Little is known about how isosorbide dinitrate (ISDN) contribute to bathing effects on patients with myocardial infarction. A study using an invasive method was made on 29 patients with myocardial infarction to clarify the hemodynamic changes occurring during bathing with and without sublingual ISDN, and to evaluate the overall effects of the ISDN. In bathing after discontinuing dosing of vasodilators (PRE-ISDN), patients were divided into the following two groups depending on the difference between the peak pulmonary capillary wedge pressure (PCWP) during bathing and PCWP before bathing: Increased PCWP group [(Group A): Δ PCWP≥10mmHg] and Unincreased PCWP group [(Group B): Δ PCWP <10mmHg]. Bathing was taken for 5 minutes at 42°C in a Hubbard tank, hemodynamics were observed during bathing and for 10 minutes after bathing, and after 30 minutes of sublingual administration of 5mg ISDN, bathing was taken in a similar manner. Group A patients showed a greater increase in heart rate, blood pressure, pulmonary arterial pressure (PAP), and right artial pressure than of Group B patients during bathing before being dosed with ISDN, and it seemed to be a considerable load on the heart. Although the remarkable increase of PAP and PCWP observed during the early stage of bathing before dosing with ISDN significantly decreased after sublingual dosing of ISDN (POST-ISDN) among Group A patients, these effects were not found in Group B patients. Group A showed more frequent reinfarction from a clinical viewpoint and triple vessel disease upon coronary arteriography, a lower ejection fraction upon left ventriculography, a higher left ventricular end-diastolic pressure, and lower left ventricular performance in most cases as compared to Group B. Although ISDN was found to be effective for severe cases in which the marked pre-load was observed by bathing, no beneficial effect on mild cases with well-maintained left ventricular performance was obtained.
The effects of artificial sodium sulfate bathing on cardiopulmonary and neurohumoral systems as compared to plain water bathing were studied on five healthy subjects. The results of bathing tests made for 10 minutes at 42°C were as follows: 1) The body surface temperature was higher in three of the five subjects in artificial sodium sulfate bathing than in plain water bathing. The forehead temperature of all subjects in artificial sodium sulfate bathing was higher than in plain water bathing (p<0.05: at 17, 18min. after bathing). The change in oral temperature also showed the same tendency (p<0.05: at 27min. after bathing). 2) The frequency of respiration was less in artificial sodium sulfate bathing than in plain water bathing. Although the heart rate decreased during artificial sodium sulfate bathing as compared to the case of plain water bathing, a clear difference was not observed after bathing. The systolic blood pressure in four of the five subjects decreased in artificial sodium sulfate bathing compared to plain water bathing. One subject, who exhibited low blood pressure before bathing, was restored to his normal blood pressure after artificial sodium sulfate bathing. The sysytolic blood pressure was lower in artificial sodium sulfate bathing than in plain water bathing. (p<0.03: at 20min. after bathing). 3) The serum levels of noradrenalin, adrenalin, serotonin, ADH, renin, aldoster-one, cortisol, β-endorphine, Na+, K+, and Cl- showed no significant differences between the two types of bathing. 4) All subjects felt increased warmth and smoothness of the skin after the artificial sodium sulfate bathing compared to plain water bathing. The above results suggest that the artificial sodium sulfate bathing is superior to plain water bathing in maintaining body temperature, decreasing blood pressure, and feeling (i. e., body warmth and skin texture) after bathing. These effects result from not only the direct action on the skin but also the indirect action due to absorption of the substance through the skin by the mechanism of artificial sodium sulfate bathing.
Viability of Pseudomonas aeruginosa was examined by putting it into hot spring collected from seven places. In the acid waters (pH 2.0 to 2.2), the organisms lost their viability immediately at both cultivation temperatures of 37°C and 42°C. In alkaline waters (pH 8.0 to 9.1), the organisms were detected and increased after cultivation for 2 hours at 37°C. The above result suggests that Pseudomonas aeruginosa may be present in whirlpools and/or indoor swimming pools of alkaline waters having a large number of bathers in a relatively small volume of water.
Short-term effects of spa-drink therapy on gastric mucosal blood flow were evaluated using endoscopic organ reflex spectrophotometry together with an Olympus XQ-10 forward-viewing gastrofiberscope. Thirty-eight subjects were divided into three groups by random sampling: 12 subjects to a group for injecting hot spring water (38 to 40°C, 150ml), 12 subjects to a group for injecting warm tap water (38 to 40°C, 150ml), and 14 subjects to a groups for injecting warm air (150ml). Hot spring water, tap water, or air was injected into the stomach through the fiberscopic injection channel. Gastric mucosal blood flow was measured immediately before and 10 minutes after the injection on the three points of gastric mucosa: lesser curvature of the angle, and that of the antrum, and the pylorus. The following results were obtained: 1) Hot spring water was more effective in increasing gastric mucosal blood flow than air. The difference was statistically significant on all of the three points. 2) Hot spring water was more effective in increasing gastric mucosal blood flow than tap water. The difference, however, was significant only on the mucosa of the gastric antrum. In conclusion, spa-drink therapy was useful for treating chronic gastritis and gastric ulcer in which impairment of gastric mucosal blood flow plays an important pathogenetic role. Studies on the long-term effects of spa-drink therapy on the gastric mucosal blood flow are now under way.
In Chronic cases of hemiplegia following cerebrovascular disorders, it has been commonly accepted that the skin temperature on the affected side is lower than that of the normal side. However, there has been no report regarding changes of the skin temperture before and after a long-term rehabilitation. In this study, skin temperature of the lower legs before and after a long-term rehabilitation was measured in 21 normal subjects and in 53 patients with hemiplegia lasting over a month from the onset of cerebrovascular disorders. Although the skin temperture of the lower legs in 21 normal subjects showed almost no difference between the two legs, that of hemiplegic patients was lower on the affected side and it was extremely lower in patinets with moderate or advanced hemiplegia. In the hemiplegic patients with moderate or advanced muscle atrophy on the affected side, the drop of skin temperature on that side was larger than that of the patients with no or sligit muscle atrophy. In the hemiplegic patients who showed a moderate or marked improvement of the walking ability after rehabilitatlon, the skin temperature on both legs had been considerably lower than that of the patients who showed no or slight improvement of the walking ability before the rehabilitation. However it increased remarkably after the rehabilitation so that there was no significant differences of the skin temperature between the two groups of patients.
Examinations to some extent were made on yearly transitions of 52 patients with bronchial asthma who were hospitalized in Misasa Medical Branch, Okayama University Medical School and received spa therapy during the five years from 1982 to 1986. 1) In the first two years (1982 to 1983), we had many patients from Okayama Prefecture. The majority of them had suffered from severe asthma attacks. They included a higher rate of cases of dependency on steroid-therapy as compared to those patients in the last three years (1984 to 1986). Some cases exhibited a remarkable airways obstruction in spite of high dosage of steroid hormone. 2) From 1984 to 1986, the patients with bronchial asthma from Tottori Prefecture increased. Their involvements were less severe with a lower dependency on steroid-therapy as compared to those hospitalized during the first two years. 3) Terms of hospitalization were generally reduced in the last two years as compared to the preceding three years. The average term was about two months from 1985 to 1986. 4) No difference in clinical symptoms based on the patient's age, age at onset, or asthma types was found between the first two years and the last three years.