• Title/Summary/Keyword: treatment methods

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Colon Perforation during Air Enema Reduction of Intussusception (소아 장중첩증에서 공기 주입 정복술 시행 도중 발생한 장천공)

  • Kim, Yong Kuk;Im, Hae Ra;Lee, Gwang Hoon;Han, Soo Jin;Sun, Yong Han;Ryoo, Eell;Cho, Kang Ho;Tchah, Hann;Lee, Hak Soo
    • Clinical and Experimental Pediatrics
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    • v.46 no.1
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    • pp.37-41
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    • 2003
  • Purpose : Although air enema reduction has been known as a good method of diagnosis and treatment of intussusception, it could develop colon perforation. However, there have been few studies about this complication. So we analyzed the risk factors of colon perforation during air enema reduction in patients with intussusception. Methods : We reviewed the charts of 12 colon perforation patients during air enema reduction of intussusception, who were admitted to Gil Medical Center from Jan. 1990 to Dec. 2001. Their age, sex, major symptoms, length of time till hospital visit, types of intussusception, operative findings and pathologic reports were reviewed. Results : Among 657 cases, 596 patients(90.7%) were successfully treated, but 12 patients(1.83%) failed in air enema reduction and had colon perforation. In patients with colon perforation the male to female ratio was 11 : 1, and average age was 5.3 months. The most common symptom at the time of hospital visit was vomiting(91.7%). Cyclic irritability(75.0%), bloody stool(75.0%) and abdominal mass(41.7%) were also noted. The average length of time between symptom onset and hospital visit was 44.7 hours. Types of intussusception were predominantly ileocolic, ileocecal, and ileoileocolic. The site of perforation was most commonly found at the proximal part of intussusception including ascending colon(50%) and transverse colon(50%). Most cases were uncomplicated, and had a single perforation. Pathologic reports showed hemorrhagic necrosis and mesenteric laceration at the site of colon perforation. Complications of colon perforation were tension pneumoperitonium(58.3%), requiring immediate decompression. Conclusion : The chance of colon perforation during air enema reduction increases in cases with small bowel obstruction on simple abdominal x-ray of a patient younger than 6 months, delay in time till hospital visit and higher air pressure during reduction. Therefore more careful investigation is needed in these cases.

Nutritional Assessment and the Effectiveness of Dietary Counseling in Infants and Young Children with Iron Deficiency Anemia (철결핍성 빈혈을 가진 영유아에서 영양학적 평가 및 영양상담 효과)

  • Kim, Ja Kyoung;Ko, Eun Young;Lee, Yu Jin;Jun, Yong Hun;Kim, Soon Ki
    • Clinical and Experimental Pediatrics
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    • v.46 no.1
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    • pp.11-16
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    • 2003
  • Purpose : Iron deficiency is still the most common nutrient deficient disorder despite the improvement in general health and nutrition. This study is designed to evaluate the dietary history of infants and young children with iron deficiency anemia(IDA) and the effects of nutritional counseling. Methods : This study was conducted on 120 children from 6 to 36 months of age with IDA. Their parents completed a questionnaire and took counsel for nutrition. IDA was defined as Hb <11.0 g/dL, ferritin <10 ng.mL or transferrin saturation <15%, or Hb increase >1 g/dL after iron preparation. The questionnaire consisted of their feeding patterns, weaning time and kinds of food. Results : In the 120 infants and young children aged from 6 to 36 months, the parents of 82 cases was counseled about nutrition. Fifty six infants among 82 cases have started weaning and the main foods of weaning were rice and/or rice gruel. Nutritional problems in weaning were that some children over one year of age were using a bottle, and parents restricted weaning food at will because of allergic disease or chronic disease. Most parents were satisfied with the nutritional counseling given from a clinical dietitian and showed good compliance. Conclusion : Many infants and young children with IDA were provided with non iron-fortified foods and made an inadequate wean. Most parents were satisfied with the nutritional counseling and showed good compliance. The need of dietary counseling was required for prevention and treatment of iron deficiency anemia because of inadequate weaning.

