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

Lack of historical records causes some difficulties in the historical studies of ancient Korea. It is the same case as that of the history of medicine. We imagine what the situation of medicine was like in ancient Korea with a bit of historical records. In ancient times, medicine had very close relation with religions. In ancient Korea, it had very close relation with Buddhism. According to {Sam Kuk Sa Ki and {Sam Kuk Yu Sa buddhists monks treated patients with the religious rituals. In this article, the authors would like to present a record which had been unnoticed until now. It is the commentary of Wonhyo on a certain Buddhistic cannon called {Kum Kwang Myung Kyung. A chapter of this cannon is on the theory of medicine, causes of diseases and treatments. We can presume Wonhyo's knowledge of medicine at that time through his commentary on this chapter.
Buddhism/*history ; English Abstract ; History of Medicine, Ancient ; Korea ; Religion and Medicine

This dissertation is concerned not with medical theories, but with practices of Greek physicians, and I have addressed the subject of medical ethics as related to the Hippocratic tradition. And I have attempted a synthetic account of Greek physicians' actual practice and its ideals in the Hippocratic tradition. My understanding of the tradition succeeds the revelations in the first chapter of my doctorial thesis, one of them is the fact that Hippocratic tradition is amalgamation of ethical code with rational or scientific medical theory. In the first chapter of this dissertation, I have attempted a social history of Greek physicians by analyzing Hippocratic writings. The Hippocratic collections, Corpus Hippocraticum, throw light not only on the origins and early development of classical medicine, but on its place in Greek Society. In the second chapter, I aim at understanding of the medical morality in its practice by analyzing the Corpus. Particularly the Oath shall be examined. Some questions, above all, such as "Was it ever a reality or merely a 'counsel of perfection'?" can not be answered. But by the way of the examination of the deontological treatises, the characters of the ethics of Greek physicians become clear. It was the result of outward performance in the relation of inner intention. In the result Greek physicians were the first to attempt to establish a code of behaviour for the medical profession and to define the doctor's obligations to the society.
English Abstract ; Ethics, Medical/*history ; Greece ; History of Medicine, Ancient

Stem cells are undifferentiated cells capable of undergoing self-renewal and differentiation into a variety of cell types. They are derived from adult tissues (adult stem cells) as well as embryonal blastocysts (embryonic stem cells). Embryonic stem cells have pleuripotent capacity able to form tissues of all three germ layers but many ethical controversies concerning resource allocation or methods of harvesting are arising. Recently, many studies have demonstrated the multipotency of adult stem cells, but the mechanism of the plasticity remains to be determined yet. Several studies have suggested the possibilities of application of stem cells or tissue specific cells to regenerate gastroenterologic diseases such as liver cirrhosis, hepatitis, or inherited metabolic disorders. However, most of those trials are still limited to animal models, although anecdotal claims of successful therapy in humans have been reported. Even though the expectations and the promise of cell therapy are high, clinical efficacy has not been definitely demonstrated at this time. Thus, the application of cell therapy cannot be recommended to the patients outside the clinical trial setting.
English Abstract ; Gastrointestinal Diseases/*surgery ; Humans ; *Stem Cell Transplantation

