• Title/Summary/Keyword: candidiasis

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Isolation Frequency of Candida species from Clinical Specimens (임상검체에서 Candida spp.에 대한 분리빈도)

  • Shin, Hyun-Sung;Park, Youn-Bo;Shin, Du-Sik
    • The Korean Journal of Mycology
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    • v.38 no.2
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    • pp.146-151
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    • 2010
  • A total of 167,955 microorganisms were isolated from 366,661 clinical specimens. Among them, 6,517 strains of the Candida spp. were isolated from the department of laboratory medicine in "C" hospital from Jan. 1, 2005 to Dec. 31, 2009. All clinical specimens were reviewed by the medical records of patients with Candida by the method of retrospectiveness. From this, we got the some isolated pure cultured yeasts. We identified these yeast by the identification kit system of VITEKII and VITEKII-ID-YST card. The isolation frequencies of Candida spp. were as follows. 56.4%,of C. albicans, 17.7% C tropicalis, 10.7% C glabrata and 9.5% C parapsilosis. The isolated frequency of Candida spp. in 2009 was 1.9 times higher than that in 2005. The clinical materials showing over 10.0% isolation rate were in sputum (30.1%), random urine (25.0%), 15.8% blood (15.8%) and catheterized urine (13.5%) in Candida spp.. The clinical department of showing over 7.0% isolation rate were in pulmonary medicine (20.5%), renal medicine (11.0%), infection disease medicine (10.4%), critical care medicine (10.0%), hematooncology (9.6%), general surgery (7.5%) and gastrointestinal medicine (7.4%) in Candida spp.. In monthly analysis, Candida spp. were most friquency isolated in July (10.6%), but lowest one in February (6.1%). Candida spp. were most frequently isolated in patient of over 50 years old (16.7-40.1%) than those isolated from the patients under the age of 0-49 (1.3-7.5%).

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.

Trends of Antifungal Agent Susceptibility of Candida Strains Isolated from Blood Cultures in 2009~2018 (2009~2018년 혈액배양으로부터 분리된 Candida 균종의 항진균제 감수성의 경향)

  • Hwang, Yu-Yean;Kang, On-Kyun;Park, Chang-Eun;Lee, Moo-Sik;Kim, Young-Kwon;Huh, Hee-Jae;Lee, Nam-Yong
    • Korean Journal of Clinical Laboratory Science
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    • v.54 no.2
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    • pp.133-141
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    • 2022
  • Candida is one of the most common causes of bloodstream infections and a leading cause of morbidity and mortality among hospitalized patients. The purpose of this study was to provide important information for formulating empirical treatment plans for candidemia by investigating the antifungal resistance rate of Candida. Among the Candida strains (973 cases) isolated from blood culture tests at the S hospital in 2009~2018, 4.7% (N=44) comprising the Candida spp. (932 strains) showed resistance to fluconazole. The resistant strains included C. albicans, C. parapsilosis, C. tropicalis, and C. glabrata. In addition Candida spp. (947 strains) showed resistance to amphotericin B (N=6, 0.6%), flucytosine (N=23, 2.4%) and voriconazole (N=24, 3.1%). C. albicans was resistant to fluconazole (N=23, 6.9%) and voriconazole (N=21, 6.0%), The statistical analysis showed that C. albicans and non-albicans Candida species were resistant to fluconazole (P=0.039) and voriconazole (P<0.001). A monitoring system to understand the rate of candidiasis infections in a hospital setting is required. It is also important to make the right choice of the antifungal agent based on drug susceptibility patterns. Therefore, an infection surveillance policy that tracks Candida resistance through regular antifungal susceptibility tests is necessary.

Late-Onset Candida Vertebral Osteomyelitis in Two Young Patients Who Underwent Heart Transplant Surgery (심장 이식술을 받은 젊은 환자에서 발생한 2예의 지연성 칸디다 척추 골수염)

  • Kang, Min Seok;Son, In Seok;Kim, Tae Hoon;Lee, Suk Ha
    • Journal of the Korean Orthopaedic Association
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    • v.54 no.1
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    • pp.72-77
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    • 2019
  • Candida vertebral osteomyelitis (CVO) is a rare disease that is a complication of intravenous drug use, but recently it has been recognized as mostly an opportunistic infection. Because CVO appears to mimic pyogenic spondylodiscitis in terms of the clinical and radiologic presentations, it is often neglected in a usual clinical setting. The clinical, radiological, and biological characteristics of CVO are often used to make a differential diagnosis with vertebral osteomyelitis from other etiologies. Once an initial proper diagnosis was performed, the treatment relies on the prompt initiation of appropriate pharmacotherapy and serial monitoring of the clinical progress. This paper report late-onset CVO in two young patients who underwent a heart transplant surgery and had postoperative systemic candidiasis. These two cases are a good reminder of the potential of CVO in immunosuppressive patients treated with anti-fungal agents. This paper presents these two cases with a review of the relevant literature.

