with protein folding in order to protect cells from protein denaturation or cell death under stress conditions.<br> In TO-2 cardiomyopathic hamsters, the cardiac expression of 4-hydroxy-2-nonenal (4HNE), a marker of oxidative stress, was decreased in the 4-week Waon therapy compared to untreated hamsters. Also, the cardiac expressions of Hsp 27, Hsp 32 and manganese superoxide dismutase (Mn-SOD), which reduce oxidative stress, were significantly upregulated by the 4-week Waon therapy compared to untreated hamsters. In addition, Waon therapy upregulated Hsp90, which contributes to the activation of the AkteNOSNO pathway, and induced angiogenesis in mice with hindlimb ischemia. However, Waon therapy did not increase the expression of Hsp70, Hsp60, Hsp32 and Hsp27 in the same model mice. The thermal stimulation with Waon therapy upregulated specific Hsp isoforms depending on different organs and diseases. The specific function of Hsp induced by Waon therapy is suggested to play an important role in improving cardiovascular diseases.

The Effect of Waon Therapy on Failed Myocardium and Ischemic Limb via Heat Shock Proteins / 日本温泉気候物理医学会雑誌

 Waon therapy uses a far infrared-ray dry sauna, which is evenly maintained at 60°C and differs from the traditional sauna. The patients were placed in a 60°C sauna system for 15 minutes, in which the deep-body temperature has increased by 1.0 to 1.2°C. Then, after leaving the sauna, they underwent bed rest with a blanket to keep them warm for an additional 30 minutes. All patients were weighed before and after the therapy, and they drank some water at the end of Waon therapy to compensate for weight lost due to perspiration and prevent the dehydration.  We have previously reported that Waon therapy improves the cardiac and vascular endothelial function in patients with chronic heart failure (CHF) and the limb ischemia and symptoms in patients with arteriosclerosis obliterans (ASO). As underlying molecular mechanisms, we demonstrated that Waon therapy upregulates nitric oxide (NO) and endothelial NO synthase (eNOS), which would improve vascular endothelial and cardiac function in TO-2 cardiomyopathic hamsters and augment ischemia-induced angiogenesis. In order to investigate the mechanism of Waon therapy, we examined the effect of Waon therapy on heat shock proteins (Hsp) in failed myocardium and ischemic limb. Hsp are stress response proteins that can be induced by stress signals, including thermal stimulation. Hsp function as chaperones to assist with protein folding in order to protect cells from protein denaturation or cell death under stress conditions.  In TO-2 cardiomyopathic hamsters, the cardiac expression of 4-hydroxy-2-nonenal (4HNE), a marker of oxidative stress, was decreased in the 4-week Waon therapy compared to untreated hamsters. Also, the cardiac expressions of Hsp 27, Hsp 32 and manganese superoxide dismutase (Mn-SOD), which reduce oxidative stress, were significantly upregulated by the 4-week Waon therapy compared to untreated hamsters. In addition, Waon therapy upregulated Hsp90, which contributes to the activation of the AkteNOSNO pathway, and induced angiogenesis in mice with hindlimb ischemia. However, Waon therapy did not increase the expression of Hsp70, Hsp60, Hsp32 and Hsp27 in the same model mice. The thermal stimulation with Waon therapy upregulated specific Hsp isoforms depending on different organs and diseases. The specific function of Hsp induced by Waon therapy is suggested to play an important role in improving cardiovascular diseases.

Comparative Study on the Effects of Health Promotion of Single Bathing and 200m Running / 日本温泉気候物理医学会雑誌