Morphologic Changes of the Pulmonary Arteries after Stent Implantation on Branch Pulmonary Artery Stenosis - Impact of Pulmonary Insufficiency - (폐동맥 분지협착에 스텐트 삽입 후 유발되는 폐동맥의 형태변화 - 폐동맥 폐쇄 부전의 역할 -)

  • Kim, Me Jin;Kang, Du Cheol;Choi, Jae Young;Lee, Jong Kyun;Sul, Jun Hee;Lee, Sung Kyu
    • Clinical and Experimental Pediatrics
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    • v.46 no.1
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    • pp.67-75
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    • 2003
  • Purpose : Intravascular stent implantation for the treatment of postoperative branch pulmonary artery(PA) stenosis has been used successfully. However, the cross sectional area of contralateral branch PA does not regress in spite of the successful dilation of the stenotic branch PA after stent implantation. We analyzed the morphologic and hemodynamic factors on the size of branch PA after successful stent implantation. Methods : The subjects in our study were 23 children who had undergone stent implantaion from Jan. 1995 to Jul. 2002 in the Division of Yonsei Pediatric Cardiology. We evaluated the cross sectional area index(CSAI) of branch PA before and after stent implantation at follow-up catheterization. We also investigated factors such as residual pulmonary stenosis, pulmonary regurgitation(PR), systolic pressure of right ventricle, and lung perfusion scan. Results : The CSAI of the RPA without stenosis changed from mean $238{\pm}17mm^2/BSA$ to mean $249{\pm}20mm^2/BSA$(P=0.47), but didn't regress. The CSAI of the LPA with stenosis was increased effectively by stent implantation from the mean $102{\pm}12mm^2/BSA$ to mean $125{\pm}11mm^2/BSA$(P< 0.05). At follow up after stent implantation, the CSAI of PA is correlated with the residual PR fraction after stent implantation. Conclusion : In a group with increased residual PR, CSAI of RPA was found to be significantly increased between the pre- and post-stages of stent implantation. So, we suspect that the pulmonary regurgitation remaining after right ventricle outlet tract(RVOT) dilatation surgery is correlated with the increase in CSAI of RPA.

Nationwide surveillance of acute interstitial pneumonia in Korea (급성 간질성 폐렴의 전국적 현황 조사)

  • Kim, Byoung-Ju;Kim, Han-A;Song, Young-Hwa;Yu, Jinho;Kim, Seonguk;Park, Seong Jong;Kim, Kyung Won;Kim, Kyu-Earn;Kim, Dong Soo;Park, June Dong;Ahn, Kang Mo;Kim, Hyo-Bin;Jung, Hyang-Min;Kang, Chun;Hong, Soo-Jong
    • Clinical and Experimental Pediatrics
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    • v.52 no.3
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    • pp.324-329
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    • 2009
  • Purpose : Acute interstitial pneumonia (AIP) is a rare disease, but its prognosis is fatal because of lack of efficient treatment modality. Recently, it has been reported that there was epidemic AIP in Korea. This study aims to investigate the past and current status of AIP in Korea. Methods : We performed a nationwide survey and a prospective study. From August 6 to 15, 2008, a questionnaire survey was conducted to identify the prevalence, local distribution, and response to current treatments. The questionnaire was answered by pediatrician working in 23 referral centers in Korea. In addition, 5 referral centers in Seoul performed a preliminary prospective observational study by obtaining clinical data and specimens from appropriate patients. The Korea Centers for Disease Control and Prevention analyzed the samples for possible pathogens. Results : The survey showed 78 AIP cases had occurred and 36 patients had died. Lung biopsy was performed only on 20 patients. In 2008, 9 AIP cases developed. In a prospective study, 9 (M:F=5:4) patients developed AIP in spring and 7 (78%) died, with the mean rate of death occurring 46 days after diagnosis. Human corona virus 229E, cytomegalovirus, influenza A virus, influenza B virus, and parainfluenza virus were isolated from the respiratory specimens. Conclusion : This study showed nationwide prevalence of AIP in Korea. In addition, because of the high mortality rate and rapid progress, pediatricians need to be aware of the disease. Further studies and a nationwide network are required for reducing the morbidity and mortality rates related to AIP.