The Distribution of Oral Candida Species in Patient with Prosthetic Appliance (보철물 장착 환자의 구강 칸디다균 분포)

  • Son, Seung Hwa;Baek, Su Min;Park, Young Min
    • Journal of dental hygiene science
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    • v.14 no.4
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    • pp.477-487
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    • 2014
  • Of the many pathogenic Candida species, Candida albicans is the main fungal pathogen of humans. The oral environmental factors considered in the Candida albicans colony forming unit test contain both host and microbial factors associated with candidiasis. In particular, Candida biofilms can develop on surfaces of prosthesis. The purpose of this study was to investigate the distribution of oral Candida species between the type of prosthesis and the situation of oral environment in patient with prosthetic appliance. The patients were 30 elderly subjects with different types of prosthesis, 7 who wore denture, 12 who wore implant and 15 who wore removable orthodontic appliance. We used Candida albicans colony forming unit test using saliva to exam the distribution of Candida albicans related with 5 oral environmental factors, gender, smoking or nonsmoking, alcohol/nonalcohol consumption, the type of prosthetic appliance and its treatment duration as well as tooth brushing frequency per day. In conclusion, for the patient's gender, site in the oral cavity and the type of prosthetic appliance and its treatment duration was associated with an increase in the distribution of Candida albicans in saliva. The distribution of Candida albicans within the oral cavity performs to be modulated to varying extents by oral environmental factors and, further investigations are required to elucidate these complex interactions.

The Relationship between Conical Pap. Smear Findings and Related Factors for Uterine Cervical Cancer in Ullungdo Females (울릉도 여성들의 자궁경부 세포학적 검사소견과 관련요인과의 관계)

  • 윤인숙;이혜자
    • Biomedical Science Letters
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    • v.4 no.2
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    • pp.143-151
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    • 1998
  • To study the incidence and epidemiological factors of uterine cervical cancer in medical underserved area females, the questionnaire survey and Pap. smear for uterine cervical cancer was done on total 330 women who lived in Ullungdo from 5th to 12th August, 1998. The results were summarized as follows: The age distribution of subjects was 50s (24.5%), 60s (24.5%) and their educational level was “no schooling” (14.2%) and “elementary school” (42.7%). The first coital age of subjects was 19∼21yrs (30.0%), 16∼18yrs (13.9%) and the first pregnancy age was 22∼24yrs (36.7%) and 19∼21yrs (30.0%). The frequency of total pregnancy of subjects was over 5 times (52.1%). The frequency of total delivery was “3∼4 times” (35.5%) and “5∼6 times” (15.2%). 68.8% of subjects had experience of abortion and 80.0% of their husband were on the phimosis. 172 (52.1%) subjects had gynecological symptoms, their symptoms were leukorrhea (48.3%), pruritus (21.5%) and leukorrhea with pruritus (20.3%). 63.9% of total subjects have been received Pap. smear and the frequency of their Pap. smear was “only 1 time” (44.1 %), “irregularly” (30.3%) and the reason of respondents who have not been received Pap. smea. was “no specific symptom” (51.3%). Among the 330 women screened there were negative (45.8%), inflammation (47.3%), trichomoniasis and candidiasis (1.8%), atypical cells (4.5%) and dysplasia (0.6%).

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Prevalence and Risk Factors Associated with Esophagitis in Children with Abdominal Pain (복통이 있는 소아청소년에서 식도염의 유병률과 위험인자)

