İNATÇI FİSTÜL TEDAVİSİ VE CERRAHİ YARA İYİLEŞMESİNDE OZONİZE ZEYTİNYAĞININ ETKİLERİ

İnatçı fistül ve 

Therapeutic Effects of Ozonized Olive Oil in the Treatment of Intractable Fistula and Wound after Surgical Operation

Akiyo Matsumoto1, Shotaro Sakurai2, Nariko Shinriki3, Shigeru Suzuki4 and Toshiaki Miura5

1Department of Surgery, Chiba-Tokushukai Hospital, Narashino-dai, Funabashi, 274-8503, Japan

2Department of Pharmacy, Kashiwa Municipal Hospital, Fuse, Kashiwa, 277-0825, Japan

3Tsukuba Materials Information Laboratory, Sapporo Branch, Sapporo, 062-0906, Japan

4Nippon Ozone Co. Ltd., Arakawa 7-4-3, Tokyo, 116-0002, Japan

5College of Medical Technology, Hokkaido University, Kita-ku, Sapporo, 060-0812, Japan

Abstract

20 patients at several hospitals who underwent surgical operation between August 1998 to August 2000 had ozonized olive oil applied to their intractable fistula or wounds. The ozonized olive oil treatment was fully effective in 19 of the cases. The one exception was for a case of pilonidal sinus. Ozonized olive oil was especially effective in treating intractable abdominal fistula to digestive tract after surgical operation. No adverse side effects were observed in the administration of the ozonized olive oil. It was fully effective for a discharge of pus and the formation of granulation.

Introduction

There have been many cases of intractable fistula forming after surgical operations. In Europe

ozonized olive oil has been used to treat serious wounds and good results have been achieved,

however it has almost never been used in clinical applications in Japan. We started to test

ozonized olive oil by treating intractable wound which resulted in a cure. Since then we have

applied it for many kinds of cases, e.g., intractable fistula, decubitus anal fistula, pilonidal

sinus and so on. We will report good results we achieved.

Materials and Methods

The main component of ozonized olive oil was found to be triolein triozonide as explained in

the proceeding presentation..

Refrigerated ozonized olive oil which was obtained from Pharmoxid, Germany was brought

to a viscous state at room temperature before use.

20 patients who had been treated unsuccessfully for intractable fistulas and wounds were

selected. These patients had previously been treated by curettage, saline deterge, antibiotic

ointment and/or drainage. Before treatment with ozonized olive oil an informed consent form

was obtained.

Pus from the intractable fistulas and wounds was discharged and the ozonized oil was

administered to the opening by a 1.0 or 3.0 ml syringe. After the application of the ozonized

oil the fistula or wound was loosely covered by gauze. In some cases excess pus was

produced so a saline deterge was used, and debridement was done in cases of necrosis. There

was no administration of antibiotics either externally or orally, nor were the fistulas or wounds

stuffed with gauze or drained.

Results

20 cases are shown in Table 1. The number of other treatments before the ozonized oil (saline

deterge, antibiotic ointment, curettage and drainage) and the interval between treatments is

shown on the center. In the right columns we show the number of treatments of the ozonized

oil, dosage volume and intervals of application until the patient was cured.

There were three cases of intractable fistula after operation for inguinal hernia, including one

case of intractable fistula with infected mesh (case 2), which was cured by only 5 applications

of the ozonized oil.

Four cases of intractable fistula after operation for acute appendicitis with peritonitis (case 4

to 7) had difficulty in closing the opening, but after using the ozonized oil for only 3 to 10

applications they were cured. Photo.1 shows case 4 pre and post the ozonized oil treatment.

Five cases of intractable wound after operation for infected epidermal cyst were also shown.

Case 11 needed 24 applications but the others soon recovered. Photo. 2 shows case 10 pre and

post the ozonized oil treatment.

One case (case 13) was fistula after incision to treat an infected urachal cyst. Excretion of pus

was limited but the incision wound did not easily close after the operation. However after

only 3 treatments with the ozonized oil it closed.

We treated three cases of fistula after incision and drainage for infected pilonidal sinus. In

case 19 the number of treatments was higher than usual but a cure was effected. Case 17 had a

3 cm diameter abscess cavity under the skin that was not cured despite many applications of

the ozonized oil.

In a case of lower limb ulceration due to sunburn (case 20), a patient had a 3.0cm diameter

blister . Following usual practice the blister was pricked and treated, however the abscess

belaque at the bottom of the ulcer did not disappear. After application of the ozonized oil pus

solidification and a drying up at the ulcer bottom started and epithelization appeared, and then

the ulcer cured. This is shown in Photo. 3.

We treated three cases of fistula after incision and drainage for perianal abscess (cases 14 to

16), including one case for periviorectal abscess (case 15). We showed the cure proceedings

of case 15 in Photo. 4. Abscess cavities were formed in the range of 1) ischiorectal fossa on

the right, 2) internal and external obturator muscles on the left, 3) piriform muscles, 4) a part

of maximum gluteal muscle. A patient had a fever over 38°C and an increase of leukocyte

(15,200/mm3). After repeated incisions and drainage for perianal abscess, a decrease of

excretion of pus occurred and on the 8th day from the operation the patient started to eat.

However he again had a fever of 38°C and an increase in the amount of pus. We were forced

operation we started to treat his fistula with the ozonized oil, then the administration of oral

antibiotics became unnecessary. On the 14th day of treatment with the ozonized oil he started

to have meals without a fever nor an increase in leukocyte although a small amount of pus

was excreted. Photo. 4-B is a X-ray using diatorizonate sodium and shows the intractable

fistula at the start for the ozonized oil treatment. Photo. 4-D shows the fistula after 18

applications of the ozonized oil, and only ramiform fistula remained in the range of 1)

ischiorectal fossa on the right and the back of the rectum. In the CTs (4-E1~E3) abscess

formation could not be found. On the incised part of the right side around the anus a fistula

into which a sonde could only be inserted 2 cm remained and there was no excretion of pus.

From then the patient became an outpatient and until now there has been no sign of

recurrence.

Discussion and Conclusion

We often see intractable fistulas and wounds as a result of surgical operation. In the treatment

of intractable fistulas, use of local applications of Picibanil, fiblin paste and/or medicine made

from human blood coagulation factor 8, high oxygen pressure treatment and laser beam

irradiation method have been reported.1)-5) Operation for inguial hernia often gives rise to

infected mesh ( case 2 ) resulting in the need for a second operation. The infection is initially

cured but soon gets re-infected causing a repeat hernia. In operations for acute appendicitis

with diffuse peritonitis the formation of intractable fistula is often seen6). Even in cases of

relatively simple fistula observed by X-ray diatorizoate sodium treatment becomes very hard

due to the difficulty in overcoming infection and the elimination of bad granulation. In cases

of infected epidermal cyst, incision to eliminate pus often causes the infection to spread and

consequently subcutaneous tissue is lost, increasing the difficulty in curing the wound.

We tried treating intractable fistulas and wounds with the ozonized oil, which is especially

easy to apply without any special instrument. The application of the ozonized oil decreased the

excretion of pus along with a corresponding increase in granulation at the rim of the wound.

Then the opening reduced to a pin point or line state, and finally the excretion of pus stopped

and the fistula closed. In cases of fistula with minimal excretion of pus, epithelization of the

opening parts and subsequent closing were rapid. Infected urachal cysts and infected pilonidal

sinuses which are not cured by antibiotics7) usually need radical operations, however in our

study they were seen to be effectively cured by the ozonized oil. Anal fistulas, which are

easily formed after incision and drainage for perianal abscesses often need a radical operation,

but cases 14 and 16 soon healed after application of the ozonized oil, and there has been no

sign of recurrence. In case 15 a periviorectal abscess showed a rapid reduction of fistula size

and a tendency to heal. Until now, after debriedment intractable fistulas and wounds were

classified by their conditions and their treatment was carried out according to this

classification. Wounds with large amounts of pus had saline deterge, drainage and local

application of antibiotics. After the granular formation some drugs which promote the

formation of granulation was used. Using the ozonized oil by itself resulted in pus

solidification, an ocurrence of drying, the appearance of epithelization and a decrease in the

size of abscesses. The fistulas and wounds had a tendency to cure; therefore the ozonized oil

itself can cure these independently. Intractable wounds that had a certain degree of

granulation after debriedment of the parts of necrosis and abscess had the ozonized oil applied

and this resulted in rapid epithelization and a closing of the opened wounds.

