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A study for the factors on choosing hospitals and patients satisfaction between Geriatric Hospitals and General Hospitals (노인병원과 종합병원의 선택요인 및 환자만족도 분석)

  • Yoon, Seo-Jung;Yu, Seung-Hum;Kim, Young-Hoon;Lee, Ji-Jeon
    • Korea Journal of Hospital Management
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    • v.9 no.2
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    • pp.46-75
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    • 2004
  • This research anticipated on acknowledging the inpatients factors in choosing which hospital for the geriatric hospital and general hospital they would prefer to go to the analization of different factors in patients satisfaction, and the relation between satisfactory standards and the patients intentions on recommendation or re-visiting the hospital. The statistical data was based upon the 359 question and answer papers that were done by inpatients that were hospitalized in two geriatric hospitals and two general hospitals, and the methods used for analyzing were frequency, t-test, factor analysis, and hierarchical multiple regression. The results are as follows. 1. The factors on choosing hospitals between geriatric hospital and general hospitals were different. The priority for the geriatrics was kindness, and then considerate nursing, and the reliance of treatment. The patients of general hospitals looked first for reliance of treatment, reputation and history of the hospital, and the kindness of the staff. The kindness of the staff, good nursing, and easy procedures were the primary factors of choosing geriatric hospital. 2. The four primary factors in choosing which hospital patients would go to were the predominance of the facilities, kindness and convenience, the reliance and proximity of medical treatment, and recommendation. The patients in the geriatric hospital first looked for kindness and convenience, second the reliance and proximity of medical treatment, third predominance of facilities, and last recommendation. The general hospitals main priority was the reliance and proximity of medical care, second predominance of facilities, kindness and hospitality, and last recommendation. 3. The satisfaction rate was higher in the geriatric hospital compared to general hospitals, but the satisfactory of factors were very similar. Patients in the geriatric hospital were pleased with the hospital staffs kindness, quick nursing and the improvement of inconvenient matters, and clear diagnosis of the doctors. The general hospital patients were satisfied with the hospital staffs clear explanation and accurate diagnosis 4. The analysis in the satisfactory factors turned out to be the environment of the hospital, kindness of the staff, and convenience. Both the patients of the geriatric hospital and general hospitals were very pleased with the kindness of the hospital staff. Ranking second and third was convenience and service for the geriatric hospital, and environment of the hospital and convenience for the general hospital. 5. According to a rank of multiple recurrent analysis of the patients satisfaction and the intention of re-visiting in addition to intention of solicitation, in the case of a geriatric hospital, when the intention of re-visiting is the dependent variable, the first stage shows that the less insurance the patient has, the higher was the intention of re-visiting. In the second stage, the more satisfied the patient is of the staffs kindness, the higher was the intention of re-visiting. Further more, when the intention of solicitation is the dependent variable, the first stage shows that not all the independent variables were significant, but the second stage shows that the more satisfied the patient is of the staffs kindness and the hospital along with the medical treatment expenses, the higher was the intention of solicitation. 6. In the first stage of a rank of multiple recurrent analysis of the satisfaction of the general hospital and the intention of re-visiting, not all the variables were significant, but in the second stage, all the satisfaction by factors were significant. Moreover, when the intention of solicitation was the dependent variable, the first stage shows not all the variables were significant, but in the second stage, all the satisfaction by factors were significant. That is to say, in the case of a general hospital, the satisfaction of the hospital and the medical treatment expenses were high, and the more satisfied the patient is of the hospitals environment and the staffs kindness, the intention of re-visiting and the intention of solicitation was higher.

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Molecular Epidemiological Characteristics of Vibrio Parahaemolyticus as Recently wilde-spreaded in Korea (최근 한국에서 유행하는 장염비브리오균의 분자 역학적 특성)