  • Kwon, Hyun-Jung;Yi, Dae-Yong;Ryoo, Eell;Cho, Kang-Ho;Son, Dong-Woo;Tcha, Han
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.11 no.2
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    • pp.103-109
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    • 2008
  • Purpose: Children with esophagitis express a variety of nonspecific symptoms and signs depending on their age, and diagnosis is limited because gastrointestinal endoscopy (GFS) and biopsy are difficult to perform. The aim of this study was to examine the prevalence of esophagitis in children with upper abdominal pain, to determine the necessity of esophageal biopsy, and to evaluate the associated risk factors. Methods: We reviewed 266 pediatric patients with upper abdominal pain who underwent history-taking, physical examination, and GFS with esophageal and gastric biopsies between January 2006 and December 2007. Esophagitis was confirmed on biopsy. We analyzed the risk factors for histologic esophagitis and the necessity of esophageal biopsy. Results: The prevalence of esophagitis was 19.9% (53/266 patients). The sensitivity and specificity of endoscopic diagnosis were 41.5% and 77%. Of 53 patients with histologic esophagitis, reflux esophagitis was seen in 50 patients, eosinophilic esophagitis was seen in 2 patients, and esophageal candidiasis was seen in 1 patient. Vomiting was a significant factor in patients under 8 yr of age (p<0.05). H. pylori infection was documented in 41.5% of patients with histologic esophagitis, compared with 58.5% of patients not infected with H. pylori (p<0.05). The possibility of histologic esophagitis was higher in patients with H. pylori infection (OR 2.5, 95% CI 1.2544 to 4.8286) and in those who visited in the spring (OR 2.5, 95% CI 1.2544 to 4.8286). Conclusion: We believe esophageal tissue biopsy should be performed in pediatric patients with upper gastrointestinal symptoms who are undergoing GFS and stomach tissue biopsy, especially preschoolers and H. pylori-infected children in the spring.

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Frequency of Candida Strains Isolated from Candidiasis Patients at A Tertiary Hospital over the Last 10 Years (최근 10년 동안 일개 상급종합병원의 칸디다혈증 환자에서 분리된 칸디다 균종의 빈도)

  • Hwang, Yu-Yean;Kang, On-Kyun;Park, Chang-Eun;Hong, Sung-No;Kim, Young-Kwon;Huh, Hee-Jae;Lee, Nam-Yong
    • Korean Journal of Clinical Laboratory Science
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    • v.54 no.2
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    • pp.110-118
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    • 2022
  • Candidemia is a major cause of nosocomial infections resulting in increased morbidity and mortality. It remains a serious risk in inpatients and increases medical treatment costs. From 2009 to 2018, Candida strains (3,533) isolated from blood culture tests at the S Hospital were analyzed according to the period, year, sex, age, ward, etc. During the entire period, 54,739 of 717,996 blood culture tests showed a positive rate (7.6%) and the Candida isolation rate was 3,533 (6.4%) out of 1,036 patients. Among the Candida isolates, C. albicans was most common (33.8%), followed by C. tropicalis (28.6%), C. glabrata (19.8%), C. parapsilosis (7.8%), and C. krusei (4.0%). In early (2009~2013)/late (2014~2018) isolation, C. tropicalis decreased by 3.8% and C. glabrata increased by 3.4%. After 50 years of age, the higher the separation frequency. C. parapsilosis (31.3%) in 1~10s, C. tropicalis (30.3%) and C. glabrata (27.6%) in 41~50s, and C. tropicalis (28.6%) in 80s are relatively frequent. has been separated C. krusei was isolated in a relatively high proportion from females (60.9%). Therefore, a systematic and continuous nosocomial infection control system should be established for appropriate treatment as per antifungal treatment guidelines. The system should continuously monitor the distribution of Candida species and provide rapid identification results.

Studies on Epidemiological Survey of Infectious Disease of Chicken in Korea (국내 닭 전염성 질병에 관한 역학적 조사 연구)