Eight cases of incidentally diagnosed as subclinical rickets (우연히 발견된 무증상 구루병 8예)

  • Seo, Ji-Young;Kim, Curie;Lee, Hee-Woo;Ahn, Young-Min
    • Clinical and Experimental Pediatrics
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    • v.51 no.8
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    • pp.812-819
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    • 2008
  • Purpose : Vitamin D plays a key role in bone mineralization of the skeleton and vitamin D deficiency can lead to rickets. It is well known that vitamin D deficiency is common in breast fed infants. Of these patients, clinically, some have no signs of rickets, but laboratory and radiographic findings are diagnostic for vitamin D deficiency rickets (subclinical vitamin D deficiency rickets). The purpose of this study is to clarify current causes and ways to prevent this disease. Methods : We reviewed the clinical and laboratory characteristics of children who were incidentally diagnosed as subclinical rickets during treatment of other disease such as pneumonia, gastroenteritis, urinary tract infection at Eulji Hospital, Seoul, Korea from March, 2003 to July 2007. Results : Eight patients (six boys and two girls) were diagnosed with subclinical vitamin D deficiency rickets. The mean age of the patients was $12.6{\pm}5.8months$, and they were diagnosed from January to July. The associated diseases were pneumonia, urinary tract infection, acute gastroenteritis, and iron deficiency anemia. All patients were breast-fed. Two showed growth failure. The mean serum alkaline phosphatase was $1995.8{\pm}739.5IU/L$, the mean calcium count was $9.5{\pm}0.6mg/dL$, and the mean phosphorus content was $3.6{\pm}1.5mg/dL$. The mean intact parathyroid hormone was $214.8{\pm}155.9pg/mL$ (reference range, 9-65), the mean 1,25-dihydroxyvitamin D was $82.4{\pm}49.3pg/mL$ (reference range, 2070), and the mean 25-hydroxyvitamin D was $29.6{\pm}10.6ng/mL$ (reference range, 1030). A radiographic examination showed cupping, fraying, and flaring of metaphyses in all patients. Six patients were administered calcitriol (400 IU/day) for three months. A consequent radiographic and laboratory examination showed improvement. The first two patients were initially diagnosed with metaphyseal dysplasia, without the detection of vitamin D deficiency and they spontaneously improved without vitamin D supplements. However, two years later, they showed mild scoliosis and metaphyseal dysplasia, respectively. Conclusion : Breast-feeding without supplementation involves high risk of vitamin D deficiency. Some infants may also develop rickets; therefore, such groups should be considered for vitamin D supplementation.

A Study on processing of medicinal on medical books of before Han(漢)dynasty (한대(漢代) 이전의 의적(醫籍)을 통한 '포제(炮制)'의 연구)

  • Kim, Sung-Cheol;Ha, Hong-Ki;Kim, Ki-Wook
    • Journal of Korean Medical classics
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    • v.24 no.4
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    • pp.157-174
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    • 2011
  • We derived following result by organizing research about processing of medicinal of before Han(漢) dynesty. The human being intake of natural substance for the purpose of treatment was what happened later than the use of natural substance as food. According to the record of by the early years of Shang(商) dynasty, we can assume that we cooked food with water and fire. The reason why there is no appearance of common production that can be included under the name of 'Tang Ye(湯液)' in the medical record discovered from Ma Wang Dui(馬王堆) is because 'Tang Ye' was yet developed. However, as the presentation of format of medicine process, there was gradual formation of medicinal fluid concept. There are quite of records on major details of cloth manufacture like washing and selection, grinding, processing of medicine from the recordings of "Wu Shi Er Bing Fang(五十二病方)", "Yang Sheng Fang(養生方)", "Za Liao Fang(雜療方)" discovered at Ma Wang Dui. It used words like 'Ze(擇)', 'Qu(去)' for the selection and 'Jiu(酒)', 'Zhuo(濯)' for the wash as a process method before cloth manufacture. When filter the processed medicine, it used words like 'Zhuo(捉)', 'Suo(索)', 'Jun(浚)' and used 'Yin Gan(陰乾)', 'Bao(暴)', 'Yang(暘)' for dry. The 'cutting(切削)' that crushes the medicine used different names based on the properties of medicines. The most frequent crush is 'Ye(冶)' and it means the powered medicine after dry. There was thermal process of mild fire(微火) and heating of 'Wen(溫)'. There are many states of medicine seen from the medical record discovered at Ma Wang Dui so they can be said as original medicine. 藥末劑 is relatively commercialized type then. Here, it includes later 湯劑 but there was no name such as 'decoction(湯)' or 'decoction of medical ingredients(湯液)'. Also, 'Fu Ju(㕮咀)' is the transformation of what was 'Fu Qie(父且)' at "Ja Liao Fang" of medical books of Ma Wang Dui with time flow. The original meaning of 'Fu Qie(父且)' is 'Fu Zu(斧俎)' and it means the crushing medicine with axe. The most important thing among the medical books of Han dynasty is "Shen Nong Ben Cao Jing(神農本草經)" and "Shang Han Za Bing Lun(傷寒雜病論)" of Zhang Zhong Jing(張仲景). "Shen Nong Ben Cao Jing" mentioned the dry method of medicine, collection and process production time, cooked and uncooked use of medicine and there are several types of medicine. Other than those, it mentioned 'Seven methods of combining herbs(七情合和)' to address cautions for combining medicines. Therefore, the 'processing of medicinal' in east Han dynasty period entered the theoretical step. However, there is only little recording on cloth manufacture of detailed medicine. From the "Shang Han Za Bing Lun" of Zhang Zhong Jing, the development in the way of 'processing of medicinal' reveled the cloth manufacture for each medicine. This tradition is continued until today and so it presents the development of purpose of 'processing of medicinal' is to greatly present the effect of medicine and to reduce the side-effect.