  • 김상숙;이희무;이중복
    • KSBB Journal
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    • v.18 no.6
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    • pp.522-528
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    • 2003
  • The purpose of this study is to inquire into molecular epidemiological characteristics of Vibrio parahaemolyticus. For this study, 120 strains(120 strains of Vibrio parahaemolyticus sampled from diarrhea patients) were examined and analyzed for biochemical characteristics, TDH (thermostable direct hemolysin) antibiotics sensitivity and detection of toxR, gyrE, tdh, and tds gents. G-S PCR (Group Specific Polymerase), PFGE (Pulsed-field Gel Electrophoriesis) methods were performed on the materials from patients were results. 1 Vibrio parahaemolyticus didn't grow in 0% density of NaCl, but the fact was found that those grew in 8% density of NaCl. 2. O:K serotypes of Vibrio parahaemolyticus was turned up in domestic patients was 17 types. Among those O3:K6 was the most, it was 68.3%. 3. In 18 kinds of antibiotic tests resistant against Ampicillin, Ticacillin was comparatively high. the case of resistant against Ampicillin, Ticacillin, Vancomycin at the multiple resistant was 52.5%. 4. Toxin gene tdh had only 109 strains among 120 ones isolated from patients held the genes of 199bp size, and 11 strains was negativity 5. In the test of Kanagawa toxic productivity, 107 strains among strains isolated from patients appeared to be positivity reaction 6. The strain that held trh toxin was only 3, and those among test strains had the genes of 250bp size and that had tdh, trh genes at a time were 3 strains, and TDH toxic productivity of those were 16 times, and it was weak. 7. Group Specific-PCR appeared to be useful in the confirmation of O3:K6 serotype interrelations. 8. Three strains which showed difference of 7 DNA sequence even in the same serotype were detected by the result of analyzing the regular gene, toxRS DNA sequence. These strains are differ from general strains which carry infection easily. 9. These mutual dose epidemiological relations were classified into smaller-parts through PFGE method. As a result of such classify, 3 findings were found. V. parahaemolyticus sampled from diarrhea patients were classified into 3 types. And third, the result obtained through PFGE method can be used as a useful tool in a point of molecular-epidemiological view.

Development of a Value Inquiry Model in Biology Education (생물교육에서의 가치 탐구 모형 개발)

  • Jeong, Eun-Young;Kim, Young-Soo
    • Journal of The Korean Association For Science Education
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    • v.20 no.4
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    • pp.582-598
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    • 2000
  • There are many bioethical issues in line with the rapid advance of biology. In this situation, it is important for students to make a rational decision on value problem. In this study 'value inquiry in biology education' is defined as 'the process of rational value judgement and wise decision-making in the biology-related value problem' and the model was developed. To develop the model, value inquiry models were reviewed. Value clarification model is helpful for the formation of the personal value as the process of individual value inquiry, but it isn't helpful for clarifying the value conflicts. Value analysis model focuses on the rational solution of value problem through the logical procedure. But it has the limitations that overemphasizing the logical and systematic aspects results in devaluating students' affective aspects. So it is necessary to coordinate psychological and logical aspects of value inquiry. In this regard, the model was developed, including identifying and clarifying value problem, understanding biological knowledge related to conflict situation, considering on the related persons, searching for alternatives, predicting the consequences of each alternative, selecting the alternative, evaluating the alternative, and final value judgement and affirming it. The educational objectives of value inquiry were selected in consideration of the ability to carry out the steps of the developed model. And the selected contents were animal duplication, test-tube baby, genetic engineering, growth hormone injection problem, brain death, organ transplant, animal to be experimented and were organized on the basis of the 6th and the 7th science curriculum. And the suitable instructional models for the value inquiry education were selected: bioethical value clarification decision-making model, group presentation according to the value analysis model, role play and debate, and discussion through web forum. And the interview was considered to be suitable to evaluate the students' value inquiry ability and the rubric was made to evaluate the attainment of the educational objectives for value inquiry.

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Induction of Phase I, II and III Drug Metabolism/Transport by Xenobiotics