The disinfection effect of ozonized olive oil has already been reported8). On the other hand the

stimulation mechanism of the ozonized oil to the tissue (e.g., granulation and epithelization

etc.) has not been clarified enough. However, in ozone treatment (e.g., autohemotherapy)

ozone has been recognized to have some stimulating effects on leukocytes, e.g., induction of

many cytokines was clearly confirmed by Bocci9,10). In ozone gas rinsing of ulcers caused by

arterial circulation disorders (diabetes), increases of granulation tissue and epidermal

epithelium were observed by Rokitansky11). Also in the case of ozonized olive oil some active

oxygen species which are considered to be generated from the breakdown of triolein

triozonide will be able to react and/or stimulate the cells. About this point more study will be

needed.

In conclusion we think that because of its good results with no side effects and ease of

application ozonized olive oil should be used for the treatment of intractable fistulas and

wounds after surgical operations.

References

1) Nakanishi Y, Nakajima T, Yoshimura Y et al.: Nihon Keisei-geka Gakkai Kaishi (J. Japan

Soc. Plastic and Reconstructive Surgery) 17: 428-433, 1997

2) Hiraguchi E, Miyake Y, Sunaga M et al.: Nihon Rinsyo-geka Gakkaishi (J. Japan Surgical

Assoc.) 53: 209-214, 1992

3)Usui A, Kubota M, Ohkita J et al.: Hinyouki-geka (Japanese J. Urological Surgery) 6 : 373-

376, 1993

4) Kawashima M, Tamura H, Takao K et al.: Nihon Iji Shinpou (Japan Medical Journal)

No.3525 : 43-45, 1991

5) Suguro M, Ejiri S, Sakashita T : Shohkaki Naishikyo (Endoscopia Digestiva) 9 : 411-416,

1997

6) Yamamoto S, Watabe T, Matsumoto Y et al.: Geka (Surgery) 57 : 149-154, 1995

7) Lundhus E, Gottru F : Outcome at three to five years of primary closure of perianal and

pilonidal abscess. A randomised, double-blind clinical trial with a complete three-year

follow up of one compared with four days’ treatment with ampicillin and metronidazole.

Eur. J. Surg. 159 : 555-558, 1993

8) Lezcano I, Nuñez N, Espino M, Gómez M : Antibacterial activity of ozonized sunflower

oil, Oleozón, against Staphylococcus aureus and Staphylococcus epidermidis. Ozone Sci.

Eng. 22 : 207-214, 2000

9) Bocci V, Paulesu L : Studies on the biological effects of ozone. 1; Induction of interferon

γ on human leucocytes. Haematologica 75 : 510-515, 1990

10) Paulesu L, Luzzi E, Bocci V: Studies on the biological effects of ozone. 2; Induction of

tumor necrosis factor (TNF-α) on human leucocytes. Lymphokine Cytokine Res. 10, 409-

412, 1991

11) Werkmeister H : Subatomospheric O2/O3-treatment of therapy-resistent wounds and

ulcerations. OzoNachrichten 3/4, 53-59, 1985

 

 

 

 

 

 Photo. 1 Case 4: Formation of intractable fistula after operation for acute appendictis

A: Wound before medication of ozonized olive oil

B: X-ray with diatorizoate sodium (X-ray) of intractable fistula

C: Wound after one application of the ozonized oil

D: Wound after 6 applications of the ozonized oil

Photo. 2 Case 10: Formation of intractable fistula after operation for infected epidermal cyst

A: Wound before medication

B: Wound after one application of the ozonized oil

C: Wound after 4 applications of the ozonized oil

Photo. 3 Case 20: Debriedment of lower limb ulceration

A: Wound before medication

B: Wound after 2 applications of the ozonized oil

C: Wound after 7 applications of the ozonized oil

D: Wound after 16 applications of the ozonized oil

Photo. 4 Case 15: Formation of intractable fistula after incision and drainage for perianal abscess

A: Wound before medication B: X-ray of intractable fistula C1, C2: CT with diatorizoate sodium (CT) of intractable fistula

D: X-ray of intractable fistula after 18 applications of the ozonized oil. E1, E2, E3: CT of intractable fistula after 18 applications of the ozonized oil. Before medication, abscess cavities were formed in the range of 1), 2), 3) and 4) in the pictures. After 18 applications, only ramiform fistula remained in the range of 1) and the back of the rectum, and abscesses in other parts were not detected by CT. 1) ischiorectal fossa on the right 2) internal and external obturator muscles on the left 3)piriform muscle 4) a part of maximum gluteal muscle

Mevcut yazılı metin bilgilendirme amaçlıdır. Bilimsel verilerden elde edilmiş bilgilerdir. Konu hakkında uzman kişiler tarafından yönlendirilmeniz ve tedaviye yönelik işlemleri bir hekim kontrolünde uygulamanız veya uygulatmanız önerilir.Ankara ozon , ozon ankara , DMSO , C Vitamini , PRP ,

OZONUN CİLT ÜZERİNE ETKİLERİ

        Ozon tedavisi her şekli ile cilt üzerinde anti-aging etki oluşturur. Yapılan majör tedavi sonrası hastalarımızın yüzleri parlar ve ciltleri gençleşmeye başlar. Bu etki zaman içerisinde oluşur. Gösterdiği  etki antioksidan özellikleri ve oksijenizasyon artışı ile birlikte oluşur.

         Ozon gazı PRP işlemi sırasında da kanın zenginleştirilmesinde kullanılırsa PRP etkinliğini artırır.

         Ozon gazının direk cilde enjeksiyonu sonrasında ciltte skılaşma ve gençleşme görülür. Özellikle göz altı torbaları ve göz altı morluklarında ozon gazı enjeksiyonları yüz güldürücü sonuçlar almamızı sağlar.

The dual action of ozone on the skin

G. Valacchi,* V. Fortino* and V. Bocci*

*Department of Physiology, University of Siena, Siena 53100, Italy

Department Internal Medicine, School of Medicine, University of California Davis, Davis, CA 95616, U.S.A.

Correspondence   G. Valacchi.

Summary

The aim of this brief review is to summarize the recent literature on the effect of ozone (O3) on cutaneous tissues. Recently it has been reported that a chronic contact with O3 can be deleterious for the skin. Our group and others have shown a progressive depletion of antioxidant content in the stratum corneum and this can then lead to a cascade of effects resulting in an active cellular response in the deeper layers of the skin. Using an in vivo model we have shown an increase of proliferative, adaptive and proinflammatory cutaneous tissue responses. On the other hand the well known activity of O3 as a potent disinfectant and oxygen (O2) donor has been also studied for therapeutic use. Two approaches have been described. The first consists of a quasi-total body exposure in a thermostatically controlled cabin. This treatment has proved to be useful in patients with chronic limb ischaemia. The second approach is based on the topical application of ozonated olive oil in several kinds of skin infection (from soreness to diabetic ulcers, burns, traumatic and surgical wounds, abscesses and skin reactions after radiotherapy). We and other authors have observed a striking cleansing effect with improved oxygenation and enhanced healing of these conditions. It is now clear that, on the skin, O3, like other drugs, poisons and radiation, can display either a damaging effect from a long exposure or a beneficial effect after a brief exposure to O2 and O3 or to the application of ozonated oil to chronic wounds. Christian Friedrich Schonbein discovered ozone (O3) in 1839 and in 1853 he made the first measurement of O3 in the Austrian mountains. Today, we know that some gases such as O3, carbon monoxide, nitric oxide and carbon dioxide can have dual actions, behaving either as useful or as harmful agents.1 The O3 layer is located at an altitude of about 22 km. Approximately 90% of the O3 in the atmosphere resides in the stratosphere. The O3 concentration in this region is about 10 parts per million by volume. O3 absorbs the bulk of solar ultraviolet (UV) radiation in the wavelengths from 290 to 320 nm. These wavelengths are harmful to life because they can be absorbed by the nucleic acid in cells and damage it.

