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

In Taegu, the Yaknyongshi was established as early as the 9th year of King Hyojong(1658) of the Chosen Dynasty, and in the 10th year of King Hyojong(1659) the 'Tonguibogam' was published as a Yongyongbon edition by the Kyongsang Provincial Government In fact, it may not be an exaggeration to say that Taegu was the base of the traditional medicine in Korea. In the meantime the general public began to become aware of the importance of Western medicine when Dr. Woodbridge O Johnson of the Northern Presbyterian Church introduced Western medicine by opening the 'Miguk Yakpang'(American dispensary) and began to teach Western medicine to Korean youths. At that time, while constructing the Kyong for a war against Russia, Japanese began to establish hospitals in several major cities and towns along the railway line and mobilized Tonginhae doctors. However, those medical facilities were solely for the benefit of Japanese people residing in Korea and had nothing to do with ordinary Koreans. The attached medical school of the Taegu Tonginuiwon failed, contrary to expectation, to turn out even a single Korean medical doctor. This hospital was later reorganized into Taegu Chahyeuiwon and was soon closed according to the policy of educational unification of the Government General Korea. The keen interest in the Western medicine shown by the people of Taegu resulted from the long history of this area as a base of Oriental medicine. More than 10 years after the abolition of the institute far Western medicine in Pyongyang a Western medical training center was inaugurated as a night school in January 1923 by the Chahyeuiwon and the school began to be operated under the name of the Pyongyang Provincial Medical Training Institute. In July 1923, in Taegu, the Taegu Medical Training Institute was inaugurated in the compound of the Chahyeuiwon as a night school in imitation of the institute in Pyongyang. In march 1924, this institute, following the example of that in Pyongyang was renamed the Taegu Provincial Medical Training Institute with the promulgation of a decree of Kyongsangbukdo regarding the regulation on the Taegu Medical Training Institute. Thanks to the strong demand by the population of the Kyongsanbukdo, fund-raising and other campaigns by Koreans and Japanese, and active efforts by the local governmental authorities, the Taegu Provincial Medical Training Institute was approved as an institute of a semimedical college level by the Government-General in Korea with the promulgation of the regulations on the Kyongsangbuk-do Medical Training Institute in May 1929. In March 1930, both the Taegu Provincial Medical Training Institute and Pyongyang Provincial Medical Training Institute were designated as "Uihakkyo(medical school)" by the Government-General in Korea. By this designation, the graduates of the schools were given a medical license permitting them to practice medicine in korea. That is to say, the graduates enjoyed the same privilege to exercise professional right within Korea as those of other medical colleges. Three years later, on March 4 1933, the regulations on public schools in Korea were revised and, on March 6, the establishment of medical colleges were permitted. Thus, in Kyongsangbukdo, the regulations on the Taegu Medical College were proclaimed in the form of a decree of the provincial government and, in accordance with the regulations, professors were nominated and students were recruited. In the meantime, with the timely completion of construction of the college building in August 1933, the college moved to the new compound in November of the same year. Thus, the Taegu Medical College, equipped with new facilities, emerged and satisfied the long-cherished desire of the people in this area. Unlike the Pyongyang Medical College, the Taegu Medical College had some Korean teaching staff members. They were: Pak Jae-Hwan(professor) ; Seo Sung-Hae, Chung He-Taek, Lee Myeng-Hun, Kwon Kil-Chae, Choe Duk-Saeng, Pae Chong-Ho, Lee Chil-Hui(assistant professor) ; and Cha Ham-Su, Kee Yong-Suk(instructors). They taught and conducted research in various departments of clinical and basic medicine. However, there were few Korean graduates of the Taegu Medical College who continued study and research at their alma mater. It is known that Korean graduates of this medical college did their study and research mostly at medical colleges in Japan or at the Medical Department of the Kyongsuong Imperial University. The author wishes to pay his tribute of sincere praise to the painstaking efforts and diligence of the small number of graduates of this medical college who, in spite of the haughtiness and prejudice by the Japanese, conducted study and research that later led to the foundation of the Kyongbuk University Medical College.
Education, Medical/*history ; English Abstract ; History of Medicine, 20th Cent. ; Korea

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

Treatment for patients with esophageal cancer remains unsatisfactory. Although surgery alone or chemoradiotherapy have been generally accepted as reasonable options for patients with locoregional esophageal cancer, 5-year survival rate of either management is about 20%. The limited success of single modality treatment using radiotherapy or surgery has led to the investigation of multimodality therapies, combining chemotherapy, radiotherapy, and surgery. However, the appropriateness of such therapies remains unanswered. A number of prospective randomized trials of trimodality therapy versus surgery alone suggest benefits of combined-modality therapy. Concurrent chemoradiotherapy is an alternative treatment in selected resectable cases to show potential benefits in survival and local control. Patients with complete response following neoadjuvant therapy have consistent, substantial benefits in survival. Pretreatment staging is necessary for standardization of patients undergoing treatment protocols and for outcome evaluation. Biologic markers can be used to predict response to therapy and might allow designation of treatment based on the individual tumor. In the future, clinical trials testing optimal integration of preoperative regimen including new drugs may impact on the prognosis of esophageal cancer.
Combined Modality Therapy ; English Abstract ; Esophageal Neoplasms/*therapy ; Humans

