Fructose Administration Increases Intraoperative Core Temperature by Augmenting Both Metabolic Rate and the Vasoconstriction Threshold

Mer om hvordan fruktose øker kroppvarme (termogenese). I denne er det snakk om å bruke det intravenøst for å unngå at pasienter blir kalde etter operasjoner. Det øker restitusjonsevnen etter operasjonen.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1473168/

Abstract

Background

We tested the hypothesis that intravenous fructose ameliorates intraoperative hypothermia both by increasing metabolic rate and the vasoconstriction threshold (triggering core temperature)

Methods

40 patients scheduled for open abdominal surgery were divided into two equal groups and randomly assigned to intravenous fructose infusion (0.5 g·kg−1·h−1 for 4 h, starting 3 h before induction of anesthesia and continuing for 4 hours) or an equal volume of saline. Each treatment group was subdivided: esophageal core temperature, thermoregulatory vasoconstriction, and plasma concentrations were determined in half, and oxygen consumption was determined in the remainder. Patients were monitored for 3 h after induction of anesthesia.

Results

Patient characteristics, anesthetic management, and circulatory data were similar in the four groups. Mean final core temperature (3 h after induction of anesthesia) was 35.7±0.4°C (mean ± SD) in the fructose group and 35.1±0.4°C in the saline group (P=0.001). The vasoconstriction threshold was greater in the fructose (36.2±0.3°C) than in the saline group (35.6±0.3°C; P<0.001). Oxygen consumption immediately before anesthesia induction in the fructose group (214±18 ml/min) was significantly greater than in the saline group (181±8 ml/min, P<0.001). Oxygen consumption was 4.0 L greater in the fructose patients during 3 hours of anesthesia; the predicted difference in mean-body temperature based only on the difference in metabolic rates was thus only 0.4°C. Epinephrine, norepinephrine, and angiotensin II concentrations, and plasma renin activity were similar in each treatment group.

Conclusions

Preoperative fructose infusion helped maintain normothermia by augmenting both metabolic heat production and increasing the vasoconstriction threshold.

Fructose is known to provoke the greatest thermogenesis among various carbohydrates.19,20 Fructose also provokes dietary-induced thermogenesis in awake healthy volunteers, and does so far better than glucose.15 We thus tested the hypothesis that intravenous fructose increases metabolic heat production in anesthetized humans. We also tested the hypothesis that fructose, like amino acids, increases the vasoconstriction threshold and thus has a thermoregulatory as well as metabolic contribution to maintaining perioperative normothermia.

CO2 production before infusion showed no significant difference between saline group (147+19 ml min−1) and fructose group (142+16 ml min−1) but increased significantly in the fructose group (201+26 ml min−1) just before induction of anesthesia, compared with the saline group (146+19 ml min−1)(p<0.001). This increased level was maintained for 135 min after induction of anesthesia.

Zazen and Cardiac Variability

Endelig en studie som nevner noen effekter av Zen meditasjon hvor fokus er på å puste veldig sakte, helt ned til 1 pust/min, bl.a. varme. Viser hvordan HRV påvirkes forskjellig, hvor hos noen økes hjerterytmen betraktelig i små perioder, noe som kan være en effekt av ting som skjer under meditasjonen. Desverre innser de at de burde ha målt kroppstemperatur, CO2, blodsirkulasjon og flere parametere for å se tydeligere hva som skjer i kroppen under så sakte pust.

http://www.psychosomaticmedicine.org/content/61/6/812.long

Figure 3 shows pre-Zazen rest period data from a Zen master (KS). This individual breathed close to 6 breaths/min throughout the rest period. Note the comparative absence of high-frequency cardiac variability and the major low-frequency peak at 0.1 Hz. A very-low-frequency peak also is notable. Note the periodic occurrence of irregularities in cardiac rhythm, superimposed on the sinus rhythm, each with a short R-R interval followed by a long one.

Figure 4 shows the last 5-minute period of Zazen from KS. During this period, respiration rate was slowed to less than 1 breath/min. Cardiac variability at this time occurred almost exclusively within the very-low-frequency range (Figure 4), with a power of more than 13 times greater than at rest.

Feelings of Warmth

The participants’ experiences of warmth during Zazen suggest that the body’s thermoregulatory system may have been affected by practice of this discipline. Subject KS, whose very-low-frequency wave amplitudes particularly increased, specifically remarked on his feelings of increased warmth during Zazen. Perhaps breathing at this very slow rate stimulated sympathetic reflexes that affect oscillations in HR within this very-low-frequency range. The meaning of these observations remains ambiguous, however, because we did not specifically examine thermoregulation, vascular tone, blood pressure, or any index of sympathetic activity. Although increases in HR occurred among some Rinzai subjects, these changes were small and not significant. Additional data are required on vascular and body temperature changes during Zazen and their possible relationship with increased sympathetic arousal and HR very-low-frequency wave activity. Previous observations of experienced Indian Yogis have similarly shown significant increases in body temperature during practice of yoga (58).

