In rheumatoid arthritis (RA), the histological findings of the irradiated synovial membrane showed flattening of epithelial cells, decreased villous proliferation, narrowed vascular lumen, and reduced infiltration of inflammatory cells compared with nonirradiated synovia. However, the mechanisms of the action of low energy lasers in RA are unclear.
In order to clarify the effects of low energy laser irradiation, the lymphoid cells in the RA synovial membrane were studied using immuno-histology and the cultured synovial cells were studied with an electron microscopy.
The knee joints of 12 RA patients who had been scheduled for arthroplasty were irradiated with a gallium-aluminum-aresenide (Ga-Al-As) laser (790nm wavelength, 10-mW output) two to seven days before the surgical operation, at six points. On the day following the last irradiation, pieces of synovial membrane from the lateral irradiated area and from the medial nonirradiated area as a control were resected during the arthroplasty. The immuno-histological findings of the irradiated synovial membrane based on the peroxidase anti-peroxidase (PAP) method showed decreased CD4 cells in nine cases. A significant difference was seen in Wilcoxon's test (p<0.05). However the findings of the irradiated synovial membrane showed increased CD8 cells in two cases and decreased cells in seven cases. No significant difference was found by Wilcoxon's test on CD8 and CD4/8 of the irradiated synovial membrane. No significant difference in CD4 and CD8 of irradiated peripheral lymphoid cells was revealed by Wilcoxon's test. We noted histological changes (dilation of rER, hypertrophy of Golgi complexes, and decrease in secretions) on the irradiated cultured rheumatoid synovial cells observed by electron microscopy.
These findings suggest that low energy laser irradiation decreased T lymphoid cells presumably through disturbance of cytokine secretion in synovial cells.

The following analgesic effects have resulted from irradiating each finger joint (DIP, PIP, and MCP) of patients with rheumatoid arthritis for 20 seconds using the semiconductor laser, “uni-Laser” (10mw, 790nm) from ITO company.
1) Comparison of the post-exposure state with the pre-exposure state in the open test
i) Of 13 cases of joint pain, 7 cases showed improvement and 6 cases showed no change with no case showing aggravation.
ii) Duration of analgesic effect was less than 48 hours in 2 cases, less than 72 hours in 1 case, and more than 96 hours in 3 cases.
2) Comparison of the post-exposure state with the pre-exposure state in the single blind test on a total of 25 patients with rheumatoid arthritis. Twelve patients were exposed to the irradiation twice per week, 10 times a session (irradiated group) and 13 were exposed to the dummy of the above (control group).
i) The irradiated group improved considerably in the number of painful joints, frequency of joint pain, and grasping power. The rate of improvement was superior to that of the control group (P<0.05).
ii) No significant improvement in duration of morning stiffness was shown in either group.

　　The impact of health guidance is recently becoming higher quality health services, and the next task is finding ways to establish a system that delivers higher quality services. Institutions that provide health guidance need to improve their services by analyzing the lifestyle habits and health examination results (e.g., BMI and blood pressure) of their clients. This study conducted simultaneous health and dietary habit checkups so that key elements for guidance (e.g., individual dietary habits, population characteristics, and main tasks) could be shared among guidance providers and be utilized for follow-up guidance. Most subjects were in their sixties or seventies, many of whom were diagnosed with obesity and/or dyslipidemia based on health examination results. Dietary habit evaluations revealed high intake of a main dish among both men and women. Intake of a main dish and a sweet snack was particularly high among men. Many subjects who excessively take in both a main dish and sweet snack were obese with a high percentage of saturated fatty acid-derived energy, indicating that this subgroup needs to be prioritized to receive guidance. Those with an appropriate intake of both a main dish and sweet snack might have consumed inadvisable levels of other dietary components, including luxury food items. However, an individual approach is also required to address the risk associated with intake of a low percentage of protein-derived energy. Similar studies in other populations and other communities are needed to assess whether the characteristics revealed in this study are specific to this particular population.

　　Muscle training is effective for improving motor function, although withdrawal within 3-6 months has been reported in many cases. Thus, we aimed to establish locomotion training recommended by the Japanese Orthopaedic Association and our own locomotive syndrome prevention training (herein after collectively referred to as “locomotive training”) as a daily routine. Subjects were 30 participants of a training course held in 2014. Nine sessions (including 1 follow-up session) were organized to repetitively teach the importance of locomotive training; participants were instructed to record daily training activities during the course. Duration of oneleg standing balance with eyes open was measured each session so that participants were aware of the effects of the training. At the time of the last session of the course and at the follow-up session, 90% and 83% of participants completed home training twice or three times a week, respectively. Participants reported physical changes such as amelioration of knee pain and ability to put on a Wellington boot while standing on one leg. Also, physical fitness tests performed before and after the course showed significant improvement on the Timed Up and Go test, 30-s chair stand test, and one-leg standing with eyes open after the training course. Furthermore, the locomotive syndrome test resulted in a decrease in the number of participants who were judged to have a possibility to suffer from locomotive syndrome. Taken together, introducing a cycle comprising the three components of motivation-building through lectures, increasing awareness by recording performance, and awareness of the training effect by measuring duration of one-leg standing balance contributed to training continuity and consequent improvement in motor function.

