DE19632014A1 - Microclimatic saline chamber system for personal well being - Google Patents

Abstract

The microclimatic saline chamber system is designed as a complex, with a chamber, which is insulated to create a microclimate. The mineral covering (2) of the chamber consists of a salt mixture. The air treatment plant consists of a salt chamber atomiser (4). An air conditioning plant (5), ventilators (9) and an air ioniser (6) may also be included. Control units are provided for controlling and monitoring of the microclimate. The relaxation complex may consist of relaxation chairs (10), earphones, tape recorders, slide and film projector (11), in order to attain audio-visual effects.

Description

A. Statistics

In the Federal Republic of Germany there are 28% of respiratory diseases Sick leave in the first place of all diseases.

In 1990, 27% of all incapacity for work accounted for the compulsorily insured 42.9 days on average for patients with respiratory diseases. Be in Germany 55,000 medical procedures for respiratory diseases are carried out annually, and approx. 12,000 Patients retired early, around 45,000 people die each year from the consequences of the disease. In this regard, 3.3 million days of lost work per year will cost 340 million DM registered for early retirement, rehabilitation procedures and deaths.

5% of the total population suffering from bronchial asthma of different degrees of severity, and in children, asthma is the most common disease with increasing incidence worldwide.

Despite the constant improvement of diagnostic and therapeutic options, one is There was no decline in asthma morbidity and mortality. Responsible for primarily ecological factors and insufficient acute care are made.

From these For reasons we present an innovative method and lean on it Exposure treatment in underground excavations, the speleotherapy that we get through the have optimized microclimatic saline therapy. The decisive advantage of the M.S.K. consists in working in a given room with given sizes can. It is a climate chamber in the polyallergic and bacterial Contamination can be largely eliminated.

Hypertonic sols up to about 2% osmotically trigger a secretion stimulus on the mucous membranes and increase the ciliary frequency as measured by animal experiments. (Dirnagel, K. Mechanism of action of the brine springs. Z. Angew. Bath and climate healing. (25 / 225-235 / 1978)).

Alkaline water and Ca increase the effect on ciliary activity. Inhalation brines are used hence the treatment of chronic diseases of the upper and lower respiratory tract as well NNH.

B. The physiological-biochemical requirements for building the microclimatic saline chamber treatment 1. The histological structure of the airway epithelium

The extrapulmonary epithelium of the respiratory tract begins in the nasal area and extends to the tracheobronchial tree and merges into the alveolar part. It represents one pseudo-stacked column that contains 3 basic types of cells: ciliary, basal and  Goblet cells. The epithelium has some other cell types (e.g. Clara or Gap cells), but the purpose of this chapter is to transport electrolytes to show schematically in the extrapulmonary epithelium, therefore we see no reason to look at the morphological structure and pathomorhological significance of the epithelium closer to restrict.

Ciliary cells and goblet cells extend from the surface of the mucosa to the basal membrane. Basal cells are located next to the basal membrane and give it Epithelium its pseudo-stacked appearance. The ciliary cells are characteristic Column-shaped, the height 20-60 and the width 4-7 µm on the apical surface and 1-4 µm wide on the basal surface. Approx. 250 cilia cover the apical Surface of each individual cell; they grow out of the basal bodies that are under the apical membrane are located and protrude 6 µm above the cell surface. The basolateral Cell surface very often forms complex connections with neighboring cells.

The goblet cells are characterized by the relative density of the cytoplasm - one Appearance resulting from the mucus particles and ribosomes. The mucus particles give the cell its typical cup-like appearance with the broad apical part and narrow basal segment. The ciliary cells are more widely represented than the goblet cells - the Relationship between their parts is approximately 5: 1. The proportional part of the Goblet cells depend on the degree of irritability or inflammatory processes within the Respiratory tract. In the chronically irritated airways (e.g. chronic smokers) the proportion of goblet cells increases considerably.

Basal and intramedial (cigar-like, expanded) cells are on the basal membrane attached, but do not reach the surface of the respiratory tract. Under the action of The weakly differentiated basal cells initially develop into unknown factors intramedial and end up in the ciliary and goblet cells.

With the help of the electron microscope, the compounds that were in the Airway cells perform the functions of a barrier. This close heterogeneous connections of the ciliary cells have a positive influence on the water - salt permeability of the Epithelium. The barrier connections participate very actively in the regeneration of the damaged epithelium. These observations can also account for the high proportion of Explain barrier connections in the artificially cultivated cells of the tracheal epithelium.