Effects of a traditional Chinese medicine formula and its extraction on muscle fiber characteristics in finishing pigs, porcine cell proliferation and isoforms of myosin heavy chain gene expression in myocytes

  • Yu, Qin Ping;Feng, Ding Yuan;He, Xiao Jun;Wu, Fan;Xia, Min Hao;Dong, Tao;Liu, Yi Hua;Tan, Hui Ze;Zou, Shi Geng;Zheng, Tao;Ou, Xian Hua;Zuo, Jian Jun
    • Asian-Australasian Journal of Animal Sciences
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    • v.30 no.11
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    • pp.1620-1632
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    • 2017
  • Objective: This study evaluated the effects of a traditional Chinese medicine formula (TCMF) on muscle fiber characteristics in finishing pigs and the effects of the formula's extract (distilled water, ethyl acetate and petroleum ether extraction) on porcine cell proliferation and isoforms of myosin heavy chain (MyHC) gene expression in myocytes. Methods: In a completely randomized design, ninety pigs were assigned to three diets with five replications per treatment and six pigs per pen. The diets included the basal diet (control group), TCMF1 (basal diet+2.5 g/kg TCMF) and TCMF2 (basal diet+5 g/kg TCMF). The psoas major muscle was obtained from pigs at the end of the experiment. Muscle fiber characteristics in the psoas major muscle were analyzed using myosin ATPase staining. Cell proliferation was measured using 3-(4,5-dimethyl-2-thiazolyl)-2,5-diphenyl-2H-tetrazolium bromide (MTT) dye and cytometry. Isoforms of MyHC gene expression were detected by real-time quantitative polymerase chain reaction. Results: The final body weight and carcass weight of finishing pigs were increased by TCMF1 (p<0.05), while the psoas major muscle cross-sectional area was increased by TCMF (p<0.05). The cross-sectional area and diameter of psoas major muscle fiber Ι, IIA, and IIB were increased by TCMF2 (p<0.05). The cross-sectional area and fiber diameter of psoas major muscle fiber IIA and IIB were increased by diet supplementation with TCMF1 (p<0.05). Psoas major muscle fiber IIA and IIB fiber density from the pigs fed the TCMF1 diet and the type IIB fiber density from the pigs fed the TCMF2 diet were lower compared to pigs fed the control diet (p<0.05). Pigs fed TCMF2 had a higher composition of type Ι fiber and a lower percentage of type IIB fiber in the psoas major muscle (p<0.05). The expression levels of MyHC Ι, MyHC IIa, and MyHC IIx mRNA increased and the amount of MyHC IIb mRNA decreased in the psoas major muscle from TCMF2, whereas MyHC Ι and MyHC IIx mRNA increased in the psoas major muscle from TCMF1 (p<0.05). Peroxisome proliferator-activated receptor ${\gamma}$ $coactivator-1{\alpha}$ and CaN mRNA expression in the psoas major muscle were up-regulated by TCMF (p<0.05). Porcine skeletal muscle satellite cell proliferation was promoted by $4{\mu}g/mL$ and $20{\mu}g/mL$ TCMF water extraction (p<0.05). Both $1{\mu}g/mL$ and $5{\mu}g/mL$ of TCMF water extraction increased MyHC IIa, MyHC IIb, and MyHC IIx mRNA expression in porcine myocytes (p<0.05), while MyHC Ι mRNA expression in porcine myocytes was decreased by $5{\mu}g/mL$ TCMF water extraction (p<0.05). Porcine myocyte MyHC Ι and MyHC IIx mRNA expression were increased, and MyHC IIa and MyHC IIb mRNA expression were down-regulated by $5{\mu}g/mL$ TCMF ethyl acetate extraction (p<0.05). MyHC Ι and MyHC IIa mRNA expression in porcine myocytes were increased, and the MyHC IIb mRNA expression was decreased by $1{\mu}g/mL$ TCMF ethyl acetate extraction (p<0.05). Four isoforms of MyHC mRNA expression in porcine myocytes were reduced by $5{\mu}g/mL$ TCMF petroleum ether extraction (p<0.05). MyHC IIa mRNA expression in porcine myocytes increased and MyHC IIb mRNA expression decreased by $1{\mu}g/mL$ in a TCMF petroleum ether extraction (p<0.05). Conclusion: These results indicated that TCMF amplified the psoas major muscle cross-sectional area through changing muscle fiber characteristics in finishing pigs. This effect was confirmed as TCMF extraction promoted porcine cell proliferation and affected isoforms of MyHC gene expression in myocytes.

