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

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

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

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

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