• Title/Summary/Keyword: therapeutic intervention

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The Role of the Endometrium and Embryo in Human Implantation (인간 착상 과정에 자궁내막과 배아의 역할)

  • Jee, Byung-Chul
    • Development and Reproduction
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    • v.13 no.1
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    • pp.1-11
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    • 2009
  • Implantation itself is governed by an array of endocrine, paracrine and autocrine modulators, of embryonic and maternal origin. Window of implantation is the unique temporal and spatial expression of factors allows the embryo to implant via signaling, appositioning, attachment, and invasion in a specific time frame of $2{\sim}4$ days. When the embryo has arrived in the uterine cavity, a preprogrammed sequence of events occurs, which involves the production and secretion of a multitude of biochemical factors such as cytokines, growth factors, and adhesion molecules by the endometrium and the embryo, thus leading to the formation of a receptive endometrium. Cytokines such as LIF, CSF-1, and IL-1 have all been shown to play important roles in the cascade of events that leads to implantation. Integrin, L-selectin ligands, glycodelin, mucin-1, HB-EGF and pinopodes are involved in appositioning and attachment. The embryo also produces cytokines and growth factors (ILs, VEGF) and receptors for endometrial signals such as LIF, CSF-1, IGF and HB-EGF. The immune system and angiogenesis play an important role. The usefulness of these factors to assess endometrial receptivity and to estimate the prognosis for pregnancy in natural and artificial cycles remains to be proven. Integrins, pinopodes, glycodelin and LIF (from biopsies) are promising candidates; from uterine flushings, glycodelin and LIF are also candidates. The ideal serum marker is not available, but VEGF, glycodelin and CSF have some clinical implications. Further evaluation that includes larger groups of infertile women and fertile controls are needed to elucidate whether their presence in plasma, flushing fluid, or endometrial samples can be used as some kind of a screening tool to assess endometrial function and prognosis for pregnancy before and after artificial reproductive therapy. A better understanding of their function in human implantation may lead to therapeutic intervention, thereby improving the success rate in reproduction treatment. New molecular techniques are becoming available for measuring both embryonic and endometrial changes prior to and during implantation. The use of predictive sets of markers may prove to be more reliable than a single marker. Ultimately, the aim is to use these tools to increase implantation in artificial cycles and consequently improve live-birth rates.

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The Therapeutic Effect of Postganglionic Nerve Block for Symptomatic Schmorl Nodule: A Retrospective Case Series (증후성 쉬모를 결절에 대한 신경절 이후 신경차단술의 치료 효과: 후향적 증례 분석)

  • Son, In Seok;Hwang, Suk Hyun;Lee, Suk Ha;Kang, Min Seok
    • Journal of Korean Society of Spine Surgery
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    • v.25 no.4
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    • pp.147-153
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    • 2018
  • Study Design: Retrospective case series. Objectives: We retrospectively evaluated the clinical efficacy of postganglionic nerve block in symptomatic Schmorl nodules (SNs). Summary of Literature Review: SNs are common lesions that are often asymptomatic. In certain cases, SNs have been reported to cause severe axial back pain, thereby considerably impacting patients' quality of life. No consensus currently exists on the treatment of symptomatic SNs. Materials and Methods: From October 2015 to October 2017, a total of 21 patients with symptomatic SNs diagnosed by magnetic resonance imaging (MRI) that did not respond to conservative treatment after 4 weeks were included in the study. All patients received postganglionic nerve block. We evaluated effective pain relief (improvement of back pain of more than 50% compared with before the intervention) and functional improvements, assessed by visual analogue scale (VAS) and Oswestry Disability Index scores obtained at 4 hours, 4 weeks, 8 weeks, 3 months, and 6 months after the procedure. Results: Symptomatic SNs were more common at the L2-3 level, and the lower end plate was more commonly involved than the upper end plate. Eighteen of the 21 patients (85.7%) showed effective pain relief, and no deterioration was observed within the followup period. Throughout the follow-up period, the VAS remained significantly improved compared to before the procedure (p<0.05). Complications were not reported in any cases. Conclusions: Postganglionic nerve block for symptomatic SNs that do not respond to conservative treatment is a non-invasive modality for pain relief.

