1.Changes in Tissue Partial Pressure of Oxygen and Carbondioxide in CO2 Vapour Bath
Tomoji KOHMOTO ; Yoshiaki KOMOTO
The Journal of The Japanese Society of Balneology, Climatology and Physical Medicine 1982;46(2):76-83
Subcutaneous and muscular (cranial tibial) tissue PO2 and PCO2 in CO2 vapour bath were measured on rabbit by means of Medical Mass Spectrometry, MEDSPECT II, Chemetron, U. S. A.
Subcutaneous PO2 increased by 30% during CO2 vapour bath of 5L/min at 37°C and muscular PO2 increased by 50% after CO2 vapour bath, keeping the level at least for 2 hours.
Ideal elevation of PO2 level was observed in vapour bath of 1L/min at 37°C for 30min.
A number of factors causing an elevation of PO2 in tissue by topically applied CO2 are to be thought, such as a vasodilating effect, pH-lowering, shift to right of oxygen dissociation curve and so on.
It is assumed that the PO2 elevation together with an improved tissue perfusion could ameliorate complains of patients suffering from degenerative pathology and peripheral arterial insufficiency by stimulating patients' own potential curability.
2.Basic Conditions for CO2 Vapour Bath
Tomoji KOHMOTO ; Yoshiaki KOMOTO
The Journal of The Japanese Society of Balneology, Climatology and Physical Medicine 1983;46(3-4):138-142
Tissue partial pressure of O2 (PO2) and CO2 (PCO2) in CO2 vapour bath were measured on rabbit by means of Medical Mass Spectrometry, MEDSPECT II, Chemetron, U. S. A.
Topical absorption of CO2 through the skin exposed to CO2 gas was confirmed by comparing the subcutaneous tissue PO2 and PCO2 in CO2 vapour bath with those of CO2 free head area; subcutaneous tissue PO2 and PCO2 were elevated by 92% and 48% respectively in the former, whereas subcutaneous tissue PO2 and PCO2 in the latter were found no change. Lowering of subcutaneous pH was found simultaneously with the elevation of PCO2 in CO2 vapour bath, contributing largely to the elevation of PO2 in response to CO2 accumulation.
Subcutaneous tissue PCO2 reaches a saturated level in about 30 minutes regardless of each CO2 flow rate varying from 1 to 5 liters per minute. Too much application of CO2 gas is not always so effective as expected. Changes of PCO2 and PO2 were not in proportion to a rise in temperature from 33.4°C to 41.5°C on the same rabbit. It is, therefore, suggested that the optimal application of CO2 gas on rabbits is at their indifferent temperature of around 37°C.
The optimal conditions for rabbits would be suggested as 1 liter of CO2 gas per minute at 37°C for 30 minutes in consideration of the side effects on both circulatory and respiratory systems.
Based on the experimental data, conditions of 30 liters per minute at 40°C for 30 minutes would be recommended in clinical application of CO2 gas cabin.
3.Changes in Tissue Partial Pressure of Oxygen and Carbon dioxide in Water Bath
Tomoji KOHMOTO ; Yoshiaki KOMOTO
The Journal of The Japanese Society of Balneology, Climatology and Physical Medicine 1983;46(3-4):143-148
We examined Tissue Partial Pressure of O2 (PO2) and CO2 (PCO2), changes of Pulse Rate (P. R.) and Blood Pressure (B. P.) in a bath at different temperature using rabbit. Expeilmental method;
A rabbit about 2kg body weight is taken a bath at each temperature of 37°C, 40°C, and 43°C for 30 minutes by means of constant-temperature water bath method under the anesthesia of venous drip of NEMBUTAL® (Pentobarbital Sodium).
Teflon catheters for tissue gas analyses are inserted to the Cranial tibial muscle and the over-lying subcutaneous tissue. Tissue PO2 and PCO2 in a bath are measured by Medical Mass Spectrometry (MEDSPECT II, Chemetron, U. S. A.). The changes of B. P. and P. R. are recorded simultaneously.
Results and Discussion;
1, In a bath at 37°C, there are no changes on both B. P. and P. R., but the elevation of PO2 is a little, leading to an insignificant effect.
