• Title/Summary/Keyword: Clinical investigation

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Initial experience of magnetic resonance imaging/ultrasonography fusion transperineal biopsy: Biopsy techniques and results for 75 patients

  • Tae, Jong Hyun;Shim, Ji Sung;Jin, Hyun Jung;Yoon, Sung Goo;No, Tae Il;Kim, Jae Yoon;Kang, Seok Ho;Cheon, Jun;Kang, Sung Gu
    • Investigative and Clinical Urology
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    • v.59 no.6
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    • pp.363-370
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    • 2018
  • Purpose: The aim of this study is to describe the technique and to report early results of transperineal magnetic resonance imaging and ultrasonography (MRI-US) fusion biopsy. Materials and Methods: A total of 75 patients underwent MRI-US fusion transperineal biopsy. Targeted biopsy via MRI-US fusion imaging was carried out for cancer-suspicious lesions with additional systematic biopsy. Detection rates for overall and clinically significant prostate cancer (csPCa) were evaluated and compared between systematic and targeted biopsy. In addition, further investigation into the detection rate according to prostate imaging reporting and data system (PI-RADS) score was done. Results of repeat biopsies were also evaluated. Results: Overall cancer detection rate was 61.3% (46 patients) and the detection rate for csPCa was 42.7% (32 patients). Overall detection rates for systematic and targeted biopsy were 41.3% and 57.3% (p<0.05), respectively. Detection rates for csPCa were 26.7% and 41.3%, respectively (p<0.05). The cancer detection rates via MRI fusion target biopsy were 30.8% in PI-RADS 3, 62.1% in PI-RADS 4 and 89.4% in PI-RADS 5. Rates of csPCa missed by targeted biopsy and systematic biopsy were 0.0% and 25.0%, respectively. The cancer detection rate in repeat biopsies was 61.1% (11 among 18 patients) in which 55.5% of cancer suspected lesions were located in the anterior portion. Conclusions: Transperineal MRI-US fusion biopsy is useful for improving overall cancer detection rate and especially detection of csPCa. Transperineal MRI-US targeted biopsy show potential benefits to improve cancer detection rate in patients with high PIRADS score, tumor located at the anterior portion and in repeat biopsies.

Growth of Candida albicans Biofilm is Inhibited by Salvia miltiorrhiza (단삼에 의한 Candida albicans 바이오필름 발달의 억제)

  • Lee, Heung-Shick;Kim, Younhee
    • Microbiology and Biotechnology Letters
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    • v.47 no.3
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    • pp.465-472
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    • 2019
  • Candida albicans is an opportunistic human pathogen that causes infections. Candidiasis is often related to antifungal resistance because the pathogen has the ability to form biofilms. In a previous study, we found that the Salvia miltiorriza ethanol extract demonstrated anticandidal activity by altering membrane permeability and inhibiting the cell wall synthesis in C. albicans. Our results here demonstrate that $78{\mu}g/ml$ of the S. miltiorriza extract significantly diminished the early stage biofilms formed by 10 clinical C. albicans isolates by 51.3%; this was analyzed by 2,3-Bis-(2-methoxy-4-nitro-5-sulfophenyl)-2H-tetrazolium-5-carboxanilide salt (XTT) reduction assay. The effect of the S. miltiorrhiza extract on the adhesion of C. albicans cells to polystyrene plates and germ tube formation was examined via microscopic investigation. Although the density of the adhered cells was remarkably reduced up on incubation with $39{\mu}g/ml$ S. miltiorrhiza extract, germ tube formation by C. albicans was rarely affected. Quantitative real-time PCR analysis showed that the S. miltiorrhiza extract downregulated the expression of C. albicans hypha-specific genes, EAP1 by 34.7% (p < 0.001), ALS1 by 45.0% (p < 0.001), ALS3 by 48.1% (p < 0.001), and ECE1 by 21.3% (p = 0.006), respectively. Our data suggest that the S. miltiorrhiza ethanol extract significantly inhibited the early stage of biofilm formation by C. albicans by interfering with cell adhesion, by downregulating EAP1, ALS1 and ALS3, and presumably by modifying the cell wall and membrane structure.