This article explores the medical system of the Koryo Dynasty period and its social characteristics. First, the structure of medical system and roles of medical institutions during the Koryo Dynasty period will be summarized. Then, the characteristics of the medical system will be identified through exploring the principles of its formation in a view of social recognition of medical care and a view of public policy. During the Koryo Dynasty period, medical experts were trained in national education institutions from the early days of Dynasty. After trained, they were appointed to the posts at government service with their medical profession. In the meantime, they sought ways to ascend their social position. Physicians of Oriental medicine were appointed to the posts at each local government and troops to take charge of medical treatments of the common people. Also, the state tried to assume the reins of medical system by actively taking part in circulation (collection and distribution) of herb. Taeuigam and Sangyakguk represent central medical institutions of the Koryo, taking charge of medical service for the aristocracy and the bureaucracy. The Common people were treated at DongSeoDaeBiWOn, JeWuiBo, HyeMinGuk, and YakJum in SeoKyung. However, activities of these institutions became less active around the days of military officials regime, as officers became negligent and financial base went broken. The roles of medical institutions of the Koryo government were not restricted to the treatment of diseases. Policies for the common people were constituted by two main policies, the policy for encouraging agriculture and the policy for giving relief to people. Medical institutions, with other social systems, had a social responsibility to support the governing system of the Koryo and maintain the stability of the society. In this aspect, medical institutions such as DongSeoDaeBiWon and JeWuiBo, and relief institutions such as UiChang, were all related and connected organically, and they were results of, and bases of the relief policy. However, medical system for the common people was made up first for practical needs and then improved successively. Allocation of medical experts and execution of relief work were carried out by each local government, except the case of serious disaster, which central government took part in. As the Koryo Dynasty went into its latter period, temporary institutions and one - time benefits replaced permanent institutions. These four characteristics described above were systemic characteristics of medical system during the Koryo Dynasty period.
English Abstract ; History of Medicine, Medieval ; Korea ; *Medicine ; Political Systems/*history

Medical education in North Korea began with 2 medical colleges established during the 1930s and 1940s, and each Province came to have one medical college by the 1970s. It is presumed to exist 14 medical colleges in 1992. Apart from medical colleges, there are several kinds of medical schools. the number of medical practitioners has increased as the number of educational institutes for medicine increased. In 1996, there was 29.7 medical practitioners for 10,000 persons. They have several kinds of academic degrees in North Korea. They include: Wonsa, candidate Wonsa, doctor, vice-doctor, candidate doctor. In the university they have professor, associate professor, associate professor, lecturer, and research assistant. Academic degrees and positions are given not by the university nor research institute, but by the Government Board for Awarding Academic Degree and Position. Concerning research institutes, there is Chosen Institute for Medical Science that once was a medical research center under the Central Science Academy, and became an independent institute in 1963. Besides this institute, universities have their own research institutes, and there are also some other independent institutes.
Education, Medical/*history ; English Abstract ; History of Medicine, 20th Cent. ; Korea

Kim Doo-jong, the founder of the history of medicine in Korea, was born on 2nd March, 1896. After finishing his primary education in his home town, he went to Seoul to receive a higher education. He entered Keijo Medical College in 1918. However, at the end of his first year, he participated in the 3 . 1 movement which protested against Japanese harsh rule over Korea. On account of his participation in the movement, he was forced to leave the college which was run by the Japanese colonial government. Then he went to Japan to enter Kyoto Municipal Medical College, from which college he graduated in 1924. After the graduation, he went to Beijing to work in a hospital run by Japanese. Having felt uncomfortable about the situation in Beijing, he moved to Manchuria, where he opened his private clinic and saw patients for 7 years. As the life as a clinician did not satisfy him, he gave up his practice, and determined to devote himself to the study of history of medicine. He was 43 years old when he started studying history of medicine at the Dong Ah Institute, an affiliated research institute of Manchuria Medical College founded by Japanese. The institute had a large and magnificent collection of ancient texts of oriental medicine. He set on historical studies on the oriental medicine from the perspective of the Western medicine. His doctorial dissertation was about anatomy in oriental medicine. He intended to continue his study on organology, myology, etc., but the sudden end of the World War II made him return to Korea. This meant that he could not make access to the large collection of the institute, and his themes of the research had to be changed. On returning to Korea, he established the Department of the History of Medicine in Seoul National University, which was the only and the first one of its kind. He wrote History of Korean Medicine, which still remains one of the most important works on the history of Korean medicine. He was very energetic and active in his academic activities even during his late years. He passed away on 18th May 1988 at the age of 92.
English Abstract ; *Historiography ; History of Medicine, 20th Cent. ; Japan ; Korea

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

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