PURPOSE: The purpose of this study was to investigate the of laughter therapy on depression, anxiety, and stress among patients underwent radiotherapy. METHODS: Participants in the study were comprised of 60 breast cancer outpatients who received radiotherapy. Thirty-one of the patients were assigned in the experimental group and the other 29 patients made up the control group. Laughter therapy was consisted of the delivery of information and active motion resulting in laughter. We provided laughter therapy 4 times for 2 weeks. Each session lasted 60 min. The experimental group received laughter therapy intervention as a group. An average attendance frequency per person was 2.7. To evaluate the effect of laughter therapy, the degrees of depression and anxiety were measured by Hospital Anxiety and Depression (HAD) and stress was measured by the Brief Encounter Psychosocial Instrument (BEPSI). Data analysis included a 2-test, t-test, and Fisher's exact test using SPSS 12.0 and SAS 8.0. RESULTS: There was significant decrease in the degrees of depression, anxiety, and stress in the experimental group compared to those in the control group (p<.01, p=.04, and p<.01, respectively). CONCLUSION: This study provides evidence that laughter therapy is an effective intervention in improving depression, anxiety, and stress in breast cancer patients.
Anxiety ; Breast ; Breast Neoplasms ; Depression ; Humans ; Laughter ; Laughter Therapy ; Outpatients ; Phenothiazines ; Statistics as Topic

BACKGROUND: Due to a reduction in the number of parasite infections, attention paid to the importance of intestinal parasites has decreased. However, intestinal parasite infections remain ubiquitous and have reappeared as a growing problem in recent decades due to changing lifestyles such as increased overseas travel. In this study, we evaluated trends in intestinal parasite infection using stool examination in a single institute. METHODS: From January 2003 to December 2012, we reviewed all stool examination results performed at Samsung Medical Center. Fecal examinations were performed by formalin-ether sedimentation. RESULTS: A total 429,866 stool examinations were performed resulting in 14,672 cases with positive findings of helminth eggs or protozoan cysts, of which the positive rate was 3.41% on average. The annual positive rate decreased from 5.68% in 2003 to 2.43% in 2012. The positive rate of intestinal parasites, excepting Endolimax nana and Entamoeba coli, was 1.52% on average. Positive rates decreased from 2.13% to 1.10% for helminth egg detections and from 2.55% to 1.30% for protozoan cyst detections during the same time period. Among nematodes, Trichuris tricuria was the most common and had an increasing positive rate after 2010. Clonorchis sinensis was the most prevalent trematode parasite, with an annual average of 528 cases. CONCLUSION: Infection rates of intestinal parasites have decreased over the last 10 years. However, Trichuris tricuria has reappeared and has become a major contributor to parasite infections. Further education and control efforts are needed for greater prevention and eventual eradication of parasitic infections.
Clonorchis sinensis ; Eggs ; Endolimax ; Entamoeba ; Helminths ; Korea ; Life Style ; Ovum ; Parasites ; Trichuris

BACKGROUND AND OBJECTIVES: Tinnitus is the perception of a sound produced involuntarily inside the body. Tinnitus can be divided into two major categories: (1) tinnitus generated by para-auditory structure, usually from vascular or myoclonic sources: and (2) tinnitus generated by the sensorineural auditory system. With the recent advent of magnetic resonance imaging and auditory brain stem response, it is now possible to diagnose objectively the lesion as causes of intractable tinnitus while they are still quite rare. So, we can consider the surgical treatment on objective causes of tinnitus. MATERIALS AND METHODS: The authors analysed forty patients with tinnitus, who had visited the OPD of our ENT dept. from 1998 April to 1998 September, through history taking, physical examination, many objective auditory tests including auditory brain stem response (ABR) and MRI scan. RESULTS: In ABR test, conduction pathway of BAEP (Brain stem auditory evoked potential) was abnormal in 31 (59.6%) patients. Average latency of I-III, III-V and I-V were 2.29 msec, 1.92 msec and 4.22 msec. The 22 of 31 patients who had abnormal conduction pathway of BAEP showed hearing disturbance. Two patients showing normal conduction pathway of BAEP had hearing disturbance. In MRI scan, abnormal findings were observed only in 13 (25%) patients. CONCLUSION: The use of ABR and MRI to diagnose intractable tinnitus might be valuable in routine tests.
Evoked Potentials, Auditory, Brain Stem ; Hearing ; Humans ; Magnetic Resonance Imaging ; Physical Examination ; Tinnitus*