  • 이용호;박근식;오세정
    • Korean Journal of Poultry Science
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    • v.16 no.3
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    • pp.175-192
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    • 1989
  • A total of 9, 012 cases was submitted for diagnosis of chicken diseases to Veterinary Research Institute, Rural Development Administration from domestic chicken farms during 18 years from 1971 to 1988. Of them, 6, 181 cases diagnosed as the infectious disease were investigated for the detection rate of infections on basis of you, season , and chicken age. The results obtained were summarized as followings:1. Detection rate or the infections was lowest as 49.3% in the year 1973, and highest as 78.6% in 1985 (average 68.6%). 2. Of infections detected, bacterial diseases were most frequent (32.6%), and followed in order by viral (26.3%), parasitic (7.7%), and fungal diseases (2.1%) in geneal. 3. The most frequently detected bacterial diseases in order of prevalence were mycoplasmosis (8.8%), colibacillosis (8.5%), and staphylococcosis (5.8%), and followed by salmonellosis pullorum disease , yolk sac disease, and salpingitis (0.8-1.5%). 4. In viral diseases, 7.5% of infections detected was lymphoid leukosis and 7.2%-Marek's disease, 4.4%-Newcastle disease, 2.0%-infectious laryngotracheitis, 1.7%-infectious bursal disease, and 1.0%-avian encephalomyelitis, while detection rate of infectious bronchitis, egg drop syndrome '76, and inclusion body hepatitis was less than 1.0%, respectively. 5. The most prevalent parasitic disease was coccidiosis (4.5%), followed by ascariasis (1.4%). The detection rate of other parasitic diseases including leucocytozoonosis, black head , heterakiasis, and ectoparasitosis was very as 0.2-0.7%, respectively: In fungal diseases, 2.0% of infections was detected as aspergillosis, and followed by candidiasis (0.1%). 6. Detection rate of the infections on basis of season was somewhat higher in summer. (27.7%), and autumn (27.7%) than in winter (23.5%), and spring (21.5%) in general. In bacterial, viral, and fungal diseases, there were the similar tendencies of detection rate as in infections, while parasitic diseases were much highly detected in summer (34.3%), and autumn (39.5%) than in any other season. 7. Among bacterial diseases colibacillosis was most frequently detected in summer, and staphylococcosis in autumn. In detection rate of viral diseases, Marek's disease, infectious laryngotracheitis, and infectious bursal disease was highest in summer, lymphold leukosis, fowl pox and egg drop syndrome '76 in autumn, and infectious trachitis in winter, repectively. The majority of important parasitic diseases including coccidiosis were highly detected in summer and autumn. 8. On basis of chicken age, detection rate of infections were highest in chicken of growing period between 30 and 150 days of age (41.4%), and followed by 35.3% in laying chicken over 150 days of age, and 17.3% in chicken of brooding age under 30 days of age. Bacterial, and parasitic diseases were most frequently detected in chicken of growing period, viral diseases in chicken of growing, and laying period as nearly equal rate of detection, and fungal diseases in chicken of brooding age.

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A Literature Study of Dermatosurgical Diseases in the ImJeungJiNamUiAn (臨證指南醫案에 나타난 피부외과 질환에 대한 문헌고찰)