Increased penetration of UV radiation to the planet’s surface would damage plant life and have harmful environmental consequences. Appreciably increased amounts of solar UVradiation at the Earth’s surface would result in a host of biological effects, such as a dramatic increase in cancer; it seems that a 10% drop in the level of the O3 layer may cause a 25% increase in skin carcinoma and melanoma.2 Moreover this risk has recently been enhanced by excessive pollution with O3 in the troposphere, particularly evident during summertime in large cities.3 Thus the strong oxidative power of O3 in association with other contaminants, can be harmful for plants and animals. The human bronchopulmonary system and the

skin are the most accessible targets; they are vulnerable owingto the paucity of local antioxidant defences. O3 toxicity for the pulmonary system has been extensively examined while attention to the skin problem is more recent but no less important.

An interesting difference that we would like to point out here is that while the pulmonary system is absolutely intolerant to O3 and this gas should never be inhaled, the skin, forbanatomical and biochemical reasons, is somewhat more resistant. Recent literature points out that although a long exposure is certainly deleterious, transitory exposure at low and precisely controlled O3 concentrations can have useful effects.

The damage to the respiratory tract by oxidative environmental pollutants such as O3 and nitrogen oxides have already been reviewed4 while recent literature has focused only on the damaging interaction between long exposures to O3 and cutaneous tissues.5–10

We believe that it is now also correct to discuss the unexpected herapeutic effect of a brief exposure of patients to O3 or the use of ozonated oil for cutaneous infections. 1096 2005 British Association of Dermatologists • British Journal of Dermatology 2005 153, pp1096–1100

Skin responses to environmental stress The skin consists of two main layers, the epidermis and the dermis, of which the latter is superficial to the subcutaneous fat tissue. Dermal fibroblasts synthesize a complex extracellular matrix containing collagenous and elastic fibres. Blood capillaries reach the upper part of the dermis. The epidermis contains mostly keratinocytes that rise to the skin surface as they differentiate progressively to form the non-nucleated corneocytes that comprise the superficial part of the epidermis, the stratum corneum (SC).

The skin, as an interface between the body and the environment, is chronically exposed to stress from both UV radiation and environmental oxidative pollutants such as diesel fuel exhaust, cigarette smoke, halogenated hydrocarbons, heavy metals and O3 (one of the most toxic of these compounds).11 The skin is protected against oxidative stress by a variety of antioxidants; these include enzymatic antioxidants such as glutathione peroxidase, superoxide dismutase, catalases and nonenzymatic low-molecular weight antioxidants such as vitamin E isoforms, vitamin C, glutathione (GSH), uric acid and ubiquinol. 7 Recently, the presence of a- and c-tocopherol, ascorbate, urate and GSH has been shown also in the SC.10 Interestingly, the distribution of antioxidants in the SC follows a gradient with higher concentrations in deeper layers.12 This may be explained by the fact that SC layers move up in time as a part of the physiological turnover of skin cells and are replaced by freshly differentiated keratinocytes. Therefore, the superficial layer is exposed to chronic oxidative stress for a longer time than the deep layer. Compared with the SC, the surface lipids contain high levels of a- and c-tocopherol because of the secretion of vitamin E by sebaceous glands.13 Eventually, the uppermost layer of the SC will desquamate and the remaining antioxidants and reacted products will be eliminated from the body.

In general the outermost part of the skin, the epidermis, contains lower concentrations of antioxidants than the dermis. In the lipophilic phase, a-tocopherol is the most prominent antioxidant, while vitamin C and GSH are the most abundant in the aqueous phase.  Skin responses to ozone  It is generally understood that the toxic effects of O3 are mediated through free radical reactions, although O3 is not a radical species per se.14 They are achieved either directly by the oxidation of biomolecules to give classical radical species (hydroxyl radical) or by driving the radical-dependent production of cytotoxic, nonradical species (aldehydes).15

Furthermore, the formation of the oxidation products characteristic of damage from free radicals has been shown to be prevented by the addition of the antioxidants vitamin E and C, though the mechanism is not fully understood. The target specificity of O3 towards specific compounds together with its physicochemical properties of fairly low aqueous solubility and diffusibility, must be taken into account when a target tissue

(lung and skin) is exposed to O3.16 Polyunsaturated fatty acids Cell membranes and their lipids are relevant potential targets of environmental stressors such as UV and O3. Using a spin trapping technique, the formation of radicals in the SC upon exposure to O3 and ⁄or UV was detected (L. Packer, unpublished

observation). The spin adduct could arise from an alkoxyl radical formed during lipid peroxidation. Furthermore, lipid radicals (LÆ) are generated in epidermal homogenates that have been exposed to environmental stressors. The organic free radical LÆ reacts with O2, forming peroxyl radical LOOÆ and hydrolipoperoxides  (LOOH). Transition metals and in particular iron, play a key role in the reactions of LOOH and in the subsequent generation of alkoxyl radicals (ROÆ can amplify the lipid peroxidation process).

The stratum corneum as the first target of environmental stressors Within the skin, the SC has been identified as the main target of oxidative damage.17,18 As the outer skin barrier, the SC has important functions, limiting transepidermal water loss and posing a mechanical barrier to penetration by exogenous chemicals and pathogens. It comprises a unique two-compartment system of structural, non-nucleated cells (corneocytes) embedded in a lipid enriched intercellular matrix, forming stacks of bilayers that are rich in ceramides, cholesterol and free fatty acids.19,20 The effects of O3 on cutaneous tissues have recently been evaluated using a murine model. While no effect of O3 on endogenous antioxidants was observed in full thickness skin (dermis, epidermis and SC), it could be demonstrated that a single high dose of O3 (10 lg g)1 · 2 h) significantly depleted topically applied vitamin E.21 When the skin was separated into upper epidermis, lower epidermis and papillary dermis, and dermis, O3 induced a significant depletion of tocopherols and ascorbate followed by an increase in the lipid peroxidation measured as malondialdehyde (MDA) content. O3 is known to react readily with biomolecules and does not penetrate through the cells; therefore, it was hypothesized that O3 mainly reacts within the SC.17 This hypothesis was supported by further experiments, where hairless mice were exposed to varying levels of O3 for 2 h. Depletion of SC lipophilic (tocopherols)

as well as hydrophilic (ascorbate, urate, GSH) antioxidants was detected upon O3 exposure and it was accompanied by a rise in lipid peroxidation as an indicator of increased oxidative stress.22 Furthermore, a recent study has shown the increase of 4-hydroxylnonenal (4-HNE) content in murine SC using both Western blot and immunohistochemical analysis.23 Skin cellular responses to ozone exposure As mentioned above, O3 exposure was shown to induce antioxidant depletion as well as lipid and protein oxidation in the 2005 British Association of Dermatologists • British Journal of Dermatology 2005 153, pp1096–1100 Ozone on the skin, G. Valacchi et al. 1097 SC. Recent studies have investigated the effects of O3 in the deeper functional layers of the skin.23–25 To evaluate the effect on cutaneous tissues of O3 exposure, hairless mice were exposed for 6 days to 0Æ8 lg g)1 for