BACKGROUND AND OBJECTIVES: The CO2 laser is commonly used in the oral cavity and pharyngolaryngeal lesion, since, unlike the conventional scalpel technique, it provides excellent hemostasis and visualization and thus enables the surgeon to operate in a precise manner. Additional advantages include decreased postoperative pain and less swelling. Despite this advantage, several studies have reported impaired wound healing associated with the use of CO2 laser. Fibronectin is a high molecular weight glycoprotein and serves as a substrate for adhesion and migration of cells which repair cell defects together with fibrin. Fibronectin is involved in the generation of reticulin matrix together with the type III collagen. MATERIALS AND METHODS: The histological changes and the expression of fibronectin activities following incision of tongue mucosa by the CO2 laser and the conventional scalpel technique were compared over a period of 7 days in a rat model. RESULTS: A delay was noted in the healing of the CO2 laser wound. Both CO2 laser and scalpel wound expressed fibronectin, soon after wounding. The expression of fibronectin activities in the CO2 laser rose to the maximal level more slowly than the scalpel wound and its degree was weaker. CONCLUSION: Delayed expression in fibronectin may play a role in the delay of the CO2 laser wound healing.
Animals ; Collagen Type III ; Fibrin ; Fibronectins* ; Glycoproteins ; Hemostasis ; Lasers, Gas* ; Models, Animal ; Molecular Weight ; Mouth ; Mucous Membrane ; Pain, Postoperative ; Rats* ; Reticulin ; Tongue* ; Wound Healing* ; Wounds and Injuries*

BACKGROUND AND OBJECTIVES: Cholesteatoma is composed of hyperproliferative keratinizing epithelium in the middle ear cavity. Although the mechanism of bone destruction by cholesteatoma has not been fully elucidated, it has been reported that activation of several cytokines followed by osteoclast activation might have a major effect on bone resorption in cholesteatoma. Among the several cytokines, it has been suggested that the overexpression of tumor necrosis factor-alpha (TNF-alpha), interleukin-1alpha (IL-1alpha) and interleukin-6 (IL-6) in the cholesteatomatous tissue is correlated with bone destruction, and transforming growth factor-beta1 (TGF-beta1) and interleukin-4 (IL-4) are associated with osteoclast inhibitory activity. To determine the potential role of several cytokines in the pathogenesis of cholesteatoma and its bone destruction, we investigated mRNA expression of four cytokines in the cholesteatomatous tissue. MAERIALS AND METHODS: We investigated mRNA expression of cytokines in 20 cholesteatomatous tissues as well as in the normal postaural skins using RT-PCR (reverse transcriptase-polymerase chain reaction). RESULTS: 1) Out of 20 cholesteatomatous tissues, six were mRNA expressions of IL-1alpha, four of IL-6, ten of TGF-beta1 mRNA, but no expressions of IL-4. There was no gene expression except six cases for TGF-beta1 in the normal postaural skin. 2) Three cases that expressed IL-1alpha, IL-6, and TGF-beta1 showed severe bone destruction, whereas no bone destruction was noted in 5 cases that expressed only TGF-beta1. 3) There was no significant correlation between the duration of disease and the individual cytokine expression. CONCLUSION: These findings suggest that IL-1alpha and IL-6 may play a major role in the proliferation and growth of cholesteatoma as well as the excitatory effect for bone destruction by cholesteatoma, and TGF-beta1 might have a protective effect for bone destruction.
Bone Resorption ; Cholesteatoma* ; Cytokines ; Ear, Middle ; Epithelium ; Gene Expression* ; Interleukin-1alpha ; Interleukin-4 ; Interleukin-6 ; Osteoclasts ; RNA, Messenger ; Skin ; Transforming Growth Factor beta1 ; Tumor Necrosis Factor-alpha

