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

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

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

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

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

Hansung Physicians Association was organized in Dec. 1915. Its members were medical practitioners residing in Kyungsung(Seoul). It was apposed to Kyunsung physicians Association, of which members were Japanese. After the foundation of Hansung Physicians Association some other local physicians associations were beginning to be founded. Hansung Physicians Association's social activities were fee-free round practice and improving sanitary conditions. It was basically gathering-meeting or interest group for doctors, which is reflected in the fact that Hansung Physicians Association limited its members as medical practitioners. It is contrasted with the Chosun Medical Association which was founded in 1930. Chosun Medical Association differs from Hansung Physicians Association in the it was a academic association. The first issue of Bulletin of Hansung Physicians Association was published in August 1933. But it came to be the last issue. Hansung Physicians Association was disorganized compulsarilly in 1941 by Japanese Government-General of Korea
English Abstract ; History of Medicine, 20th Cent. ; Korea ; Societies, Medical/*history