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      Radon transfer from thermal water to human organs in radon therapy: exhalation measurements and model simulations

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          Abstract

          The transfer of radon from thermal water via the skin to different human organs in radon therapy can experimentally be determined by measuring the radon activity concentration in the exhaled air. In this study, six volunteers were exposed to radon-rich thermal water in a bathtub, comprising eleven measurements. Exhaled activity concentrations were measured intermittently during the 20 min bathing and 20 min resting phases. Upon entering the bathtub, the radon activity concentration in the exhaled breath increased almost linearly with time, reaching its maximum value at the end of the exposure, and then decreased exponentially with time in the subsequent resting phase. Although for all individuals the time-dependence of exhaled radon activity was similar during bathing and resting, significant inter-subject variations could be observed, which may be attributed to individual respiratory parameters and body characteristics. The simulation of the transport of radon through the skin, its distribution among the organs, and the subsequent exhalation via the lungs were based on the biokinetic model of Leggett and co-workers, extended by a skin and a subcutaneous fat compartment. The coupled linear differential equations describing the radon activity concentrations in different organs as a function of time were solved numerically with the program package Mathcad. An agreement between model simulations and experimental results could only be achieved by expressing the skin permeability coefficient and the arterial blood flow rates as a function of the water temperature and the swelling of the skin.

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          Skin blood flow in adult human thermoregulation: how it works, when it does not, and why.

          The thermoregulatory control of human skin blood flow is vital to the maintenance of normal body temperatures during challenges to thermal homeostasis. Sympathetic neural control of skin blood flow includes the noradrenergic vasoconstrictor system and a sympathetic active vasodilator system, the latter of which is responsible for 80% to 90% of the substantial cutaneous vasodilation that occurs with whole body heat stress. With body heating, the magnitude of skin vasodilation is striking: skin blood flow can reach 6 to 8 L/min during hyperthermia. Cutaneous sympathetic vasoconstrictor and vasodilator systems also participate in baroreflex control of blood pressure; this is particularly important during heat stress, when such a large percentage of cardiac output is directed to the skin. Local thermal control of cutaneous blood vessels also contributes importantly--local warming of the skin can cause maximal vasodilation in healthy humans and includes roles for both local sensory nerves and nitric oxide. Local cooling of the skin can decrease skin blood flow to minimal levels. During menopause, changes in reproductive hormone levels substantially alter thermoregulatory control of skin blood flow. This altered control might contribute to the occurrence of hot flashes. In type 2 diabetes mellitus, the ability of skin blood vessels to dilate is impaired. This impaired vasodilation likely contributes to the increased risk of heat illness in this patient population during exposure to elevated ambient temperatures. Raynaud phenomenon and erythromelalgia represent cutaneous microvascular disorders whose pathophysiology appears to relate to disorders of local and/or reflex thermoregulatory control of the skin circulation.
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            Doses to organs and tissues from radon and its decay products.

            This paper discusses the doses from radon and from its short-lived decay products to a number of organs and tissues and to the foetus. The aim is to put all these doses into context rather than concentrating only on the largest contributions. There is also a brief discussion of the evidence from epidemiology on the risks of exposure to radon and its decay products. As is well known, under normal circumstances the greatest hazard is to the respiratory tract from inhalation of radon decay products. Radon decay products may also give substantial doses to skin. Under some circumstances it seems likely that ingested radon could give significant doses to the stomach. Other risks appear to be smaller; the results given here allow them to be compared.
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              Combined spa-exercise therapy is effective in patients with ankylosing spondylitis: a randomized controlled trial.

              To determine the efficacy of combined spa-exercise therapy in addition to standard treatment with drugs and weekly group physical therapy in patients with ankylosing spondylitis (AS). A total of 120 Dutch outpatients with AS were randomly allocated into 3 groups of 40 patients each. Group 1 (mean age 48 +/- 10 years; male:female ratio 25:15) was treated in a spa resort in Bad Hofgastein, Austria; group 2 (mean age 49 +/- 9 years; male:female ratio 28:12) in a spa resort in Arcen, The Netherlands. The control group (mean age 48 +/- 10 years; male:female ratio 34:6) stayed at home and continued their usual drug treatment and weekly group physical therapy during the intervention weeks. Standardized spa-exercise therapy of 3 weeks duration consisted of group physical exercises, walking, correction therapy (lying supine on a bed), hydrotherapy, sports, and visits to either the Gasteiner Heilstollen (Austria) or sauna (Netherlands). After spa-exercise therapy all patients followed weekly group physical therapy for another 37 weeks. Primary outcomes were functional ability, patient's global well-being, pain, and duration of morning stiffness, aggregated in a pooled index of change (PIC). Analysis of variance showed a statistically significant time-effect (P < 0.001) and time-by-treatment interaction (P = 0.004), indicating that the 3 groups differed over time with respect to the course of the PIC. Four weeks after start of spa-exercise therapy, the mean difference in PIC between group 1 and controls was 0.49 (95% confidence interval [CI] 0.16-0.82, P = 0.004) and between group 2 and controls was 0.46 (95% CI 0.15-0.78, P = 0.005). At 16 weeks, the difference between group 1 and controls was 0.63 (95% CI 0.23-1.02, P = 0.002) and between group 2 and controls was 0.34 (95% CI--0.05-0.73; P = 0.086). At 28 and 40 weeks, more improvement was found for group 1 compared with controls (P = 0.012 and P = 0.062, respectively) but not for group 2 compared with controls. In patients with AS, a 3-week course of combined spa-exercise therapy, in addition to drug treatment and weekly group physical therapy alone, provides beneficial effects. These beneficial effects may last for at least 40 weeks.
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                Author and article information

                Contributors
                +43 662 8044 5701 , Werner.Hofmann@sbg.ac.at
                Journal
                Radiat Environ Biophys
                Radiat Environ Biophys
                Radiation and Environmental Biophysics
                Springer Berlin Heidelberg (Berlin/Heidelberg )
                0301-634X
                1432-2099
                29 June 2019
                29 June 2019
                2019
                : 58
                : 4
                : 513-529
                Affiliations
                [1 ]GRID grid.7039.d, ISNI 0000000110156330, Biological Physics, Department of Chemistry and Physics of Materials, , University of Salzburg, ; Hellbrunner Str. 34, 5020 Salzburg, Austria
                [2 ]GRID grid.21604.31, ISNI 0000 0004 0523 5263, Institute of Physiology and Pathophysiology, , Paracelsus Medical University, ; Strubergasse 21, 5020 Salzburg, Austria
                [3 ]GRID grid.21604.31, ISNI 0000 0004 0523 5263, Gastein Research Institute, , Paracelsus Medical University, ; Strubergasse 21, 5020 Salzburg, Austria
                [4 ]Ludwig Boltzmann Institute for Arthritis and Rehabilitation, Strubergasse 21, 5020 Salzburg, Austria
                Author information
                http://orcid.org/0000-0002-1946-7837
                Article
                807
                10.1007/s00411-019-00807-z
                6768894
                31256227
                8daec98c-e469-453a-a597-00fc0bc06aea
                © The Author(s) 2019

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.

                History
                : 26 November 2018
                : 21 June 2019
                Funding
                Funded by: Forschungsfonds Forschungsinstsitut Gastein
                Award ID: FOI-10/13-18-HOF
                Award Recipient :
                Categories
                Original Article
                Custom metadata
                © Springer-Verlag GmbH Germany, part of Springer Nature 2019

                Biophysics
                radon therapy,thermal water,radon skin transfer,exhalation measurements,biokinetic simulations

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