Incidence and Procedure-Related Risk Factors of Delirium in Patients Admitted to an Intensive Care Unit (중환자실 입원 환자의 섬망 발생과 처치 관련 위험인자)

  • Ahn, Jee Seon;Oh, Jooyoung;Park, Jaesub;Kim, Jae-Jin;Park, Jin Young
    • Korean Journal of Psychosomatic Medicine
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    • v.27 no.1
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    • pp.35-41
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    • 2019
  • Objectives : Although delirium is a common complication among patients hospitalized in intensive care units(ICUs), little is known about the roles that diagnostic and therapeutic procedures play in its development. This study investigates the procedure-related risk factors of delirium in ICU patients. Methods : All the consecutive patients admitted to the ICU between June 2016 and May 2017 were routinely evaluated for delirium by psychiatrists. In total, 1156 patients met the inclusion criteria and were retrospectively analyzed. A multiple logistic regression analysis was conducted to investigate independent risk factors of delirium development while adjusting for other characteristics. Results : The age, Acute Physiology and Chronic Health Evaluation (APACHE II) score, proportion of patients who had undergone an operation, and proportion of patients who were foley catheterized, mechanically ventilated, and physically restrained were higher in the delirium group. The multiple logistic regression analysis confirmed that the use of restraint was an independent risk factor of delirium (odds ratio : 10.006 ; 95% confidence interval : 6.120-16.360 ; p<0.001). The patient factors independently associated with delirium were an advanced age and a higher APACHE II score. The incidence of delirium was 15.3%. Conclusions : There is a high prevalence of delirium influenced by potentially harmful procedures in patients in ICU settings. The use of physical restraint had the strongest association with the development of delirium. These findings advocate the need to target procedure-related risk factors such as the use of restraints as preventive intervention measures for ICU delirium.

Predicting Healthy Lifestyle Patterns in Older Community Dwelling Adults: A Latent Profile Analysis (잠재프로파일 분석을 활용한 한국 노인 라이프스타일 유형화와 영향요인 분석)

  • Park, Kang-Hyun;Yang, Min Ah;Won, Kyung-A;Park, Ji-Hyuk
    • Therapeutic Science for Rehabilitation
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    • v.10 no.2
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    • pp.75-93
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    • 2021
  • Objective : The aim of this study was to identify subgroups of older adults with respect to their lifestyle patterns and examine the characteristics of each subgroup in order to provide a basic evidence for improving the health and quality of life. Methods : This cross-sectional study was conducted in South Korea. Community-dwelling older adults (n=184) above the age of 65 years were surveyed from April 2019 to May 2019. This study used latent profile analysis to examine the subgroups. Chi-squared (χ2) and multinomial logistic regression measures were then used to analyze individual characteristics and influencing factors. Results : The pattern of physical activity which is one of the lifestyle domains in elderly was categorized into three types: 'passive exercise type (31.1%)', 'low intensity exercise type (54.5%)', and 'balanced exercise type(14.5%)'. Activity participation was divided into three patterns: 'inactive type (12%)', 'self-management type (61%)', and 'balanced activity participation type (27%)'. In terms of nutrition, there were only two groups: 'overall malnutrition type (13.5%)' and 'balanced nutrition type (86.5%)'. Furthermore, as a result of the multinomial logistic regression analysis to understand the effects of lifestyle types on the health and quality of life of the elderly, it was confirmed that the health and quality of life were higher in those following an active and balanced lifestyle. In addition, gender, education level and residential area were analyzed as predictive factors. Conclusion : The health and quality of life of the elderly can be improved when they have balanced lifestyle. Therefore, an empirical and policy intervention strategy should be developed and implemented to enhance the health and quality of life of the elderly.