  • Xu Chang Jiang;Li Christina YongTao;Kong AhNg Tony
    • Archives of Pharmacal Research
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    • v.28 no.3
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    • pp.249-268
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    • 2005
  • Drug metabolizing enzymes (DMEs) play central roles in the metabolism, elimination and detoxification of xenobiotics and drugs introduced into the human body. Most of the tissues and organs in our body are well equipped with diverse and various DMEs including phase I, phase II metabolizing enzymes and phase III transporters, which are present in abundance either at the basal unstimulated level, and/or are inducible at elevated level after exposure to xenobiotics. Recently, many important advances have been made in the mechanisms that regulate the expression of these drug metabolism genes. Various nuclear receptors including the aryl hydrocarbon receptor (AhR), orphan nuclear receptors, and nuclear factor-erythoroid 2 p45-related factor 2 (Nrf2) have been shown to be the key mediators of drug-induced changes in phase I, phase II metabolizing enzymes as well as phase III transporters involved in efflux mechanisms. For instance, the expression of CYP1 genes can be induced by AhR, which dimerizes with the AhR nuclear translocator (Arnt) , in response to many polycyclic aromatic hydrocarbon (PAHs). Similarly, the steroid family of orphan nuclear receptors, the constitutive androstane receptor (CAR) and pregnane X receptor (PXR), both heterodimerize with the ret-inoid X receptor (RXR), are shown to transcriptionally activate the promoters of CYP2B and CYP3A gene expression by xenobiotics such as phenobarbital-like compounds (CAR) and dexamethasone and rifampin-type of agents (PXR). The peroxisome proliferator activated receptor (PPAR), which is one of the first characterized members of the nuclear hormone receptor, also dimerizes with RXR and has been shown to be activated by lipid lowering agent fib rate-type of compounds leading to transcriptional activation of the promoters on CYP4A gene. CYP7A was recognized as the first target gene of the liver X receptor (LXR), in which the elimination of cholesterol depends on CYP7A. Farnesoid X receptor (FXR) was identified as a bile acid receptor, and its activation results in the inhibition of hepatic acid biosynthesis and increased transport of bile acids from intestinal lumen to the liver, and CYP7A is one of its target genes. The transcriptional activation by these receptors upon binding to the promoters located at the 5-flanking region of these GYP genes generally leads to the induction of their mRNA gene expression. The physiological and the pharmacological implications of common partner of RXR for CAR, PXR, PPAR, LXR and FXR receptors largely remain unknown and are under intense investigations. For the phase II DMEs, phase II gene inducers such as the phenolic compounds butylated hydroxyanisol (BHA), tert-butylhydroquinone (tBHQ), green tea polyphenol (GTP), (-)-epigallocatechin-3-gallate (EGCG) and the isothiocyanates (PEITC, sul­foraphane) generally appear to be electrophiles. They generally possess electrophilic-medi­ated stress response, resulting in the activation of bZIP transcription factors Nrf2 which dimerizes with Mafs and binds to the antioxidant/electrophile response element (ARE/EpRE) promoter, which is located in many phase II DMEs as well as many cellular defensive enzymes such as heme oxygenase-1 (HO-1), with the subsequent induction of the expression of these genes. Phase III transporters, for example, P-glycoprotein (P-gp), multidrug resistance-associated proteins (MRPs), and organic anion transporting polypeptide 2 (OATP2) are expressed in many tissues such as the liver, intestine, kidney, and brain, and play crucial roles in drug absorption, distribution, and excretion. The orphan nuclear receptors PXR and GAR have been shown to be involved in the regulation of these transporters. Along with phase I and phase II enzyme induction, pretreatment with several kinds of inducers has been shown to alter the expression of phase III transporters, and alter the excretion of xenobiotics, which implies that phase III transporters may also be similarly regulated in a coordinated fashion, and provides an important mean to protect the body from xenobiotics insults. It appears that in general, exposure to phase I, phase II and phase III gene inducers may trigger cellular 'stress' response leading to the increase in their gene expression, which ultimately enhance the elimination and clearance of these xenobiotics and/or other 'cellular stresses' including harmful reactive intermediates such as reactive oxygen species (ROS), so that the body will remove the 'stress' expeditiously. Consequently, this homeostatic response of the body plays a central role in the protection of the body against 'environmental' insults such as those elicited by exposure to xenobiotics.