Developing Social Play Evaluation Items for Preschool Children: A Delphi Study (학령전기 아동의 사회적 놀이 평가 문항 개발: 델파이 연구)

  • Lee, Sun-Hee;Jung, Min-Ye;Yoo, Eun-Young;Hong, Ickpyo;Kim, Jung-Ran;Park, Hae Yean
    • Therapeutic Science for Rehabilitation
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    • v.10 no.3
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    • pp.97-110
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    • 2021
  • Objective : This study aimed to develop evaluation items based on Parten's social play developmental stages to measure social play in preschool children. Methods : Through a literature review, the investigation items according to Parten's social play developmental stages were collected. Two Delphi surveys were conducted using 22 expert panels. An understanding of the contents of the preliminary items was determined via parents of preschool children. The evaluation method was established through an expert advisory meeting. Results : Through data collection and the Delphi survey, a total of 89 items were drawn, including 12 unoccupied behaviors, 7 onlooker behaviors, 14 solitary play, 16 parallel play, 17 associative play, and 23 cooperative play items. The average content validity ratio of the Delphi survey was 0.85. The stability was 0.15. The consensus was 0.78. The final preliminary evaluation items comprised a total of 40 items, including 17 for associative play and 23 for cooperative play. Conclusion : An evaluation items that can measure social play in preschool children was developed, and its content validity was verified. It is expected to be used as an evaluation tool in clinical practice.

Protective Effects of Traditional Korean Medicine Preparations, Herbs, and Active Compounds on the Blood-brain Barrier in Ischemic Stroke Models (허혈성 뇌졸중 모델에서 혈액-뇌 장벽에 보호효과를 나타내는 한약처방, 한약재 및 활성화합물)

  • Shin, Su Bin;Jang, Seok Ju;Lee, Na Gyeong;Choi, Byung Tae;Shin, Hwa Kyoung
    • Journal of Life Science
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    • v.32 no.7
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    • pp.550-566
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    • 2022
  • Stroke is among the leading causes of death and long-term physical and cognitive disabilities worldwide, affecting an estimated 15 million people annually. The pathophysiological process of stroke is complicated by multiple and coordinated events. The breakdown of the blood-brain barrier (BBB) in people with stroke can significantly contribute to the development of ischemic brain injury. Therefore, BBB disruption is recognized as a hallmark of stroke; thus, it is important to develop novel therapeutic strategies that can protect against BBB dysfunction in ischemic stroke. Traditional medicines are composed of natural products, which represent a promising source of new ingredients for the development of conventional medicines. Indeed, several studies have shown the effectiveness of Korean medicine on stroke, highlighting the value of Korean medicinal treatment for ischemic stroke. This review summarizes the current information and underlying mechanisms regarding the ameliorating effects of the formula, decoction, herbs, and active components of traditional Korean medicine on cerebral ischemia-induced BBB disruption. These traditional medicines were shown to have protective effects on the BBB in many cellular and animal ischemia models of stroke, and experiments in various animal species, such as mice and rats. In addition, they showed brain-protective effects by protecting the BBB through the regulation of tight junction proteins and matrix metalloproteinase-9, reducing edema, neuroinflammation, and neuronal cell death. We hope that this review will help promote further investigation into the neuroprotective effects of traditional Korean medicines and stimulate the performance of clinical trials on Korean herbal medicine-derived drugs in patients with stroke.

The Clinical Investigation of Necrotizing Fasciitis in Burn Center (화상센터에서 치료한 괴사성근막염의 임상적 고찰)