6 h day)1 and the homogenized whole skin was analysed. Under these experimental conditions an increase of proinflammatory marker cyclooxygenase-2 (COX-2) expression was detected confirming the role that O3 can play in skin inflammation. This induction was accompanied by an increase in the

protein level of heat shock protein (HSP)32, also known as haem oxygenase-1 (HO-1), confirming that HSPs are sensitive markers of O3-induced stress in cutaneous tissues. Our group was the first to document the upregulation of HSPs 27, 32 and 70 in homogenized murine skin upon O3 exposure (8Æ0 lg g)1 for 2 h).25 HSP27 showed the earliest (2 h) and highest (20-fold) response to O3 compared with the delayed induction (12 h) of HSP70 and HO-1. Increased expression of HSP27 has been demonstrated following heating of both keratinocyte cell lines and organ-cultured human skin.26,27 HSP27 is expressed predominantly in the suprabasal epidermis in human skin,28 whereas HSP70 predominates in the dermis compared with the epidermis. These differences in location between HSP27 and HSP70 might explain the different time course of induction of these stress proteins upon O3 exposure. Interestingly, O3 induction of HO-1 showed a delayed time course compared with that for HSP27 and 70, in line with a previous study, which showed a peak of HO-1

induction at 18–24 h in rat lungs after O3 treatment.29 It is therefore possible that bioactive compounds generated by products of O3 exposure may be responsible for the induction of HO-1 as was also shown after UV irradiation.30,31 As HSPs are involved in cell proliferation, apoptosis and

inflammatory response, O3-mediated HSPs induction can affect normal skin physiology. Thus, HSPs might provide an adaptive cellular response to O3; enhancing the expression of HSPs might turn out to be a new way to deal with the immediate and long-term consequences of O3 exposure. A arerequisite for the utilization of this concept is the development of nontoxic HSP inducers and their evaluation for clinical efficacy and safety.

Furthermore, increased levels of metalloproteinase-9 (MMP-9; mRNA and activity) was observed after O3 exposure (0Æ8 lg g)1 for 6 h).24 MMPs have been associated with the degradation of the basal membrane and play important roles in wound healing and in tumour development. In addition,

MMPs may contribute to the enhancement of skin ageing and formation of wrinkles.32 O3 is also able to modulate proliferative responses in mouse skin.23 Proliferating cellular nuclear antigen (PCNA) is a protein identified as the polymerase-associated protein synthesized in the early G1 and S phases of the cell cycle involved in DNA replication and repair. PCNA is induced by stress responses that cause DNA damage;33 it has been reported that PCNA gene expression can be induced in the lungs by diesel exhaust particles, another form of oxidative lung damage,34 suggesting that oxidation can affect proliferative behaviour in target tissues. O3 exposure can also affect cell differentiation. In skin tissue, we detected an increase of keratin 10 (K10) production after O3 treatment;23 K10 is a keratin produced in well differentiated, suprabasal keratinocytes; O3-induced changes in K10 suggest that O3 (at levels of 0Æ8 lg g)1) induces keratinocyte proliferation and differentiation.35 It is not clear how O3 displays its effects, but recent studies have shown that it is able to induce the activation of the transcription factor, NF-jB, by phosphorylation of the kinase, IjBac.23 Changes in the redox state have been shown to activate the NF-jB intracellular signalling pathway; this cascade includes several kinases and transcription factors. NF-jB-mediated signal

transduction has been implicated in the regulation of viral

replication, autoimmune diseases, tumorigenesis and apoptosis,

and in the inflammatory response. In this regard, the activation

of NF-jB is known to play a crucial role in COX-2

gene activation,36 suggesting that O3 plays a role in the

expression of numerous proinflammatory and adaptive inflammatory

responses.

It is not surprising that exposure of the skin to O3 can trigger

several biochemical pathways leading to inflammation and

affecting skin biology. On the other hand basic and clinical

work developed during the last 15 years has shown that transient

treatment and small O3 doses can reactivate useful body

functions and might display therapeutic activity.37

Is a brief application of ozone on the skin medically

useful?

This question may be surprising but important anatomical and

functional aspects can explain how a very brief exposure of the

skin to O3 may display systemic activity with no toxicity. First,

the layer of lipids overlying the SC consists of an unusual oily

material derived from sebum,38,39 that is the external line of

defence against O3 and UV irradiation. Secondly, O3 cannot

penetrate into the cutaneous tissues because it immediately

reacts with the polyunsaturated fatty acids and traces of water

overlaying the SC, generating reactive oxygen species (ROS) and

lipooligopeptides (LOP), among which are hydrogen peroxide,

peroxyl radicals and 4-HNE. Thus, only newly generated ROS

and LOPs can be either partly reduced by the skin antioxidants

or partly absorbed via the venous and lymphatic capillaries.

Quasi-total body exposure (excluding the neck and head to

avoid breathing O3) to O2 and O3 is performed in a tightly

closed cabin, thermostatically controlled at about 40 C and

saturated with water vapour. As the time spent in the cabin is

only 15–20 min, the skin is exposed to progressively increasing

O3 concentrations of no more than 0Æ9 lg mL)1 for only

a few minutes. In human volunteers several parameters such as

variation of total antioxidants, peroxidation products, protein

thiol groups and cytokine plasma levels were examined after

the constant introduction of 1 L min)1 volume of O2 and O3

(98% and 2%) into a 440-L cabin. A significant increase of

pO2 and of peroxidation products in venous plasma was detected,

indicating a systemic effect of absorbed O2 and O3-

derived compounds from the skin. Negligible variations of the

2005 British Association of Dermatologists • British Journal of Dermatology 2005 153, pp1096–1100

1098 Ozone on the skin, G. Valacchi et al.

plasma antioxidant capacity and other haematochemical and

enzymatic components assured lack of toxicity and all volunteers

reported a feeling of well-being in the next few days.40

This approach appears to help patients with chronic limb ischaemia

and deserves to be pursued scientifically.37

Topical application

Interestingly, in spite of its instability, the O3 molecule can be

stabilized as an ozonide between the double bonds of a

monounsaturated fatty acid such as oleic acid.37 As a consequence,

ozonated olive oil remains stable for 2 years at 4 C.

This preparation is proving to be ideal for the topical use of

O3 in the treatment of chronically infected cutaneous and

mucosal areas of the body.

O3 is widely recognized as one of the best bactericidal, antiviral

and antifungal agents and therefore it is profitably and

practically employed as ozonated olive oil with well defined

peroxide contents. The ozonated oil is now used topically for

the treatment of war wounds, anaerobic infections, herpetic

infections (HHV I and II), trophic ulcers and burns, cellulitis,

abscesses, anal fissures, decubitus ulcers (bed sores), fistulae,

fungal diseases, furunculosis, gingivitis and vulvovaginitis.41

Matsumoto et al. tested the efficacy of the ozonated oil in the

treatment of fistulae and chronic surgical wounds and, in a

series of 28 patients, the ozonated oil was fully effective in 27

cases without side-effects.42 Even radiodermatitis lesions in

patients with cancer have been found to be beneficially influenced

by exposure to O3

43 but far better results could be

achieved with the simple application of ozonated oil.

Conclusions

Biological and clinical studies on the effects of O3 on the skin

have shown that O3 can be either toxic, or safe at the point of

use as a real drug, depending upon its dosage, length of exposure

and the antioxidant capacity of the tissue exposed.

The ambivalent character of O3 has been likened to the

Latin god Janus;44 indeed O3 is useful in the stratosphere but

is toxic in the troposphere because of its chronic effects on

the respiratory system, skin and mucosae.45

On the other hand, it has recently been observed that olive

oil, which during ozonation traps O3 in the form of a stable

ozonide, when applied to all sorts of acute and chronic cutaneous

infections, slowly release O3 which, in comparison with

conventional creams, displays effective disinfectant and stimulatory

activities that lead to rapid healing. The dual behaviour

of O3 fits well the concept of ‘hormesis’ that says the exposure

of a living organism to a very low level of an agent

harmful at high or chronic levels induces an adaptive and

beneficial response.46,47

Acknowledgments

The authors thank Italian MIUR Project ‘Rientro dei Cervelli’

for partial financial support.

