In order to compare the result of local cryo-therapy on rheumatoid arthritis against the conventional local heat application a comparative clinical study was performed.
Twenty rheumatoid patients with bilateral knee joint involvement were selected cryo-therapy was given for five minutes with cryogenic air generator (Nihonsanso-L-10) at-100°C on below in eleven patients, whereas local heat was applied with hot packs for 15 minutes at 70-80°C in nine patients.
All the patient underwent a daily active exercise schedule after the local treatment, these treatment were given for three months continuously and the result were evaluated. For the evaluation, twelve items were selected including, range of motion, muscle strength, walking capacity, roentgengram and etc.
The patients were evaluated before the treatment, 1.5 months after the treatment and at the end of the treatment.
The result: both groups showed some improvement in general, but there was no significant difference between them, muscle stiffness and joint pain seemed to be slightly between after the cryo-therapy compared to the local heat application, however post-treatment x-ray showed some progression of joint destruction in the former. The result suggest that local cryo-therapy has a certain place in rheumatoid treatment although not significantly better than the conventional local heat application, if it is applied under due care.

The short wave diathermy was utilized on the 25 patients with rheumatoid arthritis suffering from the pain of the knee joint and therapeutic effects were evaluated.
Ito rator K-I, a short wave generator for the treatment at home (voltage: 100v, 28MHZ), was applied on the painful knee joint daily for 20 minutes.
The therapeutic effects were assessed by the findings before and after daily single application of the short wave diathermy (I), and also by the findings after a series of the treatments during a month (II).
In the latter case, the short wave diathermy was utilized for 20 minutes every morning between nine and ten except on Sundays.
For the purpose of the evaluation of the therapeutic effects, six items of the studies were selected, including (1) points of the joint pain, (2) A-ROM of the knee flexion, (3) gait time for 10 meters, (4) time between the flexion and extension, (5) extensor muscle strength of the knee, and (6) flexor muscle strength of the knee.
The results were as follows:
(1) The knee joint pain was improved after daily single application of the short wave diathermy and the decrease in their pain points was 30 per cent.
(2) Gait time for 10 meters and time between the knee flexion and extension (10 times) were significantly improved after daily single application of the short wave diathermy.
(3) After a series of treatments of thort wave diathermy during a month some improvements were showed on the all items, but every improvements was not significant.

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.

Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is useful for diagnosing mediastinal lymph node lesions. Cell blocks prepared from the needle washing fluid and flow cytometry of tissue samples are helpful in making the diagnosis, but the combination of both examinations is not routinely performed. A 77-year-old woman with fever, dyspnea, and anorexia was admitted to our hospital. Computed tomography showed enlarged mediastinal lymph nodes with calcification and left ureteral calculus; however, no focus of infection was identified. We suspected lymph node tuberculosis or malignant lymphoma, and EBUS-TBNA was performed to evaluate the mediastinal lymph node lesions. Because a cell block prepared from the needle rinse fluid was suspicious for malignant lymphoma, we changed the puncture needle from 22 G to 19 G and performed a second EBUS-TBNA. Diffuse large B-cell lymphoma (DLBCL) was diagnosed based on the results of flow cytometry of the EBUS-TBNA samples. Here we report this case of DLBCL in which mediastinal lymph node tuberculosis was suspected and cell block preparation and flow cytometry using EBUS-TBNA specimens were useful for the diagnosis.