In search of Jong Ha Kim, the first Korean medical doctor in modern Daejeon city

Recently, it was revealed that Jong-Ha Kim was the first self-employed Korean physician in Daejeon city of South Korea during the Japanese colonial period. However, little is known about him. In this paper, the author aimed to search for historical records of his activities as the first Korean physician in Daejeon city.Current Concepts: Kim’s clinic in Daejeon city was called Chung-Ang Clinic. This is all that has ever been confirmed about Jong-Ha Kim. The author has been searching for his medical record for the last year. Kim’s medical records were collected from journal papers on the modern history of Korea, National Institute of Korean History database, Naver news library archive, official gazette of the Japanese government-general of Korea, database of Seoul National University alumni, and a resume of a professor at the Hamhung Medical School. The results are as follows. He was born in Shinchang-ri Hamheung city Hamgyeongnam-do on August 9, 1900. He graduated from the missionary school established by Canadian missionaries and was admitted to Kyungseong (Keijo) Medical School in 1918. It was recently discovered that he participated in the Independence movement on March 1, 1919. His picture, an old leaflet for his clinic which he had used, and his resume as a professor at the Hamhung Medical School were discovered for the first time.Discussion and Conclusion: The historical records of Jong-Ha Kim’s life provide insight into the lives of contemporary doctors in modern Korea. During the period of 1900 to 1950, which encompasses his historical records, significant events took place in Korean history, and he actively participated in these events. Despite facing numerous difficulties as a doctor in modern Korea, Jong-Ha Kim made decisions that had a great impact. He was a great doctor who served as a good role model.

Akkermansia muciniphila-derived extracellular vesicles influence gut permeability through the regulation of tight junctions

The gut microbiota has an important role in the gut barrier, inflammation and metabolic functions. Studies have identified a close association between the intestinal barrier and metabolic diseases, including obesity and type 2 diabetes (T2D). Recently, Akkermansia muciniphila has been reported as a beneficial bacterium that reduces gut barrier disruption and insulin resistance. Here we evaluated the role of A. muciniphila-derived extracellular vesicles (AmEVs) in the regulation of gut permeability. We found that there are more AmEVs in the fecal samples of healthy controls compared with those of patients with T2D. In addition, AmEV administration enhanced tight junction function, reduced body weight gain and improved glucose tolerance in high-fat diet (HFD)-induced diabetic mice. To test the direct effect of AmEVs on human epithelial cells, cultured Caco-2 cells were treated with these vesicles. AmEVs decreased the gut permeability of lipopolysaccharide-treated Caco-2 cells, whereas Escherichia coli-derived EVs had no significant effect. Interestingly, the expression of occludin was increased by AmEV treatment. Overall, these results imply that AmEVs may act as a functional moiety for controlling gut permeability and that the regulation of intestinal barrier integrity can improve metabolic functions in HFD-fed mice.

Less than 0.5 cm Papillary Thyroid Cancer / 대한내분비외과학회지

PURPOSE: The authors analyzed the characteristics of papillary thyroid microcarcinomas less than 0.5 cm in diameter to investigate an optimal extent of surgical resection. METHODS: Between October 1994 and October 2003, out of 635 cases of papillary thyroid microcarcinomas, 229 cases less than 0.5 cm in diameter were reviewed retrospectively to analyze their clinical and pathological characteristics. RESULTS: Mean diameter of the carcinomas was 3.9±1.2 mm for carcinomas less than 0.5 cm in diameter (group 1) and 7.7±1.4 mm for carcinomas between 0.5 and 1.0 cm in diameter (group 2). Total thyroidectomy, subtotal thyroidectomy, lobectomy & isthmectomy in group 2 were carried out in 308 (75.9%), 72 (17.7%) and 26 (6.4%) cases. Follow by group 1 were carried out in 109 (47.6%), 84 (36.7%) and 36 (16.7%)cases respectively. Between the two groups, perithyroidal invasion was 29.3% and 49.0%, multifocality was 24.9% and 32.8%, bilaterality was 13.1% and 21.4%, lymph node metastasis was 10.1% and 18.3% respectively with each data showing statistical significance (P<0.05). Completion thyroidectomy was carried out in 14 cases, of which 8 cases revealed carcinomas in the residual thyroid lobe. The group 1 required completion thyroidectomy more than the group 2 (P=0.026). There were less cases of lymph node metastasis among the group 1. Nine out of the 36 cases (25%) of the group 1 which underwent lobectomy & isthmectomy needed completion thyroidectomy, among them 6 cases (66.7%) revealed papillary carcinoma in the residual thyroid lobe. CONCLUSION: Micropapillary cancer was discovered more frequently by increasing the use of ultrasonography. Multifocality, bilateraluty and perithyroidal invasion were observed higher in group 2 rather than group 1. However, the relation between these facts and prognosis will need long term follow up.