Serum Carbohydrate Antigen 19-9 as an Indicator of Liver Metastasis in Colorectal Carcinoma Cases

  • Dong, Hang;Tang, Jie;Li, Long-Hao;Ge, Jun;Chen, Xin;Ding, Jing;Men, Hai-Tao;Luo, Wu-Xia;Du, Yang;Li, Cong;Zhao, Feng;Chen, Ye;Cheng, Ke;Liu, Ji-Yan
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.2
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    • pp.909-913
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    • 2013
  • Purpose: The liver is the organ to which colorectal carcinomas (CRCs) most commonly metastasize, and surgical resection has been established as the most effective and potentially curative treatment for CRC with liver metastasis (LM). Therefore, surveillance of LM is vital for improvement of prognosis of CRC patients. In this study, we aimed to explore the potential value of carbohydrate antigen 19-9 (CA 19-9), carcinoembryonic antigen (CEA), and marker enzymes in indicating LM with CRC. Methods: Three groups of eligible patients with metastatic cancers were retrospectively included: CRC patients with LM (CRC-LM) or without LM (CRC-NLM), and non-CRC patients with LM (NCRC-LM). All metastatic lesions were identified by CT or MRI. Data on characteristics of the patients, the primary site, the locations of metastasis, CA 19-9, CEA, and biochemical parameters were collected for analysis. Results: A total of 493 patients were retrospectively included. More alcohol consumption was found in CRC-LM than CRC-NLM. Some biochemical enzymes were found to be significantly higher in groups with LM than without (CRC-LM or NCRC-LM v.s CRC-NLM). Both CEA and CA 19-9 were much higher in CRC-LM than CRC-NLM or NCRC-LM. For CRC patients, CA 19-9, ${\gamma}$-glutamyl transpeptidase, CEA and alcohol consumption were identified as independent factors associated with LM. Conclusion: Our analysis suggested the CA 19-9 might be a potential valuable indicator for LM of CRC in the clinic.

The Results of Partial Meniscectomy according to the Grade of the Articular Cartilage Injury (관절 연골 손상 정도에 따른 반월상 연골 부분절제술의 결과)