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1100 Ozone on the skin, G. Valacchi et al.Mevcut yazılı metin bilgilendirme amaçlıdır. Bilimsel verilerden elde edilmiş bilgilerdir. Konu hakkında uzman kişiler tarafından yönlendirilmeniz ve tedaviye yönelik işlemleri bir hekim kontrolünde uygulamanız veya uygulatmanız önerilir.

HASTALAR İÇİN OZON BİLGİSİ

Information for patients

What is Ozone ?
What is Ozone Therapy ?
In what diseases is ozone therapy usually applied ?
What should I know as a patient ?
Ozone fingerprint
Where can I obtain information ?
What is Ozone ?

     Ozone is a chemical compound consisting of three oxygen atoms O3 (ie triatomic oxygen), a highly energetic form of normal (diatomic) atmospheric oxygen (O2). Thus, the molecules of these two forms are different in structure, ie:

     At room temperature, O3 is a colorless gas with a characteristic odor (eg after thunderstorms, at high altitudes or near the sea etc). Its name is from the Greek ozein (ozein) meaning “to smell”, and it was discovered in 1840 by the German chemist Christian Friedrich Schönbein (1799-1868). Closer to ground level it can occur in the form of smog at concentrations of 1 part O3 per 10 million parts air (= 0.1 ppm = 200 µg/m³); at a height of 2,000 meters (or 6,561.6 feet), however, it is much less, as a rule only 0.03 - 0.04 ppm.

     Due to its being an extremely powerful oxidizing agent and a highly effective disinfectant, it is used throughout the world to destroy germs in water treatment installations supplying drinking water. What is Ozone Therapy ?

Ozone as a therapeutic

Medical ozone is always a mixture of purest ozone and purest oxygen.

According to its application, the ozone concentration can vary between 1 and 100 µg/ml (0.05 – 5 % O3). The ozone therapist, a trained physician, determines the complete dosage according to the medical indication and the patient's condition.

Properties and effect

     Medical ozone has highly pronounced bactericidal, fungicidal and virostatic properties, and is thus widely used in disinfecting infected wounds, as well as in bacterially and virally produced diseases.

     Its ability to stimulate the circulation is used in the treatment of circulatory disorders and makes it valuable in revitalizing organic functions.

     When administered at low concentrations, the organism's own resistance is mobilized, ie ozone (re)activates the immune system.

     As a response to this activation through ozone, the body's immune cells produce special messengers called cytokins (including important mediators such as interferones or interleukins). These inform other immune cells, setting off a cascade of positive changes throughout the immune system, which is stimulated to resist diseases for example. This means that the application of medical ozone is extremely useful for immune activation in patients with a low immune status and/or immune deficit.

     Small quantities of ozone applied in what is called “major autohemotherapy” (external treatment of the patient's blood before reinfusion) consequently activate the body's own antioxidants and radical scavengers.

     It is thus possible to understand why ozone is used in diseases which involve chronic inflammation.

     Indications

    Thanks to its selective properties, medical ozone is used in three principal fields of indication: The treatment of circulatory disorders, also in the field of geriatrics, and The treatment of diseases produced by viruses such as liver diseases (hepatitis) and herpes The treatment of infected, badly healing wounds and inflammatory processes, such as for example Open ulcers on the legs (ulcus cruris) Inflammatory intestinal conditions (Colitis, Proktitis), Burns, scalds and infected wounds, fungus infections and others


     As an additive or complementary therapy in various types of cancer, ozone is applied for general immunoactivation at low dosages in the form of "major autohemotherapy" (reinfusion) or "minor autohemotherapy" (reinjection) via the intramuscular route.
Forms of application

NOTE: In any form of ozone therapy, the breathing in of ozone gas is forbidden.

     Many decades of experience and a number of recent clinical studies have shown that the following five application methods are valid for ozone:



     Major autohemotherapy (treatment of the patient's blood outside the body before reinfusion) in geriatrics (age-related conditions), for revitalization, in the treatment of circulatory disorders and virus-produced diseases, and for general immunoactivation. By this method, 50 to 100 ml of the patient's own blood is withdrawn in the normal manner, enriched externally with an exactly defined quantity of ozone (with disposable sterile material and containers!). The ozone reacts completely - ie at a rate of 100 % - with specific substances making up the red and white blood cells and thereby activates their vital activities = metabolism. It is this activated blood (not ozone or oxygen!) that is immediately reintroduced into the patient's system using a normal drip unit.


     Using the same principle, minor autohemotherapy is an application, via the intramuscular route, of O3 treated blood for unspecific immunoactivation revitalization: it can be used in allergic diseases or in a general way to improve the body's inherent resistance.


     External treatment is primarily achieved through a closed system using O3 gas fed into special plastic “boots” (for the legs and feet) or bags, foils etc fitting various parts of the body. These are of course made of ozone-resistant materials. The parts of the body treated have previously been moistened with water, as ozone cannot act on dry areas. This method is highly effective in treating ulcers, sores, open wounds, postoperative lesions, shingles (herpes) and infected areas etc. Other forms are ozonized pure water (eg in dental treatments) and ozonized pure medical olive oil (for skin eruptions such as eczemas and conditions involving molds, funguses and lichens etc).


     O3 gas application via the rectal route is not as inconvenient or unpleasant as it sounds (medically, it is called insufflation). In fact, the patient feels absolutely nothing, as the O3 gas is directly absorbed by the sensitive intestinal membranes; in addition, the specially designed disposable tube is lubricated, which makes the method totally hygienic - and practical, as a patient can apply it himself/herself. This method is primarily indicated for inflammatory conditions of the intestinal tract, but is finding increasing use for general revitalization processes.


     Injection of ozone into the joints (ie via the intraarticular route); as the term implies, ozone is carefully injected - by a trained specialist - in the treatment of inflamed and painful joints (arthritis, recurrent arthrosis, general pathological stiffness). This is a must in many orthopedic practices.
In what diseases is ozone therapy usually applied ?


     A whole number of pathological conditions exist which can be influenced positively or even healed by ozone. This is a fact which has been confirmed by a wide series of scientific investigations and medical publications. As a rule, medical ozone is applied in addition to other therapeutic methods ie it belongs to the field of complementary medicine.

     For all patients, men and women, to know about the latest developments in ozone therapy – and as quickly as possible – a large number of therapists (in Europe) got together and founded the (legally registered) Medical Society for Ozone Application in Prevention and Therapy, formerly called the Medical Society for Ozone Therapy, with the aim of providing basic information to doctors/therapists and patients alike. This important information exchange function has increased over the years.

     As to how far your physician is able to inform and help you depends on the country you are in and the current status of medical ozone. All should know, however, that medical ozone, when properly and responsibly handled (and the correct indication has been established), is safe, practical, effective and – as a preventive at least - low in cost.

     Naturally, in spite of this , as with all other forms of medical treatment, no 100 % guarantee can be given that ozone therapy will alleviate the condition it has been applied for. Success will vary according to the patient's state of health, the frequency of ozone treatment, the doses and concentrations applied, and a number of other factors.

Circulatory disorders

     Arterial circulatory disorders, for which, among other symptoms, a feeling of coldness in the legs or pains after walking only short distances ("short cut" syndrome) are alarming signs, have been a classical indication for ozone therapy for over 40 years now. Its success has been confirmed by a large number of clinical trials. Ozone is applied as a complement to and in combination with other methods in classical and complementary medicine.

Regeneration and revitalisation

     Stress situations on the job or conditions of excessive mental and physical tension respond particularly well to O3 application. Its ability to activate red and white blood cell metabolism produces an improvement in general wellbeing, and brings about a general revitalisation. Professional sportsmen and -women profit greatly from this fact as well. Although ozone does not give its user a higher performance level, it does improve physical output during the endurance phase, ie just below maximum exertion. In addition, the regeneration phase is measureably shortened in endurance sports.