Clinical Review of Primary Hyperparathyroidism / 대한내분비외과학회지

PURPOSE: The increased detection of hypercalcemia during health screening has been increased the diagnosis of hyperparathyroidism. The surgical treatment of primary hyperparathyroidism has been changing from standard exploration for all 4 parathyroid glands to minimally invasive surgery focused to abnormal gland. For the latter, exact preoperative localization is necessary. The aims of this study were to evaluate clinical features of patients with primary hyperparathyroidism and the preoperative localization methods. METHODS: A retrospective study was performed for 61 patients with primary hyperparathyroidism in Samsung Medical Center. RESULTS: There were 19 males and 42 females whose ages ranged from 12 to 76 years. Among 61 patients with primary hyperparathyroidism, there were 51 adenomas, 7 hyperplasias and 3 adenocarcinomas. Preoperative parathyroid hormone (PTH) level was increased in all patients except in a MEN IIA associated patient. Among the methods for preoperative localization, ultrasonography detected 47 of 55 cases (85.5%), (99m)Tc-sestamibi scan 40 of 49 cases (81.6%), MRI 3 of 5 cases (60.0%), CT 9 of 18 cases (50.0%) and Tl-Tc subtraction scan 6 of 9 cases (66.7%). In 26 patients who have been diagnosed as single nodular lesion in the same area by the parathyroid scan and ultrasonography, we could find a single parathyroid adenoma in that area during exploration. Postoperative PTH level of all patients but one were normalized. CONCLUSION: Single gland disease detected by both parathyroid scan and ultrasonography was mostly due to adenoma which can be treated safely by unilateral exploration or minimally invasive surgery.

Activities of Daily Living of Elderly in a Rural Area and Study for Related Factors

BACKGROUND: The population is aging and life expectancy is increasing. It is important to evaluate the functional ability of elderly for optimal care for elderly. This study was conducted to assess functional disability of elderly and to find out the factors having an effect on the disability. METHODS: It surveyed 1,541 individuals aged 65 years and older in Cluing-Yang province. Six ADL categories (bathing, dressing, feeding, transferring, toileting, and walking) were assessed and related factors were analyzed. RESULTS: ADL was independent in 85.2% of elderly and dependent in 14.8% of elderly. 55.1% of dependent elders were living without family. Bathing was the most common disable AI)L category. The factors having an effect on the disability of ADL were brain disease, self-rated health status, dyspnea, constipation, heart disease, diabetic mellitus, and living status. CONCLUSION: In a rural area, special prevention programs for brain disease, heart disease, and diabetic mellitus and a rehabilitation health service may improve ADL status of elders.

Effects of Cyclosporin A on the Cell Cycle Regulation of Human Gingival Fibroblasts / 대한치주과학회지

Cyclosporin A is a cyclic polypeptide produced by the metabolism of fungi. It is widely used at present as immunosuppressive treatment following organ transplants. It is also used to deal with autoimmune diseases such as rheumatoid arthritis or type II diabetes. Gingival hyperplasia is one of the most frequent side-effects associated with the prescription of Cyclosporin A. The mechanisms involved in Cyclosporin A induced gingival hyperplasia are not yet clear. In vitro Cyclosporin A promotes proliferation of gingival fibroblasts, that Cyclosporin A act as a mitogen. Its action is based on mitosis of gingival fibroblasts regulated by cell cycle regulatory proteins. It was the purpose of the present study to examine the effects of Cyclosporin A on human gingival fibroblasts by means of biological and biochemical criteria. In this present study, we examined change of cell proliferation, cell activity, cell viability and cell cycle progression after application of Cyclosporin A. We also examined expression of cell cycle regulatory proteins by western blot analysis. Human gingival fibroblasts were cultured for 48 hours with application of Cyclosporin A at concentrations of 0.01, 0.1, 1, and 10 ng/ml. Cyclosporin A(1 ng/ml) significantly increased the cell activity of gingival fibroblast. Proliferation and viability of gingival fibroblasts were also increased in group treated with 1 ng/ml of Cyclosporin A compared to control group. In the cell cycle analysis, S phase was increased and G1 phase was decreased in the group treated with 1 ng/ml of Cyclosporin A. Cyclosporin A increased the expression of cdk4 and inhibited the expression of pRB and p21. These results suggest that 1 ng/ml of Cyclosporin A may increase the cell cycle progression of human gingival fibroblasts, and its mechanisms may increase the expression of cdk4 and decrease the expression of pRB and p21.