2, In a bath at 40°C, subcutaneous tissue PO2 and muscular tissue PO2 are found elevated by 74% and 53% respectively. P. R. is found increased by 34%, and B. P. is found reduced by 8%. This reduce of B. P. is due possibly to the peripheral vasodilatation. From the standpoint of a peripheral circulation, bath temperature of 40°C is thought to be efficient in washing out metabolites, leading to recovery from fatigue.
3, In a bath at 43°C, subcutaneous tissue PO2 and muscular tissue PO2 are found elevated by 74% and by 53% respectively. And tissue PCO2 are found elevated by 65% in subcutaneous tissue and by 64% in muscular one; 13% up from those found in a bath at 40°C, leading to some fatigue. B. P. is elevated by 16% and P. R. is increased by 69% respectively in a bath at 43°C. Arrhythmia occurs sometimes. It is, therefore, assumed that the man who has a handicap on the circulation system and the elder who has arteriosclerosis in his base should not take a bath at high temperature and/or for a long time.
4.Experimental study on the effects of serial artificial CO2 bathing.
Mitsuru SUNAKAWA ; Tomoji KOHMOTO ; Yoshiaki KOMOTO ; Hidenori YOROZU ; Yasuteru EGUCHI
The Journal of The Japanese Society of Balneology, Climatology and Physical Medicine 1986;49(2):83-88
Actual changes in tissue partial pressures of each gas and tissue perfusion with serial artificial CO2 bathing were evaluated by means of medical mass spectrometry using 5 rabbits.
An artificial CO2 bath was prepared by adding “BUB”-KAO, a 50g sodium hydrogencarbonate and succinic acid tablet producing fine CO2 bubbles in water of constant temperature 20-litre tub at 36-37°C.
Regional tissue perfusion volume was determined on the basis of a clearance curve for Argon tissue partial pressure which was monitored by an on-line computer system with mass spectrometry.
Increase in subcutaneous tissue PCO2 changed from 27% to 10%, and in PO2 from 12% to 5% on average by serial bathing every day for 4 weeks, on the other hand tissue perfusion volume was increased in 3 out of 5 cases; from 20.85±3.56 (X±SE) ml/100g/min, SD=6.71, p<0.05 to 25.23±8.00 (X±SE) ml/100g/min, SD=6.96, p<0.05.
CO2 has been shown to be locally absorbed through the skin resulting in the elevation of subcutaneous tissue CO2 partial pessure which decreases depending on the tissue perfusion irrespective of metabolic processes. It is, therefore, assumed that the elimination of absorbed constituents by serial bathings is not caused by a decrease in the percutaneous absorption rate but an increase in washing out rate by the improved tissue perfusion.
5.Research for carbon dioxide bathing. V. Effect of the artificial CO2-bathing on blood lactic acid and myalgia.
Hidenori YOROZU ; Yasuteru EGUCHI ; Mitsuru SUNAKAWA ; Tomoji KOHMOTO ; Yoshiaki KOMOTO
The Journal of The Japanese Society of Balneology, Climatology and Physical Medicine 1986;49(2):89-94
Artificial CO2-bath was prepared with a tablet (50g): made from sodium bicarbonate and succinic acid, putting simply in plain water bath tub of 100-200 litre at 40C.
The effect of artificial CO2-bath was studied in relation to the change in blood lactic acid which is thought to be indicative of the physical fatigue.
It has been clearly demonstrated experimentally using rats that the blood lactic acid after exercise is significantly reduced as compared both to a plain and an artificial Na2 SO4-NaHCO3 bathing.
A favorable effect of the artificial CO2-bath was also confirmed clinically by a relief from the stiff pain following maximal abdominal muscle exercise.
6.Inefficacy of residual sodium succinate on tissue perfusion with an artificial CO2 bath.
Yoshiaki KOMOTO ; Tomoji KOHMOTO ; Mitsuru SUNAKAWA ; Yasuteru EGUCHI ; Hidenori YOROZU
The Journal of The Japanese Society of Balneology, Climatology and Physical Medicine 1986;49(3):118-122
Sodium succinate is remained behind following artificial CO2 bathing, prepared with a 50g sodium hydrogencarbonate and succinic acid tablet producing fine bubbles in water.