Apnea: A new training method in sport?

Veldig viktig studie om hva dykkeres trening i Apnea (å holde pusten) kan bidra med i annen idrett. Bekrefter det meste av det jeg har skrevet om, men oppklarer noe om blodverdier bl.a. Nevner EPO, nyrenes tilpasning, hypoxi, HIF-1, melkesyre, lungevolum

http://www.univ-rouen.fr/servlet/com.univ.utils.LectureFichierJoint?CODE=1307716204012&LANGUE=0

http://www.ncbi.nlm.nih.gov/pubmed/19850416

Breath-hold divers have shown reduced blood acidosis, oxidative stress and basal metabolic rate, and increased hematocrit, erythropoietin concentration, hemoglobin mass and lung volumes. We hypothesise that these adaptations contributed to long apnea durations and improve performance. These results suggest that apnea training may be an effective alternative to hypo- baric or normobaric hypoxia to increase aerobic and/or anaerobic performance.

Apnea durations clearly increase with training. Perhaps less well known are the findings that apnea train- ing also increases hematocrit (Hct), erythropoietin (EPO) concen- tration, hemoglobin (Hb) mass, and lung volumes [2–5]. In addition, blood acidosis and oxidative stress were shown to be re- duced after three months of apnea training [6,7]. Therefore, why not encourage apnea training for athletes?

The major determinant of aerobic performance is the capacity to deliver oxygen to the tissues [8]. An increase in the total amount of erythrocytes, as reflected by increased Hct and Hb mass, is med- iated by the glycoprotein hormone EPO, which is predominantly synthesized by the kidneys in response to chronic hypoxia [9] and to some extent (10–15% of total production) by the liver. EPO stimulates the proliferation and maturation of red blood cell precursors in bone marrow, increasing oxygen delivery to muscle and thereby enhancing sports performance [9].

(hypoxic or ischemic conditions) results in a stabilization of the transcription factor hypoxia-inducible factor (HIF)-1a, which increases EPO secretion and the expression of EPO receptor [10].

Furthermore, any training effect vanishes rapidly (two weeks), as the newly formed red cells disappear within a mat- ter of days due to neocytolysis.

The splenic contraction effect

Apnea training may well be a future training method. Splenic contraction has been described in marine mammals as improving oxygen transport, through an increase in circulating erythrocytes. Its consequence is a prolonged dive without injuries. In humans, repeated apneas (five, in general) induce splenic contraction. This increases Hct and Hb (both between 2% and 5%) independently of hemoconcentration [19] and reduces arterial oxygen desaturation, thereby prolonging the apnea duration [3,19–22].

Repeated apneas are known to induce hypoxemia in the spleen and kidney, increas- ing respectively Hct and Hb and serum EPO concentrations [2,23].

First, the splenic contraction develops quickly after three or four apneas separated by two minutes of recovery and is associ- ated with a transient increase in Hb concentration. The amplitude of the spleen volume reduction after repeated apneas, with or without face immersion, varies widely (20–46%) depending on the rate of change in oxygenation [3,19,22,25–27]. The rapidity of the splenic contraction after simulated apneas strongly suggested a centrally-mediated feed-forward mechanism rather than the influ- ence of slower peripheral triggers [19]. These spleen and Hb re- sponses may be trainable.

Second, DeBruijns et al. [2] recently observed that repeated apneas increased EPO concentration by 24%, with the peak value reached 3 h after the last apnea and a return to baseline 2 h later.

The rapid reduction in tissue oxygen levels that oc- curs during apneas has been suggested to stimulate enhanced EPO production [25]. The decreased kidney blood flow induced by apneic vasoconstriction would result in local ischemic hypoxia, stimulating kidney EPO production. Similarly, obstructive sleep ap- nea increases the levels of EPO (􏰀1.6) and Hb (+18%) [24].

The lower SaO2 decrease found in trained divers after repeated apneas may account for the reduced oxygen delivery because of the diving response (bradycardia and vasocon- striction) and/or an increase in oxygen content [1].

Long term-effects

Another important consideration is the persistence of the per- formance gains. Most of the altitude exposure studies reported short-term effects (i.e., weeks). Repeated apneas increase Hct but this increase disappears within 10min after the last apnea [22,26].