Paul D. Choy was born on February 26th. 1896. He spent his childhood in Japan and America, and he returned to Korea when he turned twenty one years old. He graduated from Severance Union Medical College in 1921. After graduating the college, he went to Peking Union Medical College to study parasitology. He came back to Korea after one year as the first parasitologist in Korea. On returning, he took the charge of the clinical laboratory of Severance Hospital. Before long he made another journey for study to Canada. He spent two years in Toronto University studying pathology. After studying pathology, he challenged a new field of medicine. It was medical jurisprudence. He stayed two years in Japan in order to earn his doctorate in medical jurisprudence in Tohoku Imperial College. This time he returned as the first specialist in medical jurisprudence in Korea. His field of study was not confined to medical field. He had deep interest in current situation in Manchuria and Mongol, and wrote a book on this matter. His interest also extended to the history of ancient Korean people. He made extensive studies on this subject, which resulted in publishing a huge work on the origin of Korean people and its ancient history. He was a true pioneer of medicine in Korea and his life was characterized by endless quest for learning.
Education, Medical/*history ; English Abstract ; History, 20th Century ; Travel/*history

The Japanese introduction of dentistry into Korea was for treating the Japanese residing in Korea Noda-Oji was the first Japanese dentist for Japanese people in Korea in 1893. and Narajaki doyoyo, an invited dentist was posted in the Korean headquarter of Japanese army in september, 1905. The imperialist Japan licensed the dental technicians (yipchisa) without limit and controled them generously so they could practice dentistry freely. This measure was contrary to that in Japan. (In Japan no new dental technician was licensed.) Komori, a dental technician opened his laboratory at Chungmuro in 1902. The dental technician had outnumerbered by 1920. In 1907, the first Korean dental technician Sung-Ryong Choi practiced dentistry in Jongno. The imperialist Japan made the regulation for dental technicians to set a limit to the advertisement and medical practice of dental technicians. The first Korean dentist Suk-Tae Ham was registered No. 1 in the dentist license. The Kyungsung dental school was established by Nagira Dasoni for the purpose of educating some korean people that contributed to Japanese colonization. It made progress with the help of Japan. it was given the approval of the establishment of the professional school in January the 25th, 1929. it was intended to produce Korean dentists in the first place but became the school for Japanese students later on. The association of Chosun dentist, which had been founded by Narajaki doyoyo, was managed by Japanese dentists in favor of the colonial ruling. The Hansung Association of Dentists established in 1925 was the organization made by the necessity of the association for Koreans only. the Japanese forcefully annexed the Association of Hansung Dentists (Koreans only) to the Association of Kyungsung Dentists to avoid collective actions of Korean dentists in the name of 'Naesunilche'--'Japan and Korea are one'. Their invading intention was shown in the event of 'decayed tooth preventive day'. Japanese controled the gold for dental treatment by licensing and limited the stuff for dental treatment by rationing. The association of Chosun dentists was a group organized for the academic purpose by Nagira Dasoni and etc. In October of 1919, where as the association of kyungsung dentists was constructed on the background of Nagira Dasoni. This establishment of the association of Kyungsung dentists represented a backlash against Ikuda singho having a complete control over the association of Chosun dentists. The number of Koreans who wrote to the Chosun Dental Science Academy was 27, and they wrote 75 articles, which amounted to 15% of 486 articles. The number of Koreans who wrote to the Kyungsung Dental Science Academy was 16, and they wrote 52 articles, which amounted to 11% of 481 articles. These had been a lot of improvement by activity backlash of the dental association. However, they experimented Korean people. The experiments included the experimental stimulation of dental pain by Nagira Dasoni, use of toxic agents on human bodies such as mercury, bismuth and carcinogenic benzole, and experimental treatments with a poor prognosis. Worst of all, the rapid discrimination was stressed. The different dentition according to races was the subject of comparison researches. The dangerous chemicals were sometimes used. The non-akaloid medication was investigated to relieve the dental pain but, the habitual side effects were not unusual by the overuse of morphine or heroin, which was known to be irrelevant due to their habitual side effect. The use of new and unproven material was recommended as well. Especially, the alloy that substituted gold, attracting attention, was substantiated by researches.
Colonialism/*history ; *Dentistry ; English Abstract ; History, 20th Century ; Japan ; Korea