     The elderly patient. Prevention and therapy

     Elderly patients respond very well to medical ozone therapy, as it is here possible to make use of all its clinical advantages, such as that of making an improved supply of oxygen accessible to all tissues, mobilising the immune system, and activating the body's own supply of antioxidants and radical scavengers. Furthermore, we have its positive influence in cerebral circulatory disorders - a condition characterized by a general reduction in physical performance, insecurity in walking, and feelings of dizziness. In addition to other measures applied in complementary medicine, medical ozone is also used as a preventive, contributing to a marked increase in life quality.

Diseases of the eye

     Circulatory disturbances due to old age also affect the eye with atrophic and degenerative changes. For example, senile macular degeneration is well known, occurring at the center of the retina - the point where visual focus is at its sharpest. Its sequels are thus able to influence the optic nerve to varying degrees, producing what is called optic nerve atrophy. Results obtained from a clinical trial carried out at the University of Siena show, in addition to reports from practical applications, improvements in vision lasting for 6 to 8 months after ozone- autohaemotransfusion. Continuing the series of treatments can produce further improvement in visual performance or prevent it from worsening.

Malignant disease (cancer)

     Ozone-autohaemotransfusion can be applied with great profit in the form of an additional, biological, therapy in malignant conditions. We here make use of ozone's immunoactivating property, produced when it is applied at a low dose. Immune cells - such as lymphocytes, helper and suppressor cells, natural killer cells - are activated via biological reactions induced by ozone to respond by producing messenger proteins called cytokines to which, for example, the interferons belong. In fact, ozone makes the body produce increased quantities of its own interferons and interleukins. On reintroduction of the ozonized blood, a cascade of positive immune reactions are set off, also contributing to general resistance and wellbeing.

Fungal skin infections and infected skin lesions

     The fungicidal and bactericidal properties of ozone have been successfully in use for over 100 years in the treatment of water for drinking. They make medical ozone an effective therapeutic agent in combating persistent skin moulds and fungi, especially those of the feet with bacterial infections, fungal infections of the trunk or against fungal/mycotic infections of the mucous membranes.

Infected wounds

     The local treatment of infected wounds, such as may easily occur with open bed sores (decubitus), ulcers of the lower leg (ulcus cruris), diabetic gangrene or delayed/disturbed wound healing processes, belong to the classical application fields of medical ozone. We here primarily make use of its disinfectant, ie bactericidal and fungicidal, effects, to obtain a germ-free and clean wound. Once this has been achieved, we then apply lower doses of O3 gas to accelerate/improve wound healing.

Intestinal diseases: proctitis and colitis

     In the case of inflammatory intestinal processes, particularly during their early stages, the local application of ozone in the form of rectal O3 gas insufflation has been proved very useful. A series of 10 ozone applications is sufficient in most cases. Several such series are only necessary in about 10 % of the patients (from a proctitic clinical study on O3 involving 248 patients).

Viral diseases

Herpes simplex (facial herpes), herpes zoster (shingles)

     Both types of herpes are caused by viruses. Herpes of the lips (H. labialis), a frequently recurring condition and a highly unpleasant disease, can be treated very successfully with ozone in combination with other medical methods. In the case of herpes zoster or shingles, the complementary application of ozone is useful, both in the form of ozonized water compresses and O3 autohaemotransfusions.

Inflammatory processes of the liver

     Inflammatory diseases of the liver are counted among the classical indications for medical ozone. Whereas the treatment of hepatitis A (HVA = hepatitis virus A) is relatively unproblematic and produces complete healing, another form, hepatitis B (HVB = hepatitis virus B), frequently takes a chronic course. Here, in addition to classical medical treatment methods, we find that ozone autohaemotransfusion or the rectal insufflation of controlled ozone/oxygen gas quantities can be successful. This also applies to the treatment of hepatitis C which, due to an incubation period capable of lasting for a number of years, is generally not diagnosed as a liver disease until it has become a chronic condition.

Inflammatory and degenerative joint conditions

     When we divide inflammatory diseases of the joints into three phases, it is particularly stages 1 and 2, ie those not yet involving a severe bone deformation, that are responsive to medical ozone application. This applies to gonarthritis (inflammation of the knee joint) or the active arthritic form in knee and shoulder joints. Here, intraarticular ozone injections applied in addition to basic standard medical methods - in this case specific exercise therapy measures - are of great use. We here make full use of the antiinflammatory effects of ozone, in addition to its immunomodulatory properties and its ability to activate cartilage metabolism.

Arthritic/rheumatic conditions

Chronic polyarthritis

     The term arthritic/rheumatic conditions includes various painful diseases of the skeletal or muscular system, partly also involving functional restrictions. In general, the application of medical ozone can here be regarded as being a complementary measure only, combined with a basic classical method and corresponding physiotherapy. In the case of rheumatic arthritis (chronic polyarthritis), our experience shows that ozone autohaemotherapy is a very useful complementary form when given during the non-acute phases. Its immunomodulatory and antiinflammatory properties are here its basic principle of action. What should I know as a patient ?



     Before undergoing any form of ozone therapy, you should inform your doctor about any medication or special dietary measures you are taking or have been taking recently. You should only discontinue a regimen of this kind if your doctor advises you to do so. He or she should also know about allergies, inherited diseases or other complaints, and how they have been treated.

     In many countries, especially outside Europe, ozone therapy is not always covered by health insurance policies or employers' medical benefit schemes.. You should also try to find out where ozone units exist in your country, what trained specialists are available, and how much treatment costs. Most ozone applications are in series of up to 10 sessions, and a second or even third series may be necessary in some indications. Nevertheless, you should always remember that a little prevention can save a much more expensive full-scale treatment later on.

     Ozone therapy is low risk and usually applied as a complementary, additive or restorative method, ie in accompaniment of standard medical treatments. OZONE fingerprint

Natural occurrence

     Ozone is one of the most important gases in the stratosphere surrounding our planet (at a height of 10 - 50 kilometers / 6 - 30 miles). At a height of 20 - 30 kilometers (12 - 18 miles), its maximum concentration is 1 part O3 per 100,000 parts air (10 ppm) and thus much greater than at ground level (0.03 - 0.04 ppm).

The ozonosphere

     This protective layer of ozone acts as a filter against the otherwise highly destructive hard radiation in the form of ultraviolet (UV) energy coming from the sun, thus helping to maintain the biological balance on our planet Earth.

The ozone gap

     Due to a complicated process caused by industrial gases (containing FCKW`s and other halogens), the O3 in our protective ozonosphere is caused to break down. As there is then not enough ozone to act as a filter, this causes an increasingly large gap through which UV rays (which are capable of causing skin cancer and influencing genetic processes) can penetrate without hindrance.

Smog alarm

     However, much closer to the ground, as in large cities, ozone can be produced via waste or exhaust gases (eg from automobiles and factories) and the interaction of nitrogen oxide and sulfur oxides, and from oxygen through ultraviolet radiation.

     As we are able to measure O3 very accurately, it is therefore used and quoted as an indicator for environmental pollution, though it does not cause it.

    Maximum worksite concentration (MWC) The maximum permissible worksite concentration (MWC) for ozone is 200 µg/m³ or 0.1 ppm, and must not be exceeded during an 8 hours' working day and 40 hours per week, as ozone is capable of causing damage to the respiratory tract and mucous membranes. Values vary from one country to another and are not always obligatory (in Germany for example, this was reversed as a legal regulation in 1995 and is now a recommendation).

Technical ozone

     Technical ozone (TechO3) is a mixture of ozone and air prepared from atmospheric air which is used all over the world, principally for sterilizing water (city installations) and in chemical bleaching processes etc.

Medical ozone

     Contrary to technical ozone, the medical form is prepared from pure medical oxygen (MedO2) via silent electrical discharge for use as an ozone/oxygen mixture at an exact concentration and dosage.