Effects of Extracts of Natural Products on Alkaline Phosphatase Activity of MC3T3-E1 Cells / 대한치주과학회지

Several growth factors and polypeptides were studied for the regeneration of periodontal supporting tissues which had been lost due to periodontal disease. But these are not commonly used for regenerators of bone tissue or alveolar bone, because of the insufficiency of studies on their side effects, genetic engineering for mass production and stability for clinical application. Recently, many natural products, which have advantage of less side effects and possibility of long-term use, have been studied for their capacity and effects of anti-bacterial, anti-inflammatory and regenerative potential of periodontal tissues. Cnidii Rhizoma, Rhinocerotis Cornu and Drynariae Rhizoma have been traditionally used as a drug for treatment of bone disease in oriental medicine. The purpose of this study was to examine the ability of alkaline phosphatase synthesis of MC3T3-E1 cells when above medicines were supplimented. MC3T3-E1 cells were cultured with alpha-MEM(negative control), dexamethasone(positive control), and each natural products for 3 and 5 days. And then ALP synthesis was measured by spectrophotometer for enzyme activity and by naphthol AS-BI staining for morphometry. Except Cnidii Rhizoma, all of the natural products of this study induced higher activity of ALP synthesis than controls. Among them Drynariae Rhizoma induced the highest activity. In the aspects of culturing time, all medicines did not showed the difference between 3 and 5 days, but 10-7g/ml group of Rhinocerotis Cornu showed significant increase at 3 days than at 5 days. These results indicate that several natural products have a inducing ability of ALP synthesis on osteoblasts.

Lymphoepithelial Cyst with Sebaceous Differentiation(unilocular sebaceous lymphadenoma) of the Pancreas; Dermoid Cyst or Not?: A case report

A 70-year old man presented with postprandial upper abdominal pain of two months duration, accompanied by indigestion, weight loss, and anorexia. There was no abnormality noted in the lab results. Abdominal CT showed a 3-cm round cystic mass in the tail of the pancreas. A distal pancreatectomy was done. The patient was discharged in 9 days. The cystic wall was composed of a keratinizing squamous epithelium surrounded by subepithelial, dense lymphoid tissue. Some clusters of the sebaceous gland were noted but there was no sweat gland or hair follicle. These findings were consistent with a lymphoepiethelial cyst with sebaceous differentiation. The patient was followed up for 12 months post operatively, and no recurrence was noted.

Lymphoepithelial Cyst with Sebaceous Differentiation(unilocular sebaceous lymphadenoma) of the Pancreas; Dermoid Cyst or Not?: A case report

A 70-year old man presented with postprandial upper abdominal pain of two months duration, accompanied by indigestion, weight loss, and anorexia. There was no abnormality noted in the lab results. Abdominal CT showed a 3-cm round cystic mass in the tail of the pancreas. A distal pancreatectomy was done. The patient was discharged in 9 days. The cystic wall was composed of a keratinizing squamous epithelium surrounded by subepithelial, dense lymphoid tissue. Some clusters of the sebaceous gland were noted but there was no sweat gland or hair follicle. These findings were consistent with a lymphoepiethelial cyst with sebaceous differentiation. The patient was followed up for 12 months post operatively, and no recurrence was noted.

Solid and Papillary Neoplasm and Nonfunctioning Islet Cell Tumor: Differential Diagnosis and Study of Histopathogenesis by Immunohistochemical Staining