  • Cho, Jae-Hun;Chae, Byung-Yoon;Kim, Yoon-Bum
    • The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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    • v.15 no.2
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    • pp.271-288
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    • 2002
  • Authors investigated the pathogenesis and treatment of dennatosurgical diseases in the ImJeungJiNamUiAn(臨證指南醫案). 1. The symptoms and diseases of dermatosurgery were as follows; 1) BanSaJinRa(반사진라) : eczema, atopic dermatitis, seborrheic dermatitis, psoriasis, lichen planus, pityriasis rosea, hives, dermographism, angioedema, cholinergic urticaria, urticaria pigmentosa, acne, milium, syringoma, keratosis pilaris, discoid lupus erythematosus, hypersensitivity vasculitis, drug eruption, polymorphic light eruption, rheumatic fever, juvenile rheumatoid arthritis(Still's disease), acute febrile neutrophilic dermatosis(Sweet's syndrome), Paget's disease, folliculitis, viral exanthems, molluscum contagiosum, tinea, tinea versicolor, lymphoma, lymphadenitis, lymphangitis, granuloma annulare, cherry angioma 2) ChangYang(瘡瘍) : acute stage eczema, seborrheic dermatitis, stasis ulcer, intertrigo, xerosis, psoriasis, lichen planus, ichthyosis, pityriasis rosea, rosacea, acne, keratosis pilaris, dyshidrosis, dermatitis herpetiformis, herpes gestationis, bullae in diabetics, pemphigus, lupus erythematosus, fixed drug eruption, erythema multiforme, toxic epidermal necrolysis, toxic shock syndrome, staphylococcal scaled skin syndrome, scarlet fever, folliculitis, impetigo, pyoderma gangrenosum, tinea, candidiasis, scabies, herpes simplex, herpes zoster, chicken pox, Kawasaki syndrome, lipoma, goiter, thyroid nodule, thyroiditis, hyperthyroidism, thyroid cancer, benign breast disorder, breast carcinoma, hepatic abscess, appendicitis, hemorrhoid 3) Yeok(疫) : scarlet fever, chicken pox, measles, rubella, exanthem subitum, erythema infectiosum, Epstein-Barr virus infection, cytomegalovirus infection, hand-foot-mouth disease, Kawasaki disease 4) Han(汗) : hyperhidrosis 2. The pathogenesis and treatment of dermatosurgery were as follows; 1) When the pathogenesis of BalSa(발사), BalJin(發疹), BalLa(발라) and HangJong(項腫) are wind-warm(風溫), exogenous cold with endogenous heat(外寒內熱), wind-damp(風濕), the treatment of evaporation(解表) with Menthae Herba(薄荷), Arctii Fructus(牛蒡子), Forsythiae Fructus(連翹) Mori Cortex(桑白皮), Fritillariae Cirrhosae Bulbus(貝母), Armeniaoae Amarum Semen(杏仁), Ephedrae Herba(麻黃), Cinnamomi Ramulus(桂枝), Curcumae Longae Rhizoma(薑黃), etc can be applied. 2) When the pathogenesis of BuYang(부양), ChangI(瘡痍) and ChangJilGaeSeon(瘡疾疥癬) are wind-heat(風熱), blood fever with wind transformation(血熱風動), wind-damp(風濕), the treatment of wind-dispelling(疏風) with Arctii Fructus(牛蒡子), Schizonepetae Herba(荊芥), Ledebouriellae Radix(防風), Dictamni Radicis Cortex(白鮮皮), Bombyx Batrytioatus(白??), etc can be applied. 3) When the pathogenesis of SaHuHaeSu(사후해수), SaJin(사진), BalJin(發疹), EunJin(은진) and BuYang(부양) are wind-heat(風熱), exogenous cold with endogenous heat(外寒內熱), exogenous warm pathogen with endogenous damp-heat(溫邪外感 濕熱內蘊), warm pathogen's penetration(溫邪內陷), insidious heat's penetration of pericardium(伏熱入包絡), the treatment of Ki-cooling(淸氣) with TongSeongHwan(通聖丸), Praeparatum(豆?), Phyllostachys Folium(竹葉), Mori Cortex(桑白皮), Tetrapanacis Medulla(通草), etc can be applied. 4) When the pathogenesis of JeokBan(적반), BalLa(발라), GuChang(久瘡), GyeolHaek(結核), DamHaek(痰核), Yeong(?), YuJu(流注), Breast Diseases(乳房疾患) and DoHan(盜汗) are stagnancy's injury of Ki and blood(鬱傷氣血), gallbladder fire with stomach damp(膽火胃濕), deficiency of Yin in stomach with Kwolum's check (胃陰虛 厥陰乘), heat's penetration of blood collaterals with disharmony of liver and stomach(熱入血絡 肝胃不和), insidious pathogen in Kwolum(邪伏厥陰), the treatment of mediation(和解) with Prunellae Spica(夏枯草), Chrysanthemi Flos(菊花), Mori Folium (桑葉), Bupleuri Radix(柴胡), Coptidis Rhizoma(黃連), Scutellariae Radix(黃芩), Gardeniae Fructus(梔子), Cyperi Rhizoma(香附子), Toosendan Fructus(川?