     Its concentration ranges from 1 to 100 micrograms per milliliter (µg/ml), corresponding to an ozone/oxygen mixture at ratios between 0.05 % O3 to 99.95 % O2 and 5 % O3 to 95 % O2. As the ozone molecule is not stable, its medical form is always freshly prepared on site (in a special generator) for immediate use ie administration. (This is because, after about 1 hour, only half the original ozone is still present, the rest having decomposed to become oxygen again.)

Ozone therapy - a quick survey EFFECT MEDICAL USES
Activation of red blood cell metabolism
improved oxygen supply arterial circulatory disorders (peripheral and cerebral in particular);
Revitalization
Activation of immune cells
(the body releases is own vital cytokins, such as interferones and interleukins add. / complementary therapy in various kinds of cancer)
Revitalization;
General immune weakness.
Increase and activation of the body's own antioxidants and radical scavengers Inflammatory processes, eg arthritis, reactivated arthrosis, vascular conditions;
Age-related processes.

Where can I obtain information ?

Depending on what country you are in, your physician and/or pharmacist may know about medical ozone and its uses in therapy. However, basic information in all fields can be obtained from the:

Medical Society for Ozone Application
in Prevention and Therapy


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Oksijen ve Kanser

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N C Med J. 1997 Mar-Apr;58(2):140-3.

Oxygen and cancer.
Dunn T.

Abstract
Tumor hypoxia results from multiple pathophysiologic interactions. Abnormalities in tumor vessel structure and function lead to decreased oxygen delivery relative to normal tissue. Furthermore, a relatively high rate of tumor cell proliferation increases oxygen consumption by tumor tissue. The net result of decreased oxygen supply and increased oxygen demand is hypoxia. Hypoxia makes tumors resistant to radiation and some chemotherapy, and it induces expression of growth factors, angiogenic factors, and cell cycle regulatory proteins that affect tumor phenotype. Recent attempts to make tumors more sensitive to radiation and chemotherapy by reducing hypoxia (by increasing tumor blood flow, the use of oxic gases, and blood substitutes) have been ineffective. Future research may be directed more toward decreasing oxygen consumption or actually exploiting the hypoxic environment to achieve a therapeutic benefit.

PMID: 9088144 [PubMed - indexed for MEDLINE]
http://www.ncbi.nlm.nih.gov/pubmed/9088144

Mevcut yazılı metin bilgilendirme amaçlıdır. Bilimsel verilerden elde edilmiş bilgilerdir. Konu hakkında uzman kişiler tarafından yönlendirilmeniz ve tedaviye yönelik işlemleri bir hekim kontrolünde uygulamanız veya uygulatmanız önerilir.

Bel ağrısında ozon tedavisi

Ağırlıklı olarak major otohematorapi amaçlı kullanılan medikal ozonun lokal uygulamalarına olan tıbbi ilgi gün geçtikçe artmaktadır. Artan bu ilgi literatürde yayımlanan randomize çalışmaların sayısı ile de paralellik göstermektedir. Alanının saygın dergisi Spine’da (Tübitak A grubu) yayımlanan yeni bir klinik çalışma etkileyici sonuçlar ortaya koydu (Intramuscular Oxygen-Ozone Therapy in the Treatment of Acute Back Pain With Lumbar Disc Herniation A Multicenter, Randomized, Double-Blind, Clinical Trial of Active and Simulated Lumbar Paravertebral Injection; SPINE, 2009: 34 (13); 1337–1344).

Disk hernisine bağlı akut bel ağrısı şikayeti ile başvuran 60 hasta üzerinde yapılan bu çift-kör çalışmanın sonuçlarına göre paravertebral bölgeye intramusküler olarak uygulanan ozon-oksijen enjeksiyonlarının hastaların %61’inde ağrıyı tamamen geçirdiği rapor edilmiştir. Anti-inflamatuar ilaçların verildiği kontrol grubunda iyileşme oranı %33’te kalmıştır.

İntradiskal ve intraforaminal ozon uygulamalarının akut bel ağrısında yararlı sonuçlar verdiği uzun zamandır bilinmektedir. Ancak görece invaziv olan bu yöntemlerle karşılaştırıldığında paravertebral kaslara ozon-oksijen karışımı enjeksiyonu uygulaması son derece kolay ve ucuz bir yöntemdir. Skopi ve ameliyathane şartları gerektirmemesi, yan etki profilinin çok düşük olması ve kolay uygulanabilmesi bu tedavi yöntemini öne çıkaran diğer unsurlardır.

Paravertebral intramusküler ozon enjeksiyonlarının etkin tedavi edici özelliği, disk hernisi vakalarının yaygınlığı düşünüldüğünde son derece önemli bir kazanım olarak durmaktadır. Ülkemizde bilinilirliği ve uygulama merkezleri hızla artan ozon tedavisinin disk hernilerine bağlı akut bel ağrısında da kullanılabileceğine dair yeterli bilimsel ve klinik kanıt oluşmuştur. Bel ağrısı ile uğraşan merkez ve kliniklerin hastalarına ozon tedavisini de önermeleri birkaç nedenle önem arz etmektedir.

Tedavinin maliyeti oldukça düşük ve uygulaması kolaydır. Minimal invaziv bir tedavi yöntemidir. Hastaların ağrı kesici ve NSAID kullanma ihtiyaçlarını anlamlı derecede düşürmektedir. Sadece kronik böbrek yetmezliği vakalarının %15’inden kontrolsüz ağrı kesici ve NSAID ilaç kullanımının sorumlu olduğu düşünüldüğünde, bu yeni yaklaşımın önemi daha da artmaktadır.



Kaynak:
Intramuscular Oxygen-Ozone Therapy in the Treatment of Acute Back Pain With Lumbar Disc Herniation A Multicenter, Randomized, Double-Blind, Clinical Trial of Active and Simulated Lumbar Paravertebral Injection; SPINE, 2009: 34 (13); 1337–1344


Kaynak: allturk.com

Mevcut yazılı metin bilgilendirme amaçlıdır. Bilimsel verilerden elde edilmiş bilgilerdir. Konu hakkında uzman kişiler tarafından yönlendirilmeniz ve tedaviye yönelik işlemleri bir hekim kontrolünde uygulamanız veya uygulatmanız önerilir. , ankara ozon , ozon ankara , ankara ozon tedavisi , ozon tedavisi , ozon terapisi , ozon tedavisi ankara , ankara ozon , ozon ankara , ankara ozon tedavisi , ozon tedavisi , ozon terapisi , ozon tedavisi ankara , ankara ozon , ozon ankara , ankara ozon tedavisi , ozon tedavisi , ozon terapisi , ozon tedavisi ankara , ankara ozon , ozon ankara , ankara ozon tedavisi , ozon tedavisi , ozon terapisi , ozon tedavisi ankara , ankara ozon , ozon ankara , ankara ozon tedavisi , ozon tedavisi , ozon terapisi , ozon tedavisi ankara , ankara ozon , ozon ankara , ankara ozon tedavisi , ozon tedavisi , ozon terapisi , ozon tedavisi ankara , ankara ozon , ozon ankara , ankara ozon tedavisi , ozon tedavisi , ozon terapisi , ozon tedavisi ankara , ankara ozon , ozon ankara , ankara ozon tedavisi , ozon tedavisi , ozon terapisi , ozon tedavisi ankara , ankara ozon , ozon ankara , ankara ozon tedavisi , ozon tedavisi , ozon terapisi , ozon tedavisi ankara , ankara ozon , ozon ankara , ankara ozon tedavisi , ozon tedavisi , ozon terapisi , ozon tedavisi ankara , ankara ozon , ozon ankara , ankara ozon tedavisi , ozon tedavisi , ozon terapisi , ozon tedavisi ankara ,