Research on the Size, Formation and Tendency to Evade the Road of the Feeding Flocks of Crane Species - Centering on the Effect of Road vs. Traffic Condition - (두루미류의 취식무리 크기 및 구성과 도로에 대한 회피 - 도로의 영향 vs 통행에 의한 영향? -)

  • Yoo, Seung-Hwa;Lee, Ki-Sup;Kim, In-Kyu;Kang, Tae-Han;Lee, Han-Soo
    • Korean Journal of Environment and Ecology
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    • v.23 no.1
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    • pp.41-49
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    • 2009
  • This research conducted a survey on the feeding crane's size, formation and distribution distance subsequent to road pattern and feeding flock's size during the wintering season eight times at the Cheolwon basin in Korea from December 2005 until February 2006. The survey results are as follows: First, the feeding flocks of the Red-crowned and White-naped Crane were found to mainly consist of two to four individuals. Mono-specific feeding flocks were more identified than hetero-specific feeding flocks in both Red-crowned and White-naped Cranes. There existed a significant difference in the ratio by size between the feeding Red-crowned and White-naped Cranes. The crane's average distribution distance from the paved road was much farther than from the unpaved road, paved farm road and unpaved farm road. In case of the white-naped crane, there was a difference in its distance length from between the road and farm road and there existed a significant difference only in the paved road in the distance length by road pattern between these two bird species[Red-crowned and White-naped Crane]. Such a result indicates that crane species don't prefer the road with frequent vehicular traffic to the road with low vehicular traffic. 5 or more individuals of feeding flocks of the Red-crowned Crane were located at a farther distance length from the paved road comparing to less than 5 individuals of the whole feeding flocks and less than 5 individual feeding flocks. 5 or more individuals of feeding flocks of the White-naped Crane were located at a farther distance length from the paved road, paved farm road and unpaved farm road than less than 5 individuals of feeding flocks of the White-naped Crane; however, there existed no difference in distance length subsequent to their group size. Conclusively, it was found out that the flocks with a larger size were more greatly affected by interrupting factors. Considering such results, there seems to be a more relation to the fact that larger size feeding flocks of crane species have a higher efficiency in the lookout for their surroundings.

Actual State of Structures and Environmental Control Facilities for Tomato Greenhouses in Chungnam Region (충남지역 토마토 재배온실의 구조와 환경조절설비 실태분석)

  • Nam, Sang-Woon;Kim, Young-Shik
    • Korean Journal of Agricultural Science
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    • v.36 no.1
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    • pp.73-85
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    • 2009
  • An investigation was conducted to get the basic data for establishing structural safety and environmental management of tomato greenhouses in Chungnam region. The contents of the investigation consisted of actual state of greenhouse structures and environmental control facilities. Most of greenhouses were arch type single-span plastic houses and they had too low height for growing tomatoes. Frameworks of multi-span greenhouses were suitable, but those of single-span were mostly insufficient. Every greenhouse had thermal curtain movable or covering fixed inside the greenhouse for energy saving, and heating facilities were mostly warm air heater. Irrigation facilities were mostly drip tube and controlled by manual operation or timer. Almost all of the greenhouses didn't install high level of environmental control facilities such as ventilator, air circulation fan, $CO_2$ fertilizer, insect screen, supplemental light, and cooling device.

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Morphological, Physiological andd Biochemical Characteristics of Early Senescence Mutant in Rice (Oryza sativa L) (벼의 조기노화 변이체의 형태, 생리 및 생화학적 특성)

  • 이숙영
    • Korean Journal of Plant Resources
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    • v.8 no.3
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    • pp.325-334
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    • 1995
  • The early senescence mutant induced from Gihobyeo by $\gamma-ray$ irradiation was determined. The mutated gene expression was identified with comparing the characteristic of original cultivar. The mutant had so similar the morphological characteristics to original cultivar that it couldn't be distinguished until senescence occurred at about 20 days after heading. Suddenly yellow leaves were observed within a few days due to great decreases in total chlorophyll and various carotenoid contents. Transmission electron microscopy showed the formation of starch granules, distortion of fine structure of leaf cell organelles, especially grana structures, and the decrease in grain filled after senescence occurred. But banding patterns of total proteins and isozymes have not show any differences, The early senescence mutant will be very useful for study material not only on physiological and biochemical properties of plant senescence but also on gene expression regulating senescence which gives great influence on yield potential and its stability.