  • Kim, Euimyung;Chun, Jin Woo;Kim, Young Min;Yoon, Jae Chul;Lim, Hae Jun;Cho, Yong Suk;Kim, Dohern;Hur, Jun;Chun, Wook
    • Journal of the Korean Burn Society
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    • v.22 no.2
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    • pp.66-70
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    • 2019
  • Purpose: The necrotizing fasciitis is a terrifying infectious disease that can rapidly spreads to surrounding tissues when fascia is infected and it can cause sepsis to death if not properly diagnosed and treated. The purpose of this study is to investigate the characteristics, causes, and treatment methods of necrotizing fasciitis in Korea through reviewing patients admitted to our burn center. Methods: 21 patients with necrotizing fasciitis were selected for this study among those inpatients with electronic medical records (EMR) admitted to Hallym University Hangang Sacred Heart Medical Center from Jan 1, 2008 to June 30, 2019. The medical records and wound photos of those 21 selected subjects were reviewed. Results: There were 13 male and 8 female patients and mean age was 58.76 years old. 13 of 21 subjects were survived and 8 died (38% mortality rate). The surgical treatments performed were I&D, fasciotomy, debridement, allograft, burring, STSG, flap, and amputation. The most common causes were burns in 9 subjects (6 contact burns) and cellulitis occurred on skins in 5 subjects. And other various causes were observed as fournier's gangrene, stab wound, intramuscular injection, tumor and bleu toe syndrome (toe necrosis). The infected areas were 11 feet and legs, 7 hips, 3 abdomen and trunk in 21 subjects. Of the 8 deaths, 3 were infected in feet and legs, 2 were infected in hips, and 2 were infected in abdomen and trunk. As for underlying diseases, 12 patients with hypertension or diabetes were the highest and others such as cancer and stroke were found. Conclusion: The only method to increase the survival rate is to 'suspect' the disease as much as possible and perform early extensive excision. It is advisable to treat the disease by the burn center to properly provide adequate and optimal wound management, infection control, medical care and nutritional supports.

The Clinical Investigation Study of Pancreatitis Developed in Burn Patients (화상환자에서 발생한 췌장염의 임상적 고찰)

  • Cho, Gi Yuon;Chun, Jin Woo;Kim, Young Min;Yoon, Jae Chul;Yim, Haejun;Cho, Yong Suk;Kim, Dohern;Hur, Jun;Chun, Wook
    • Journal of the Korean Burn Society
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    • v.22 no.1
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    • pp.10-14
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    • 2019
  • Purpose: To find progression and prognosis of pancreatitis developed in massive burn patients through retrospective analysis. Methods: A retrospective study was conducted on 32 patients with abnormal increase of serum lipase level among 2523 acute burn patients admitted to our burn center from January 1, 2017 to June 30, 2018. Pancreatitis in this study was defined as a serum lipase concentration level that is higher than 180 IU/L which is three times more than the normal level (less than 60 IU/L). In this study, a retrospective analysis was performed on patients with serum lipase level higher than 300 IU/L to better understand causality of burns and pancreatitis. Results: 32 patients (1.27%) had serum lipase level higher than 180 IU/L among 2523 acute burn subjects. And 13 patients (0.52%) of these 32 patients had serum lipase level elevated more than 300 IU/L. The study indicated serum lipase level was increased around 7 days after the injury. It returned to normal level early as after 1 to 2 weeks and late as after 4 to 6 weeks of injury. The serum amylase level was increased as similar modality as to the serum lipase level increase. The serum bilirubin, AST, ALT, LD, and GGT were also observed to be elevated when serum lipase was more than 1000 IU/L. Conclusion: The pancreatitis developed in burn patients are mostly as mild symptom. It could due to the ischemic injury and can easily be treated by a temporary fasting, TPN, and Gabexate intravenous injection.

Monitoring of Japanese eel (Anguilla japonica) diseases from 2021 to 2023: significance of Japanese Eel Endothelial Cells-infecting Virus (JEECV) and Edwardsiella anguillarum (2021년부터 2023년까지 뱀장어(Anguilla japonica) 질병 모니터링: 혈관내피세포감염바이러스(JEECV)와 Edwardsiella anguillarum의 중요성)

