RESUMO
Blood glucose disposition rate after intravenous glucose infusion is considered to reflect mainly the rate of cellular glucose uptake, the rate of glucose degradation process and gluconeogenesis. excluding the influense of glucose absorption. <br> When it is hypothesized that the elevated blood glucose is disposed by constant rate (one-compartment theory), the following formula will be realized.<br> Ct = A (1— k)<sup>t</sup> Ct = blood glucose level at t-minutes after infusion<br> A = initial glucose level after infusion<br> k = constant glucose disposition index / min<br> log Ct = log A (1—k) <sup>t</sup>= log A + t log (1 — k)<br> This formula demonstrates that logarithm of blood glucose concentration (Ct) is a one-dimensional (linear) function of time t with a slope log (1 — k), and blood glucose disposition index k can be calculated from this slope.<br> To examine the validity of this hypothesis, 1.5 ml / kg of 20% glucose (0.3g / kg) was infused at rest within 3 minutes into an antecubital vein and plasma glucose was determinned at 1, 3, 5, 10, 15, 20, 30 and 40 min after the cessation of infusion.<br> In 10 healthy subjects, linear regression coefficient between logarithm of plasma glucose and time t was significantly higher (r= 0.992 ± 0.006, p<0.001) during 5 to 40 min. Calculated k index ranged from 0.78 to 4.54% / min and the correlation between the 1st and the 2nd measurements (n=5) within a week was also significantly high (0.92±0.06, p<0.01). These results highly support the validity of basic formula (one-compartment theory) and practical procedure to measure k index.<br> The effects of warm water bathing (42 C, 10min) was examined in 7 subjects keeping warmth by blankets. After bathing, k value remained in nearly the same in 4 subjects, decreased in 2 and increased in 1. Although more detailed studies are needed, the effect of single bathing on glucose disposition seems to be not so significant.
RESUMO
There are many studies on physical effects of hot spring bathing, but few studies have been made on effects of hot spring bathing on coagulation and fibrinolytic systems. Therefore we studied the effects of hot spring bathing blood coagulation and fibrinolytic systems by measuring levels of tissue plasminogen activator (t-PA), euglobulin lysis time (ELT), plasminogen (PLG), alpha plasmin inhibitor (alpha 2 PI), fibrinogen (FBG), antithrombin III (AT III), thrombin antithrombin III complex (T-AT), and von Willebrand factor (vWF) in plasma before and after hot bathing.<br>Methods: The above measurements were made on 20 patients with chronic thrombotic stroke (65±12 years old (mean±2SD), comprising 18 cases of deep branch artery occlusion including four cases of multiple infarction and two cases of main trunk artery occlusion.<br>Collection and assay methods: Blood was collected from antecubital veins before and after a five-minute hot bath (at 40°C) and dissolved into 3.8% sodium citrate at the volume ratio of 1:10. T-PA and T-AT were measured by specific enzyme-linked immunoadsorbent assay. ELT by the fibrin plate method. and vWF by immunoelectrophoresis. Activities of P1G, alpha 2 PI, and AT III were measured by S 2251 and S 2238.<br>Results: The basal level of t-PA was 5.4±.8ng/ml (±2SD) and rose to 7.2±1.8ng/ml (±2SD) after a five-minute hot bath (p<0.005). ELT decreased from 6.5±1.5 hours (±2SD) to 4.9±1.8 hours (±2SD) (0.1<p<0.2). No fluctuation was observed in other factors. A positive interrelation was observed between the reduction rates of ELT and 10-m gait time in 10 cases (0.1<p<0.2).<br>Conclusion: The above results show that fibrinolysis is induced during hot bathing by the release of tissue plasminogen activator from vessel walls without causing significant coagulative activities, suggesting the clinical significance of hot bath in patients with thrombotic stroke.