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

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

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

Recently, the detection of early gastric cancer (EGC) has increased because of the development of diagnostic techniques. Accordingly, new surgical procedures with minimal invasiveness including laparoscopic gastrectomy have been developed. Since the first laparoscopic-assisted distal gastrectomy (LADG) for EGC was performed, various new laparoscopic procedures, such as laparoscopic wedge resection (LWR) and intragastric mucosal resection (IGMR) have been developed for the treatment of EGC. Laparoscopic approaches to gastric cancer provide for minimal invasion, early recovery and decreased morbidity and mortality according to several short-term results. In the future, laparoscopic procedures for gastric cancer will be widely accepted in Korea, if the advantages of laparoscopic approaches are confirmed in randomized controlled trials of long-term outcomes.
English Abstract ; *Gastrectomy/methods ; Humans ; *Laparoscopy/methods ; Stomach Neoplasms/*surgery

Endoscopic mucosal resection (EMR) has come to play an increasingly important role in treatment of early cancer in gastrointestinal tract. Recent advances in EMR are very remarkable. These allow minimally invasive treatment of diseases that would otherwise require major surgery. The most important factors of EMR are accuracy and safety. Further improvement in both staging and resection technologies, as well as safety and short procedure time will ultimately conspire to make this an even more effective tool in the management of early cancer in gastrointestinal tract. EMR must prove to be safe for the majority of patients when performed by competent endoscopist. The new techniques will continue to solve the limitations of endoscopic treatment and its use will also continue to expand increasingly. Also, further studies are required to refine and standardize EMR. As EMR technology becomes more complex, necessitating the use of multiple accessories simultaneously, technical ease may be enhanced by simple adjunct devices. The future of EMR depends on extending its boundaries safely in a controlled setting of prospective clinical trials. I believe that current EMR techniques and devices are only the beginning of a new age in therapeutic endoscopy, the age of minimal invasive endosurgery, the next frontier.
English Abstract ; Gastric Mucosa/*surgery ; *Gastroscopy ; Humans ; Stomach Neoplasms/*surgery

The purpose of this paper is to show the influence of Early greek medicine on Plato's Cosmology. Alcmaeon holds that health depends on proportion (equality; isonomia) or proportioned mixture of opposing factors. This notion dominated nearly all greek medicine, and also influenced Plato's cosmology greatly. Generally early greek doctors believed that man consisted of opposing factors, though these are designated differently. Alcmaeon takes powers - hot and dry, cold and hot, vitter, sweet and the rest as those factors. On the other hand, Philistion of Locri adopts the four element theory of Empedocles. He conceives that human body as a mixture of the four elements, and health consists in proportion of these opposing four element, basically as Alcmaeon. This notion is accepted by Plato. Only Plato differs from Philistion in that he does't consider the four elements as the ultimate factors. In Timaeus Plato explains that the Demiourgos constructed the four elements through introducing 'proportion' into the primitive materials (the oppositives) by means of shapes and mumbers. And Plato thinks that the cosmic body and soul was constructed basically in the same way as the four elements. This is true of the human body and soul. Also Plato explicates diseases from standpoint of proportion or symmetry. Moreover according to Philebus, the good states (i.e. 'health', 'music', 'seasons' etc) in the cosmos arises out of the right mixture of the limit and the unlimited. In other word this mixture is proportioned mixture of the oppositives by aid of ratios. In short Plato believes that both the cosmos itself and the good states is proportioned mixture of the oppositives. Thus Plato' cosmology is fundamentally based upon Alcmaeon's or Philistion's concept of Health.
English Abstract ; Greece ; History of Medicine, Ancient ; *Medicine ; Philosophy/*history

This paper is concerned not with medical theories, but with "discourses" about a famous physician, and I have addressed the subject of Hippocratic Legends as related to the Hippocratic Tradition. In this research, I pay attention to the Asclepiad guild of Cos, especially its status and privilege among Greek physicians and its role in the development of Hippocratic Tradition. In examining this issues Pseudepigrapha which are parts of the Hippocratic collections, that is Corpus Hippocraticum, are the most important texts, though they have been neglected for various reasons. It will be useful to look at some epigraphical and historical informations in comparison with the Pseudepigrapha, especially with the Presbeutikos, from which Hippocratic legends originate. In the result, it will be manifest that the Presbeutikos is a species of propaganda for the Coan Asclepiads and Pseudepigrapha's introduction into the Corpus, in the absence of biographical and historical information about Hippocrates, had much to do with the characterization of early Greek medical tradition, that became common in antiquity. In the conceptual dimension, we can and must distinguish between the idealization of Hippocrates as "the father of medicine", and the idealization of him as a respectable physician. But in reality, or historically, the ancient Hippocratic Tradition is amalgamation of these two aspects.
*Biography ; English Abstract ; Greece ; History of Medicine, Ancient ; *Medicine