<B>Purpose</B><br> The effects of10 min bathing at 41°C and 200 m/1.2min running inducing similar tachycardic response were examined comparatively on cardiovascular functions, blood gas and tissue metabolism, and peripheral blood compositions.<br><B>Subjects and Methods</B><br> The subjects examined were 13 healthy males (28.7±3.6 yrs). They kept rest for 30min before bathing and running study and measurements of blood pressure (BP), heart rate (HR), sublingual temperature and skin blood flow and a indwellng catheter for blood sampling in cubital vein were performed. The subjects had 41°C bathing for 10 min and 200 m running/1.2 min (10km/hr) separately which induced the increase in heart rate by 30bpm in preliminary study. Measurements and blood sampling were done just after the loading (bathing or running) and 15min after the loading.<br><B>Results and Discussion</B><br> The increase in HR just after bathing and running were nearly the same level, 27 and 25 bpm, respectively. The increase in systolic BP after running was greater than that after bathing, and diastolic BP was significantly reduced after bathing from resting level. Sublingual temperature and skin blood flow were increased only after bathing suggesting the marked thermal vasodilation.<br> After bathing, venous pO<SUB>2</SUB> was significantly increased and pCO<SUB>2</SUB> was significantly decreased, and there were no significant changes in lactate and pyruvate level. On the contrary, after 200 m running, venous pO<SUB>2</SUB> was decreased and pCO<SUB>2</SUB> was increased, and blood lactate, pyruvate and P/L ratio were significantly increased. These changes show that bathing provides tissue full oxygenation and washout of CO<SUB>2</SUB> by increased blood supply without metabolic activation. After running, increased glycolysis in muscle and delayed oxidation by TCA cycle were suggested.<br> As the increase in WBC after bathing (+6%) and exercise (+22%) subsided very shortly., these changes might be explained by mixing perivascular flow enriched with leucocytes and central flow enriched with plasma due to increased circulation. Previous reports on the change of lymphocyte subsets after bathing and exercise should be examined from this viewpoint. The role of plasma concentration estimated from the changes in RBC and plasma protein was relatively low, around 2% by bathing and 4% by running.<br><B>Conclusion</B><br> Health promotion by bathing seems to be conducted through sufficient O<SUB>2</SUB> supply and washout of CO<SUB>2</SUB> by thermal vasodilation without metabolic activation. Health promotion by exercise is induced by strong activation of cardiovascular and muscle metabolic function. Combination of passive effects by bathing and active exercise will be favorable for balanced health promotion.

Comparative Study on the Effects of Health Promotion of Single Bathing and 200m Running / 日本温泉気候物理医学会雑誌

Purpose  The effects of 10 min bathing at 41°C and 200 m/1.2min running inducing similar tachycardic response were examined comparatively on cardiovascular functions, blood gas and tissue metabolism, and peripheral blood compositions. Subjects and Methods  The subjects examined were 13 healthy males (28.7±3.6 yrs). They kept rest for 30min before bathing and running study and measurements of blood pressure (BP), heart rate (HR), sublingual temperature and skin blood flow and a indwellng catheter for blood sampling in cubital vein were performed. The subjects had 41°C bathing for 10 min and 200 m running/1.2 min (10km/hr) separately which induced the increase in heart rate by 30bpm in preliminary study. Measurements and blood sampling were done just after the loading (bathing or running) and 15min after the loading. Results and Discussion  The increase in HR just after bathing and running were nearly the same level, 27 and 25 bpm, respectively. The increase in systolic BP after running was greater than that after bathing, and diastolic BP was significantly reduced after bathing from resting level. Sublingual temperature and skin blood flow were increased only after bathing suggesting the marked thermal vasodilation.  After bathing, venous pO2 was significantly increased and pCO2 was significantly decreased, and there were no significant changes in lactate and pyruvate level. On the contrary, after 200 m running, venous pO2 was decreased and pCO2 was increased, and blood lactate, pyruvate and P/L ratio were significantly increased. These changes show that bathing provides tissue full oxygenation and washout of CO2 by increased blood supply without metabolic activation. After running, increased glycolysis in muscle and delayed oxidation by TCA cycle were suggested.  As the increase in WBC after bathing (+6%) and exercise (+22%) subsided very shortly., these changes might be explained by mixing perivascular flow enriched with leucocytes and central flow enriched with plasma due to increased circulation. Previous reports on the change of lymphocyte subsets after bathing and exercise should be examined from this viewpoint. The role of plasma concentration estimated from the changes in RBC and plasma protein was relatively low, around 2% by bathing and 4% by running. Conclusion  Health promotion by bathing seems to be conducted through sufficient O2 supply and washout of CO2 by thermal vasodilation without metabolic activation. Health promotion by exercise is induced by strong activation of cardiovascular and muscle metabolic function. Combination of passive effects by bathing and active exercise will be favorable for balanced health promotion.