2. Mucociliary clearance (MC) and electrolyte transport (ET)

MC is a process of epithelial protection in the airways, the inhaled particles be removed from it. With the help of this process, the infection becomes the risk of Development of bronchial carcinoma when inhaling toxins and carcinogens Avoid airway obstruction. The defense comes both mechanically (through the coordinated eyelash movements that expel mucus from the alveoli) as well physiologically.

The epithelium is covered with two layers of fluid - with mucus as a gel and periciliary Liquid as sol. The mucus layer is 5-10 µm deep and covers the airways like one large blanket or floats on the eyelashes in the form of many small "islands". The mucus captures and transmits the inhaled particles. How well he does his job depends on the Quantity, the degree of toughness and thus the quality of its connections with the crests of the eyelashes underneath.

The biochemical structure of the mucus is complicated. The submucosal glands, goblet cells and other cells of the epithelium are the sources of the macromolecules from which the The final product is in the end. The transition medium between the mucus and the  Eyelashes are the periciliary fluid; their toughness is less than that of the mucus and Depth corresponds to the eyelash length of approx. 6 µm. The periciliary fluid secures the Eyelashes the water-containing medium in which they can move freely only with their free ends touching the mucus. This movement guides the mechanical energy of the Eyelash continues on the mucus above. The depth of the periciliary fluid directly influences the success of the MC, because if it were too big, the communication would be between the eyelashes and the mucus layer quickly interrupted and at a shallower depth the eyelash movement would be disturbed by the mucus particles.

3. The relationship between the MC and the ET

The ET in the epithelium of the respiratory tract partially controls the concentration and the Composition of the secretion, which also has a positive influence on the MC. Some studies provide that the epithelium secretes the periciliary fluid and thus moistened the mucus. With the help of hormonal regulators, the epithelium intensively secrete the Cl ions, which continue to transmit the moisture of the secretion. The other hypotheses suggest that the (periciliary) fluid is on the surface the alveoli, next to them or in the alveoli themselves.

After that, the liquid spreads very quickly over the entire surface of the airways, which grows more slowly the further we move upwards from the alveoli. This Process runs parallel to Na absorption, overfilling and averting obstruction. It is not obvious that the alveoli and small airways secrete the fluid; some researchers suspect that the alveoli of the epithelium also absorb salt and water. The role of evaporation in regulating fluid in the airways is unknown under certain conditions, however, the loss of fluid in large quantities are caused. The flawless course of the MC guarantees protection from the Pathogenesis of many lung diseases.

4. Transepithelial electrical properties of the airway epithelium

The active ET causes a transepithelial voltage of 10-40 mV in relation to the Surface of the mucus. In various experiments it was found that the Short circuit current of the strength 30-140 µA / cm² through the secretive chlorine flow of Submucus to mucus and absorptive sodium flow in the opposite direction can be caused.

The secretion of the chlorine is usually 2-4 times greater than the Na absorption.

The ET can control the movement of the liquid; stimulates Cl secretion a small amount of the secretive flow. A significant portion of the fluid moves through the lateral spaces between the cells of the epithelium, reflecting the changes in the Confirm the structure of such spaces that accompany the transport.

When stimulating the secretion of the fluid and the flow of Cl by the hormone Epinephrine begins to narrow and disappear in the lateral spaces. On the other hand, the amphotericin stimulates the absorption of the liquid and the Na flow, which makes the lateral spaces wider. This effect is also observed when the osmotic gradient causes the flow from the mucus to the submucus.

Since the surface of the respiratory tract lying on the periphery is much larger than this value of the centrally located airways is such type of research Significance, the tendency to decrease the resistance and the voltage on the periphery the airway shows.  

The epithelial electrical voltage coincides with the resistance, while the Current strength remains the same, resulting in that on the periphery of the airways Connections between cells are much more permeable.

We have already dealt with the fact that the airways (depending on the region and the type of exposure) secrete Cl and absorb Na, explored. A Experiments with the cultivated play a major role in the research of the ET single layer epithelium of the cells in the respiratory tract; observation was particularly important that the cells have the same mechanisms in vitro to secrete Cl and Na to absorb like the epithelium in vivo.

