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

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

Generally the originating area of ginseng is known to be in Shangdang, China. The originating time, which has been estimated according to textual and archeological outcomes, is known to be the first century B.C., during the Han dynasty era. This can be referred to as the 'Chinese origin theory of ginseng'. According to such hypothesis, the Chinese only discovered ginseng 'suddenly' during this time when it should have been self-generating for thousands of years before. However, Shangdang has been one of the historic centers of China since the ancient period and specially took prominence in terms of the beginning and development of Chinese pharmaceutics, which makes this theory largely dismissable. Moreover, there were six characters that expressed '[sim]' at the early stage and were used together with each other up to the days of Ming and Qing dynasty. Also this theory did not explain clearly about the formation of ginseng character. Hence it is fairly obvious that the 'Chinese origin theory of ginseng' do not answer appropriately to the fundamental questions of the origin of ginseng. In order to approach such mystery, perspectives need to be newly shifted to the 'outer origins' of Chinese ginseng. In this case 'outer' only points to Manchuria and Korea, since these areas are the only candidates regarding the natural circumstances of ginseng growth. So, it can be inferred that ginseng has first been identified with the locals of Manchuria and Korea, and then underwent influx to China to have been used as a medicinal stuff. Following such theory, the reason why ginseng suddenly appeared in Han China was that around this period, specially during the Han commandery epoch, it had just been introduced to China as a part of Korean culture. Also the reason there are many '[sim]' characters can be said that the sound of indigenous Korean 'sim' was considered in respect to selecting similarly-articulated words. Reaching such conclusion, the formating principle of '[sim]' can be no other than borrowing-sound character. To summarize our discussion, it is still unknown when was the actual origin of ginseng but it was far earlier than two thousand years ago as was previously accepted as the origin of this medicine plant. The originating place was not Shangdang of Shansi area of China as was commonly accepted, but Manchuria and Korea. Then ginseng must have been known and utilized by the locals of these areas. This is the 'Korean origin theory of ginseng' and simultaneously an indirect examination of the origin of 'Korean ginseng.'
China ; English Abstract ; History of Medicine, Ancient ; Korea ; *Panax

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

Robotics are now being used in all surgical fields. Because of increased intra-abdominal articulations while operating through small incisions, robotics are increasingly being used in a large number of visceral and solid organ operations including surgery on the gallbladder, esophagus, stomach, intestines, colon, and rectum as well as for the endocrine organs. As a speciality, robotics should continue to grow. As the robotic era invades the field of general surgeon, more and more complex procedures would be able to be approached through small incision. As technology catches up with our imagination, robotic instruments and 3D monitoring will become routine, and continue to improve patient care by providing surgeons with most precise, least traumatic ways of treating surgical disease.
*Digestive System Surgical Procedures ; English Abstract ; Humans ; *Robotics

Medical management of acute pancreatitis relies on supportive care such as fluid resuscitation and pain control. Prophylactic antibiotics can reduce the opportunity of infection in severe pancreatitis. The effect of somatostatin or protease inhibitors still needs to be evaluated through further study. Early endoscopic retrograde cholangiopancreatography (ERCP) can ameliorate the course of severe biliary pancreatitis. Although sterile pancreatic necrosis, acute fluid collection, and pseudocyst usually resolve spontaneously, endoscopic or percutaneous drainages are needed when these complications are infected.
Acute Disease ; English Abstract ; Humans ; Pancreatitis/complications/*therapy

Acute pancreatitis is an inflammatory disease of pancreas which come from various etiologies. The pathologic spectrum of acute pancreatitis varies from mild edematous pancreatitis to severe necrotizing pancreatitis. To diagnose and to predict severity in acute pancreatitis, various biochemical marker, imaging modalities and clinical scoring sytstem are needed. Ideal parameters should be accurate, be performed easily and enable earlier assess. Unfortunately, no ideal parameter is available up to date. Serum amylase and lipase are still useful for the diagnosis but meaningless in predicting severity. C-reactive protein and inflammatory cytokines are promising single parameters to predict the severity. CT finding is also an useful determinant of severity, but is expensive and is delayed in assessment.
Acute Disease ; English Abstract ; Humans ; Pancreatitis/*diagnosis ; Severity of Illness Index

Gastrointestinal tract is an organ for digestion, absorption and utilization of nutrients. Also it functions as an immunological organ in the human body. Patients with gastrointestinal disease are at increased risk for nutritional problem due to dietary restriction during the treatment or diagnostic examinations, anorexia or altered nutritional requirement. Clinically, it is important for gastroenterologists to be aware of the principles of nutritional therapy and the relationship between gastrointestinal diseases and the combined nutritional abnormalities. Removal of enteral feeding causes mucosal atrophy and leads to increased mucosal permeability to bacteria and endotoxin. The intestinal endotoxemia results from the translocation of bacteria and endotoxin to systemic circulation, may triggers off systemic inflammatory response syndrome. Therefore, it is crucial in critically ill patients to maintain the gastrointestinal mucosal integrity along with the intestinal flora that enables the host immunity to be maintained or enhanced. Immunonutrition is a therapeutic approach to enhance the gastrointestinal mucosal barrier with various specific nutrients. The intestinal endotoxemia and immunonutrition will also be reviewed briefly.
English Abstract ; Gastrointestinal Diseases/immunology/*therapy ; Humans ; *Nutritional Support