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This paper aims to examine the establishing background, curriculum and organization of personnel of Nurses' Training School of PO KU NYO KWAN(Caring For and Saving Woman's Hospital), the first nurses' training school in Korea. It is attempt to richen Korean medical history by the historical approach to modern nurses' training institution in Korea. PO KU NYO KWAN, the first women's hospital in Korea was established in 1887 by Metta Howard, who was sent by the Woman's Foreign Missionary Society of Northern Methodist Episcopal Church. Women doctors who were responsible for PO KU NYO KWAN felt the necessity of the professional nurses' training institution during performing medical activity with the help of Korean assistants and asked the Woman's Foreign Missionary Society to establish the nurses' training institution consistently. Margaret J. Edmunds was sent with the mission to establish nurses' training school in PO KU NYO KWAN. She made regulations for establishing nurses' training school, translated 'nurse' into "Gan-ho-won" in Korean language, made nurses' uniforms and prepared textbooks. Nurses' Training School of PO KU NYO KWAN was opened late December in 1903 officially. It had various subjects relating nursing in curriculum. The faculty of it was mainly comprised of medical missionaries of Methodist Episcopal Church and Presbyterian Church. Also the graduates of Severance Medical School and the graduates and students of Nurses' Training School of PO KU NYO KWAN participated its curriculum as teaching staff. In late 1920, Joseon Nurses Association (Joseon ganhobuhoe) discussed about the requirements for admission and the course of study for missionary nurses training school. After this process, students who were qualified for high-level class could have admission for Nurses' Training School of PO KU NYO KWAN. Medical staff belonged to East Gate Hospital and the graduates of Ewha College taught classes in it. First capping ceremony was held on January 25, 1906 and first graduate ceremony was held on November 11, 1908 in Nurses' Training School of PO KU NYO KWAN. They were for nurse students who finished proper course of study. Capping ceremony and graduation ceremony were not held regularly. The superintendent of Nurses' Training School graduated qualified students irregularly. The superintendents of Nurses' Training School were Margaret J. Edmunds, Alta I. Morrison, Mary M. Cutler, Naomi A. Anderson, E. S. Roberts, M. M. Rogers, and E. T. Rosenberger. They worked for the establishment of the first Korean nurses' training school, the development of the curriculum of it, the organization of faculty of it and making various opportunity for nursing practical training till the closure of it in 1933. Professional experts of Korean nursing were produced thanks to their efforts. We can identify 49 graduates of Nurses' Training School of PO KU NYO KWAN, including KIM Martha and LEE Grace. After graduation, most of them worked as nurses in mission hospitals and institutions and taught classes in nurses' training school. Nurses' Training School of PO KU NYO KWAN was the first modern nurses' training institution in Korea. Korean women could turn over new leaves, overcome their traditional view of womanhood which they had as Korean women, and change their consciousness in it.

PoKuNyoKwan was established in 1887 by Meta Howard, a female doctor who was dispatched from Woman's Foreign Missionary Society, an evangelical branch affiliated with U.S. North Methodist Church. PoKuNyoKwan was equipped with dispensaries, waiting rooms, pharmacies, warehouses, operating rooms, and wards for about 30 patients. It used a traditional Korean house, which was renovated for its medical purpose, in Ewha Haktang. Residing in Chung Dong, the medical institution had taken care of women's mental and physical health for about 25 years, until it was merged with East Gate Lillian Harris Memorial Hospital in 1912, and then its dispensary function was abolished in 1913. Medical missionaries (Meta Howard, Rosetta Sherwood, Mary M. Cutler, Emma Ernsberger, Esther K. Pak, Amanda F. Hillman) and nurse missionaries (Ella Lewis, Margaret J. Edmunds, Alta I. Morrison, Naomi A. Anderson), who were professionally trained in the United States, and their helpers, who were trained by those missionaries, managed PoKuNyoKwan. Nurses who were educated in Nurses' Training School, which was also established by PoKuNyoKwan, helped to run the institution as well. At the beginning, they usually had worked as a team of one medical missionary and three helpers. Since its establishment in 1903, however, the helpers began to enter the Nurses' Training School to become professional nurses, and the helpers eventually faded out because of the proliferation of those nurses. PoKuNyoKwan did not only offer medical services but also executed educational and evangelical activities. Medical missionaries struggled to overcome Koreans' ignorance and prejudice against westerners and western medical services, while they took care of their patients at office, for calls, and in hospital dispensaries. Enlightening the public by criticizing Korean traditional medical treatments including fork remedies, acupuncture, and superstitions, they helped modernization of medical systems in Korea. In the area of education, Rosetta Sherwood taught helpers basic medical science to make them regular medical staff members, and Margaret J. Edmunds established the Nurses' Training School in PoKuNyoKwan for the first time in Korea. The nurses who graduated from the school worked at PoKuNyoKwan and some other medical institutions. Evangelical activities included Bible study in the waiting rooms of PoKuNyoKwan and prayer meeting on Sunday for those who were treated in PoKuNyoKwan. The institution in the end worked as a spot for spreading Christianity in Korea. As the first women's hospital, PoKuNyoKwan attempted to educate female doctors. Eventually, it played a role as a cradle to produce Esther K Pak, who was the first female doctor in Korea. The hospital also ran the first nurse training center. It was, in a real sense, the foundational institution to raise professional practitioner undertaking medical services in Korea. Therefore, it is reasonable to say that PoKuNyoKwan provided sound basis for the development of modem medical services for women in Korea.