In the epithelium of the respiratory tract, the ciliary cells can secrete Cl and absorb of Na; the direct evidence of this is the results of physical experiments in the cells of the epithelium with the weak short circuit current, which the reactions from Types amiloride (delaying Na absorption) and epinephrine (stimulating Cl Secretion). The effect that one and the same cell Cl secreted and Na absorbed. Secretion occurs in the ciliary cells under the influence of immunocytochemical mechanisms and secretion-enhancing acyclic cAMP. In in the absence of Cl, the same substances regulate Na absorption. The ciliary cells do not use eyelashes for the ET, as confirmed by the in vitro experiments; because the process of the ET went undisturbed when the eyelash structure was damaged or removed continue.

5. Regulation of the ET

It has been experimentally found that the hormones prostaglandins, vasoactive peptides, β-adrenergic, epinephrine, isopreterenol with the participation of submucosal Receptors stimulate Cl secretion. Their effect is blocked by the β-antagonists, which in turn activate the adenyl cyclase. The adenyl cyclase increases the cAMP concentration in the ciliary epithelial cells, which leads to increased Cl secretion. Acetylcholine and Histamine stimulate the Na absorption and secretion of Cl all over the surface, however the transepithelial electrical properties change only insignificantly. The Observations of the allergic mediators show that acetylcholine and histamine are a cause greater secretion of the submucosal glands than the electrical stimulation.

6. The cell model of Cl secretion and Na absorption

The transepithelial Cl secretion and Na absorption by the cells of the epithelium is one active electrochemical process.

From a schematic point of view, this process consists of 5 stages:

• 1. Cl enters the cell through the basolateral membrane, probably together with Na and K; this process is electrically neutral;
• 2. the Na ions reduce the electrochemical gradient - this gives the Cl ions the necessary energy to be secreted from the cell, despite the attraction between the differently charged particles;
• 3. the Cl ions accumulate inside the cell and pass through the Cl channel in the apical Membrane and hereby control the size of the Cl secretion;
• 4. Well that enters the cell together with Cl is through the basolateral membrane, as a Part of the Na-K-ATPase excreted. The low Cl concentration in the Maintain cell, the Na-K-ATPase also accumulates K within the cell;  
• 5. K emerges from the cell through a K channel in the basolateral membrane, the gradient von K interpolarizes the cell and supplies it with the energy necessary to secrete Cl; the apical membrane also contains a Na channel through which Na enters the cell; the transepithelial flow consists of the following components:
• - the movements of Na and Cl through the ion channels in the apical membrane;
• - the movements of the Na components of the Na-K-ATPase through the K-channels in the basolateral membrane;
• - The electrically neutral entry of the Cl into the cell through the basolateral membrane.

When Cl secretion is stimulated, the uptake and excretion of Cl reach ten times their original size within the cell.

The secretion of Cl through the apical membrane occurs only through the Cl secretion, otherwise the membrane is impermeable to Cl. The substances that this permeability controls are likely to belong to the group of cAMP or cAMP kinase. Na is actively pumped out of the basolateral membrane by the Na-K-ATPase. As Evidence of this can serve the fact that their inhibitor ouabain cl secretion and Na Absorption stops.

7. The regulation of the Cl channels

According to some authors, this regulation is implemented by cAMP or cAMP kinase realized; another hypothesis provides that this regulation by the protein kinase is accomplished what the change in shape and diameter of the channel and which causes increased Cl secretion from the cell. It is believed that Ca also reinforced Secretion of the irritant substances from the cell causes what is an important contribution to the regulation the Cl channels in the cells of the airway epithelium are viewed. Although the increased approx Concentration that had caused the diameter of the Cl channels to increase this effect continues to be observed even after the removal of Ca.

In conclusion it can be said that cAMP and Ca play a leading role in regulating the Cl Play channels.

The pumping out of Na takes place as follows: Na enters the cell, forms one Connection with Cl and through the basolateral membrane using Na-K-ATPase executed. With the addition of the ATPase inhibitor ouabain, the Na absorption and Cl secretion stopped, therefore the active Na transport (pumping) takes place in the basolateral and the Cl transport in the apical membrane.

8. Inflammation and irritation

The epithelial airway barrier is the first protective measure against inflammation and irritation. The response of the epithelium to the inhaled particles, and that Interact both with the secretion of the mucus, as well as with the cells of the smooth Muscles are probably very important for the healing process.

