ABSTRACT
<b>Purpose: </b>We have previously reported the physiological and biochemical effects of bath salts. In this study, we used bath additive containing artificial carbon dioxide and sodium chloride (S bath additive), and the acute effects of bathing once with S bath additive and chronic effects of daily bathing with S bath additive for 15 consecutive days were compared with the effects of bathing once in plain water. Improvement in 10 symptoms was investigated using a 5-point verbal rating scale (VRS).<BR><b>Methods:</b> Nine patients aged 51-82 years (mean, 66.6 years) with cold intolerance and lower leg pain were treated with balneotherapy. Whole-body bathing at 40°C was performed for 10 min daily (day 1, bathing in plain water; days 2-16, bathing with S bath additive). On days 1, 2, and 16, changes in patient’s subjective symptoms were evaluated using a VRS ranging from -1 to +3.<BR><b>Results:</b> Compared with bathing once in plain water, bathing once with S bath additive was improvement of coldness, body warmth, blood circulation promotion, limb warmth, lightness of foot, and coldness in limbs. Daily bathing with S bath additive for 15 days significantly improved all symptoms compared with bathing in plain water. A comparison between single and daily bathing with S bath additive showed that relieving fatigue and lumbago were significantly improved after consecutive bathing, demonstrating the benefits of long-term usage.<BR><b>Discussion: </b>Bathing once with S bath additive had acute effects on symptoms associated with peripheral circulation, such as coldness in limbs, body warmth, and limb warmth. Daily bathing with S bath additive improved bone- and joint-related symptoms, such as lumbago and shoulder stiffness, demonstrating that the chronic effects of S bath additive differ from the acute ones. These results are consistent with previous studies on natural hot springs which found that the efficacy of short-term treatment was distinct from that obtained after >2 weeks of treatment.
ABSTRACT
Purpose: We have previously reported the physiological and biochemical effects of bath salts. In this study, we used bath additive containing artificial carbon dioxide and sodium chloride (S bath additive), and the acute effects of bathing once with S bath additive and chronic effects of daily bathing with S bath additive for 15 consecutive days were compared with the effects of bathing once in plain water. Improvement in 10 symptoms was investigated using a 5-point verbal rating scale (VRS). Methods: Nine patients aged 51-82 years (mean, 66.6 years) with cold intolerance and lower leg pain were treated with balneotherapy. Whole-body bathing at 40°C was performed for 10 min daily (day 1, bathing in plain water; days 2-16, bathing with S bath additive). On days 1, 2, and 16, changes in patient’s subjective symptoms were evaluated using a VRS ranging from -1 to +3. Results: Compared with bathing once in plain water, bathing once with S bath additive was improvement of coldness, body warmth, blood circulation promotion, limb warmth, lightness of foot, and coldness in limbs. Daily bathing with S bath additive for 15 days significantly improved all symptoms compared with bathing in plain water. A comparison between single and daily bathing with S bath additive showed that relieving fatigue and lumbago were significantly improved after consecutive bathing, demonstrating the benefits of long-term usage. Discussion: Bathing once with S bath additive had acute effects on symptoms associated with peripheral circulation, such as coldness in limbs, body warmth, and limb warmth. Daily bathing with S bath additive improved bone- and joint-related symptoms, such as lumbago and shoulder stiffness, demonstrating that the chronic effects of S bath additive differ from the acute ones. These results are consistent with previous studies on natural hot springs which found that the efficacy of short-term treatment was distinct from that obtained after >2 weeks of treatment.