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Analysis Corrosion Products Formed on the Great Buddha Image of Kotokuin Temple in Kamakura (고덕원 국보 동조아미타여래좌상의 표면에 생성한 부식생성물의 해석)

  • Matsuda Shiro;Aoki Shigeo;Kang, Dai-il
    • 보존과학연구
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    • s.17
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    • pp.161-182
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    • 1996
  • In natural atmosphere, copper and copper alloy have been used to make buddha statues and ornaments of historic buildings since the abovementioned metals have corrosion resistance in some extent, and the patinaformed on the surface of the metals has provided the people aesthetic satisfaction with its beauty. But in atmosphere polluted by $SO_x$and $NO_x$, the patina layer does not work as a protective film, and it allows damages of the metal. Since 1992, Tokyo National Research Institute of Cultural Properties(TNRICP)has conducted studies on the influence of atmospheric pollution on metal cultural property held under open air. The Great Buddha Image which is located in Kamakura about 50km west from Tokyo, has been selected as one of the objects to study because it is made by copper alloy and it has stood exposed in the air for about a few hundreds years. Furthermore it is also the reason to study on it that there are many cultural properties in the surroundings of it. We have analysed the components and the structure of the corrosion products formed on the surface of the Buddha, have carried out exposure tests using the alloy samples which have simulated the components of the Great Image, and have observed climated and polluted air in order to discuss the relation between corrosion of metals in open air and conditions of the atmosphere. In this paper, the authors have described the components and the structure of the corrosion product formed on the surface of the Great Image by means of X-ray fluorescence spectroscopy and X-ray diffraction. The conclusions are as follows. (1) Sulfate patina composed mainly with brochantite were detected on the all sides of the Image and the amount of the patina is found more on the back of the Image facing to north. (2) Antlerite were detected on the back and a park of the left side facing to west, and formation of it was considered to have close relation with malignant atmosphere. (3) A big amount of chloride patina which mainly composed of atacamite were observed on the front facing to south. (4) Carbonate patina mainly composed of malachite were detected on the area where brochantite was often detected as well. It suggested that malachite had been transformed into brochantite by deteriorated atmosphere. (5) On the all sides of the Image, patina were observed together with copper oxides mainly composed of cuprous oxide. It showed that the surface layer of the Image consists of two layers : inner layer of oxide and outer layer of patina. (6) Corrosion products of lead which was a component of copperalloy were detected on the all sides : the main lead product found on the front was chlorophosphate whereas the one on the back was sulfate.

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Induction of Systemic and Mucosal Immune Responses in Mice Orally Administered with Recombinant Attenuated Salmonella Expressing Subunits of P Fimbriae of Avian Pathogenic Escherichia coli (마우스에서 조류 병원성 대장균의 P Fimbriae subunits을 발현하는 약독화 살모넬라균 경구 접종 후 면역 반응 유도 실험)

  • Oh, In-Gyeong;Moon, Bo-Mi;Lee, John-Hwa;Hur, Jin
    • Journal of Veterinary Clinics
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    • v.28 no.3
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    • pp.297-302
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    • 2011
  • Avian pathogenic Escherichia coli (APEC) causes a number of extraintestinal diseases in poultry. A virulence factor, P-fimbriae is firmly associated with the diseases. In this study, to develop an effective vaccine for the prevention of APEC, recombinant attenuatted Salmonella Typhimurium vaccines expressing PapA and PapG of P-fimbriae were evaluated whether these induced protective immune responses in murine models. Female BALB/c mice were primed and boosted orally at 7 and 10 weeks of age. In all immunized mice, the antigen-specific serum IgG levels were remained higher than those in the control mice from the fourth week post inoculation till the end of this study. In addition, antigen-specific serum IgG levels in the prime-booster immunized mice were enhanced as compared to the single immunized mice among each immunized group. The antigen-specific mucosal IgA levels in the mice immunized with each strain also induced higher than those in control mice. In addition, serum IgG and fecal IgA levels in mice administered with the combination of both strains were highly induced compared to those in mice immunized with each strain alone. These results indicated that PapA and PapG worked together for inducing high immune responses. To partly discern the nature of immunity induced by the strains, we quantified serum IgG subtypes IgG1 and IgG2a specific to antigens. The PapA and PapG strains biased the immunity to the Th1-type, as determined by the IgG2a/IgG1 ratio. On the other hand, the immunization with the both strains in combination produced mixed Th1- and Th2-type immune responses. These indicated that immunization with the combination of PapA and PapG could elicit both humoral and cell-mediated immunities.