2NaHCO2+(CH2)2→(COOH)2→(CH2)2(COONa)2+H2O+CO2
Na2CO3+(CH2)2(COOH)2→(CH2)2(COONa)2+H2O+CO2
Balneotherapeutic effect of sodium succinate was evaluated experimentally using 10 rabbits by means of medical mass spectrometry.
Subcutaneous PO2 and PCO2 did not change during the bathing and tissue perfusion of 21.30±3.48ml/100g/min (mean±standard error), SD=4.94, p<0.05 was evaluated at 36-37°C, demonstrating no significant difference compared with that of 20.85±3.56ml/100g/min, SD=6.71, p<0.05 by plain water bathing.
These data showed clearly that the balneotherapeutic effects of an artificial CO2 bathing prepared with a CO2-tablet, “BUB”-KAO, was not from organic salt of sodium succinate but from CO2.
7.Research for carbon dioxide bathing. III. Basic points for the artificial CO2-bathing and on the effect of CO2 concentration released in the air.
Hidenori YOROZU ; Yuichiro KUBO ; Yasuteru EGUCHI ; Tomoji KOHMOTO ; Mitsuru SUNAKAWA ; Yoshiaki KOMOTO
The Journal of The Japanese Society of Balneology, Climatology and Physical Medicine 1985;48(2):79-85
It has been well recognized that no known method can produce as strong or as effective a bath as can be given with natural waters.
The method of bubbling gas through the bath water is thought to be almost entirely ineffective; the solubility of CO2-gas in water at 40°C is about 10%, but is much further enhanced about 50% by bubbling through an airstone, making fine bubbles.
Tablet form of the CO2-bath preparation, made from bicarbonate and succinic acid, produces fine CO2 bubbles so that about 80% of water solubility at 40°C can be obtained.
A CO2-bath preparation, 50g tablet, can produce 100ppm in maximum concentration in a bath of 150 liter at 40°C, maintaining the level of more than 60ppm for 2 hours.
In order for the safety to estimate the escaped CO2, a large quantity of the CO2-bath preparation, 20 and 50 tablets, was used in a relatively air tight room; CO2 concentration reached the maximum level of 1.9 and 6.6% respectively with a tendency of rapid falling, so that the critical complications could rarely be happened.
8.Research for Carbon Dioxide Bathing
Hidenori YOROZU ; Yuichiro KUBO ; Yasuteru EGUCHI ; Tomoji KOHMOTO ; Mitsuru SUNAKAWA ; Yoshiaki KOMOTO
The Journal of The Japanese Society of Balneology, Climatology and Physical Medicine 1984;47(3-4):130-136
Increase in dermal blood flow by the artificial CO2-bathing was confirmed by means of a Thermocouple flow meter and by a Laser doppler velocimeter.
The artificial CO2-bath was prepared with 50g tablet, made from sodium bicarbonate and succinic acid, putting simply in plain water at 38°C.
Dermal blood flow was increased nearly 5-fold by the simple bathing, and was further enhanced 1.3-fold by the artificial CO2-bathing.
It has been definitely shown by the artificial CO2-bathing that an increase in oral, finger tip, and forehead temperature and transepidermal water loss is significant compared to the plain bathing, so that the thermal effect equivalent to carbon-dioxated spring will be obtained.
9.Research for Carbon Dioxide Bathing
Hidenori YOROZU ; Yuichiro KUBO ; Yasuteru EGUCHI ; Tomoji KOHMOTO ; Mitsuru SUNAKAWA ; Yoshiaki KOMOTO
The Journal of The Japanese Society of Balneology, Climatology and Physical Medicine 1984;47(3-4):123-129
It was found that no effect of increase in dermal blood flow depended solely on HCO3- or CO32-, but on CO2 gas dissolved in water.
The artificial CO2 bath was prepared with sodium bicarbonate and citric acid, mixing simply in plain water at 38-40°C.
Thermal efficacy was confirmed by a rise in temperature of oral, finger tip and forehead respectively, and by a high transepidermal water loss (TWL) in consequence of increase in dermal blood flow, compared to a plain bathing.
A remarkable effect in artificial CO2 bathing of 400-800ppm has been well-known clinically, however, a substantial increase in dermal blood flow has observed with artificial CO2-bathing of 59.8ppm or greater in this study, so that a CO2-bathing using the preparation would be popularized.