The effects of repeated apneas on spleen and endogenous EPO may also constitute an alternative to using rhEPO or its analogues. In addition, comparison of resting Hb mass in elite BHDs and untrained subjects showed a 5% higher Hb mass in the BHDs, and the BHDs also showed a larger relative increase in Hb after three apneas (2.7%). The long-term effect of apnea training on Hb mass might be implicated in elite divers’ performances. Re- cently, it has been found that after a 3-month apnea training pro- gram, the forced expiratory volume in 1 s was higher (4.85 ± 0.78 vs. 4.94 ± 0.81 L, p < 0.05), with concomitant increases in the max- imal oxygen uptake, arterial oxygen saturation, and respiratory compensation point values during an incremental test [30].

In addition to increasing EPO and provoking splenic contraction, apnea training has been hypothesized to modify muscle glycolytic metabolism. An improvement in muscle buffer capacity [6,7,32] would reduce blood acidosis and post-apnea oxidative stress [6]. Delayed acidosis would also be advantageous for exercise perfor- mance. Finally, trained BHDs exhibit high lung volumes [15]. Ap- nea training might be interesting to improve respiratory muscle performance [15], thereby delaying the respiratory muscle fatigue during prolonged and maximal exercise.

Greater cerebral blood flow (CBF) increase was described during long apnea in elite BHDs than in controls and interpreted as a protection of the brain against the alteration of blood gas [33]. The CBF increase observed in BHDs could be the re- sult of an increased capillary density in the brain as has been de- scribed after a prolonged hypobaric hypoxia exposure [35]. These results suggest that apnea training per se provides hypoxic precon- ditioning, increasing hypoxemia and ischemia tolerance [33].

The physiological responses to apnea training exhibited by elite breath-hold divers may contribute to improving sports perfor- mance. These adaptations may be an effective alternative to hypo- baric or normobaric hypoxia to increase performance. Further experimental research of the apnea training effects on aerobic and/or anaerobic performance are needed to confirm this theory.

Two routes to functional adaptation: Tibetan and Andean high-altitude natives

Om hvordan pusten endres når man bor i høyland. Nevner mye om oksygentilgjengelighet, oksygenkaskade, hypoxi, kapillærer, mitokondrier, m.m., og om hvorfor vi har lite oksygen i mitokondriene. Studier undersøker spesifikt om at tibetanere har endrede gener siden de med gener som er tilpasset lave oksygennivåer har mindre fysiologisk stress og dermed større sjangse for barn som overlever, og hvilke forkjeller i hypoxi-tilpasning som har sjedd i de to befolkningene.

Ny, som må gjennomgåes: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1876443/

http://www.pnas.org/content/104/suppl.1/8655.full

These reveal generally more genetic variance in the Tibetan population and more potential for natural selection. There is evidence that natural selection is ongoing in the Tibetan population, where women estimated to have genotypes for high oxygen saturation of hemoglobin (and less physiological stress) have higher offspring survival.

At 4,000-m elevation, every breath of air contains only ≈60% of the oxygen molecules in the same breath at sea level. This is a constant feature of the ambient environment to which every person at a given altitude is inexorably exposed. Less oxygen in inspired air results in less oxygen to diffuse into the bloodstream to be carried to the cells for oxygen-requiring energy-producing metabolism in the mitochondria.

Humans do not store oxygen, because it reacts so rapidly and destructively with other molecules. Therefore, oxygen must be supplied, without interruption, to the mitochondria and to the ≥1,000 oxygen-requiring enzymatic reactions in various cells and tissues (4).


Fig. 1. Ambient oxygen levels, measured by the partial pressure of oxygen (solid line) or as a percent of sea-level values (dashed line), decrease with increasing altitude, a situation called high-altitude or hypobaric hypoxia. The atmosphere contains ≈21% oxygen at all altitudes.

The oxygen level is near zero in human mitochondria at all altitudes (5). This condition is described as “primitive,” because it has changed little for the past 2.5 billion years despite wide swings in the amount of atmospheric oxygen (at times it has been 10,000-fold lower; refs. 6 and 7) and “protective” in the sense that it circumvents potentially damaging reactions of oxygen with other molecules (8).


Fig. 2. The oxygen transport cascade at sea level (solid line) and at the high altitude of 4,540 m (dashed line) illustrates the oxygen levels at the major stages of oxygen delivery and suggests potential points of functional adaptation (data from ref. 60).

Potential and Actual Points of Adaptation to Hypoxia

Energy Production.

Lowlanders traveling to high altitude display homeostatic responses to the acute severe hypoxia. The responses are energetically costly, as indicated by an increase in basal metabolic rate (BMR; the minimum amount of energy needed to maintain life with processes such as regulating body temperature, heart rate, and breathing). BMR is increased by ≈17–27% for the first few weeks upon exposure to high altitude and gradually returns toward sea-level baseline (9). In other words, for acutely exposed lowlanders, the fundamental physiological processes required to sustain life at high altitude require more oxygen despite lower oxygen availability.