The cigarette smoke damages the course of the MC even with occasional smokers, with chronic bronchitis often occurring. As the experiments on pigs have shown Cigarette smoke increases the sensitivity of the cells in the airways.

The concentration of blood peroxidase was used as an indicator. The measurements indicated that prolonged and more intense inhalation of cigarette smoke Blood peroxidase concentration greatly increased. The smoke promotes the peroxidase between the epithelial cells and destroyed the structure of the epithelial connections, as well as during the acute inflammatory processes. Simultaneously with these morphological The epithelium secretes changes in the fluid and the polymorphonuclear  Cells infiltrate it. Research under the electron microscope showed the migration of the Leukocyte through the small openings in the epithelium and not between the epithelial cells. The epithelium performed its normal barrier function immediately after the resulting one had been removed morphological damage. The increase in epithelial permeability is also seen in the Occasional smokers observed. Smoking increases the permeability for the particles lower molecular weight (technetium, diethylene amine pentacitate in cigarette smoke are included). The acute inhalation of the smoke also slows down the Cl secretion in vitro, as well as in vivo, with minimal effect on Na absorption. These results suggest that during the pathogenesis of cigarette smoke destroys the barrier function of the epithelium.

C. The physical requirements for building the microclimatic Saline chamber treatment

After Weibel u. a. is the size of the spray particle from the moisture of the surrounding Medium dependent, with the majority of medical sprays in their structure are hygroscopic and polydispersed.

During inspiration, the spray molecules pass through a filter system (upper airways / Tracheobronchial tract / alveoli). To determine the size of such filters, the morphometric lung models, but the Weibel model is mostly used. Therefore the airways are organized in a symmetrical, tree-like system, which is controlled by the Trachea extends to the respiratory tract of the lungs and consists of 23 segments (orders) consists. The size of each order (each segment) is determined using the lung volume calculated. The deposit of the particles on the surface of the model (mucous membrane) is caused by collision with other gas molecules, as well as by gravity and inertia explained. The determining forces for this transportation are

• - gravity sedimentation,
• - the moment of inertia,
• - the "Brownian molecular motion".

The overall settling of the particles is assessed taking into account the o.g. Mechanisms. For this, the effectiveness of weaning is dependent on Particle diameter, degree of dispersion of the spray, the duration of the breathing cycle, and the Airflow speed taken into account.

The respiratory organs have a significantly higher temperature (34-36.9 ° C) and relative Humidity (H, 96-99.5%) than in the surrounding medium. In the inspiration phase the dry hygroscopic NaCl particles enter the trachea through the throat, taking in intense moisture and with a thick layer of water molecules be covered. This process causes the particles to swell so much that they become theirs Resolution is coming. The "dust spray" turns into a "fog spray" in which the Dispersion phase does not consist of the hard particles of NaCl, but of the droplets the saturated saline.

The droplets enlarge as they connect to the water in the trachea. At the point where there is a balance between the condensing and the Evaporation of the water on the surface of the droplets stops, the growth stops. The Equilibrium size of the particles depends on the initial diameter, the density (Concentration), the relative humidity of the medium and its temperature. In a medium with 96% relative humidity, the particle grows with you Diameter of one micron by 200%, with 99.5% moisture - by 500%. The time in which the hygroscopic particles settle is important Achieve equilibrium size, which depends on the initial diameter of the molecule. Particles smaller than 0.3 micron in diameter reach equilibrium  in a few tenths of a second, which in turn means that the growth process already is completed before the molecules enter the trachea.

In the alveolar and trancheobroncheal area, the maximum settling of NaCl is included 2.5-3, or 0.5-0.8 microns, during the non-hygroscopic spray Values correspondingly at 7-8 and 2-3 microns.

To ensure that the medical spray in the alveoli is fully discontinued, According to D. Persons, the highest possible concentration of NaCl must be used, whereby an output size of 0.5-1 micron must not be exceeded.

The increase in the proportion of NaCl in the dispersion phase of the spray The increase in the proportion of NaCl in the dispersion phase of the spray in the solution of 0.00045 mg / ml leads to the growth of general weaning 3-7 times. Holding your breath increases the general and alveolar stopping of the spray, with slow breathing delivering more spray into the alveoli.