Esther K. Pak (1876-1910) is believed as the first medical doctor in Korea. Esther's life can be largely reviewed in three parts: school-hood at EwhaHaktang (currently Ewha Womans University), Education in the United States, and medical missionary work after coming back to Korea from the United States. The foreign Methodist missionaries was able to enter Korea after opening of its ports and establishing its diplomatic relationship with the United States. Esther met modern sciences and Christianity at EwhaHaktang, which was founded by those missionaries. She could dream of being an American-style medical doctor in the future, while she assisted medical missionaries at PoKuNyoKwan in EwhaHaktang. She could get substantial academic help from those missionaries. With the support of Dr. Rosetta Sherwood Hall, who first introduced the world of medial science to Esther in a real sense, Esther went to the United States to study the field in 1894. While learning it, she suffered from academic frustration, economic difficulty, her husband's death and so on, but she eventually got over those adversities and completed the four years of academic courses to become a medical doctor. Her religious faith and will to help Koreans as a doctor encouraged her to finish what she had originally planned. Esther came back to Korea in 1900 and began to work earnestly as a medical missionary delegated from Woman's Foreign Missionary Society. At PoKuNyoKwan in Seoul and Woman's Hospital in Pyongyang, She performed medical work and enlightenment campaign against the superstitious healing conduct. Esther also took part in the circuit missionary performances. She devoted herself for evangelical work at Bible Institute as well. Esther's activity made people understand the effectiveness of education. She helped people to recognize education for woman, occidental medical treatment and Christianity in a positive way. On April 28, 1909, based on these excellent performances for the social development, she was invited, honored and granted a testimonial at the first welcoming ceremony, which was held by the united body of civilians and officials, for students studying abroad. But on April 13, 1910, about one year after the ceremony, she died of illness. She was 34. Although she was born at the turbulent last period of Korea Empire and lived for only 34 years, Esther's medical missionary work was evaluated as the opening of woman's participation in medical science in Korea. Not only in the 'woman's' but also in 'whole' field of medical science, her performance left significant marks in woman's and Christian history in Korea as well.

Background/aims: Percutaneous endoscopic gastrostomy (PEG) is a method widely used for long-term enteral nutrition in dysphagia. Mostly, it is preceded by nasogastric intubation (NI) for short-term enteral nutrition; endoscopic findings associated with NI are encountered during PEG. The purpose of this study was to discuss such findings and to delineate a relationship between these findings, especially esophageal lesions and the duration of NI., Methods: This study involved 185 individuals who had undergone PEG at Kyung Hee Medical Center from January 1999 to May 2002. The medical records were examined retrospectively., Results: The dysfunction of the CNS comprised 98.4% of the causes of dysphagia. The duration of NI was 15.2 weeks on average, with median value of 8.7 weeks, indicating that PEG was performed relatively soon. Endoscopic findings revealed esophagitis in 63 cases, esophageal ulcers in 27 and active bleedings in another 10. The incidence of esophageal lesions was shown to be higher in subjects with duration of NI under 12 weeks than in those with duration over 12 weeks (p=0.032)., Conclusions: PEG was carried out in many cases during the early stages of dysphagia, and NI-associated esophageal lesions appeared to be more prevalent within 12 weeks of NI duration. These results may be of help in deciding the timing of PEG.

Pouchitis, a non-specific acute inflammation occurring in the ileal pouch, is one of the most common complications developed after the restorative proctocolectomy and ileal pouch-anal anastomosis (IPAA) performed for the treatment for the patients with ulcerative colitis and familial adenomatous polyposis. The prevalence of pouchitis is known to range from 20% to 50%. One to two percent of the cases are chronic and resistant to the drug therapy. The effective treatment for this chronic resistant pouchitis is to remove the ileal pouch and perform the permanent ileostomy. Hereby, we report one case of chronic pouchitis resistant to multiple drug therapy developed after IPAA performed for the treatment of ulcerative colitis in a patient.