Ozon tedavisi ile zayıflama

       Ozon tedavisi pek çok hastalıkta yararlı sonuçlar doğuran, yüzyılı aşkın süredir bilinen ve kullanılan yardımcı bir tedavi yöntemidir. Bu tedavi ile insan vücuduna hiçbir ilaç verilmez; vücutta mevcut mekanizmalar güçlü bir şekilde uyarılır. Ozon tedavisi ile elde uyarılan mekanizmalara göz atıldığında, vücuttan yağ kaybının artırılması ve selülitlerin ortadan kalkması gibi yararlar elde edilebileceği açıktır. Ancak hiç kimse sadece ozon tedavisi alarak kilolarından kurtulamaz. Kurtulamaz çünkü gerçek anlamda yağ kaybetmek için harcanan kalori miktarından daha az kalori almak gerekir. Bu basit ancak temel mantık ile rahatlıkla kilo verebilirsiniz. Pekiyi bu kurala uymak kolay mıdır? Tabii ki değildir; öyle olsaydı kilo vermek bu kadar büyük bir toplumsal sorun haline gelmezdi. Hemen her gün internette yayına başlayan yeni siteler ne oldukları, hangi mekanizma ile zayıflattıkları hatta içinde ne olduğu bile bilinmeyen bitkisel ürünlerle insanları garantili zayıflattıklarını iddia ediyorlar.

Vücudun sesini dinlemeyen hiçbir zayıflatma yöntemi çalışmaz

        Bu nedenle ben bu iddiaların hiçbirine katılmıyorum. Hatta bitkisel bazı ürünlerle gerçekten zayıflayanlar olsa bile, bu etkinin kalıcı olmadığını biliyorum. Eğer vücudunuzu aldatırsanız kesinlikle sizden intikamını alacaktır. Sizin nefret ettiğiniz göbek, kalça vs. yağların nedeni sizsiniz. Nasıl onları vücudunuza sokarken onun sesini dinlemediniz, ihtiyacınız olmadığı halde aşırı kalorili beslendiniz; şimdi sıra vücudunuzda. O da yağlarını size kolayca vermeyecektir. Çünkü yağ dokusu olarak kilo alan insanların metabolizmaları bozulur. Başta karbonhidrat (şeker) metabolizması olmak üzere dengeler alt üst olur. Kilo alan kişi bunu fark edemeyebilir. Ancak glikoz-insülin ilişkisi hemen tüm şişmanlarda bir şekilde bozuktur. Bu bozukluğun önemli bir kriteri atıştırma ya da açlık krizleridir. Öğünler arasında ortaya çıkan halsizlik ve yorgunluk ile karakterize bu durum aslında hiç de enerjiye ihtiyacınızın olmadığı dönemlerde ortaya çıkar. Çünkü kısa bir süre önce ana öğünlerden bir tanesini (öğlen veya akşam) yemişsinizdir.

Metabolizmanızı önemsemelisiniz

     Ancak bozulmuş metabolizmanız kan şekerini sağlıklı bireylerdeki gibi düzenleyemediği için şişmanların çoğu öğünlerden sonra kan şekerinin yükselmesi, buna yanıt olarak biraz fazla insülin salgılanması ve ardından kan şekerinin düşmesi şeklinde ortaya çıkan bir döngüye sahiptirler. İşte kan şekerinin düştüğü bu dönemde atıştırma krizleri ortaya çıkar. Bu dengesizliği düzeltmedikten sonra dilediğiniz kadar destek tedavi görebilirsiniz; sonucu çok fazla değiştiremeyeceğiniz açıktır. Bu bölümde anlatılan ve başka nedenlerle aslında çoğu şişman kişi diyabet değilse bile pre-diyabetiktir. Yani gelecekte büyük olasılıkla şeker hastası olacaktır. Bu kişilerin sabah açlık kan şekerlerinin normal olmasının anlamı büyük değildir. Çünkü bizleri asıl hasta eden post-prandial dediğimiz yemeklerden sonra ortaya çıkan yüksek kan şekeri ve onu takip eden olaylardır.

Altın kurallar

      Böylece metabolizmanızın sesini dinlemek durumundasınız; bu sese kulak verdiğinizde üç altın kural duyarsınız. Birinci altın kural “makul, mantıklı ve yaşam tarzına dönüştürülebilecek beslenme alışkanlığı”, ikinci altın kural “makul, mantıklı ve yaşam tarzına dönüştürülebilecek hareket alışkanlığı” ve üçüncü altın kural ise “karbonhidrat krizlerinin önlenmesi”dir. Gümüş ve bronz kurallara geçmenin pratikte anlamı yoktur; zira pek çok insan bu üç kurala uyum sağladığında diğerleri çok daha kolay uygulanabilir prensiplerdir.

İşte bu üç altın kurala uyumunuzu kolaylaştıran ozon terapi zayıflamak isteyenleri çok mutlu edecek sonuçlar doğurabilir. Ozon tedavisi zayıflamaya kararlı ancak diyet yapmakta zorlanan, harekete isteksiz ve açlık krizleri yaşayan kişilerde etkileyici metabolik değişimlere neden olur. Diyet yapmakta zorlanan insanlardaki en temel sorunlardan bir tanesi diğer iki kural konusunda sıkıntı yaşamalarıdır. Bu insanlar diyetin yanında bir de hareket programı takip etmek istemezler. Hatta çoğu kişi vücudun çalışma prensiplerine tamamen ters olarak akupunktur gibi iştahı merkezi olarak kesen yöntemleri tercih ederler. Sonuç genellikle kısa vadede memnuniyet verici, uzun vadede ise (genellikle üzerinden bir sonbahar-kış dönemi geçtiğinde) faciadır. Oysa uygun bir diyet ile beraber hareket miktarınızı artırdığınız sürece kan şekeriniz düzenlenir, insülinin gücü artar ve açlık krizlerinin şiddeti azalır. Açlık krizlerinin şiddeti azaldıkça “atıştırma” ve “kaçak” miktarı azalır.

Ozon tedavisi zayıflamanıza yardımcı olur

        Ozon tedavisi, bireylerin metabolik hızını artırmanın en iyi yollarından bir tanesidir. Çoğu kişide kan şekerinin düzenlenmesine destek olur ve açlık krizlerini önler. Organizmanın yağlardan enerji üretmesi için gerekli hücresel düzenlemeleri kuvvetlendirir. Başta cilt olmak üzere, beyin ve kasların kan dolaşımını artırarak vücudun daha iyi oksijenlenmesine, enerjiye daha kolay ulaşmasına yardımcı olur. Pek çok bilim insanı asıl doyması gerekenin midemiz değil beynimiz ve algılarımız olduğunu kabul eder. Ozon tedavisi ile desteklenen metabolizma sonucu beynimiz ve algılarımız enerji krizine girmez, yağların enerji amaçlı kullanımı artar ve hem diyete hem de egzersize uyum desteklenir. Birkaç seans ozon tedavisinden sonra ortaya çıkan “artmış iyilik ve zindelik hali” vücut tarafından son derece olumlu algılanır. Böylece birbirini pozitif olarak etkileyen, “metabolizmanın hızlanması” “yağlardan elde edilen enerji oranının artması” “artmış zindelik ve iyilik hali” “beynin ve algıların bu durumu onaylaması” süreci kazan-kazan modeli olarak ifade edilen ve kilo vermeyi adeta eğlenceye döndüren bir döngü oluşturur.

Bu açıklamalardan sonra ozon tedavisinin zayıflamanıza paralel olarak cilt ve cilt altı dolaşımını düzenleyerek selülit sorununu da kolaylıkla çözeceğini söyleyebiliriz.

Doç.Dr. Ahmet KORKMAZ

Kaynak: allturk.com

Mevcut yazılı metin bilgilendirme amaçlıdır. Bilimsel verilerden elde edilmiş bilgilerdir. Konu hakkında uzman kişiler tarafından yönlendirilmeniz ve tedaviye yönelik işlemleri bir hekim kontrolünde uygulamanız veya uygulatmanız önerilir.