Chronic pancreatitis is a progressive disease without curative treatment. Abdominal pain is the most predominant symptom of chronic pancreatitis that initially brings most of the patients to the physician's attention. Some studies have correlated the course of pain in chronic pancreatitis in comparison with the duration of the disease, progressing exocrine and endocrine pancreatic insufficiency, and morphological changes such as pancreatic calcification and duct abnormalities. Furthermore, the course of pain has been studied after alcohol abstinence or surgery in some groups. However, there are only few well-performed and valid studies, and some of them even have produced diversing results, in part. Further controlled studies harvoring a large number of patients in a multicenter setting should be considered. Therapeutic efforts on chronic pancreatitis have focused on palliative treatment of pain which is present in about 80% of cases. Endoscopic treatment of pain in chronic pancreatitis is useful and feasible in many patients. Selecting candidate for endotherapy is mandatory. Main indication of pancreatic stent insertion in chronic pancreatitis is the presence of an obvious ductal stricture. Complications of chronic pancreatitis are also indications of endoscopic intervention. Exocrine and endocrine insufficiencies should be meticulously managed to prevent complications and to maintain good quality of life.
English Abstract ; Humans ; Pancreatitis, Chronic/*diagnosis/*therapy

Medical education in North Korea began with 2 medical colleges established during the 1930s and 1940s, and each Province came to have one medical college by the 1970s. It is presumed to exist 14 medical colleges in 1992. Apart from medical colleges, there are several kinds of medical schools. the number of medical practitioners has increased as the number of educational institutes for medicine increased. In 1996, there was 29.7 medical practitioners for 10,000 persons. They have several kinds of academic degrees in North Korea. They include: Wonsa, candidate Wonsa, doctor, vice-doctor, candidate doctor. In the university they have professor, associate professor, associate professor, lecturer, and research assistant. Academic degrees and positions are given not by the university nor research institute, but by the Government Board for Awarding Academic Degree and Position. Concerning research institutes, there is Chosen Institute for Medical Science that once was a medical research center under the Central Science Academy, and became an independent institute in 1963. Besides this institute, universities have their own research institutes, and there are also some other independent institutes.
Education, Medical/*history ; English Abstract ; History of Medicine, 20th Cent. ; Korea

Kim Doo-jong, the founder of the history of medicine in Korea, was born on 2nd March, 1896. After finishing his primary education in his home town, he went to Seoul to receive a higher education. He entered Keijo Medical College in 1918. However, at the end of his first year, he participated in the 3 . 1 movement which protested against Japanese harsh rule over Korea. On account of his participation in the movement, he was forced to leave the college which was run by the Japanese colonial government. Then he went to Japan to enter Kyoto Municipal Medical College, from which college he graduated in 1924. After the graduation, he went to Beijing to work in a hospital run by Japanese. Having felt uncomfortable about the situation in Beijing, he moved to Manchuria, where he opened his private clinic and saw patients for 7 years. As the life as a clinician did not satisfy him, he gave up his practice, and determined to devote himself to the study of history of medicine. He was 43 years old when he started studying history of medicine at the Dong Ah Institute, an affiliated research institute of Manchuria Medical College founded by Japanese. The institute had a large and magnificent collection of ancient texts of oriental medicine. He set on historical studies on the oriental medicine from the perspective of the Western medicine. His doctorial dissertation was about anatomy in oriental medicine. He intended to continue his study on organology, myology, etc., but the sudden end of the World War II made him return to Korea. This meant that he could not make access to the large collection of the institute, and his themes of the research had to be changed. On returning to Korea, he established the Department of the History of Medicine in Seoul National University, which was the only and the first one of its kind. He wrote History of Korean Medicine, which still remains one of the most important works on the history of Korean medicine. He was very energetic and active in his academic activities even during his late years. He passed away on 18th May 1988 at the age of 92.
English Abstract ; *Historiography ; History of Medicine, 20th Cent. ; Japan ; Korea

Choe Han-Ki was a philosopher of the 19th century who resided in Seoul. He accumulated vast amount of knowledge of Western science and on the basis of them he built his own philosophical system different from those of the philosophers before him. Not only has he wrote books on philosophy, but many books on science as well. Among them Shin-Ki-Chon-Hum is a very unique medical book which reveals his original medical philosophy. He acquired medical knowledge through the medical books put into Chinese by missionary doctor Hobson and on the basis of them he criticized traditional medicine. He criticized traditional medicine because it explained vital phenomenon through the reductionist theory, such as Oh-Haeng(theory of five phases). And he also criticized it because it lacked in exact anatomical knowledge and that the exact origin of the disease was not known and it had limitations on treatment. He also criticized Western Medicine because it supposed God as a creator. He saw the possibility of communication between Western Medicine and traditional medicine. He didn't regard medicine as concerning disease and health only, but it included everything in it. His philosophy of medicine is just a part of his original system of science, Ki-Hak.
English Abstract ; History of Medicine, 19th Cent. ; Korea ; Philosophy, Medical/*history

