Previously one of our colleagues reported that the serial bathing (twice a day for 3 weeks) in a cold spring, Kan-no-Jigoku (simple hydrogen sulfide spring of 14°C) resulted in clinical improvements for patients with rheumatoid arthritis (RA). In that study, the effect on immune functions was also investigated, since RA is characterized by immune abnormalities. The following results were obtained. 1. No change was observed in serum gamma globulin levels and hemolytic complement activities. 2. Rheumatoid factor titers after the latex fixation test were improved in 2 out of 8 cases, by 1-2 steps after 2 weeks of bathing. 3. Circulating immune complex levels, which were significantly higher initially, fell gradually during 3 weeks of bathing, but insignificantly. 4. OKT4T cells decreased significantly after 3 weeks of bathing, while OKT3 and OKT8T cells decreased insignificantly. The OKT4/OKT8 ratio was elevated slightly after serial bathing of 3 weeks. 5. Plasma prostaglandin E levels were elevated significantly after 2 weeks, but returned to the initial levels after 3 weeks of bathing, although all the levels were within normal range. No such changes of them were observed by a hot spring bathing. 6. Plasma cyclic AMP levels, which were a little higher than the normal range in 3 out of 9 cases initially, were also elevated significantly after 1 week of bathing and returned to the initial levels thereafter gradually, while no significant changes of them were observed by a hot spring bathing. 7. Urinary hydroxyproline excretion was not changed by the serial bathing. From the above results it was suggested that a cold spring bathing may give an immunosuppressive effect to a living body, resulting in benefit for RA patients.
Purpose To investigate the effect of CO2-inhalation on the cerebral circulation of CVA patients during artificial CO2-bathing, controlled examinations were made with 99mTc-hexamethyl propyleneamine oxime SPECT (hereinafter abbreviated as HM-PAO-SPELT). Subject and Methods HM-PAO-SPECT was conducted on four CVA patients without CO2-inhalation as a control. 0.5g of artificial CO2-bath tablet (Kao Bub®) was them added to 2l of hot tapwater at 40°C to provide an ordinary bathing concentration. The patients inhaled the CO2 generated for 3min at a height of 20cm above the water level, which was immediately followed by HM-PAO-SPECT. Similar examinations were performed at a higher bathing concentration provided by adding 50g of artificial CO2-bath tablet (Kao Bub®) to 2l of water. To compare results with systemic circulation, blood pressure and blood gas were measured before and after the CO2-inhalation. Results HM-PAO-SPECT showed a remarkable increase in blood flow in two of the four patients when 0.5g of artificial CO2-bath tablet was used to provide an ordinary bathing concentration. At a concentration 100 times higher than ordinary concentration using 50g of artificial CO2-bath tablet, obvious increase in blood flow was found in three of the patients. At both concentrations, the remaining patient showed a decrease on blood flow, with no change in blood pressure or blood gas. Discussion CO2 is considered as one of the most potent factors involved in cerebral blood flow. In these examinations, the effect of CO2-inhalation from artificial CO2-bath tablet in increasing blood flow was confirmed by means of HM-PAO-SPECT. Its usefulness was thus proven. The subject who showed a decrease in blood flow may have been in a period of steal phenomenon, or luxury perfusion, when he underwent the examination. Future studies must be performed on the relationship between the increase in blood flow and the improvement of symptom, timing of artificial CO2 bathing, and between the effect of artificial bathing and the CO2 concentration.
The effect of acupuncture stimulation on human cardiac functions was studied by radionuclide ventriculography (RV). Heart rate (HR) and blood pressure (BP) were continuously observed in nine healthy men (from 20 to 38 years old; average 26.6±5.8 years old) using a polygraph system (RM-6000, Nihon Kohden Co., Ltd.). Indocyanine green and radioactive isotope (99mTcO4) were simultaneously injected into these subjects from the cubital vein while they were in a supine position. Images were then acquired and cardiac output (CO) was measured. Before and during the acupuncture stimulation, RV data in synchronization with the R wave of the electrocardiogram were collected within a short time and cardiac functions were measured by data processing with a computer connected to a gamma camera (ZLC-7500, Siemens Co., Ltd.). Acupuncture stimulation using a stainless steel needle was applied by the tapping method to the right Ximén Point (the center of the anterior surface of the forearm). All nine subjects showed a decrease (65.3±7.1% v. s. 57.5±4.8%, P<0.001) in left ventricular ejection fraction (EF) and diffused reduction of the left cardiac wall motion during acupuncture stimulation, suggesting cardiac hypofunction during the stimulation.
The effects of immersion of the lower leg and foot in fresh water and in CO2-enriched water (1200mg CO2 per kg water; succinate+sodium bicarbonate: Kao-BubR) on cutaneous circulation, vasomotion and oxygen tension (PO2) were measured by laser Doppler flowmetry and transcutaneous oximetry. On the first of two consecutive days patients were randomly assigned to have the lower extremities immersed in either fresh water or CO2-enriched water under standardised conditions (temperature, 34°C; depth, 35cm; immersion time, 20min) with concurrent measurement. On the second day patients were switched to the other bath type. For both sets of measurements probes were attached symmetrically to the dorsum of each foot. 18 patients with mild, bilateral, peripheral, occlusive arterial disease (intermittent claudication, femoral or iliac type) were included in the study. During immersion in CO2-enriched water the Doppler laser signal and vasomotion amplitude rose by 300%, while PO2 increased by 10%. These increases were still apparent during the latter part of the measurement period, following withdrawal of the limbs from the bath, while patients were seated and supine. During immersion in fresh water and thereafter the Doppler laser signal was unchanged and the PO2 increase was considerably less marked. We were thus able to demonstrate vasodilation and increased oxygen utilisation (Bohr effect) resulting from topical CO2 application, and hence that the use of topical CO2 has an objective basis.