ABSTRACT
Our previous studies have shown that spa therapy can reduce subjective symptoms and improve ventilatory function in patients with chronic obstructive pulmonary disease (COPD). The aim of this study is to measure the effects of spa therapy on walking distance during the six-minute walk test in patients with COPD. Twenty-five COPD patients hospitalized for pulmonary rehabilitation at our hospital were included in this study. Twenty-two patients were male and 3 patients were female. Two patients had stage I, 9 patients had stage II, and 14 patients had stage III COPD, according to the Global Initiative for Chronic Obstructive Lung Disease. We offered complex spa therapy (swimming training in a hot spring pool, inhalation of iodine salt solution, and fango therapy) in all patients for 4 weeks. Ventilatory function, six-minute walk distance, oxygen saturation and Borg scale were measured. Vital capacity (VC) was significantly improved by spa therapy at 4 weeks (p<0.05). The values of forced vital capacity (FVC), forced expiratory volume in one second (FEV<sub>1.0</sub>), forced expiratory flow after 75% of expired FVC (FEF<sub>75</sub>), forced expiratory flow after 50% of expired FVC (FEF<sub>50</sub>), forced expiratory flow after 25% of expired FVC (FEF<sub>25</sub>), mean expiratory flow during the middle half of the FVC (FEF<sub>25-75</sub>), residual volume (RV), functional residual capacity (FRC), peak expiratory flow (PEF) and diffusing capacity for carbon monoxide (DLco) showed a tendency to increase, however the increase in the 10 parameters was not significant. The values of six-minute walk distance before and after spa therapy were 288±106m and 323±114m, respectively (p<0.05). There was a significant decrease in values of maximum Borg Scale values (p<0.05). The values of minimum oxygen saturation and the values of oxygen saturation at rest slightly increased, but not significantly. The change of six-minute walk distance correlated with change of VC (r=0.545; p<0.05), with change of FVC (r=0.628; p<0.05), with change of FEV<sub>1.0</sub> (r=0.559; p<0.05), with change of FEF<sub>50</sub> (r=0.480; p<0.05), with change of minimum oxygen saturation (SpO<sub>2</sub>) (r=0.554; p<0.05) and with change of SpO<sub>2</sub> at rest (r=0.445; p<0.05). We found that spa therapy induced improvements in ventilatory dysfunction and six-minute walk distance in patients with COPD. The results from this study reveal that spa therapy may improve disease control and exercise tolerance in patients with COPD.
ABSTRACT
Recently, we have also reported that spa therapy combined with dietary supplementation of perilla seed oil would be effective for patients, and would suppress the generation of leukotriene C4 (LTC4) by peripheral leucocytes. However, it is still unclear how the combination spa therapy and dietary supplementation of perilla seed oil influences on the pathophysiology of bronchial asthma. In the present study, the effects of spa therapy combined with dietary supplementation of perilla seed oil were examined in patients with asthma in relation to the serum eosinophil cationic protein (ECP) levels to investigate the effect on bronchial asthma. Ten adult asthmatic patients with moderate type asthma in terms of severity were taken to have a complex spa therapy and consume perilla seed oil-rich diet for 4 weeks. The generation of LTC4 by peripheral leucocytes, serum ECP level and pulmonary function were measured. Significant decreases were observed for LTC4 and ECP for 4 weeks. Forced vital capacity (FVC), which was one of the pulmonary function tests, improved significantly at 4 weeks (p<0.05). The number of eosinophils decreased for 4 weeks, but the differences were not significant. The results obtained here suggest that spa therapy combined with dietary supplementation of perilla seed oil leads to decrease in LTC4 and ECP and improves pulmonary function and asthma control.
ABSTRACT
<b>Purpose</b>: We examined the effects of foot baths containing artificial carbon dioxide (CO<sub>2</sub>) on peripheral circulation. Our goal was to obtain quantitative results bearing on the treatment and preservation of refractory leg ulcers and gangrene, which would occur in arteriosclerosis obliterans (ASO) and diabetic peripheral circulation disorders.<br><b>Procedures</b>: The lower legs of six healthy volunteers were placed for 10min into a 42°C bath of 10<i>l</i> in which 45g of artificial CO<sub>2</sub> “BUB” was dissolved. A laser Doppler blood-flowmeter was firmly attached. The measurements of blood flow were taken before, during, and 5, 15, 25, and 35min after each subject took a foot bath. Next, in order to examine the effects of peripheral blood flow on the whole body during the foot baths, each laser Doppler blood-flowmeters was attached on the subject's right arm, 10cm above the wrist joint.<br><b>Results</b>: The blood flow increased during the foot bath and decreased after the bath was removed; during in a 10min bath, the flow was 264±135 (%) (p<0.05) of the flow before the feet were placed into the bath. 5min after the bath was removed, the flow was 256±174 (%) of the original pre-bath rate. 15min later it was 146±60 (%), 25min later it was 112±23 (%), and 35min later it was 107±24 (%), as low as the flow before the feet were placed in the bath. The arm blood flow also increased during the foot bath and decreased after the bath was removed. During a 10min bath, the flow was 119±49 (%) of the rate before the feet were placed in the bath. 5min after the bath was removed, the flow was 120±66 (%) of the original pre-bath rate. 15min later it was 113±28 (%), 25min later it was 109±16 (%), and 35min later it was 95±14 (%), essentially the same as the flow before the feet were placed in the bath.<br><b>Discussion</b>: Our work demonstrates an increase in blood flow, by 2.6X, by using a foot bath containing artificial CO<sub>2</sub>. The increase was maintained for 5min after removed of the foot from the bath. However, the blood flow decreased 15min after the baths were removed. We hope that this simple and effective foot bath will be used both at home and elderly care service stations. Its use could see prevention from refractory leg ulcers or gangrene, particularly as average life span continues to increase in Japan.
