The effect of underwater exercise on respiratory resistance (Rrs) was examined in 12 patients with chronic obstructive pulmonary disease (COPD). Rrs was measured while the patients were sitting on land with quiet respiration, while immersed in water (at 38°C) up to the upper abdomen and upper chest in standing position, and while sitting on land with quiet respiration after mild underwater exercise. The mean Rrses in each condition were 0.37, 0.37, 0.42, 0.33kp/1/s. Rrs increased by 14% (p<0.005) after immersion in water up to the upper chest and decreased by 12% (p<0.001) after underwater exercise. The change after exercise showed a popitive correlation with FEV_1.0/FVC on spirogram. Although water immersion or underwater exercise of these COPD patients caused a slight load in ventilation, no significant aggravation of the subjective symptom was found.
The above results suggested that uoderwater exercise was beneficial as a physical treatment for mild cases of COPD.

We investigated the system of emergency medical service in the Chuno area in Gifu prefecture.It was found that about 20,000 emergency cases were carried into the Emergency Medical Center (EMC) in Chuno Kosei Hospital annually. About 90% were patitents with mild disease or injury. During the past four years an increasing number of severely ill patients such as those acute myocardial infarction and cerebral apoplexy were transfered to our EMC from other hospitals in the Chuno area.We found that many emergency patients came to our EMC, which was not staffed with so many emergency care specialists nor equiped with so many beds for emergency patients. Therefore, we requested residents, family doctors, primary care clinics, common hospitals and administrators in the Chuno area, to contribute their share to emergency medical care together with EMC.In conclusion, we thought it necessary to build a better system of emergency medical care in this area promptly.
Area ; Medical ; Central ; Bale out ; medical care