D. The general characteristics and the structure of the microclimatic Saline Chamber (MSK)

The curative effect of MSK is achieved with the help of the curable, controllable microclimate, which the Mimicking the microclimate of the underground health resorts in the salt mines. It will characterized by the presence of the highly dispersed sodium chloride spray. Man gets hypobacterial, hypoallergenic medium and pleasant microclimate Conditions. Added to this is psychological stability through a special audiovisual Program built.

The main curative factor in the microclimate of the saline chamber is one highly dispersed sodium chloride spray, which, thanks to its small size, can penetrate into the Penetrates bronchioles, activates the mucociliary transport and secretolic and anti-inflammatory effect achieved.

The MSK is involved in maintaining the microclimate at the specified level special systems. The work area is covered with a layer of salt, which has a higher buffer capacity in relation to the air humidity.

When the humidity and salt layer on the walls interact, the Submicron-sized spray particles created, which have a certain influence on the patient exercise. The main part of the spray is from salt room nebulizer, which is outside the Workspace assembled is manufactured.

The salt room nebulizer does not affect the indoor climate by increasing the Humidity equipped with the filtration system of air; as a result you get a stream of dried air that is saturated with the highly dispersed particles from the generator runs into the work area of the MSK. Within the complex houses the relaxation chairs for the patients. For cleaning the air and maintaining normal pressure when switched on An extractor filter is provided in the salt room nebuliser, which is permanently ready for operation (ventilation during and between demonstrations).

The additional psychosuggestive effect for the patients in the MSK is through a audiovisual program achieved. It is an integral part of every chamber that contains special psychotherapeutic complexes with music and slide shows to build contribute to mental stability.  

E. Advantages of the MSK

• 1. Hypobacterial medium - no possibilities of reinfection.
• 2. Hypoallergenic medium (such as in a high mountain clinic in Davos) - as a result less Strain on the immune system, termination of allergic reactions.
• 3. Comfortable relationships between temperature and humidity, there is none negative influence due to the change of season (spring - summer - autumn - winter), that occurs during spa treatment - year-round use is possible.
• 4. No acclimatization and re-acclimatization problems since the treatment is directly in is carried out near the place of residence, therefore no spa stays.
• 5. Unlike the sea spas, which in most cases are lung diseases are prescribed, the chamber has an optimal relative humidity and stable temperature. The moist air could intensify the inflammation of the chronic non-specific respiratory and lung diseases, ENT organs, skin diseases, Cause allergy to fungi.
• 6. Minimization of the periods of incapacity for work and hospital or spa stays.
• 7. Disruption of contact with pathological factors, ergo can be preventive Treatment in the respiratory and skin damaging processes can be used.
• 8. A non-drug treatment method, no risk of drug allergy, Cross-drug allergy, especially in patients with house dust, pollen, Food, mushroom allergy.
• 9. Lowering until the complete cancellation of medication (bronchospasmolytics, Antibiotics, corticosteroids and. a.), Reduction of the side effects of these preparations possible simultaneous decrease in breathlessness, coughing and expectoration.
• 10. Accompaniment through the psychosuggestive treatment methods (relaxation therapy), what creates deeper, calmer, breathing; as a result, the salt molecules penetrate deeper Bronchi.
• 11. Unlike the natural salt mines, control and maintenance is stable conditions from therapeutic influence possible. The hygroscopic Salt molecules without the addition of unwanted natural ions penetrate deeper into the bronchi and alveolus; constant maintenance of the salt concentration on optimal fixed level.
• 12. Constant release of the salt molecules from the salt blocks of the walls into the air of the Chamber. Air is saturated by the evaporation of the NaCl spray.
• 13. Comfortable hygienic cleaning and maintenance - thereby reducing the Contamination.

F. Indications and contraindications

the principle of patient selection:
the MSK is carried out in hospitals or doctor's offices. The patient selection is carried out by the specially prepared doctor with work experience in the field of general medicine, pulmonology, allergology and skin diseases. In order to maintain the aerosol concentration in the MSK, it is not allowed to enter or leave it during the session. After the session, the work space is ventilated for 20-60 minutes using the air conditioning. The chamber's work cycle can include up to 5-7 sessions per day. In the morning it is expedient to treat the patients to separate the slimy phlegm, in the day - the purulent - slimy, in the evening - the purulent. No cosmetics with a pungent smell, free clothing made of cotton. Protective clothing is used to preserve hypobacterial, allergen-free conditions.