The Research Department of the Severance Union Medical College was founded on November 4th, 1914. Drs. R. G. Mills, J. D. VanBuskirk and A. I. Ludlow were the co-founders of the department. The department aimed at investigating the medical problems of Koreans which originated from the differences of diet, customs and habits. The main fields of the research were divided into three: traditional medicine, diet of the Koreans, and special diseases in Korea. As to the research of the traditional medicine, Mills conducted extensive investigations on the drugs mentioned in the pharmacopeia of the traditional medical texts. His work included the translation of the medical texts into English, which unfortunately was not published, and the collection of thousands traditional drugs and botanical specimens. To the second field, VanBuskirk contributed much. His research was mainly focused on investigating the characteristics of Korean diet, finding out its problems, and recommending more balanced diet. The third field was the research of the diseases specific in Korea. The diseases caused by various parasites were the main targets of the research. At first, the Research Department was a laboratory where research was actually being carried out. But, its nature has been changed as each department became the center of research activities. The Research Department became a research promoting center which provides research funds for each department or individual researchers. The founding of the Research Department in the Severance Union Medical College marks a turning point in the history of SUMC in the sense that academic activities began to become more important in the missionary institute.
English Abstract ; History, 20th Century ; Korea ; Research ; Schools, Medical/*history

Orthotopic liver transplantation (OLT) is now considered as a standard procedure for patients with end-stage liver disease. The number of patients listed for OLT using the brain-dead donor continues to outpace the number of OLT performed since early 1990s because the improved results of OLT had made it as a therapeutic means for irreversible liver disease. This scarcity of organs from the deceased donors has resulted in the increased use of the living donor liver grafts. Although the shortage of the brain-dead donor organs is a world-wide problem, the situation is especially serious in our country, where the deceased donor organ donation remains below 2 per million population per year. Now, Korea has the greatest need for living donor liver transplantation although it is more complex and demanding procedure than the deceased donor (whole organ) liver transplantation. Refinements of the technique and good results have rapidly established the position of the living donor liver transplantation in our country's transplant medicine. 2,345 OLTs (1,860 from the living donor and 485 from the deceased donor) were performed in 24 institutes from March 1988 to December 2004, although 5 institutes had performed more than 10 OLTs per year. Definitely, living donors represent a large pool of organs, but there might be a significant cost, mainly donor risk, to draw from this pool. To alleviate some disadvantages of the living donor liver transplantation and to provide organ to the patients who cannot find out the potential living donor from family members, recognition of necessity and nation-wide cooperative participation of organ donation after the brain-death should be propagated and encouraged in our country.
English Abstract ; Humans ; Korea ; *Liver Transplantation/contraindications ; Living Donors

Medical license is to qualify a person for medical practice and to attribute him/her a privileged right in the practice. This privileged and exclusive right asks for protection from the side of a state and the state in turn needs qualified medical personnel in order to carry out her task of public health, one of the main duties of modern states. In Europe, physicians succeeded in obtaining medical license that guarantees the privileged right in a highly competitive medical market against other practitioners. The first regulation for medical license in Korea was made in 1900 when few Korean doctors trained in Western medicine was in practice. The regulation aimed at controlling traditional medical practitioners who had been practicing medicine without any qualification as a physician. The regulation was very brief, consisting of only seven articles. A newly revised regulation appeared in 1913 when Korea was under the occupation of Japan. The Japanese Government-General enacted a series of regulations about medical personnel, including dentists and traditional medical practitioners. This heralds its full-scale engagement in medical affaires in Korea. Unlike the case of European countries where medical license was obtained after a long struggle with other practitioners, in Korea, medical license was given to doctors too easily from the state. And this experience played a very important role in the formation of identity of Korean doctors.
English Abstract ; History of Medicine, 20th Cent. ; Korea ; Licensure, Medical/*history

Despite the small size of its genome (3.2 kb) and having only four genes that are encoded within it, the hepatitis B virus (HBV) is one of the most successful viral pathogens in human history. It is estimated that there are about 350-400 million people worldwide who are chronically infected with HBV, and even with the extensive efforts that are being done with preventive vaccination, this malady still remains a clear and present danger to the public health. How is it possible that this small double-stranded DNA virus can escape and outfox the surveillance of the complex human immune system? One explanation is that HBV gene products play multiple roles in infections and throughout the viral life cycle so that the virus can effectively survive under various hostile circumstances. Indeed, the HBV DNA polymerase, for example, exerts several functions such as reverse transcription and RNA degradation, and the HBV X protein not only acts as a transcriptional activator, but it also interferes with the host cells' DNA repair mechanism as well as inducing apoptosis and controlling signal transduction. The HBV surface protein, which is encoded in the env gene, is another intriguing example of such multifunctionality. Thus, our present article overviews and summarizes the multifaceted role of this membrane protein as shown in 1) its role as a structural protein of the virus envelope; 2) its function as the viral ligand for interacting with the viral receptors on host cells; 3) its characteristics as an energy-independent transporter molecule that can mediate the nuclear accumulation of itself and other tagged molecules; 4) its role as a viral transactivator protein that can cause hepatocellular carcinoma; 5) its hypothetical function in viral apoptotic mimicry that results in host anti-inflammatory responses; and last 6) its immunostimulatory property by providing for strong and well-defined B- and T-cell epitopes. Understanding these various functions and the versatility of this single protein will help us decipher and understand the viral- and immuno-pathogenesis of HBV itself.
Animals ; English Abstract ; Hepatitis B Surface Antigens/*physiology ; Humans