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The effects of spa therapy for asthmatics with a long history of cigarette smoking were studied, compared with the effects for those without smoking history. 1. Of 22 patients with smoking history, 15 (68.2%) had definite efficacy of spa therapy (4 had marked efficacy, and 11 had moderate efficacy), and the residual 7 had slight or no efficacy. In contrast, of 36 patients without smoking history, 29 (80.6%) had definite efficacy. The effects of spa therapy for asthmatics were significantly higher in never-smokers than in ex-smokers.<br>2. A significant increase in the production of IgE antibodies, bronchial hyperresponsiveness and the generation of leukotrienes B<sub>4</sub> (LTB<sub>4</sub>) and C<sub>4</sub> (LTC<sub>4</sub>) by leucocytes was observed in ex-smokers compared with never-smokers. 3. The frequency of patients with a positive BAST against inhalant allergens was larger in subjects with slight or no efficacy than in those with marked or moderate efficacy in never-smokers, but not in ex-smokers. 4. Bronchial hyperresponsiveness was significantly increased in patients with slight or no efficacy than in those with marked or moderate efficacy both in ex-smokers and never-smoker. 5. The generation of LTB<sub>4</sub> was more increased in subjects with slight or no efficacy than in those with efficacy both in ex-smokers and never-smokers, however, the differences were not significant. 5. The generation of LTC<sub>4</sub> tended to be more increased in subjects with slight or no efficacy than in those with efficacy in never-smokers, but not in ex-smokers, although these were not significant. The results suggest that an increase in the production of IgE antibodies, bronchial hyperresponsiveness, and the generation of LTB<sub>4</sub> and LTC<sub>4</sub>, which might be influenced by cigarette smoking, affect the effects of spa therapy for patients with asthma.
ABSTRACT
Effects of long-term spa therapy on reduction of the costs of drugs used for the treatment were examined in 23 patients with asthma. The costs of drugs used per patient for 1 year when spa therapy started (1997) were compared with the costs used for 1 year after spa therapy for 3 years (2000). 1. The decrease in the total costs of all drugs was \31, 910 in patients with stage 1, \74, 900 in those with stage 2, \113, 450 in stage 3, and \180, 910 in stage 4. The % decrease of the costs of drugs used was 34.2% in stage 1, 46.3% in stage 2, 37.1% in stage 3, and 42.4% in stage 4. The results showed that the reduction in the costs of drugs tended to increase as asthma severity increased, and that the % decrease of the costs was higher in stage 2 and 4, in which the %decrease was more than 40%. 2. The reduction of costs of each drug, bronchodilators, glucocorticoids, antiallergic agents, mucolytics, and antibiotics after spa therapy, was significant in patients with stage 3 and stage 4, whose severity was considerably increased. However, the decrease in the costs of these drugs after spa therapy was not significant in patients with stage 1 and 2. The reduction of the costs more than 50% was observed in bronchodilators, antiallergic agents, mucolytics, and antibiotics in patients with stage 4, in whom the reduction of the costs of these drugs was significant. The results obtained here suggest that the costs of drugs used for asthma treatment could be reduced by spa therapy in patients with more increased severity.
