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

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

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

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

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