Objective: This study investigates the effectiveness of the Loving-Kindness and Mindfulness Meditation (LKM) therapy in improving mood states of hematologic malignancy patients in a sterile isolation room. A randomized controlled trial was conducted, with the POMS2 Japanese version used to assess mood state improvement. Methods: The final number of participants in this study was nine (intervention group n=4, control group n=5). Patients in a sterile isolation room were provided with a tablet containing a video of the LKM. The intervention group watched the 20-minute video. POMS2 factor scores were measured before the intervention and again one and two weeks after the intervention. The data were analyzed using two-way analysis of variance (ANOVA) to compare the scores across time points. Results: No statistically significant differences were observed between the two groups for each factors; however, a trend of nonlinear change was observed in the Vigor-Apathy (VA) factor(p=0.054). Conclusion: In this pilot study, LKM did not show a significant effect on the mood state of patients, which is suggested to be due to the insufficient number of cases. It seems necessary to increase the number of subjects in future research.

Background: Masticatory muscle tendon-aponeurosis hyperplasia (MMTAH) is a relatively newly identified clinical condition that manifests as trismus with a square-shaped mandible. Herein, we report a case of MMATH that was initially misdiagnosed for polymyositis due to trismus and simultaneous lower limb pain, with literature review.Case presentation A 30-year-old woman had a history of lower limb pain after exertion for 2 years. Initial physical examination had been performed at the Department of General Medicine in our hospital. There was also redness in the hands and fingers. Although polymyositis was suspected, it was denied. The patient visited our department for right maxillary wisdom tooth extraction.Clinical examination revealed that the patient had a square-shaped mandible. The maximal mouth opening was 22 mm. There was no temporomandibular joint pain at the time of opening. Furthermore, there was awareness of clenching while working. Panoramic radiography revealed developed square mandibular angles with flattened con‑ dyles. Computed tomography showed enlarged masseter muscles with high-density areas around the anterior and lateral fascia. Magnetic resonance imaging also showed thickened tendons and aponeuroses on the anterior surface and inside bilateral masseter muscles. Finally, the patient was diagnosed with MMTAH. Bilateral aponeurectomy of the masseter muscles with coronoidectomy and masseter muscle myotomy was performed under general anesthesia.The maximum opening during surgery was 48 mm. Mouth opening training was started on day 3 after surgery. Histo‑ pathological examination of the surgical specimen showed that the muscle fibers were enlarged to 60 μm. Immuno‑ histochemistry testing for calcineurin, which was associated with muscle hypertrophy due to overload in some case reports, showed positive results. Twelve months after surgery, the mouth self-opening and forced opening were over 35 mm and 44 mm, respectively. Conclusions Herein, we report a case of MMATH. Lower limb pain due to prolonged standing at work and overload due to clenching were considered risk factors for symptoms onset of MMATH.