Purpose: This study aimed to evaluate the effects of an intervention combining warm therapy (via a thermoelectric-element tourniquet) and a distraction-based approach (via an augmented reality-based app known as TWINKLE) on pain, stress, and satisfaction during intravenous catheterization in adults. Methods: A randomized controlled trial was conducted in South Korea with 93 healthy adults who were randomly assigned to one of three groups: the experimental group (TWINKLE app with warm therapy), the comparison group (warm therapy only), and the control group (no treatment). Participants’ pain, stress, and satisfaction, as well as practitioner satisfaction, were measured after the intervention. Results: Pain scores differed significantly among the three groups (F = 5.68, p = .005), with the experimental group showing significantly lower scores than the control group (p = .003). Stress levels were also significantly lower in the experimental group than in the other groups (F = 9.42, p < .001). Participant satisfaction was highest in the experimental group (F = 17.65, p < .001), while nurse satisfaction was significantly higher in the comparison group than in the experimental and control groups (F = 67.91, p < .001), suggesting that the additional distraction intervention may have increased nurses’ workload. Conclusion Combining digital distraction with warm therapy using a thermoelectric-element tourniquet effectively reduces pain and stress while improving patient satisfaction during intravenous catheterization. Further research is needed to optimize this approach, with a particular focus on targeting digital distraction interventions to patients with higher levels of procedural anxiety and finding ways to minimize practitioner workload.

Purpose: This study aimed to evaluate the effects of an intervention combining warm therapy (via a thermoelectric-element tourniquet) and a distraction-based approach (via an augmented reality-based app known as TWINKLE) on pain, stress, and satisfaction during intravenous catheterization in adults. Methods: A randomized controlled trial was conducted in South Korea with 93 healthy adults who were randomly assigned to one of three groups: the experimental group (TWINKLE app with warm therapy), the comparison group (warm therapy only), and the control group (no treatment). Participants’ pain, stress, and satisfaction, as well as practitioner satisfaction, were measured after the intervention. Results: Pain scores differed significantly among the three groups (F = 5.68, p = .005), with the experimental group showing significantly lower scores than the control group (p = .003). Stress levels were also significantly lower in the experimental group than in the other groups (F = 9.42, p < .001). Participant satisfaction was highest in the experimental group (F = 17.65, p < .001), while nurse satisfaction was significantly higher in the comparison group than in the experimental and control groups (F = 67.91, p < .001), suggesting that the additional distraction intervention may have increased nurses’ workload. Conclusion Combining digital distraction with warm therapy using a thermoelectric-element tourniquet effectively reduces pain and stress while improving patient satisfaction during intravenous catheterization. Further research is needed to optimize this approach, with a particular focus on targeting digital distraction interventions to patients with higher levels of procedural anxiety and finding ways to minimize practitioner workload.