A Bibliographic Study on the Types of Differential Diagnosis of Amnesia (건망(健忘)의 변증분형(辨證分型)에 대(對)한 연구(硏究))

  • Choi, Yong-Jun;Seong, Gang-Gyoung;Mun, Byoung-Sun
    • The Journal of Korean Medicine
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    • v.17 no.1 s.31
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    • pp.374-406
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    • 1996
  • This study has been carried out to investigate the types of differential diagnosis of amnesia. The results are as follows; 1. Amnesia has various types of differential diagnosis(辨證分型) ; deficiency of both the heart and spleen(心脾兩虛型), deficiency of the heart(心虛型), deficiency of the kidney(腎虛型), breakdown of the coordination between the heart and the kidney(心腎不交型), mental confusion due to phlegm(痰迷心竅型), accumulation of stagnant blood(蓄血型), internal injury by seven emotion (七情所傷型). 2. The type of deficiency of both the heart and spleen(心脾兩虛型) occurs when the heart and spleen is injured by overthinking(思慮過度), The symptoms are heart palpitation(心悸), continuous palpitation(??), insomnia(少寐), hypochondric discomfort(心煩), dream disturbed sleep(多夢), being easy to be scared(易驚), dizziness(眩暈), these are caused by blood deficiency of the heart(心血不足), poor appetite(飮食不振), loss of appetite(納?), short breath(氣短), sense of turgid abdormen(腹部膨滿感), loose stool(泥狀便), these are caused by deficiency of the spleen(脾虛), lassitude and weakness (身倦乏力), lassitude of the extremities (四肢無力), dim complexion (面色少華), pale lips(舌質淡), thready and feeble(脈細弱無力), these are caused by deficiency of both qi and the blood(氣血虛損). The remedy is nourishing the heart-blood(養心血) and regulating the spleen(理脾土). I can prescribe the recipes such as Guibitang(歸脾湯), Gagambosimtang(加減補心湯), Seongbitang(醒脾湯), Insin-guisadan(引神歸舍丹), Insamyangyoungtang(人蔘養榮湯), Sojungjihwan(小定志丸), Yungjigo(寧志膏), Palmijungjihwan(八味定志丸), etc., 3. The type of deficiency of the heart(心虛型) occurs when the heart-blood is injured by the mental tiredness(神勞) and so blood cannot nourish the heart. The symptoms are amnesia(健忘), short breath(氣短), heart palpitation(心悸), perspire spontaneously(自汗), facial pallidness(顔面蒼白), pale lips (舌質淡白), feeble pulse and lassitude(脈虛無力), intermittent pulse(結代脈). The remedy is nourishing the hart and blood and allaying restlessness(補心益血安神). I can prescribe the recipes such as Chenwangbosimdan(天王補心丹), Jeongji-hwan(定志丸), Gaesimhwan(開心丸), Youngjigo(寧志膏), Chilseonghwan(七聖丸), Baegseogyoungtang(白石英湯), Oseohwan(烏犀丸), Yangsinhwan(養神丸), Guisindan(歸神丹), Bogsinsan(茯神散), Jinsamyohyangsan(辰砂妙香散), Cheongeumboksinsan(千金茯神散), Samjotang(蔘棗湯), jangwonhwan(壯元丸), Sa gunjatang(四君子湯) minus rhizoma atractylodis macrocephalae(白朮) plus rhizoma acori graminei(石菖蒲), radix polygalae(遠志), cinnabaris(朱砂), etc. 4. The type of deficiency of the kidney(腎虛型) occurs when the kidney-qi and kidney-essence is deficient(腎氣腎精不足) and so it cannot nourish the brain. The symptoms arc amnesia(健忘), ache at the waist and lassitude in the lower extremities(腰산腿軟), dizziness and tinnitus(頭暈耳嗚), emmission and premature ejaculation(遺精早泄), burning sensation of the five centres(五心煩熱), flushed tongue(舌紅), rapid and small palse(脈細數). The