  • Hyeon-Kyeong Kim;Mun-Hee Jang;Sung-Ju Jung
    • Journal of fish pathology
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    • v.36 no.2
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    • pp.239-250
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    • 2023
  • Disease monitoring was conducted to investigate the recent disease occurrence in Japanese eels (Anguilla japonica). Between May 2021 and March 2022, an investigation was conducted on eels from seven farms experiencing mortality. JEECV (Japanese eel endothelial cells-infecting virus) was detected in all examined farms, each exhibiting co-infections with 1 or 2 bacteria, including Edwardsiella anguillarum, E. piscisida, Aeromonas sp., Citrobacter freundii, Lactococcus garviae, or Vibrio sp. From March 2022 to October 2023, monthly periodic inspections were carried out at a farm in Yeonggwang, Jeollanam-do, for a total of 22 times. JEECV was detected in 10 out of 22 times, even when mortality was not recorded. Bacteria such as E. anguillarum, C. freundii, Aeromonas sp., and Vibrio sp. were isolated, but consistent clinical signs of liver abscess and hemorrhagic lesions were only recognized in fish infected with E. anguillarum. Other bacteria were often isolated from apparently healthy fish. In conclusion, mortality in eel farms frequently occurs due to co-infections of JEECV with bacteria rather than JEECV alone. Therefore, to reduce eel mortality, it is crucial to decrease co-infections, with a particular emphasis of JEECV and E. anguillarum.

Diagnostic Conundrum: Fever and Pyuria Preceding Diagnosis of Kawasaki Disease in Children

  • Jiseon Park;Young June Choe;Seung Ah Choe;Jue Seong Lee;Hyung Eun Yim;Yun-Kyung Kim
    • Pediatric Infection and Vaccine
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    • v.30 no.3
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    • pp.139-144
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    • 2023
  • Purpose: Children with incomplete Kawasaki disease (KD) and pyuria may be misdiagnosed with urinary tract infection (UTI) during the early phase of the prodrome. We investigated the percentage of UTI diagnoses preceding a KD diagnosis. Methods: Using the National Health Insurance data of South Korea, we assessed differences in UTI diagnoses made during the week preceding a KD diagnosis, according to demographic and geographic factors from November 2007-October 2019. Results: A total of 53,822 KD cases were identified, including 304 patients (0.56%) diagnosed with a UTI during the week preceding a KD diagnosis. The younger age group (0-11 months) showed the highest percentage of preceding UTI diagnoses (0.95%), with higher odds than 4-year-old children (3.12; 95% confidence interval, 2.05-4.77). Conclusions: These findings suggest a potentially misleading presentation of incomplete KD, a clinical conundrum requiring further investigation and validation, particularly in infants.