Korean modern medicine was imported from American missionaries in the late 19th century. At the beginning of the 20th century, Japanese medicine, which was influenced by German medicine, was imported along with the Japanese invasion. After the liberation of Korea, however, American medicine influenced the Korean Medicine in a broad spectrum : for example, medical science, medical instruments, and health care system. Not only an unstable social environment but also the rapid development of medical science changed medical terms. In order to investigate the 50-year transition of medical terms in Korea, we compare the names of diseases in 'Cho-Sun-Eu-Bo' published in 1934, 1935 and 1936 with those in the 'Journal of the Korean Medical Association' published in 1985. The names of diseases were classified according to number 17 classification method of ICD9(International Classification of Disease). The proportionate ratio of the number of names of disease between 1935 and 1985 was 3.2 in neoplasms, 3.1 in diseases of the circulatory system, and 2.7 in mental disorders. The causes of the transition of the names of diseases were three. The first was the simple change of the rules of spelling, the second was the change of the concept of disease, and the third was the subdivision of diseases. 26.1%(N=37) of the names of diseases in 1935(N=142) were changed by 1985.
English Abstract ; History of Medicine, 20th Cent. ; Korea ; *Terminology

In this paper, the philosophy and the content of medicinal philosophy of Lee Jae-Ma were illuminated through the history and philosophy of the late Choseon times from 1837 to 1900. Some conclusions were as follows: 1. Lee Jae-Ma was a philosopher as well as a doctor, and his philosophical background was well appeared in the book of . 2. Although the philosophy of Lee Jae-Ma and its terms were derived from the Kyunghakseol of Confucianism, the concept of these terms was different from the Neo-confucianism of Song Dynasty in China. 3. The four phases of the philosophy of Lee Jae-Ma was originated from the four important trigrams, however, he did not take the meanings of the changes and development of the trigrams in , but also took the four components of construction of cosmos similar to the Western theory of four component. 4. It is unreasonable that he is categorized in the group of the scholars of anti-Chu-tzu and neo-confucianist since the theory of the four phases was originated from the Kyunghakseol of Confucianism and also neo-Confucianism. 5. Dong Mu took the dualistic theory of mind and body in Ho Chun's as the core of his thought, but Dong Mu's method of the explanation was not based on the Taoism, the key of the thought of , but based on the Kyunghakseol of Confucianism. 6. Dong Mu wrote the two medicinal books and based on the thought of regimen of . But the philosophy of his books was based on the thought of Confucianism, not on of the nature of Taoism.
English Abstract ; History of Medicine, 19th Cent. ; Korea ; Philosophy, Medical/*history

Hepatocellular carcinoma (HCC) is one of the most common malignancies world wide. Several experimental treatments have been tested against HCC. Those are chemotherapy, high dose proton beam radiotherapy, external beam radiotherapy, cyberknife, antibody-directed therapy and immunotherapy. Neither single nor combination therapy have demonstrated any clear reproducible benefit in terms of overall survival. Tamoxifen and antiandrogen therapy were not effective in prolonging survival when tested in randomized controlled trial. The modern radiation therapy concept such as intensity-modulated, image-guided, and stereotactic body radiation therapy may show promising effects on HCC. The increasing promise of targeted drug therapy in cancer needs to be particularly pursued in the treatment of HCC, in which cytotoxic agents are not usually effective. Other approaches include hormonal manipulation, immunotherapy, and specific inhibition of angiogenesis or growth factors. These issues stress the need for basic research in carcinogenesis in general and HCC in particular.
Carcinoma, Hepatocellular/*therapy ; English Abstract ; Humans ; Liver Neoplasms/*therapy