PURPOSE: Solid and papillary neoplasms and nonfunctioning islet cell tumors are both rare pancreatic tumors, and their clinical and pathological features are similar which makes it hard to differentiate between them. Because both tumors have different prognoses, it is important to have precise diagnosis. The etiology of solid and papillary neoplasm is not precisely known. The role of sexual hormone has been debated as this tumor occurs mostly in women. METHODS: We retrospectively reviewed the medical records of 13 patients with solid and papillary neoplasm and 11 patients with nonfunctioning islet cell tumors who had been treated by surgical resection between October 1994 and May 1999 at Samsung Medical Center. Immunohistochemical stainings were performed for neuron-specific enolase (NSE), chromogranin, somatostatin, alpha 1-antitrypsin, estrogen (ER), and progesterone (PR) receptors. RESULTS: The average ages of the patients with solid and papillary neoplasms and nonfunctioning islet cell tumors were 39.5 and 47.8 respectively. The male to female ratio was 2 to 11 and 6 to 5, respectively and solid and papillary neoplasms were more common in women. CT showed a cystic mass in 76.9% (10/13) of the solid and papillary neoplasm patients and 20% (2/10) of nonfunctioning islet cell tumor patients. Lymphadenopathy was noted in 0% (0/13) of the solid and papillary neoplasm cases and in 50% (5/10) of the nonfunctioning islet cell tumor cases, and calcifications were present in 46.2% (6/13) and 0% (0/10) of those cases, respectively. The solid and papillary neoplasms were located most commonly inthe tail of the pancreas (7 cases), and nonfunctioning islet cell tumors were located most commonly in the head of the pancreas (5 cases). No malignancies were detected in the solid and papillary neoplasms. Seven cases of the nonfunctioning islet cell tumors (63.6%) were malignant. Both solid and papillary neoplasms and nonfunctioning islet cell tumors stained positive for NSE and alpha 1-antitrypsin in all cases and they were chromogranin positive in 25% (3/12) and 100% (10/10) and somatostatin positive in 25% (3/12) and 60% (6/10) of the cases, respectively. A solid and papillary neoplasm stained positive for ER in 1 case and for PR in 5 cases. However, only 1 case of a nonfunctioning islet cell tumor stained positive for PR. CONCLUSION: A nonfunctioning islet cell tumor is more malignant tumor than a solid and papillary neoplasm, and age, presence of cysts, lymphadenopathy, calcification, and chromogranin staining can all be used for differential diagnoses of these tumors. Both the solid and papillary neoplasms and the nonfunctioning tumors are thought to originate from a stem cell capable of differentiating into endocrine cells. The sexual hormone seems to have a role in the development of solid and papillary neoplasms.

Solid and Papillary Neoplasm of the Pancreas; Clinical Review of 12 cases / 한국간담췌외과학회지

No abstract available.

Pancreatic Incidentaloma New approach to the pancreatic neoplasm by health screening

PURPOSE: Recently, the importance of early diagnosis and early treatment has been increasing, and there are many cases where tumors have been discovered incidentally. However, due to lack of reports regarding pancreatic cases, the clear management plan remains in dispute. This study attempted to analyse pancreatic cases so as to offer a management direction. METHODS: From October 1994 to May 1999, we experienced 28 cases of incidentally discovered pancreatic tumors and those cases were reviewed retrospectively. RESULTS: In regards to initial referrals for diagnosis, 19 cases were from general medical examinations, and 9 cases were referred due to symptoms or signs not related to their tumors (2 cases with hepatitis B, 2 cases with lung lesions, 1 case with a gastric leiomyosarcoma, 1 case with vaginal bleeding, 1 case with acute enteritis, 1 case with a toothache and 1 case with a headache). Twenty cases were initially detected from abdominal US, 3 cases from abdominal CT, 2 case from chest CT, 2 case from the simple abdomen, and 1 case from CA 19-9 investigation. The accuracies for diagnosing the precise type of tumor were CT 42.3% (11/26), ERCP 15.3% (2/13), abdominal US 12.5%, and (3/24). Postoperative pathologies included 7 serous cystadenomas, 6 solid-pseudopapillary tumors, 4 mucinous cystic neoplasms, 4 nonfunctioning islet cell tumors, 2 intraductal papillary mucinous neoplasms, 2 simple cysts, 1 ductal adenocarcinoma, 1 benign retension cyst, and 1 pseudocyst. Among these were 5 malignant neoplasms (3 nonfunctional islet cell tumors, 1 ductal adenocarcinoma, and 1 mucinous cystic neoplasm), and 17 cases (60.7%) were premalignant tumors. All cases were treated with a pancreatic resection, and postoperative follow-up was carried out for a period of 3-66 months. During thisperiod, no recurrence or mortality was noted other than 1 case of liver metastasis 12 months postoperatively for ductal adenocarcinoma. CONCLUSION: Although presence of a ductal adenocarcinoma is rare in incidentally discovered pancreatic tumors pancreatic incidentaloma is common in premalignant neoplasms. Therefore, even in asymptomatic cases, aggressive surgical resection is necessary for accurate diagnosis and early treatment.