Effects of Combined Breathing Exercise and Neuromuscular Electrical Stimulation on Patients with Severe COPD (중증 만성폐쇄성폐질환 환자를 위한 복합호흡운동과 신경근전기자극의 효과)

  • Kang, Jeong-Il;Park, Jun-Su;Jeong, Dae-Keun
    • Journal of Korea Entertainment Industry Association
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    • v.13 no.7
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    • pp.539-548
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    • 2019
  • This study was designed to examine the effects of complex breathing exercise and neuromuscular electrical stimulation of Quadriceps Femoris muscle on pulmonary function and cerebral cortex activity in patients with severe chronic obstructive pulmonary disease. After collecting samples from 20 patients with severe chronic obstructive pulmonary disease aged 60 to 80, 10 patients each were randomly placed in an experimental group and a control group. The experimental group conducted complex breathing exercise and neuromuscular electrical stimulation of Quadriceps Femoris muscle, and the control group only conducted complex breathing exercise. As a pretest, pulmonary function and cerebral cortex activity were measured. The intervention program was applied to each group for 30 minutes, once a day, for 4 days a week, for 6 weeks, and the posttest was carried out the same way as the pretest. As a result, both groups showed significant differences in FEV1.0(Forced Expiratory Volume in One Second)(p<.001)(p<.05), and there were significant differences between the groups as well(p<.05). When comparing alpha waves in each domain of cerebral cortex, both of the experimental and control groups showed significant differences in Fp1, Fp2, F3 and F4 domains (p<.01)(p<.05). During the 6-week experiment, complex breathing exercise and neuromuscular electrical stimulation of Quadriceps Femoris muscle improved pulmonary function of patients with severe chronic obstructive pulmonary disease, and in relation to cerebral cortex activity, a positive breathing change was found due to the increase of alpha waves in the forehead domain. Therefore, it is considered that applying neuromuscular electrical stimulation of Quadriceps Femoris muscle to patients with severe chronic obstructive pulmonary disease additionally along with complex breathing exercise will bring a better therapeutic effect.

The Influence of Shame on the Dislike for Loving-kindness & Compassion Meditation: The Moderator Effect of Object of Loving-kindness & Compassion (수치심이 자비명상에 대한 저항감에 미치는 영향: 자비 대상(자기 vs. 타인)의 조절효과)

  • Do-Hyeon Park;Wan-Suk Gim
    • Korean Journal of Culture and Social Issue
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    • v.23 no.2
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    • pp.131-157
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    • 2017
  • Loving-kindness & compassion meditation (LCM) is one of the popular intervention on clinical setting to cultivate loving-kindness & compassion for self and other. Shame is known for unconscious and implicit emotion including negative self-concept. Some researchers suggest that people with high shame have difficulty in cultivating loving-kindness & compassion toward oneself because of shame including the negative self-critic. In this research, it is explored the influence of shame for the object of LCM. There are 2 experiments to find out the answer to this question. In experiment 1, participants (N = 108) are randomly assigned to two conditions. The one condition is loving-kindness meditation for self, and the other is loving-kindness meditation for positive others. Dislike and engagement from participants about loving-kindness meditation instruction are measured after meditation for 8 minutes. From the experiment 2, loving-kindness meditation is replaced with compassion meditation from the design of experiment 1. This experiment is conducted because of psychological differences between loving-kindness and compassion. Participants (N = 116) are randomly assigned to two conditions, compassion meditation for self and positive others, respectively. The results of experiment 1 show that dislike of loving-kindness meditation for self seems to high when people have high shame, but shame does not have an influence on engagement. For loving-kindness meditation for positive others, shame seems to not affect on dislike and engagement about loving-kindness meditation instruction. The results of experiment 2 show that dislike is higher for self than for positive others about compassion meditation for people with high shame, but shame does not affect on engagement. For discussion, it is suggested that shame has special features of emotion. For the future, we discuss the therapeutic strategy for people with negative self-concept.