ABSTRACT
The effects of long-term spa therapy were studied in 10 patients with pulmonary emphysema: five patients had long-term spa therapy for 5 years (group A), and another 5 patients had not spa therapy for the same 5 years (group B). There were no significant differences in %FVC, %FEV 1.0, %LAA of the lung on HRCT, %DLco and %RV between the two groups. 1. The LAA of the lung on HRCT slightly, but did not significantly increase in patients with spa therapy for 5 years. In patients without spa therapy, the %LAA of the lung significantly increased after 4-(61.1%) (p<0.01) and 5-year observation (65.5%) (p<0.001) compared with the initial value (52.2%). 2. The %DLco and %RV values slightly decreased in patients with spa therapy, but the decrease in the two parameters was not significant. 3. The %DLco significantly decreased (67.2% to 49.0%), and the %RV also significantly increased (175.4% to 230.6%) after 5-year observation in patients without spa therapy. The results obtained here suggest that spa therapy for pulmonary emphysema should start as early as possible when the diagnosis of the disease is decided, and the therapy should be continued as long as possible.
ABSTRACT
Effects of spa therapy on % low attenuation area (LAA)<-950 HU of the lungs on HRCT at full inspiration, CT number, a ratio of expiratory LAA to inspiratory LAA (exp LAA/ins LAA), residual volume (RV) and diffusing capacity for carbon monoxide (DLco) in asthma were compared between never-smokers and ex-smokers of asthmatics.<br>1. The % LAA of the lungs on HRCT in asthma significantly decreased after spa therapy both in never-smokers and ex-smokers of asthmatics. CT number also significantly increased in the two groups. 2. The exp LAA/ins LAA significantly decreased after spa therapy in never-smokers, but not in ex-smokers. 3. The %RV also significantly decreased by spa therapy in never-smokers, but not in ex-smokers. 4. The DLco value did not significantly change by spa therapy both in nevers-mokers and ex-smokers. 5. The values of %FVC and %FEV 1.0 tended to increased in the two groups, but the increase was not significant. The value of FEV 1.0% significantly increased after spa therapy in never-smokers, but not in ex-smokers. The results suggest that hyperinflation and destruction of terminal airspaces are stronger in ex-smokers than in never-smokers, and that spa therapy is more effective in never-smokers than in ex-smokers.
ABSTRACT
Characteristics of low attenuation area (LAA) of the lungs on HRCT were studied in 132 patients with asthma, and long-term spa therapy on the LAA of the lungs was observed in 5 patients with asthma, whose me an %LAA was more than 30%.<br>1. The morphology of LAA of the lungs on HRCT observed in asthma was different from that in pulmonary emphysema. 2. The LAA of the lungs in asthma was closely related to residual volume (RV). 3. The mean %LAA value significantly decreased from 33.5% before spa therapy to 24.5% at 24 months after beginning of the therapy. CT number also significantly increased after long-term spa therapy. 4. %FEV1.0 value significantly improved from 52.1% before spa therapy to 72.1% at 24 months after spa therapy. The RV value also decreased by spa therapy, however, the decrease was not significant. These results suggest that LAA of the lungs in asthma is associated with hyperinflation, and the LAA of the lungs decreases after long-term spa therapy.
ABSTRACT
Clinical effects of spa therapy for patients with pulmonary emphysema (PE) were evaluated by observing changes in %LAA of the lung on HRCT, %RV, %FVC, %FEV 1.0, and %DLco values after the long-term therapy. The subjects in this study 16 patients with PE. The subjects were divided into two groups according to the extent of %LAA<-950 HU of the lung on HRCT: %LAA<50% (N=6) and 50%≤%LAA (N=8). 1. Spa therapy significantly improved %LAA (42.5% at the initial stage to 36.3% 24 months after spa therapy), %RV (202.1% to 156.1%) and %DLco 71.0% to 85.7%), but not %FVC and %FEV 1.0, in patients with PE of %LAA<50%, however, significant. Improvement of these parameters was not observed in patients without spa therapy. 2. Spa therapy did not improve the values of %LAA, %RV, and %DLco, as well as %FVC and %FEV 1.0, in patients with PE of 50%≤%LAA. These parameters tended to decrease in the patients of 50%≤%LAA. These results suggest that spa therapy improves %LAA and parameters related to pulmonary function when they are at early stage of PE, however, the therapy was not remarkably effective for these parameters when they were at advanced stage of PE.