In recent years, growing number of literatures have supported the concept that large nodules usually found in cirrhotic livers represent premalignant lesions in the setting of chronic liver disease. With the use of advanced imaging techniques, nodules suspicious for malignancy have often been identified and resected. While some resected lesions were found to be small hepatocellular carcinomas (HCCs), others were not. Some of these non-malignant nodules were devoid of atypia, some had architectural or cytological atypia insufficient for a diagnosis of HCC though they are suggestive of a premalignant state, while others contained microscopic subnodules of HCC. In follow-up studies and series of explants from liver transplant centers, the occasional finding of microscopic foci of HCC in the nodules was confirmed and significant associations with HCC elsewhere in the same liver were established. Such findings suggested that these nodular lesions, which are referred as "dysplastic nodules" (or adenomatous hyerplasia), are probably a frequent pathway in human hepatocarcinogenesis. We discuss the pathological characteristics of dysplastic nodules and small HCCs.
Carcinoma, Hepatocellular/*pathology ; English Abstract ; Humans ; Liver Neoplasms/*pathology

Taeuiwon was in charge of the medical care of the royal family in the Chosun period of 1898. The Taeuiwon Ilgi is the document which was recorded by Taeuiwon officials. In this study, the authors studied the contents of Taeuiwon Ilgi of 1898 in order to understand the medical care of the royal family of Chosun Kingdom. In 1898, Taeuiwon took some careful measures to take good care of the royal family. Taeuiwon physicians made regular inquiry about their health through the format called Moonan. The Moonan was to check out the health conditions of them. When Taeuiwon carried out Moonan, Emperor Kojong was asked to take a medical examination called Ipjin by the court physicians of Taeuiwon, even if he were in good condition. Taeuiwon physicians also regularly prescribed Insamsokmium, when the royal family performed the religious service or went into mourning. Insamsokmium is a kind of restorative food containing ginseng. From the above, we could conclude that Taeuiwon provided the preventive care to them. It was considered the proper way to such kind of high personage in that period.
English Abstract ; *Famous Persons ; Government ; History, 19th Century ; Korea

The very first record of ginseng in the Korean peninsula dates back to early 6th century A.D., with its concentration in Chinese sources. Regardless of the fact that the Korean ginseng was introduced to China before the birth of Christ, there is no writing about it for 500 years. This is because the Chinese substituted Korean ginseng for the Chinese one, which was cultivated around the Shangdang Area. The ginseng, however, is greatly influenced by natural environment and its native area being Manchuria and the Korean peninsula. It is believed that ginseng range from the northern mountains of Pyongando and Hamkyongdo provinces to the southern Taebaek and Sobaek mountains in Korea. Especially the area of Madasan (Baekdusan?) mountain was well-known for ginseng-growing district. The ginseng taxation of the Three Kingdoms period seems to have gone through certain changes along the development stages of the ancient state. The first taxation stage is estimated to be in the form of a tribute. Afterwards, as the governing power of central government was gradually strengthened in the subjugated places, there was a major replacement from tributary form to actual goods levy. The actual areas of such tributary collection is unknown, but the [Sejongshilok Chiriji] (geographical records of Sejong chronicles) of the early Choson era indicates 113 prefectures and counties as those which submit ginseng to the central government. These administrations provide permissible clues to the historic background of ginseng-taxed regions of the Three Kingdoms. The ginseng trade also is estimated to have flourished in ancient Korea through the Han commanderies of China. However, the writings of Korean ginseng trade is non-existent until 6th century A .D., Such phenomenon can be attributed to few reasons. First, the Chinese took little interest in Korean ginseng as they believed they had their own native ginseng in China. Second, same ignorance resulted from its inflowing but new feature. Third, active communication became impossible as the Goguryo-China relations deteriorated overall after the closing of the commanderies. Nevertheless, ginseng eventually was properly introduced into China as the relations between two regions improved after the 5th century A .D., which led the Chinese to realize the difference between Chinese and Korean ginseng. So it is estimated that such causes generated the real beginning of ginseng records in the 6th century. Based on the remaining texts, it can be inferred that trade in the Three Kingdoms era usually was conducted in each kingdom were all different, which was reflected in their respective contact with China. Such characteristics must have directly influenced their ginseng trade with China as well. For example, Shilla was only able to perform major ginseng commerce with China from the 7th century. There are various records of ginseng trade in Unified Shilla period, owing mostly to the previous tributary trade. Additionally, there is a case in which a certain individual presented Korean ginseng to a Chinese, as well as a case of Shilla ginseng trade in Japan. Aforementioned examples clearly illustrate that the fundamental structure of ginseng trade in East Asia was completed during the Unified Shilla period.
Commerce/*history ; English Abstract ; History, Ancient ; Korea ; Panax/*growth & development