Manganese and Iron Interaction: a Mechanism of Manganese-Induced Parkinsonism

  • Zheng, Wei
    • Proceedings of the Korea Environmental Mutagen Society Conference
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    • 2003.10a
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    • pp.34-63
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    • 2003
  • Occupational and environmental exposure to manganese continue to represent a realistic public health problem in both developed and developing countries. Increased utility of MMT as a replacement for lead in gasoline creates a new source of environmental exposure to manganese. It is, therefore, imperative that further attention be directed at molecular neurotoxicology of manganese. A Need for a more complete understanding of manganese functions both in health and disease, and for a better defined role of manganese in iron metabolism is well substantiated. The in-depth studies in this area should provide novel information on the potential public health risk associated with manganese exposure. It will also explore novel mechanism(s) of manganese-induced neurotoxicity from the angle of Mn-Fe interaction at both systemic and cellular levels. More importantly, the result of these studies will offer clues to the etiology of IPD and its associated abnormal iron and energy metabolism. To achieve these goals, however, a number of outstanding questions remain to be resolved. First, one must understand what species of manganese in the biological matrices plays critical role in the induction of neurotoxicity, Mn(II) or Mn(III)? In our own studies with aconitase, Cpx-I, and Cpx-II, manganese was added to the buffers as the divalent salt, i.e., $MnCl_2$. While it is quite reasonable to suggest that the effect on aconitase and/or Cpx-I activites was associated with the divalent species of manganese, the experimental design does not preclude the possibility that a manganese species of higher oxidation state, such as Mn(III), is required for the induction of these effects. The ionic radius of Mn(III) is 65 ppm, which is similar to the ionic size to Fe(III) (65 ppm at the high spin state) in aconitase (Nieboer and Fletcher, 1996; Sneed et al., 1953). Thus it is plausible that the higher oxidation state of manganese optimally fits into the geometric space of aconitase, serving as the active species in this enzymatic reaction. In the current literature, most of the studies on manganese toxicity have used Mn(II) as $MnCl_2$ rather than Mn(III). The obvious advantage of Mn(II) is its good water solubility, which allows effortless preparation in either in vivo or in vitro investigation, whereas almost all of the Mn(III) salt products on the comparison between two valent manganese species nearly infeasible. Thus a more intimate collaboration with physiochemists to develop a better way to study Mn(III) species in biological matrices is pressingly needed. Second, In spite of the special affinity of manganese for mitochondria and its similar chemical properties to iron, there is a sound reason to postulate that manganese may act as an iron surrogate in certain iron-requiring enzymes. It is, therefore, imperative to design the physiochemical studies to determine whether manganese can indeed exchange with iron in proteins, and to understand how manganese interacts with tertiary structure of proteins. The studies on binding properties (such as affinity constant, dissociation parameter, etc.) of manganese and iron to key enzymes associated with iron and energy regulation would add additional information to our knowledge of Mn-Fe neurotoxicity. Third, manganese exposure, either in vivo or in vitro, promotes cellular overload of iron. It is still unclear, however, how exactly manganese interacts with cellular iron regulatory processes and what is the mechanism underlying this cellular iron overload. As discussed above, the binding of IRP-I to TfR mRNA leads to the expression of TfR, thereby increasing cellular iron uptake. The sequence encoding TfR mRNA, in particular IRE fragments, has been well-documented in literature. It is therefore possible to use molecular technique to elaborate whether manganese cytotoxicity influences the mRNA expression of iron regulatory proteins and how manganese exposure alters the binding activity of IPRs to TfR mRNA. Finally, the current manganese investigation has largely focused on the issues ranging from disposition/toxicity study to the characterization of clinical symptoms. Much less has been done regarding the risk assessment of environmenta/occupational exposure. One of the unsolved, pressing puzzles is the lack of reliable biomarker(s) for manganese-induced neurologic lesions in long-term, low-level exposure situation. Lack of such a diagnostic means renders it impossible to assess the human health risk and long-term social impact associated with potentially elevated manganese in environment. The biochemical interaction between manganese and iron, particularly the ensuing subtle changes of certain relevant proteins, provides the opportunity to identify and develop such a specific biomarker for manganese-induced neuronal damage. By learning the molecular mechanism of cytotoxicity, one will be able to find a better way for prediction and treatment of manganese-initiated neurodegenerative diseases.

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적취(積聚) 처방(處方)에 대(對)한 문헌적(文獻的) 고찰(考察)