ABSTRACT
Spa therapy has been performed at our medical center for last 20 years. The changes in number and frequency of patients with respiratory disease were analyzed every 5 year for last 20 years. The total number of patients with respiratory disease who were admitted at our medical center for last 20 years was 1934, of whom the number of patients with asthma was 1226 (63.4%), and the number of those with COPD was 415 (21.5%). The number of patients with asthma treated with spa therapy showed a tendency to increase form 57 for the first 5 years (first stage) to 465 for the last 5 years (forth stage). The number of patients with COPD also increased from 26 for the first 5 years to 227 for the last 5 years. The frequency of SDIA decreased from 68.4% for the first 5 years to 29.0% for the last 5 years. In contrast, the frequency of pulmonary emphysema increased 19.2% at the first stage to 76.7% at the forth stage. The number and frequency of elderly patients with asthma and COPD over the age of 60 tended to increase for last 20 years.
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N-3 fatty acids are reportedly effective for asthma. In addition, spa therapy has been reported to be effective for patients with asthma. In the present study, the effects of spa therapy combined with perilla seed oil-rich diet (rich in n-3 fatty acid) were examined on asthma. A total of 14 asthmatic patients had a complex spa therapy and consumed a perilla seed oil-rich diet-rich in α-linolenic acid (α-LNA) for 8 weeks. Generation of leukotriene (LT) C4 by leucocytes, respiratory function were analyzed. The generation of LTC4 by leucocytes decreased significantly for 2, 4 and 8 weeks (P<0.05). Peak expiratory flow (PEF) values increased significantly for 2, 4, 6 and 8 weeks (P<0.05). The values of ventilatory parameters [forced vital capacity (FVC), forced expiratory volume in one second (FEV<sub>1</sub>), forced expiratory flow after 25% of expired FVC (FEF<sub>25</sub>), forced expiratory flow after 75% of expired FVC (FEF<sub>75</sub>), mean expiratory flow during the middle half of the FVC (FEF<sub>25-75</sub>)] revealed a significant increase after 4 and 8 weeks of the modified diet (P<0.05). The results suggest that spa therapy combined with a perilla seed oil-rich diet are effective in the treatment of asthma in terms of its ability to suppress LTC4 generation by leucocytes, and in inducing an improvement of pulmonary function.
ABSTRACT
Effects of spa therapy on asthma were studied in 64 patients with asthma in relation to the generation of leukotrienes B4 (LTB4) and C4 (LTC4) and bronchial hyperresponsiveness. 1. The efficacy of spa therapy was marked in 12 (18.8%), and moderate in 45 (70.3%) of 64 patients with asthma, and slight or no efficacy of the therapy was observed in the residual 7 patients (10.9%). 2. Bronchial hyperresponsiveness to methacholine was the highest in patients with slight or no efficacy of spa therapy, however, there were no significant differences among the three groups classified by clinical efficacy. 3. The generation of LTC4 by leucocytes was significantly higher in patients with slight or no efficacy compared with the generation in those with marked (p<0.01) and moderate efficacy (p<0.001). However, there were no significant differences in the generation of LTB4 among them. 4. The generation of LTC4 before spa therapy significantly decreased in patients with marked (p<0.001) and moderate efficacy (p<0.01) after spa therapy, but not in those with slight or no efficacy. The generation of LTB4 was not significantly different before and after spa therapy among patients with marked, moderate, and slight or no efficacy. These results show that the efficacy of spa therapy for patients with asthma is closely related to the generation of LTC4 by leucocytes, and that the generation of LTC4 significantly decreases after spa therapy in patients with spa efficacy.
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The patients with asthma or pulmonary emphysema who were admitted at our hospital for last 9 years (1992-2000) were examined in relation to frequency of disease, patient age, and areas where patients came.<br>1. Of 1271 patients (141.2 patients/year) with respiratory disease admitted for last 9 years, 808 (63.6%, 97.8 patients/year) were patients with asthma, and 157 (12.4%, 17.4 patients/year)) were those with pulmonary emphysema.<br>2. The frequency of patients with asthma for all patients with respiratory desease tended to decease from 82.1% in 1992 to 51.3% in 2000, while the frequency of those with pulmonary emphysema increased from 2.8% in 1992 to 24.4% in 2000.<br>3. The number of patients with asthma over the age of 70 years was larger in those inside Tottori prefecture, and the number of patients between the ages of 60 and 69 years was larger in those from distant areas. The age was more than 50 years in all patients with pulmonary emphysema.<br>4. The number of patients with asthma from distant areas (outside Tottori prefecture) was larger (456 patients; 56.4%) than the number of those inside Tottori prefecture (352 patients) for 9 years. The number of patients from Okayama, Hiroshima, Hyogo and Osaka was larger than the number from other distant areas.
