The therapeutic effect of artificial CO₂ pack on pressure sores of five patients with neurological diseases was confirmed using an infrared thermometer.
The artificial CO₂ pack was prepared by dissolving a 5-g KAO-BABU tablet in 250ml of water at 50°C.
It was proven that the pressure sore recovered faster after treatment with artificial CO₂ hot-pack than that with plain water hot-pack.
In addition, the skin temperature in the area around the pressure sore became lower than the temperature just before the treatment presumably because of the steal phenomenon of blood flow under the skin.

The effect of the artificial CO₂-bathing on the blood pressure in patients with Parkinson's disease with autonomic disorder was investigated and the conclusions were obtained as follows;
1. Regardless of the extent of the autonomic disorder and the contents in the bath, the slight increase in the blood pressure was observed immediatly after the bathing.
2. Systolic blood pressure within 100-150mmHg before the bathing decreased gradually during the bathing and the degree of the decrease was proportional to the extent of the autonomic disorder. The variation of the blood pressere during the bathing was within 30mmHg.
3. Furthermore, when the artificial CO₂-bathing liquid was used, the decrease in the blood pressure after the bathing was salient in proportion to the extent of the autonomic disorder and it was observed that the restoration of the blood pressure to the level before the bathing was remarkably delayed compared with the tap water bathing. This phenomenon was similar in patient with Shy-Drager syndrome characterized by severe autonomic disorder.
4. From the above results, it was suggested that the close management of the blood pressure and the attention to the change of position are necessary during and after the artificial CO₂-bathing in patient with Parkinson's disease with severe autonomic disorders and patients with Shy-Drager syndrome.

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.

A comparative study was made on bathing-induced changes in body temperature, blood pressure, pulse rate and tissue blood flow of 12 healthy adults using tap water and artificial CO₂ water at 37°C to clarify the physiological effects of CO₂ at various concentrations of 0, 100, 300, 600, 800 and 1000ppm. There was no change in body temperature during bathing in either water, whereas blood pressure and pulse rate were similarly decreased during bathing, but either of these decreases was not significantly different between tap water and CO₂-water. Therefore, it seemed that the decrease in blood pressure due to vasodilation during bathing would be controlled through some regulatory system like autonomic nerve system not so as to result in too much decrease. But, tissue blood flow was more increased during bathing in CO₂-water than tap water, suggesting that blood circulation in the tissue near skin surface would have been more enhanced by bathing in hot CO₂-water, resulting in a decrease of blood pressure.
Since the increase in tissue blood flow during bathing was dependent on the concentration of CO₂, it seemed that an improvement of tissue circulation and metabolism would have resulted from venous return increase associated to venous dilatation, one of dose-dependent CO₂ effects.

This study examined the effects of the use of contact lenses on static and kinetic visual acuity, ocular pain, and blurred vision during a water polo match. Eleven male water polo players participated in this study, and were assigned to one of two groups: contact lens users (CL, n=5) and non-users (NCL, n=5). Both groups participated in a typical water polo match with four 7-min periods and 2-min resting intervals between the four periods. Static and kinetic visual acuity, subjective ocular pain, and blurred vision were measured before the match (pre-test), during the match (after each of four 7-min periods), and during the recovery phase at 5, 15, and 30 min after the completion of the match.Results showed that kinetic visual acuity was significantly lower for the NCL group than for CL in the 4^th period of the match. In addition, for the NCL group, kinetic visual acuity was significantly lower in the 3^rd and the 4^th periods than at the pre-test time. On the other hand, static visual acuity did not significantly differ between the two groups; but, for NCL, static visual acuity was significantly lower in the 4^th period than at the pre-test time. According to self-evaluation scores, ocular pain significantly increased in NCL compared to CL in the 3^rd and 4^th periods. Ocular pain in NCL was significantly higher between the 2^nd period and recovery phase at 5 min than at the pre-test time. Blurred vision was significantly higher in NCL than CL between the 2^nd period and recovery phase at 5 min. Blurred vision in NCL was significantly higher at the same duration than at the pre-test time.These findings indicate that the use of contact lenses may prevent ocular pain and blurred vision, maintaining both the static and kinetic visual acuity at a normal level during a water polo match. Further, the results of this study suggest that the use of contact lenses is effective for water polo players.

A 53-year-old man presented with a painful, non-healing ischemic ulcer of the left fifth toe. The patient was initially treated conservatively for 4 months with local debridement and medication with antiplatelet therapy but his symptoms and the ulcer was refractory. A computed tomography revealed a bulky, irregular, gritty, localized calcification of the infra-renal aorta and was compatible with the so-called “coral reef aorta”. Angiography confirmed the findings of the CT scan, and there was no evidence of occlusive lesions in the distal runoff vessels. A diagnosis of blue toe syndrome secondary to infra-renal coral reef aorta was made. In order to prevent further embolization, the patient underwent aortic excision with PTFE grafting via a retroperitoneal incision. In order to increase the microcirculation of the toe and to aid in the healing of the ulcer, a lumbar sympathectomy was performed simultaneously. The ulcer healed completely on postoperative day 47. The treatment method for coral reef aorta depends on the presence or absence of global ischemia of the lower extremity and embolic complications.

Seven years ago, we began the “Toride Project” which aimed at organized care, mainly on based a low-protein diet (LPD), for chronic renal failure patients. This project cumulatively involved 486 patients, and 219 of them have been followed up at our hospital.
In this paper, we report the 12 patients who had before shown progressive deterioration of renal function and turned out stable (less than 5% change) in creatinine clearance (Ccr) for 12-54 months after involved in the project. Their diseases were chronic glomerulonephritis (CGN; 10 cases) and nephrosclerosis (NSC; 2 cases), and the mean Ccr was 20.9±1.3 (SE) ml/min (16-32 ml/min). All of them carried out the well maintained LPD (0.62±0.02 g/kg/day), and showed relatively low urinary protein excretion (UPE; 0.4±0.2g/day). In contrast, 10 other cases (CGN; 9, NSC; 1) showed persistent deterioratiom of renal function even if they continued the LPD (0.60±0.02 g/kg/day). They significantly showed higher UPE (1.6±0.3 g/day, p<0.05) than the 12 cases mentioned above. Moreover, frequent examination revealed that the day-to-day change in their protein intake was more widely distributed (coefficient of variation; 19.5±1.3% vs 10.8±0.6%, p<0.05).