Treatment Strategy for a Pancreatic Cystic Neoplasm

PURPOSE: Cystic pancreatic neoplasms are rare, but interesting, because of their high cure rate. With the exception of pseudocysts and serous cystadenomas, which are always benign, these cystic neoplasms are either premalignant or malignant. However, there is no reliable clinical criteria for differential diagnosis, and the treatment plan may be confusing. METHODS: From October 1994 to November 1999, 60 cases, diagnosed as a cystic neoplasm preoperatively were reviewed retrospectively. The clinical findings of benign lesions (benign group) and those for malignant or premalignant tumors (malignant group) were compared. RESULTS: The postoperative pathology results indicate 10 serous cystadenomas, 13 mucinous cystic neoplasms, 11 solid and papillary neoplasms, 10 duct ectasias, 2 cystic islet cell tumors, 1 metastatic papillary carcinoma, 1 lymphepithelial cyst, 2 simple cysts, 6 pseudocysts, and 4 retension cysts without malignancy. The mean age of the patients was 48.6 years, and the male-to-female ratio was 5 to 7. The accuracy of CT for diagnosing the malignancy of malignant tumors was 37.8% (14/37) and that of US was 22.2% (4/18). The rate of tumors having malignant potential was 71.7% (37/60). The mean size of the tumors in the benign group was smaller than that in the malignant group (p=0.014). There was a higher proportion of females in the malignant group than in the benign group (p=0.001). Heavy alcohol consumption was found more frequently in the benign group (p=0.021). There were no differences in the other clinical findings. The mortality rate of the operations was 0%, and the morbidity rate was 18%. CONCLUSION: Since it is difficult to determine the precise tumor type of a cystic pancreatic neoplasm preoperatively, all these lesions should be treated with surgical resection in order to identify and remove the malignant or premalignant neoplasms early. However, if the operative risk is high, malignant risk factors having large sized tumor, especially more than 6 cm, female, and having no history of heavy alcohol consumption may be useful for deciding the treatment plan.

Adenocarcinoma of the Body and Tail of the Pancreas;Treatment and Prognosis / 한국간담췌외과학회지

BACKGROUND: Adenocarcinoma arising in the body or tail of the pancreas tends to be metastasized at the time of diagnosis, is mostly in inoperable stage, and poor in prognosis. In this study, we evaluated the adenocarcinoma arising in the body or tail of the pancreas and investigated the prognostic factors and ideal treatment. MATERIAL AND METHODS: We retrospectively analyzed 33 patients who were cytologically or histologically confirmed as adenocarcinoma in the body or tail of the pancreas at Samsung Medical Center from October 1994 to December 1999. RESULTS: The mean age of the patients in the resectable and unresectable groups were 63.4 and 60.6 year-old, respectively. The mean CA19-9 level was higher in unresectable group (5166.2u/ml), compared to the resectable group (964.7u/ml).(p=0.039) In the resectable group, the body was the most common location of the tumor, and in the unresectable patient group, the tail was more prevalent.(p= 0.021) The mean survival time of the resectable group was 15.1months. The univariate analysis of the resectale group showed that the age, sex, lymph node metastasis, chemotheraeutic modalities, radiotherapeutic modalities, and the location of tumor were not significantly related with the prognosis. In unresetable group, the mean survival time was 6.4months. The mean survival time were 3.3 months in patients over 60 year-old and 9.9 months in patients less than 60, showing statistically significant difference.( p=0.007) The mean survival time were 12.2 months and 3.4 months in patients who received the chemotherapy and who did not, respetively.(p=0.004) Evaluating the relationship between the extent of metastasis and survival, the mean survival length of single metastasis was 9.3 months, showing significantly higher survival length compared that of multiple metastasis.(p=0.027) Patient's sex, radiotherapeutic modality and location of the tumor were not significantly related with the prognosis. Multivariate analysis of prognostic factor showed that the patietnt's age (p=0,842), the extent of metastasis( p=0.458), and chemotherapeutic modality (p=0.078) were unrelated with prognosis. CONCLUSION: In adenocarcinoma arising in the body and tail of the pancreas, the CA19-9 level and tumor location could be utilized as indicating factors of the operability of the tumor. Age, sex, lymph node metastasis, and location of the adenocarcinoma are not significantly related with the survival length in both the resectable and unresectable groups. Also, in both groups, the chemotherapeutic and radiotherapeutic modalities were not related with the survival length.