In contrast to acutely exposed lowlanders and despite the equally low level of oxygen pressure in the air and lungs, both Andean and Tibetan highlanders display the standard low-altitude range of oxygen delivery from minimal to maximal. Both populations have the normal basal metabolic rate expected for their age, sex, and body weight (1416), implying that their functional adaptations do not entail increased basal oxygen requirements. Furthermore, Andean and Tibetan highlanders have maximal oxygen uptake expected for their level of physical training (12, 13, 17).

Ventilation.

One potential point of adaptation in oxygen delivery is ventilation, which, if raised, could move a larger overall volume of air and achieve a higher level of oxygen in the alveolar air (Fig. 2) and diffusion of more oxygen. An immediate increase in ventilation is perhaps the most important response of lowlanders acutely exposed to high altitude, although it is not sustained indefinitely and is not found among members of low-altitude populations born and raised at high altitude, such as Europeans or Chinese (3, 18).

For example, a comparative analysis summarizing the results of 28 samples of Tibetan and Andean high-altitude natives at an average altitude of ≈3,900 m reported an estimated resting ventilation of 15.0 liters/min among the Tibetan samples as compared with 10.5 liters/min among the Andean samples (19).

Fig. 3 illustrates the higher resting ventilation of Tibetans as compared with Andean highlanders evaluated using the same protocol at ≈4,000 m. The mean resting ventilation for Tibetans was >1 SD higher than the mean of the Andean highlanders (20).

Oxygen in the Bloodstream.

The higher ventilation levels among Tibetans that move more oxygen through the lungs, along with the higher HVRs that respond more vigorously to fluctuations in oxygen levels, might be expected to result in more oxygen in the bloodstream. However, the level of oxygen in the arterial blood (Fig. 2) of a sample of Tibetans at ≈3,700 m was lower than that of a sample of Andean high-altitude natives at the same altitude (54 as compared with 57 mmHg; 1 mmHg = 133 Pa) (24, 25). In addition, hemoglobin, the oxygen-carrying molecule in blood, is less saturated with oxygen among Tibetans than among their Andean counterparts (26, 27). Fig. 3 illustrates the lower percent of oxygen saturation of hemoglobin in a sample of Tibetans at ≈4,000 m. The increased breathing of Tibetans does not deliver more oxygen to the hemoglobin in the arteries.

Fig. 3 illustrates the markedly lower hemoglobin concentrations in a sample of Tibetan men and women as compared with their Andean counterparts at ≈4,000 m. [The average hemoglobin concentrations were 15.6 and 19.2 g/dl for Tibetan and Andean men, respectively, and 14.2 and 17.8 g/dl for women (28).] Hemoglobin concentration is influenced by many factors, including erythropoietin, a protein that causes differentiation of the precursors that will become hemoglobin-containing red blood cells. Tibetans have slightly lower erythropoietin concentrations than Andean highlanders at the same altitude (25). When matched for volume of red blood cells, a procedure that would effectively compare the highest Tibetan and the lowest Andean values, Andean highlanders have much higher erythropoietin levels, which implies that some sensor is responding as if the stress were more severe, even though the samples were collected at the same altitude of ≈3,700 m.

Andean highlanders have overcompensated for ambient hypoxia according to this measure, whereas Tibetan highlanders have undercompensated. Indeed, Tibetans are profoundly hypoxic and must be engaging other mechanisms or adapting at different points in the oxygen transport cascade to sustain normal aerobic metabolism.

Fig. 4. The calculated arterial oxygen content of Tibetan men and women is profoundly lower than their Andean counterparts measured at ≈4,000 m (data from ref. 62), whereas the exhaled NO concentration is markedly higher (recalculated from data reported in ref. 34).

Blood Flow and Oxygen Diffusion.

Other potential points of functional adaptation include the rate of flow of oxygen-carrying blood to tissues and the rate of oxygen diffusion from the bloodstream into cells.

Because blood flow is a function of the diameter of blood vessels, dilating factors could, in principle, improve the rate of oxygen delivery. Sea-level populations respond to high-altitude hypoxia by narrowing the blood vessels in their lungs, the first point of contact with the circulation. Known as hypoxic pulmonary vasoconstriction, that reflex evolved at sea level to direct blood away from temporarily poorly oxygenated toward better oxygenated parts of the lung. High-altitude hypoxia causes poor oxygenation of the entire lung and general constriction of blood vessels to the degree that it raises pulmonary blood pressure, often to hypertensive levels (3, 29).