  • Choi, Nam-Yong;Yang, Young-Jun;Nah, Ki-Ho;Yang, Hyuk-Jae;Song, Hyun-Seok
    • Journal of the Korean Arthroscopy Society
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    • v.13 no.1
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    • pp.22-27
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    • 2009
  • Purpose: To identify the damage of the articular cartilage and analyze the clinical results of the partial medial meniscectomy. Materials and Methods: From January 2001 to December 2004, forty-eight patients in the degenerative arthritis and medial meniscal tear of knee who undertook arthroscopic partial meniscectomy and were able to keep pace with the times follow-up for more than 3 years were enrolled in this study. Six cases were men and 42 were women, and the mean age was 55.7 years (40~78 years). The patients were classified into two groups according to the Outerbridge grade. Grade I and II were classified into group 1 and grade III and IV into group 2. Group 1 included 30 cases and group 2 included 18 cases. The result were analyzed according to the Tapper & Hoover classification and Lysholm knee scoring scale. And we measured the distance of medial joint space in standing anteroposterior (AP) view of both sides at the pre-operative and the last follow-up. Results: According to the Tapper & Hoover classification, 28 cases were excellent, 7 cases good, 8 cases fair, and 5 cases poor. Among group 1, 25 cases were excellent, 2 cases good, 2 cases fair, 1 case poor. However, among group 2, 3 cases were excellent, 5 cases good, 6 cases fair, 4 cases poor. Average Lysholm knee score was improved from 62.4 preoperatively to 94 postoperatively in group 1, and from 58 preoperatively to 77.9 postoperatively in group 2. The joint space narrowing showed no statistically significant difference in both knees standing AP view. Conclusion: The arthroscopic partial meniscectomy for a patient with the degenerative articular cartilage was an effective treatment. However, we could not satisfy the results, in cases of Outerbridge grade III and IV. In grade III and IV, the partial meniscectomy was not aggravated the cartilage damage.

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The E-mail Survey on the Neck Pain for Acupuncture and Moxibustion Clinical Guideline (경항통에 관한 침구임상 진료지침 개발을 위한 전자우편 설문조사)

  • Kim, Hyun-Wook;Kim, Sung-Soo;Nam, Dong-Woo;Kim, Eun-Jung;Hong, Kwon-Eui;Kim, Sung-Chul;Kim, Sun-Woong;Lee, Jae-Dong;Kim, Kap-Sung;Lee, Geon-Mok
    • Journal of Acupuncture Research
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    • v.26 no.3
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    • pp.67-80
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    • 2009
  • Objectives : The purpose of this survey is the development on the neck pain for acupuncture and moxibustion clinical guideline. Methods : The survey questionnaire was developed by the committee of experts who major in acupuncture & moxibustion or statistics for acupuncture clinical trial protocol development. The questionnaires were distributed via e-mail to 75 members of Korean Acupuncture & moxibustion society. 57 members completed answers, and the computerized data were analyzed by SPSS 17.0 statistical program. Results and Conclusions : 1. The first selected pattern identification on the neck pain This study shows that the meridian pattern identification was selected 35 times(61.4%), the pattern identification based on cause of disease was selected 8 times(14.0%), the visceral pattern identification was selected 7 times(12.3%), the other pattern identification was selected 4 times(7.0%), Qi blood yin yang pattern identification was selected 2 times(3.5%), according to symptoms was selected 1 time(2.4%). 2. Meridian pattern identification Small intestine meridian of hand Taeyang was used 39 times(18.1%), Large intestine meridian of hand Yangmyeong and Bladder meridian of foot Taeyang was used 34 times(15.7%), Gall-bladder meridian of foot Soyang was 32 times(14.8%), Tripple energizer meridian of hand Soyang was used 31 times(14.4%), Governor meridian was used 30 times(13.9%), Lung meridian of hand Taeeum was used 8 times(3.7%), Heart meridian of hand Soeum and Pericarduim meridian of hand Gworeum was used 4 times(1.9%). 3. Pattern identification based on cause of disease Wind-Cold-Dampness was used 31 times(17.5%), Accumulation of the collateral by Phelgm-Dampness was used 16 times(14.0%), affection by exopathogen Wind-Cold(stiff neck, sprain of cervical) was used 13 times (11.4%), Defecient-Cold was used 10 times(8.8%), affection by exopathogen Wind-Dampness was used 9 times(7.9%), Deep Invasion by Wind-Cold was used 8 times(7.0%), Wind-Cold was used 7 times (6.1%), Wind-Cold was used 6 times(5.3%), Accumulation in the Center by Phelgm-Dampness, Imparement of bou fluid by Pathogenic Heat, Wind-Heat with Dampness was used 5 times(4.4%), affection by exopathogen Wind-Dampness and Accumulation of the collateral by Wind-Cold was used 4 times(3.5%), Invasion of Dampness-Heat was used 2 times(1.8%). 4. Visceral pattern identification Rising of the Liver yang was used 16 times(41%), Yin deficiency of Liver and Kidney+pathogens was used 15 times(38.5%), Yin deficiency of Liver and Kidney was used 8 times(20.5%) on this survey.

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