Indications of MS therapy 1. The respiratory tract pathology

• a. diseases of the upper respiratory tract,
• b. acute bronchitis with a permanent course,
• c. Recessive bronchitis,
• d. chronic diffuse bronchitis,
• e. chronic obstructive bronchitis without the characteristics of the cor pulmonale,
• f. Bronchial asthma / endogenous and / or exogenous light and medium difficulty,
• G. obstructive bronchitis and bronchial asthma in children from 3 to 15 years.

The use of the MSK for the prophylaxis of the chronic, non-specific respiratory diseases, especially among workers those under health-damaging influences (dust, gas, smoke, chemically active Substances, changes in air temperature) are employed and chronic Smokers. The healing takes place due to the interruption of contact with the unfavorable Environmental factors, as well as thanks to the specific effect of the dispersed dry Aerosol of NaCl, which helps to remove such allergens and infection carriers.

2. The pathology of the ENT organs

• a. allergic rhinitis,
• b. allergic sinusitis,
• c. Pollen allergy,
• d. chronic rhinitis,
• e. chronic sinusitis,
• f. chronic tonsillitis.

3. The skin diseases

• a. Neurodermatitis,
• b. atopic dermatitis / diffuse and exudative form / stabilization phase,
• c. Psoriasis in the stabilization phase,
• d. Eczema,  
• e. Hypersecretion of the sebaceous glands (oily skin),
• f. Acne vulgaris.

Contraindications

• 1. Acute conditions and exacerbation of chronic respiratory diseases
• 2. acute infectious diseases until the end of the isolation period
• 3. all acute therapeutic diseases
• 4. All diseases that are aggravated by acute pus secretions.
• 5. Respiratory failure: II and III. Degrees
• 6. Chronic decompensated cor pulmonale
• 7. Circulatory insufficiency
• 8. malignant tumors of any location or suspected of them
• 9. All forms of active tuberculosis
• 10. All blood disorders in the acute stage and exacerbation phase
• 11. Repeating or extensive bleeding
• 12. Mental illness
• 13. Pregnancy.

List of sources

• 1. Cauer H .: Chemical-physical studies of the climatic conditions in the clod cave, Arch. Physical. Ther. 1954, 6: 1.
• 2. Alan M. Weinstein: Analysis of volume regulation in an epithelial cell model Bulletin of Mathematical Biology 1992, Vol. 54, 4: 537-561.
• 3. Jörg Zimmermann and Sabine Utermann: Photosol therapy in patients with psoriasis and Neurodermatitis atopica. Dermatologist 1994, 45: 849-853.
• 4. Dr. K.-H. Spannagel, Ennepetal-Voerde Treatment of bronchial asthma and chronic bronchitis in the cluster cavity Currently applied baths-Klimahk. 1960, 7: 684-696.
• 5. Born Christiane Burnus hammer Inaugural dissertation for obtaining the medical doctoral degree in medical Faculty of the Albert-Ludwigs-University Freiburg i. Br. Freiburg, 1993.
• 6. Schapowal A., Schmitz M., Rninitis - Sinusitis - Asthma Immunology diagnostic therapy Respiratory and lung diseases, Zschr. For diagnostics and therapy, Editorial, 1994, 2.
• 7. Knowles M., Olivier K., Noone P., Boucher R. Pharmacologic Modulation of Salt and Water in the Airway Epithelium in Cystic Fibrosis At the. J. Respir. Crit. Care Med 1995, 151: 65-69.

Claims (2)

This device is a complex to create a microclimate.
This complex consists of a room that will serve to improve the well-being of people. 1. This complex consists of a room with a mineral covering and air conditioning devices, including a relaxation complex with technical devices to achieve audiovisual effects.

• 1.1. The room is isolated to create a microclimate.
• 1.2. The mineral covering consists of a salt mixture.
• 1.3. The air treatment system consists of a salt room nebulizer.
• 1.3.1. This includes air conditioning.
• 1.3.2 This includes fans.
• 1.3.3. This includes an air ionizer.
• 1.3.4 This includes control devices for controlling and monitoring the microclimate.
• 1.4. The relaxation complex consists of relaxation armchairs, headphones, tapes, screen, slide and film projector to achieve an audiovisual effect.