Purpose: Thyroid transcription factor 1 (TTF-1) expression is a useful predictor of treatment efficacy in advanced non-squamous non–small cell lung cancer (NSCLC). This study aimed to evaluate whether TTF-1 could predict the effectiveness of chemotherapy versus chemoimmunotherapy in patients with non-squamous NSCLC with programmed death ligand-1 (PD-L1) expression between 1% and 49%. Materials and Methods: We conducted a retrospective study of patients with NSCLC who were treated with chemotherapy or chemoimmunotherapy between March 2016 and May 2023. The patients had histologically confirmed NSCLC, stage III-IV or postoperative recurrence, TTF-1 measurements, and PD-L1 expression levels between 1% and 49%. Clinical data were analyzed to evaluate the effect of TTF-1 expression on treatment efficacy. Results: This study included 283 of 624 patients. TTF-1–positive patients showed longer progression-free survival (PFS) and overall survival (OS) (PFS: 6.4 months [95% confidence interval (CI), 5.0 to 9.4] vs. 4.1 months [95% CI, 2.7 to 6.1], p=0.03; OS: 17.9 months [95% CI, 15.2 to 28.1] vs. 9.4 months [95% CI, 6.3 to 17.0], p < 0.01) in the chemotherapy cohorts (n=93). In the chemoimmunotherapy cohort (n=190), there was no significant difference in PFS and OS between TTF-1–positive and –negative groups (PFS: 7.6 months [95% CI, 6.4 to 11.0] vs. 6.0 months [95% CI, 3.6 to 12.6], p=0.59; OS: 25.0 months [95% CI, 18.0 to 49.2] vs. 21.3 months [95% CI, 9.8 to 28.8], p=0.09). Conclusion In patients with NSCLC with PD-L1 expression between 1% and 49%, TTF-1 expression was a predictor of chemotherapeutic, but not chemoimmunotherapeutic, efficacy.

Purpose: Thyroid transcription factor 1 (TTF-1) expression is a useful predictor of treatment efficacy in advanced non-squamous non–small cell lung cancer (NSCLC). This study aimed to evaluate whether TTF-1 could predict the effectiveness of chemotherapy versus chemoimmunotherapy in patients with non-squamous NSCLC with programmed death ligand-1 (PD-L1) expression between 1% and 49%. Materials and Methods: We conducted a retrospective study of patients with NSCLC who were treated with chemotherapy or chemoimmunotherapy between March 2016 and May 2023. The patients had histologically confirmed NSCLC, stage III-IV or postoperative recurrence, TTF-1 measurements, and PD-L1 expression levels between 1% and 49%. Clinical data were analyzed to evaluate the effect of TTF-1 expression on treatment efficacy. Results: This study included 283 of 624 patients. TTF-1–positive patients showed longer progression-free survival (PFS) and overall survival (OS) (PFS: 6.4 months [95% confidence interval (CI), 5.0 to 9.4] vs. 4.1 months [95% CI, 2.7 to 6.1], p=0.03; OS: 17.9 months [95% CI, 15.2 to 28.1] vs. 9.4 months [95% CI, 6.3 to 17.0], p < 0.01) in the chemotherapy cohorts (n=93). In the chemoimmunotherapy cohort (n=190), there was no significant difference in PFS and OS between TTF-1–positive and –negative groups (PFS: 7.6 months [95% CI, 6.4 to 11.0] vs. 6.0 months [95% CI, 3.6 to 12.6], p=0.59; OS: 25.0 months [95% CI, 18.0 to 49.2] vs. 21.3 months [95% CI, 9.8 to 28.8], p=0.09). Conclusion In patients with NSCLC with PD-L1 expression between 1% and 49%, TTF-1 expression was a predictor of chemotherapeutic, but not chemoimmunotherapeutic, efficacy.

Purpose: Thyroid transcription factor 1 (TTF-1) expression is a useful predictor of treatment efficacy in advanced non-squamous non–small cell lung cancer (NSCLC). This study aimed to evaluate whether TTF-1 could predict the effectiveness of chemotherapy versus chemoimmunotherapy in patients with non-squamous NSCLC with programmed death ligand-1 (PD-L1) expression between 1% and 49%. Materials and Methods: We conducted a retrospective study of patients with NSCLC who were treated with chemotherapy or chemoimmunotherapy between March 2016 and May 2023. The patients had histologically confirmed NSCLC, stage III-IV or postoperative recurrence, TTF-1 measurements, and PD-L1 expression levels between 1% and 49%. Clinical data were analyzed to evaluate the effect of TTF-1 expression on treatment efficacy. Results: This study included 283 of 624 patients. TTF-1–positive patients showed longer progression-free survival (PFS) and overall survival (OS) (PFS: 6.4 months [95% confidence interval (CI), 5.0 to 9.4] vs. 4.1 months [95% CI, 2.7 to 6.1], p=0.03; OS: 17.9 months [95% CI, 15.2 to 28.1] vs. 9.4 months [95% CI, 6.3 to 17.0], p < 0.01) in the chemotherapy cohorts (n=93). In the chemoimmunotherapy cohort (n=190), there was no significant difference in PFS and OS between TTF-1–positive and –negative groups (PFS: 7.6 months [95% CI, 6.4 to 11.0] vs. 6.0 months [95% CI, 3.6 to 12.6], p=0.59; OS: 25.0 months [95% CI, 18.0 to 49.2] vs. 21.3 months [95% CI, 9.8 to 28.8], p=0.09). Conclusion In patients with NSCLC with PD-L1 expression between 1% and 49%, TTF-1 expression was a predictor of chemotherapeutic, but not chemoimmunotherapeutic, efficacy.