remedy is nourishing the kidney and strengthen the essence(補腎益精). I can prescribe the recipes such as Gagamgobonhwan(加減固本丸), Jeongjihwan(定志丸), Gongseongchlmjungdan(孔聖枕中丹), Yugmigihwanghwan(六味地黃丸) plus ra-dix polygalae(遠志), fructus schizandrae(五味子), Yugmigihwanghwan(六味地黃丸) plus radix polygalae(遠志), fructus schizandrae(五味子), rhizoma acori graminei(石菖蒲), semen zizyphi spinosae(酸棗仁), Palmihwan(八味丸) plus fructus schizandrae(五味子), semen zizyphi spinosae(酸棗仁). etc., 5. The type of breakdown of the coordination between the heart and the kidney (心腎不交型) occurs when the heart-fire(心火) and kidney-fluid(腎水) are imbalanced. The symptoms are amnesia(健忘), hypochondric discomfort(心煩), insomnia(失眠), dizziness and tinnitus(頭最耳嗚), feverish sensation m the palms and soles(手足心熱), emmision(遺精), ache at the waist and lassitude in the lower extremities(腰?腿軟), flushed tongue(舌紅), rapid pulse(脈數). The remedy is coordinating each other(交通心腎). I can prescribe the recipes such as Gangsimdan(降心丹), Jujaghwan(朱雀丸), Singyotang(神交湯), Simsinyang- gyotang(心腎兩交湯), Yugmihwan(六味丸) plus fructus schizandrae(五味子), radix polygalae(遠志), Yugmihwan(六味丸) plus fructus schizandrae(五味子), radix polygalae(遠志), rhizoma acari graminei(石菖蒲), semen zizyphi spinosae(酸棗仁), etc., 6. The type of mental confusion due to phlegm(痰迷心竅型) occurs when the depressed vital energy(氣鬱) create phlegm retention(痰飮) and phlegm stagnancy(痰濁) put the heart and sprit(心神) out of order. The symptoms arc amnesia(健忘), dizziness(頭暈), chest distress(胸悶), nausea(惡心), dull(神思欠敏), dull and slow facial expression(表情遲鈍), tongue with yellow and greasy fur(舌苔黃?), sliperry pulse(脈滑). The remedy is removing heat from the heart to restore consciousness and dispersing phlegm(淸心化痰開竅) I can prescribe the recipes such as Gamibogryeongtang(加味茯?湯), Goa-rujisiltang(瓜蔞枳實湯), Jusaansinhwan(朱砂安神丸), Dodamtang(導痰湯) plus radix saussurea(木香), Yijintang(二陳湯) plus succus phyllostachyos(竹瀝), rhizoma zingiberis(生薑) Ondamtang(溫膽湯) plus rhizoma acori graminei(石菖蒲), rhizoma curcumae aromaticae(鬱金), etc., 7. The type of accumulation of stagnant blood(蓄血型) occurs when the blood is accumulated in the lower part of body. The symptoms are amnesia(健忘), chest distress(胸悶), icteric skin(身黃), rinsing the mouth but don't wanting eat(漱水不欲燕), madness(發狂), black stool(屎黑), pain in the lower abdomen(小腹硬痛). The remedy is dispersing phlegm and absorb clots (化痰化瘀), I can prescribe the recipes such as Jeodangtang(抵當湯), Daejeodanghwan(代抵當丸), Hyeolbuchugeotang (血府逐瘀湯) plus rhizoma acori graminei (石菖蒲), rhizoma curcumae aromaticae(鬱金), Jusaansinhwan(朱砂安神丸) plus rhizoma curcumae aromaticae(鬱金), radix polygalae(遠志), semen persicae(桃仁), cortex moutan radicis(收丹皮), etc., 8. The type of internal injury by seven emotion(七情所傷型) occurs when the anger injures the will stored in the kidney(腎志). The symptoms are amnesia(健忘), heart palpitation(心悸). hot temper(易怒), being easy to be scared(善驚), panic(易恐). The remedy is relieving the depressed liver and regulating the circulation of qi(疏肝解鬱). I can prescribe the recipes such as Tongultang(通鬱湯), Sihosogantang(柴胡疏肝湯) plus rhizoma acari graminei(石菖蒲), rhizoma curcumae aromaticae(鬱金), etc.

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