子), Curcumae Radix(鬱金), Moutan Cortex(牧丹皮), Paeoniae Radix Rubra(赤芍藥), Unoariae Ramulus Et Uncus(釣鉤藤), Cinnamorni Ramulus(桂枝), Paeoniae Radix Alba(白芍藥), Polygoni Multiflori Radix (何首烏), Cannabis Fructus (胡麻子), Ostreae Concha(牡蠣), Zizyphi Spinosae Semen(酸棗仁), Pinelliae Rhizoma(半夏), Poria(백복령). etc can be applied. 5) When the pathogenesis of BanJin(반진), BalLa(발라), ChangI(瘡痍), NamgChang(膿瘡). ChangJilGaeSeon(瘡疾疥癬), ChangYang(瘡瘍), SeoYang(署瘍), NongYang(膿瘍) and GweYang(潰瘍) are wind-damp(風濕), summer heat-damp(暑濕), damp-warm(濕溫), downward flow of damp-heat(濕熱下垂), damp-heat with phlegm transformation(濕熱化痰), gallbladder fire with stomach damp(膽火胃濕), overdose of cold herbs(寒凉之樂 過服), the treatment of damp-resolving(化濕) with Pinelliae Rhizoma(半夏), armeniacae Amarum Semen(杏仁), Arecae Pericarpium(大腹皮), Poria(백복령), Coicis Semen(薏苡仁), Talcum(滑石), Glauberitum(寒水石), Dioscoreae Tokoro Rhizoma(??), Alismatis Rhizoma(澤瀉), Phellodendri Cortex(黃柏), Phaseoli Radiati Semen(?豆皮), Bombycis Excrementum(?沙), Bombyx Batryticatus(白??), Stephaniae Tetrandrae Radix(防己), etc can be applied. 6) When the pathogenesis of ChangPo(瘡泡), hepatic abscess(肝癰) and appendicitis(腸癰) are food poisoning(食物中毒), Ki obstruction & blood stasis in the interior(기비혈어재과), damp-heat stagnation with six Bu organs suspension(濕熱結聚 六腑不通), the treatment of purgation(通下) with DaeHwangMokDanPiTang(大黃牧丹皮湯), Manitis Squama(穿山甲), Curcumae Radix(鬱金), Curcumae Longae Rhizoma(薑黃), Tetrapanacis Medulla(通草), etc can be applied. 7) When the pathogenesis of JeokBan(적반), BanJin(반진), EunJin(은진). BuYang(부양), ChangI(瘡痍), ChangPo(瘡泡), GuChang(久瘡), NongYang(膿瘍), GweYang(潰瘍), Jeong(정), Jeol(癤), YeokRyeo(疫?) and YeokRyeolpDan(疫?入?) are wind-heat stagnation(風熱久未解), blood fever in Yangmyong(陽明血熱), blood fever with transformation(血熱風動), heat's penetration of blood collaterals(熱入血絡). fever in blood(血分有熱), insidious heat in triple energizer(三焦伏熱), pathogen's penetration of pericardium(心包受邪), deficiency of Yong(營虛), epidemic pathogen(感受穢濁), the treatment of Yong & blood-cooling(淸營凉血) with SeoGakJiHwangTang(犀角地黃湯), Scrophulariae Radix(玄參), Salviae Miltiorrhizae Radix(丹參), Angelicae Gigantis Radix(當歸), Polygoni Multiflori Radix(何首烏), Cannabis Fructus(胡麻子), Biotae Semen(柏子仁), Liriopis Tuber(麥門冬), Phaseoli Semen(赤豆皮), Forsythiae Fructus(連翹), SaJin(사진), YangDok(瘍毒) and YeokRyeoIpDan(역려입단) are insidious heat's penetration of pericardium(伏熱入包絡), damp-warm's penetration of blood collaterals(濕溫入血絡), epidemic pathogen's penetration of pericardium(심포감수역려), the treatment of resuscitation(開竅) with JiBoDan(至寶丹), UHwangHwan(牛黃丸), Forsythiae Fructus(連翹), Curcumae Radix(鬱金), Tetrapanacis Medulla(通草), Acori Graminei Rhizoma(石菖蒲), etc can be applied. 9) When the pathogenesis of SaHuSinTong(사후신통), SaHuYeolBuJi(사후열부지), ChangI(瘡痍), YangSon(瘍損) and DoHan(盜汗) are deficiency of Yin in Yangmyong stomach(陽明胃陰虛), deficiency of Yin(陰虛), the treatment of Yin-replenishing(滋陰) with MaekMunDongTang(麥門冬湯), GyeongOkGo(瓊玉膏), Schizandrae Fructus(五味子), Adenophorae Radix(沙參), Lycii Radicis Cortex (地骨皮), Polygonati Odorati Rhizoma(玉竹), Dindrobii Herba(石斛), Paeoniae Radix Alba(白芍藥), Ligustri Lucidi Fructus (女貞子), etc can be applied. 10) When the pathogenesis of RuYang(漏瘍) is endogenous wind in Yang collaterals(陽絡內風), the treatment of endogenous wind-calming(息風) with Mume Fructus(烏梅), Paeoniae Radix Alba (白芍藥), etc be applied. 11) When the pathogenesis of GuChang(久瘡), GweYang(潰瘍), RuYang(漏瘍), ChiChang(痔瘡), JaHan(自汗) and OSimHan(五心汗) are consumption of stomach(胃損), consumption of Ki & blood(氣血耗盡), overexertion of heart vitality(勞傷心神), deficiency of Yong(營虛), deficiency of Wi(衛虛), deficiency of Yang(陽虛), the treatment of Yang-restoring & exhaustion-arresting(回陽固脫) with RijungTang(理中湯), jinMuTang(眞武湯), SaengMaekSaGunjaTang(生脈四君子湯), Astragali Radix (황기), Ledebouriellae Radix(防風), Cinnamomi Ramulus(桂枝), Angelicae Gigantis Radix(當歸), Ostreae Concha(牡蠣), Zanthoxyli Fructus(川椒), Cuscutae Semen(兎絲子), etc can be applied.

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