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The kind of respiratory disease, age, and areas where patients came from, were analyzed in 763 patients with COPD admitted at our hospital for last 7 years from 1992 to 1998. 1. For the last 7 years 886 patients with respiratory diseases were admitted at our hospital. Of these patients, 763 (86.1%) were those with COPD. Of the 763, 613 (80.3%) were patients with asthma, 27 with chronic bronchitis, 41 with obstructive bronchiolitis, and 87 with pulmonary emphysema. 2. The number of patients with pulmonary emphysema showed a tendency to increase. 3. The number of patients from distant areas was considerably larger (43.8% in 1997, 53.4% in 1998) compared to the number of patients from Tottori prefecture. The number of patients from Okayama, Hyogo, Osaka, Hiroshima, Yamaguchi, and Ehime prefectures was predominantly larger than the number of patients from other distant areas. 4. Regarding the age distribution of these patients, the number of patients over the age of 60 was predominantly larger than the number of patients under the age of 59: patients between the ages of 60 and 69 were more frequently observed in those coming from distant areas (outside Tottori prefecture), and those over the age of 70 in those coming from Tottori prefecture.
ABSTRACT
We observed peripheral circulation in patients suffering from peripheral neuropathy in order to quantify the effect of spa therapy on peripheral neuropathy.<br>The peripheral circulation was observed using thermography and Laser-Doppler blood flowmetry. Thirteen patients with a mean age of 71.9 years (range of 59-82) suffering from diabetic neuropathy with coldness, numbness, neuralgia in their feet or walk disturbance, and 11 patients with a mean age of 72.3 years (range of 60-84) suffering from lumbago, were examined by the methods. The blood flow, mass and velocity were measured by a Laser-Doppler blood flowmetry, after pre-loading with hot water at 36°C for 5min (hot loading), and after cold loading with cold water at 20°C for 5min. Thermographic results were analyzed quantitatively by calculating a recovery ratio as: Recovery ratio=[Total counts of thermography (Pixels) over 27°C after cold loading] ÷ [Initial counts over 27°C after hot loading]×100 (%).<br>The recovery ratio in diabetes mellitus was between 0-93.5% (mean=46.8%), whereas the recovery ratio in lumbago was between 0-91.3% (mean=41.3%). The blood flow in patients with diabetes mellitus was 1.11-5.36 (ml/min/100g tissue), (mean=2.44), the blood mass was 85-255 (mean=155), and the velocity was 0.447-0.784 (mean=0.591). The blood flow in patients with lumbago was 1.18-3.82, (mean=2.19), the blood mass was 89-195 (mean=144), and the velocity was 0.464-0.8 (mean=0.615). The recovery ratio and blood flow in patients with diabetes mellitus were correlated, r=0.62 and p<0.0002, as the recovery ratio and blood mass were correlated, r=0.59 and p<0.0001. However the blood flow and the velocity in these patients were not correlated, r=0.11. The recovery ratio and blood flow in patients with lumbago were not correlated, r=0.02, but the recovery ratio and blood mass showed some correlation, r=0.38. The recovery ratio and the velocity in these patients were correlated, r=0.64 and p<0.005. The blood flow in patients with diabetes mellitus was greater after hot loading (mean=2.89) than after cold loading (mean=2.44). The blood mass in patients with diabetes mellitus was greater after hot loading (mean=180) than after cold loading (mean=155). However, there was no significant change in the velocity after hot loading (mean=0.572) compared with the velocity after cold loading (mean=0.591).<br>It was revealed that patients with diabetes mellitus with low recovery ratios in thermography had low blood flow and blood mass in their peripheral circulation. Patients suffering from lumbago had different peripheral circulation compared with diabetes mellitus. Spa therapy was effective on diabetic peripheral neuropathy as the peripheral circulation improved with hot water at 36°C