In contrast, most Tibetans do not have hypoxic pulmonary vasoconstriction or pulmonary hypertension. This is indicated by essentially normal pulmonary blood flow, as measured by normal or only minimally elevated pulmonary artery pressure (29, 30).

a mean pulmonary artery pressure of 31 mmHg for the Tibetan 28% lower than the mean of 43 mmHg for the Andean (35 mmHg is often considered the upper end of the normal sea-level range) (30, 31). Andean highlanders are consistently reported to have pulmonary hypertension (29). Thus, pulmonary blood flow is another element of oxygen delivery for which Tibetans differ from Andean highlanders in the direction of greater departure from the ancestral response to acute hypoxia.

A probable reason for the normal pulmonary artery pressure among Tibetans is high levels of the vasodilator nitric oxide (NO) gas synthesized in the lining of the blood vessels. Low-altitude populations acutely exposed to high-altitude down-regulate NO synthesis, a response thought to contribute to hypoxic pulmonary vasoconstriction (32, 33). In contrast, NO is substantially elevated in the lungs of Tibetan as compared with Andean highlanders and lowlanders at sea level (Fig. 4) (34). Among Tibetans, higher exhaled NO is associated with higher blood flow through the lungs (30).

Several other lines of evidence highlight the importance of high blood flow for Tibetans. These include greater increase in blood flow after temporary occlusion (35) and higher blood flow to the brain during exercise (36) as compared with lowlanders.

Generally, Tibetans appear to have relatively high blood flow that may contribute significantly to offsetting their low arterial oxygen content.

A denser capillary network could potentially improve perfusion and oxygen delivery, because each capillary would supply a smaller area of tissue, and oxygen would diffuse a shorter distance. Tibetans (the study sample were Sherpas, an ethnic group that emigrated from Tibet to Nepal ≈500 years ago) who are born and raised at high altitude have higher capillary density in muscles as compared with Andean high-altitude natives, Tibetans born and raised at low altitude, or lowlanders (Fig. 5) (40).


Fig. 5. High-altitude native Tibetans have higher capillary density than their Andean counterparts or populations at low altitude; Tibetan and Andean highlanders both have lower mitochondrial volume than low-altitude populations (data from refs. 40, 44, 63, and64).

The last potential point of adaptation is at the level of the mitochondrion itself. Acutely exposed lowlanders lose mitochondria in leg muscles during the first 3 weeks at altitude. Similarly, both Tibetan (Sherpas) and Andean high-altitude natives have a lower mitochondrial volume in leg muscle tissue than sea-level natives at sea level (Fig. 5) (40).

Among Tibetans, a smaller mitochondrial volume somehow supports a relatively larger oxygen consumption, perhaps by higher metabolic efficiency (12, 43, 44).

Another candidate gene is the transcription factor hypoxia-inducible factor 1 (HIF1) often called the “master regulator” of oxygen homeostasis, because it induces >70 genes that respond to hypoxia (5658). An investigation of polymorphisms in the HIF1A gene of Tibetans (Sherpas) found a dinucleotide repeat in 20 Tibetans that was not found in 30 Japanese lowlander controls (59).

Effects of Respiratory-Muscle Exercise on Spinal Curvature

Nevner hvor mye diafragma og pustemuskler har å si for kontroll og stabilitet i bevegelse. Bla. kjernemuskulatur og intraabdominalt trykk.

http://posturalrestoration.com/media/pdfs/Effects_of_Respiratory-Muscle_Exercise_on_Spinal_Curvature.pdf

Respiratory-muscle exercises are used not only in the rehabilitation of patients with respiratory disease but also in endurance training for ath- letes. Respiration involves the back and abdominal muscles. These muscles are 1 of the elements responsible for posture control, which is integral to injury prevention and physical performance.

The results suggest that respiratory-muscle exercise straightened the spine, leading to good posture control, pos- sibly because of contraction of abdominal muscles.

In competitive sports, the spine of young athletes can have excess thoracic kyphosis and lumbar lordosis because it is the conduit for transferring mechanical power between the upper and lower extremities during rapid and forceful movements.1

Under the influence of these forces, athletes have much degeneration of the intervertebral disks,2 and the loss of disk height with denaturation is associated with increased spine curva- ture.1 Thoracic kyphosis and lumbar lordosis contribute to back pain.3

The loss or increase of lumbar lordosis correlates well with the incidence of chronic low back pain.4,5 In addition, thoracic kyphosis leads to shoulder pain.3

Spinal-alignment control is essential for preventing various injuries. Align- ment depends on muscle strength and balance, muscle tightness, and skeletal structure.9

The trunk muscles are grouped into 2 categories: global and local stabilizers.10 The global stabilizers com- prise superficial muscles such as the rectus abdominis and longissimus muscles, and the local stabilizers are deep muscles, for example, the transverse abdominal and multifidus muscles.10 Cholewicki et al11 reported that thecontraction of local stabilizers is indispensable to trunk stability; that is, the trunk becomes unstable in the case of contraction of global stabilizers alone. The unstable trunk increases stress to the ligament and bone that control the end of motion and cause pain such as back pain.12

Respiratory-muscle exercises are used in the reha- bilitation of chronic obstructive pulmonary disease18 and endurance exercise for athletes.19 The muscles comprise the diaphragm, intercostal muscles, and the accessory muscles of respiration.20 The accessory muscles of res- piration consist of several of the trunk muscles, includ- ing local stabilizers. Therefore, this study focused on exercises for the respiratory muscles, which have the advantage that the load can be accurately set by regulating frequency and depth of breathing.

