In this study, we investigated the effects of L-Arginine, which increases the production of nitricoxide (NO) with vasodilative actions, on forearm bathing. The subjects were 12 healthy adult males with 24±1 years old. We compared the changes of blood pressure, heart rate, deep/superficial temperatures, and dermal blood flow by forearm batlmg with or without the oral ingestion of 2000mg L-Arginine. After a 30-minute rest following ingestion, the subjects took a forearm bathing ; immersion of the right forearm below the elbow in 41°C hot water for 15 minutes. There were no significant differences neither in blood pressure, heart rate, nor sublingual temperature between the changes by L-Arginine and water ingestion. Although the superficial temperature of the left toe was significarttly increased 15 minutes after the start of bathing regardless of the presence or absence of L-Arginine (p<0.01), the increase with L-Argilline ingestion was significantly greater (p<0.01) than that without L-Arginine. Furthemore, an increase in left dorsal skin blood flow after 10 to 15 minutes bathing with L-Arginine was more marked than that without L-Arginine. The increasing ratio of blood flow after 15 minutes of right forearm bathing against pre-bathing value was significantly higher (p<0.05) in case with L-Argitme than that in its absence. These results suggest that the oral administration of L-Arginine accelerates thermal vasodilative effects during forearm bathing.

Purpose: To investigate the factorial structure of physical fitness of male paraplegics with thoracic or lumbar spinal cord injury and to develop a battery of field tests for predicting their general physical fitness level.Methods: Fifty-three active male paraplegics with spinal cord injury (PSCI) (age range: 18-54; spinal cord injury level: T4 to L4) were examined. Thirteen feasible variables were selected using physical fitness components based on the International Committee for the Standardization of Physical Fitness Tests and previous PSCI studies. Factor analysis was applied to 14 variables; 13 of these involved physical fitness tests stratified by age to determine the factorial structure of physical fitness variables. Multiple regression analysis was performed to obtain a linear regression equation using a representative variable for each factor in the factorial structure as an independent variable. A first principal component score was obtained by principal component analysis using each variable as a dependent variable.Results: For factorial structure, wheelchair driving ability (3-minute shuttle run), body composition (sebum thickness), respiratory function (vital capacity) and shoulder joint extension force factors were obtained. The results of multiple regression analysis involved 5 variables (the 4 above-mentioned variables plus age); and the first principal component score of each subject from all variables provided a significant linear regression equation (r = 0.934, P ＜0.01) when the body composition factor was excluded.Conclusions: The representative measurement variables obtained from the factorial structure allowed for the development of a battery of field tests for predicting general physical fitness level of PSCI.

  My research started in 1973 at Kagoshima University Hospital Kirishima Branch founded at 1937. The hospital was reorganized as the Department of Rehabilitation Medicine and Kirishima Rehabilitation Center in 1988.   I established a new pharmacological method to measure integrated cardiovascular autonomic nervous functions, and essential hypertension was classified into two types, Type I with low sympathetic, low renin, Na-retention type and Type II with high sympathetic, high rennin, non-Na-retention type.   By bathing at 41°C for 10 min, an increase in HR and CO and decrease in TPRi was shown. Using autonomic blockers, tachycardia was shown to be derived by vagal inhibition and vasodilation by a non-autonomic mechanism. Scarlet coloring of venous blood due to increased pO2 and decreased pCO2 highly suggested improved tissue oxygenation as the basic bathing effects.   Tachycardia during exercise was derived firstly by increased sinus automaticity, and secondly vagal inhibition and sympathetic activation. Athletic bradycardia was induced firstly by decreased sinus automaticity, and secondly by vagal activation and sympathetic suppression.   Hemodynamic studies of Ibusuki sandbath showed a remarkable increase in CO and decrease in TPRi, and an increase in RAP and PAP due to heavy sand. Increased venous pO2 and decreased pCO2 and lactate-pyruvate level indicate highly accelelated tissue oxygenation and clearance of wasted material by increased peripheral circulation.   Although ICG clearance rate was reduced, increased acetoaminophen absorption indicated an increased intestinal blood flow. Increased RPF and unchanged GFR suggested suppressed intra-glomerular pressure from bathing. Urodynamic study after bathing, showed reduced intravesical pressure and increased bladder volume indicating the effects of bathing on pollakiuria in winter due to the relaxation of detrusor muscle.   Against the usual concept that bathing is harmful for CHF, we showed bathing at 40°C for 10 min was a very useful tool as a new vasodilation therapy for CHF. Sauna bathing at 60°C for 15 min was more convenient and Dr. Tei named it Waon therapy. He achieved remarkable improvements in NYHA class symptoms and circulatory parameters in severe CHF, i.e., CO, EF, intra cardiac pressure and BNP. Waon therapy was also shown to be very useful in peripheral arterial disease, post-operative paretic ileus and fibromyalgia.