Pancreatic Islet Cell Tumor: Clinical Review of 12 Cases

BACKGROUND: Pancreatic islet cell tumors are very rare tumors that are classified into functioning, secreting hormone with specific symptoms, and nonfunctioning tumors without distinct symptoms. Because of their rarity, studies of them have been limitted. METHODS: We experienced 12 cases of pancreatic islet cell tumor at Samsung Seoul Medical Center from October 1994 to May 1998 and reviewed charts retrospectively. RESULTS: The mean age was 43.3 years; 46.3 years for those with functioning tumors. The most common symptom in nonfunctioning tumors was abdominal pain; other symptoms were abdominal mass, diabetes mellitus, and jaundice. With the functioning tumors, loss of conciousness and hypoglycemic sympathetic symptoms were present in all patients, and a seizure occurred in one case. The tumors were localized with abdominal CT in 91.7% (11 of 12), abdominal US in 87.5% (7 of 8), and selective angiography in 42.9% (3 of 7). The mean size was 1.7 cm in functioning tumors and 7.6 cm in nonfunctioning tumors. In 5 of the 6 cases, where the tumor was located in the pancreatic head, a pancreaticoduodenectomy was performed; enucleation was done in the other case. In the cases receiving a pancreaticoduodenectomy, choledochojejunostomy leakage was the only postoperative complication one case; there was a pancreatic pseudocyst in one case of enucleation. Of the functioning tumors, 3 (25%) were insulinoma; the remaining 9 (75%) tumors were nonfunctioning tumors. There were 4 cases (33.3%) of malignancies, and they were all nonfunctioning tumors. An immunohistochemical staining study showed evidence of multi-hormonal production in 45.5% of the cases, and all tumors showed a positive reaction to at least one hormonal marker. Two of the 3 insulinoma cases showed a positive reaction to insulin. Somatostatin was positive in 81.8% of the tumors, glucagon in 45.5%, and insulin in 18.2%. Chromogranin was positive in 71.4% of the tumors, synaptophysin in 60%, and neuron-specific enolase in 60%. CONCLUSION: There may be more cases of functioning tumors than have been reported and early diagnosis and treatment will reduce the incidence of malignancy. Abdominal CT or US is comparatively useful to localize the site of tumor and spiral CT angiography may be useful for the cases where nothing is detected with routine CT. Immunohistochemical staining is non-specific in classification of each islet tumor, but the positivity of any one of the hormonal markers may be useful in differentiating of pancreatic islet cell tumors from non-ilset cell tumors.

Effects of Several Natural Medicines on Alkaline Phosphatase Synthesis in MC3T3-E1 Cells / 대한치주과학회지

Several growth factors and polypeptides are not commonly yet used for regenerators of bone tissue or alveolar bone because of the insufficiency of studies on their side effects, genetic engineering for mass production and stability for clinical application. Recently, many natural medicines, which have advantage of less side effects and possibility of long-term use, have been studied for their capacity and effects of anti-bacterial, antiinflammatory and regenerative potential of periodontal tissues. Olibanum, Myrrha, Phlomis Radix, and Cimicifugae Rhizoma have been traditionally used as a drug for treatment of bone disease in oriental medicine. The objective of this study was to examine the ability of alkaline phosphatase(ALP) synthesis of rat calvarial osteoblast(MC3T3-E1) when several natural medicines were supplemented. MC3T3-E1 cells were cultured with alpha-MEM(negative control), dexamethasone(positive control), and each natural medicines for 3 and 5 days. And then ALP synthesis was measured by spectrophotometer for enzyme activity and by naphthol AS-BI staining for morphometry. All of the natural medicines induced higher activity of ALP synthesis than the negative controls. Especially Olibanum induced the higher activity than the positive controls(p<0.05). In the aspects of culturing time, except Cimicifugae Rhizoma, the natural medicines induced higher activity of ALP synthesis at 5 days than at 3 days(p<0.05). In morphometry, all of the natural medicines showed statistical significance compared to the negative control(p<0.05). Myrrha and Phlomis Radix showed larger positively stained area at 5 days than at 3 days, whereas the others did not showed the difference between at 5 and at 3 days(p<0.05). These results indicate that several natural medicines have an inducing ability of ALP synthesis in MC3T3-E1 cells.