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

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

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

Medical management of acute pancreatitis relies on supportive care such as fluid resuscitation and pain control. Prophylactic antibiotics can reduce the opportunity of infection in severe pancreatitis. The effect of somatostatin or protease inhibitors still needs to be evaluated through further study. Early endoscopic retrograde cholangiopancreatography (ERCP) can ameliorate the course of severe biliary pancreatitis. Although sterile pancreatic necrosis, acute fluid collection, and pseudocyst usually resolve spontaneously, endoscopic or percutaneous drainages are needed when these complications are infected.
Acute Disease ; English Abstract ; Humans ; Pancreatitis/complications/*therapy

Acute pancreatitis is an inflammatory disease of pancreas which come from various etiologies. The pathologic spectrum of acute pancreatitis varies from mild edematous pancreatitis to severe necrotizing pancreatitis. To diagnose and to predict severity in acute pancreatitis, various biochemical marker, imaging modalities and clinical scoring sytstem are needed. Ideal parameters should be accurate, be performed easily and enable earlier assess. Unfortunately, no ideal parameter is available up to date. Serum amylase and lipase are still useful for the diagnosis but meaningless in predicting severity. C-reactive protein and inflammatory cytokines are promising single parameters to predict the severity. CT finding is also an useful determinant of severity, but is expensive and is delayed in assessment.
Acute Disease ; English Abstract ; Humans ; Pancreatitis/*diagnosis ; Severity of Illness Index

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