The effects of repeated thermal therapy for two patients with chronic fatigue syndrome

Abstract Objective: This paper describes the successful treatment of two patients with chronic fatigue syndrome (CFS) using repeated thermal therapy. Methods: Two patients with CFS underwent treatment with prednisolone (PSL), with no satisfactory effect. They were subjected to thermal therapy that consisted of a far-infrared ray dry sauna at 60 8C and postsauna warming. The therapy was performed once a day, for a total of 35 sessions. After discharge, these subjects continued the therapy once or twice a week on an outpatient basis for 1 year. Results: Symptoms such as fatigue, pain, sleep disturbance, and low-grade fever were dramatically improved after 15 to 25 sessions of thermal therapy. Although PSL administration was discontinued, the subjects showed no relapse or exacerbation of symptoms during the first year after discharge. The patients became socially rehabilitated 6 months after discharge. Conclusions: These results suggest that repeated thermal therapy might be a promising method for the treatment of CFS.

Isolated annular dilation does not usually cause important functional mitral regurgitation Comparison between patients with lone atrial fibrillation and those with idiopathic or ischemic cardiomyopathy

AbstractObjectivesWe sought to test whether isolated mitral annular (MA) dilation can cause important functional mitral regurgitation (MR).BackgroundMitral annular dilation has been considered a primary cause of functional MR. Patients with functional MR, however, usually have both MA dilation and left ventricular (LV) dilation and dysfunction. Lone atrial fibrillation (AF) can potentially cause isolated MA dilation, offering a unique opportunity to relate MA dilation to leaflet function.MethodsMid-systolic MA area, MR fraction, LV volumes and papillary muscle (PM) leaflet tethering length were compared by echocardiography among 18 control subjects, 25 patients with lone AF and 24 patients with idiopathic or ischemic cardiomyopathy (ICM).ResultsPatients with lone AF had a normal LV size and function, but MA dilation (isolated MA dilation) significant and comparable to that of patients with ICM (MA area: 8.0 ± 1.2 vs. 11.6 ± 2.3 vs. 12.5 ± 2.9 cm2[control vs. lone AF vs. ICM]; p < 0.001 for both lone AF and ICM). However, patients with lone AF had only modest MR, compared with that of patients with ICM (MR fraction: −3 ± 8% vs. 3 ± 9% vs. 36 ± 25%; p < 0.001 for patients with ICM). Multivariate analysis identified PM tethering length, not MA dilation, as an independent primary contributor to MR.ConclusionsIsolated annular dilation does not usually cause moderate or severe MR. Important functional MR also depends on LV dilation and dysfunction, leading to an altered force balance on the leaflets, which impairs coaptation