  • Mun, Gu;Jo, Seong-Gak
    • THE JOURNAL OF KOREAN ORIENTAL ONCOLOGY
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    • v.2 no.1
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    • pp.113-160
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    • 1996
  • Cancer is one of the most important cause of death. So recently, investigation of cancer progress prosperously all over the world. Cancer in the present medicine correspond to You-Am, Sin-Am, Young-Soon, Sel-Gyun, Sil-Young, Young-Lyoo, Seg-Je, Seg-Young, Seg-Ha, Jerk-Chui(積聚), Jing-Ha, Oel-Gyek, Ban-Oui, Bi-Gi, Bok-Lyang, Jang-Dan, Hyen-Bek in the oriental medicine. Among these, generally Jerk-Chui(積聚) is expressed to cancer. So to develop of new drugs of cancer in the present medicine, bibliographic investigation of mass-prescriptions was studied in the oriental medicine-books. According to the bibliographic study of Jerk-Chui-prescriptions, the results run as follows. 1. According to the analyses of three hundred sixty eight Jerk-Chui-prescriptions in the twenty-seven kinds of literature, the frequency number of the used drugs were Pericarpium Citri Nobilis Viride 140 times, Pericarpium Citri Reticulatae 135 times, Rhizoma Scirpi 124 times, Radix Aucklandie 115 times, Rhizoma Zedoariae 114 times, Cortex Magnoliae Officinalis 111 times, Radix Glycyrrhizae 106 times, Rhizoma Zingiberis 100 times, Rhizoma Coptidis 94 times, Radix Ginseng 93 times, Poria 86 times, Rhizoma Pinelliae 85 times, Semen Arecae 83 times, Rhizoma Cyperi 82 times, Radix Angelicae Sinensis 80 times, Rhizoma Atractylodis 74 times, Massa Fermentata Medisinalis 67 times, Radix Et Rhizoma Rhei 66 times, Fructus Aurantii 62 times, Fructus Hordei Genninatus 55 times, Conex Cinnamomi 54 times, Fructus Evodiae 51 times, Fructus Aurantii Immaturus 49 times, Fructus Crataegi 49 times, Rhizoma Cnidii 46 times, Radix Platycodi 44 times, Semen Tiglii 44 times, Radix Aconiti 43 times, Fructus Amoni 38 times, Semen Raphani 37 times, Radix Aconiti Praeparata 36 times, Radix Scutellariae 35 times, Pericarpium Zanthoxyli 35 times, Rhizoma Corydalis 33 times, Rhizoma Acori Graminei 31 times, Carapax Amydae 31 times, Fructus Foeniculi 31 times, Semen Persicae 30 times, Radix Bupleuri 30 times. 2. The frequency number of the most imponant used drugs in the Jerk-Chui-prescriptions were Rhizoma Coplidis 41 times, Rhizoma Scirpi 35 times, Radix Et Rhizoma Rhei 31 times, Pericarpium Citri Reticuiatae 30 times, Rhizoma Zedoariae 27 times, Rhizoma Cyperi 22 times, Cortex Magnoliae Officinalis 22 times, Rhizoma Atraclylodis 22 times, Pericarpium Citri Nobilis Viride 21 times, Rhizoma Pinelliae 20 times, Semen Arecae 20 times, Fructus Crataegi 18 times, Rhizoma Zingiberis 17 times, Carapax Amydae 16 times, Semen Pharbitidis 13 times, Poria 12 times, Radix Angelicae Sinensis 10 times, Semen Persicae 10 times, Fructus Evodiae 10 times, Radix Aeoniti 10 times, Radix Glycyrrhizae 9 times, Massa Fennenlata Medisinalis 9 times, Fructus Aurantii 9 times, Fructus Hordei Genninatus 8 times, Radix Aueklandie 8 times, Rhizoma Atractylodis 8 times, Radix Bupleuri 8 times, Radix Ginseng 7 times, Semen Raphani 7 times, Radix Astragali 7 times, Cortex Cinnamomi 6 times, Fructus Aurantii Immaturus 6 times, Rhizoma Cnidii 6 times, Radix Aconiti Praeparata 5 times, Fructus Foeniculi 5 times, Lacca Sinica Exsiccata 5 times, Radix Aconiti 5 times, Rhizoma Zingiberis 5 times. 3. The clinical-botanic classifications of the used drugs in the Jerk-Chui-prescriptions were regulating the flow of Qi drugs, warm-heating drugs, promoting blood circulation drugs, killing mass drugs, resolving drugs, purgative drugs, Qi and blood tonics drugs, heat clearing drugs, removing dampness by promoting diures is drugs, phlegm eliminating drugs, allaying pain drugs. 4. According to the nature and taste in the drugs, warm and heating recipes were used most, heatclearing recipes were used a few times assistantly. 5. The Jerk-Chui-prescription used frequently was Bun-Don-Tang, which was used 13 times ; Bok-Oyang-Hoan 12 times, Bi-Gi-Hoan(肥氣丸) 12 times, Sik-Boon-Hoan 12 times, A-Uie-Hoan 12 times, Bi-Gi-Hoan 12 times, Dai-Cil-Gi-Tang 8 times, San-Cuie-Tang 8 times, Guye-Gyen-Tang 6 times, On-Baig-Won 5 times, So-Jek-Jeng-Ouen-San 5 times, Jin-In-Hoa-Cel-Tang 5 times, Byel-Gab-San 5 times, Sng-Hong-Hoan 5 times, Ji-Sil-San 4 times, So-A-Oie-Hoan 4 times, Hyang-Rng-Hoan 4 times.

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