Increased spine curvature is responsible for low back pain4,5 and swim- mer’s shoulder,6 so respiratory-muscle exercise may prevent these dysfunctions.

Because muscle strength for trunk flexion was noted to increase only in the exercise group, we conclude that the exercises strongly affected the abdominal muscles. Abe et al32 reported that the transverse abdominal muscle is the most powerful in the abdominal muscle group with respect to respiration. The transverse abdominal muscle may have been specifically targeted in this exercise. This important muscle is a key local stabilizer.

Contraction of the transverse abdominis increases intra-abdominal pressure, which leads to lumbar
straightening.33 In addition, a rise in intra-abdominal pres- sure presses the rib cage upward and effectively allows the extension of the thoracic vertebrae.34

In addition, we attribute the decrease of thoracic curvatures to a stretching effect on the thorax. In a previous study, Izumizaki et al35 reported that thoracic capacity and rib-cage movement were changed by thixotropy, which is the exercise of maxi- mal expiration from maximum inspiration. The stiffness of the rib cage leads to thoracic kyphosis.3 In this study, repetitive deep breathing resolved the stiffness of the rib cage and straightened thoracic kyphosis. This process may be responsible for altering the spinal curvature.

These training methods require a long period of 12 weeks for improvement. By contrast, our intervention period was 4 weeks, so spinal alignment may be improved in a much shorter period.

Positive Effect of an Autologous Platelet Concentrate in Lateral Epicondylitis in a Double-Blind Randomized Controlled Trial

Viser at Platelet-Rich Plasma (PRP) gir betraktelig økning i regnerering av tennisalbue. Med apnea-trening pumper milten ut ny PRP, så denne studien kan bekrefte apnea som helbreldelse. Resultatene er langt bedre enn ved kortisoninjeksjoner.

http://ajs.sagepub.com/content/38/2/255.short

«Treatment of patients with chronic lateral epicondylitis with PRP reduces pain and significantly increases function, exceeding the effect of corticosteroid injection. »

«The results showed that, according to the visual analog scores, 24 of the 49 patients (49%) in the corticosteroid group and 37 of the 51 patients (73%) in the PRP group were successful, which was significantly different (P <.001).»

YOGA OF PSYCHIC HEAT (GTUM-MO) RESEARCH TECHNIQUES AND RESULTS

En russisk artikkel fra en forsker som har interessante teorier om tummo og varmegenereringen. Spesielt det som skjer i lungenes blod hvor fettsyrer forbrennes og dermed skaper varme. Forfatteren nevner at kolestrolnivået synker etter bare 10 minutter med tummo. Interessante teorier som er verdt å undersøke videre, men fullstendig umulig å bruke denne artikkelen som vitenskapelig grunnlag.

http://www.worldscientists.ru/psychology-and-pedagogy/38-yoga-of-psychic-heat-gtum-mo-research-techniques-and-results.html

«Technique of inner fire awakening is described in Yoga Kundalini Upanishad as follows: “When Apana on its way up reaches the place of fire then fire awaken by the wind inflates and grows. Then Prana itself ignites with the came fire and then fire overwhelms all body with continuous burning”»

«In the 50-ies of the 20th century K.S. Trincher, the physiologist, proved it and published his monograph Heat-Generating Function and Alkalinity of Pulmonary Tissue Response [13] in which he stated that under some conditions human lungs could perform not only respiratory but also non-respiratory functions. In particular, non-fermentative blood lipids peroxidation could take place in lungs. Energy releasing reaction of aerobic lipids peroxidation results in significant alteration of thermodynamic characteristics of the body.»

«First experiment was taken in March, 2004. During experiment venous blood sampling was taken after which Tummo was practiced during 10 minutes. Then repeated venous blood sampling was taken. Blood was analyzed for blood lipids. The analyses revealed cholesterol, lipoproteins and triglycerides quantity reduction. It was found that the author’s total cholesterol was 6.54 mmole/l before practice and 6.14 mmole/l after practice (N 3.6 – 5.2).»