Purpose: This study aimed to evaluate the effects of an intervention combining warm therapy (via a thermoelectric-element tourniquet) and a distraction-based approach (via an augmented reality-based app known as TWINKLE) on pain, stress, and satisfaction during intravenous catheterization in adults. Methods: A randomized controlled trial was conducted in South Korea with 93 healthy adults who were randomly assigned to one of three groups: the experimental group (TWINKLE app with warm therapy), the comparison group (warm therapy only), and the control group (no treatment). Participants’ pain, stress, and satisfaction, as well as practitioner satisfaction, were measured after the intervention. Results: Pain scores differed significantly among the three groups (F = 5.68, p = .005), with the experimental group showing significantly lower scores than the control group (p = .003). Stress levels were also significantly lower in the experimental group than in the other groups (F = 9.42, p < .001). Participant satisfaction was highest in the experimental group (F = 17.65, p < .001), while nurse satisfaction was significantly higher in the comparison group than in the experimental and control groups (F = 67.91, p < .001), suggesting that the additional distraction intervention may have increased nurses’ workload. Conclusion Combining digital distraction with warm therapy using a thermoelectric-element tourniquet effectively reduces pain and stress while improving patient satisfaction during intravenous catheterization. Further research is needed to optimize this approach, with a particular focus on targeting digital distraction interventions to patients with higher levels of procedural anxiety and finding ways to minimize practitioner workload.

Purpose: This study aimed to evaluate the effects of an intervention combining warm therapy (via a thermoelectric-element tourniquet) and a distraction-based approach (via an augmented reality-based app known as TWINKLE) on pain, stress, and satisfaction during intravenous catheterization in adults. Methods: A randomized controlled trial was conducted in South Korea with 93 healthy adults who were randomly assigned to one of three groups: the experimental group (TWINKLE app with warm therapy), the comparison group (warm therapy only), and the control group (no treatment). Participants’ pain, stress, and satisfaction, as well as practitioner satisfaction, were measured after the intervention. Results: Pain scores differed significantly among the three groups (F = 5.68, p = .005), with the experimental group showing significantly lower scores than the control group (p = .003). Stress levels were also significantly lower in the experimental group than in the other groups (F = 9.42, p < .001). Participant satisfaction was highest in the experimental group (F = 17.65, p < .001), while nurse satisfaction was significantly higher in the comparison group than in the experimental and control groups (F = 67.91, p < .001), suggesting that the additional distraction intervention may have increased nurses’ workload. Conclusion Combining digital distraction with warm therapy using a thermoelectric-element tourniquet effectively reduces pain and stress while improving patient satisfaction during intravenous catheterization. Further research is needed to optimize this approach, with a particular focus on targeting digital distraction interventions to patients with higher levels of procedural anxiety and finding ways to minimize practitioner workload.

Bacillus Calmette-Guerin (BCG) has been traditionally used as a vaccine against tuberculosis. Further, intravesical administration of BCG has been shown to be effective in treating bladder cancer. Although BCG contains a live attenuated strain of Mycobacterium bovis, complications such as M. bovis BCG infection caused by BCG administration are extremely rare. Here, we report a case of BCG infection occurring after intravesical BCG therapy. A 67-yr-old man presented with azotemia and weight loss. He had been diagnosed with bladder cancer 4 yr back, and had undergone transurethral resection of the bladder tumor and intravesical BCG (Tice strain) therapy at that time. An acid-fast bacterial strain was isolated from his urine sample. We did not detect Mycobacterium tuberculosis protein 64 (MPT-64) antigen in the isolates obtained from his sample, and multiplex PCR and PCR-reverse blot hybridization assay indicated that the isolate was a member of the M. tuberculosis complex, but was not M. tuberculosis. Finally, sequence analysis of 16S ribosomal RNA and DNA gyrase, subunit B (gyrB) suggested that the organism was M. bovis or M. bovis BCG. Although we could not confirm that M. bovis BCG was the causative agent, the results of the 3 molecular methods and the MPT-64 antigen assay suggest this finding. This is an important finding, especially because M. bovis BCG cannot be identified using common commercial molecular genetics tools.
Administration, Intravesical ; Aged ; BCG Vaccine/administration & dosage/*adverse effects ; DNA Gyrase/genetics ; Humans ; Male ; Mycobacterium Infections/*diagnosis/etiology ; Mycobacterium bovis/genetics/*isolation & purification ; Polymerase Chain Reaction ; RNA, Ribosomal, 16S/genetics ; Urinary Bladder Neoplasms/*therapy