«»

Neurocognitive and Somatic Components of Temperature Increases during g-Tummo Meditation

Viktig studie om tummo som oppklarerer flere misforståelser og beskriver mange aspekter som tidligere ikke er beskrevet. Nevner bl.a. at vestlige også kan øke sin kroppstemperatur med disse teknikkene.

http://www.plosone.org/article/info%3Adoi%2F10.1371%2Fjournal.pone.0058244

«Reliable increases in axillary temperature from normal to slight or moderate fever zone (up to 38.3°C) were observed among meditators only during the Forceful Breath type of g-tummo meditation accompanied by increases in alpha, beta, and gamma power.»

«Overall, the results suggest that specific aspects of the g-tummo technique might help non-meditators learn how to regulate their body temperature, which has implications for improving health and regulating cognitive performance.»

«The authors reported that three g-tummo meditators showed a dramatic increase of up to 8.3°C in peripheral body temperature (fingers and toes), more modest skin temperature increases of 1.9°C in the navel and lumbar regions, and no increase in rectal temperature. Unfortunately, these findings have subsequently been distorted in reports in other sources, possibly due to confusion between Fahrenheit and Centigrade scales or lack of clear specification regarding the anatomical sites of temperature measurement, leading to general claims of temperature increases during g-tummo ranging from “… up to 15 degrees only within a few moments of concentration” [3] to “17 degrees in peripheral body temperature” [8]

«The visual effect of steaming sheets reported by eye-witnesses of the g-tummo ceremony cannot be taken as evidence of elevated body temperature. Wet sheets wrapped around a practitioner’s body would steam and dry due to the significant temperature difference between the wet sheets (heated by a human body) and the cold air outside, even if the practitioners simply maintain their normal body temperature.»

«Furthermore, they did not exceed the peripheral body temperature increases reported in clinical studies of (non-meditating) individuals who were able to increase hand or finger temperature by up to 11.7°C during biofeedback alone or in combination with hypnosis, mental imagery, or autogenic training[9][11]. Subsequent clinical research, however, reported that such peripheral temperature increases were primarily mediated by somatic (e.g., altered respiration and/or tensing and contracting of muscles) but not cognitive factors [12]

«The g-tummo practice involves both somatic and neurocognitive components. The somatic component involves specialized breathing techniques as well as isometric exercises (i.e. exercises performed in static positions, rather than incorporating a range of motion) involving muscle tensing and contraction. The neurocognitive component involves meditative visualization requiring the generation and maintenance of mental images of flames at specific locations in the body accompanied by intense sensations of bodily heat in the spine.»

«Recent studies report that raising body temperature might be an effective way to boost immunity and treat infectious diseases and immunodeficiencies [13][15] as well as to induce synaptic plasticity in the hippocampus [16]. It has been long recognized that increased body temperature (in the zone of a slight fever) is associated with higher alertness, faster reaction time, and better cognitive performance on tasks such as visual attention and working memory [17][19]. »

«Some, but not all, of these monasteries test their practitioners’ capabilities at the end of a three-year retreat with a ceremony where the practitioners dry wet sheets. As a testament to the importance of the g-tummo practice at Gebchak nunnery, this ceremony is held annually, at dawn, and all of the experienced practitioners walk slowly for a few hours around the nunnery complex in −25°C to −30°C weather, wearing only short skirts and shoes and a wet sheet draped around their naked torsos.»

«The g-tummo practice is characterized by a special breathing technique, “the vase”, accompanied by isometric muscle contractions, where after inhalation, during a period of holding their breath (apnea), the practitioners contract both abdominal and pelvic muscles so that the protruding lower belly takes the shape of a vase or pot [1]

Tilsvarerer akselereringsfasen i vårt tummo konsept.
«FB is forceful and vigorous, while GB is gentle and without any strain. Whereas the goal of FB is to raise “psychic heat”, the goal of GB is to maintain it. During FB, attention is focused on visualizing a rising flame that starts below the navel and with each breath rises up to the crown of the head, whereas GB is accompanied by visualization of the entire body being filled with a surging sensation of bliss and heat.»

Man kan enkelt måle kjernetemperatur selg med termometer i armhulen eller munnen.
«We recorded EEG activity of the meditators as well as their peripheral (left fifth finger) and core body temperature (left armpit) during g-tummo practices»
«Although not as precise as an internally taken rectal or oral measurement of core body temperature [20], axillary measurements are less intrusive. Importantly, they are not affected by muscle contractions (e.g., anal sphincter), or the airflow through the mouth, during the vase breathing.»

«The results indicated peripheral (finger) temperature increases between 1.2°C to 6.8°C during different conditions»

«During BFB, the maximum CBT increase was 1.14°C (participant #3) and the maximum temperature reached was 37.45°C (participant #4).»
«The maximum CBT increase from the beginning of the experiment to the end of MFB was 2.2°C (participant #3), and the maximum temperature reached was 38.30°C (participant #5).»


«Figure 3. CBT increases for Study 1 participants #1, #3, and #4 during BFB, BGB, MFB, and MGB performed in a continuous sequence.
Since the duration of each of the four practices varied from participant to participant, to simplify the figure presentation, the duration of each practice is rescaled from 0 to 1, with t0 the starting point of each practice, and t1 the ending point.»

«During FB (either BFB or MFB), participants’ CBTs typically exhibited a step-like pattern, with a period of steady temperature increase followed by a plateau or equilibrium phase corresponding to the “temperature saturation point”, above which the participants were not able to raise their CBT further despite their efforts to continue with FB. This pattern of CBT increases is very similar to that usually observed during induction of systemic hyperthermia (i.e., deliberate heating of a patient’s body to achieve an elevated core temperature for therapeutic purposes), where the equilibrium phase indicates the beginning of heat losses due to physiological mechanisms (e.g. vasodilation, evaporation) limiting the rate of heating that can be achieved, and thus protecting the body from excessively high temperatures [22]


«we defined the rise time (ΔTr) as the time taken for the CBT to rise from 10% to 90% of its final value »

«In summary, the results suggest that although CBT increases during BFB were not as dramatic as during MFB, participants were able to produce body heat, utilizing only the somatic component of the FB practice (breathing and isometric techniques). However, the meditators were able to reach an elevated CBT, significantly above the normal axillary temperature, only during MFB practice. As for GB practice, consistent with practitioners’ reports that it is used to maintain (but not to increase) body heat, no significant changes in participants’ CBT were observed during either GB baseline or meditation.»

«Furthermore, the higher the increases in alpha power developed by participants during FB meditation, the larger their increases in CBT during FB meditation, while the CBT increases during BFB were achieved without any changes in alpha power. This suggests that different mechanisms may be affecting CBT increases during MFB versus BFB, and that meditative visualization characterized by significant increases in alpha power might uniquely contribute to overall CBT increases beyond the contribution of the vase breathing technique.»

«In summary, our findings indicate that the two parameters, apnea duration and increases in alpha power achieved during meditative visualization are significant predictors of the overall CBT increases during FB practice. The apnea duration is significantly related to the rate of CBT increase. The increase in alpha power developed during FB meditation is related to the CBT rise time, that is, it predicts how long the meditators are capable of sustaining their CBT increases without reaching equilibrium.»

«The average initial CBT of all the participants before BFB was 36.38°C (SD = 0.23), while the average temperature at the end of BFB reached 36.99°C (SD = 0.13), only marginally above the normal axillary temperature of 36.6°C in the healthy population [one sample two-tailed t(10) = 2.02, p = 0.07]. The maximum CBT reached during BFB was 37.02°C. «

«The average apnea duration of the participants was 30.38 sec (SD = 6.35), ranging from 19 to 41 sec; the apnea duration correlated with the rate of CBT increase during BFB: r = 0.60, p = 0.050.»

«all the Western non-meditator participants returned to their baseline CBT during the next 20 minutes. This is in contrast to Tibetan practitioners performing GB (Study 1) who did not show any decreases in their CBTs during either BGB or MGB (δ = 0.011°C/min and δ = 0.002°C/min respectively), and were able to maintain an elevated body temperature throughout the whole duration of MGB (on average 21.50 min). This further confirms that the GB practice facilitates maintenance of body temperature.»


«Figure 7. CBT increases during FB as performed by a Western non-meditator and a Western g-tummo practitioner.»

«In summary, the results of Study 2 indicate that the BFB technique brings about significant increases in CBTs not only in meditators but also in those individuals who do not have any prior experience in meditation. »

«As for the increased gamma activity observed during FB meditation, studies on meditation consider it a signature of “samadhi” (deep meditative states of consciousness), but the regions of increase have varied, with recent studies reporting in some cases a frontally distributed increase in gamma [28], and in other cases an increase in gamma at posterior and occipital electrodes [29]. »

«In the case of FB meditation, one of the possible mechanisms preventing heat loss could be the mental imagery of flames and heat. Indeed, previous research has regarded mental imagery as a potentially effective technique in influencing peripheral body temperature, blood flow, and local vasodilation [38][41]. »

«If future studies show that it is possible to self regulate CBT, by mastering vase breathing in conjunction with guided mental imagery without extensive meditation experience, it will open a wide range of possible medical and behavior interventions, such as adapting to and functioning in hostile (cold) environments, improving resistance to infections, boosting cognitive performance by speeding response time, and reducing performance problems associated with decreased body temperature as reported in human factor studies of shift work and continuous night operations[44], [45]