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문희석,강윤세,김연수,박기오,이엄석,성재규,이병석,노승무,송규상,조준식,신경숙,정현용,Moon Hee-Seok,Kang Yoon-Sae,Kim Yeon-Soo,Park Ki-Oh,Lee Eum-Seok,Sung Jae-Kyu,Lee Byong-Seok,Noh Seung-Moo,Song Kyu-Sang,Cho June-Sick,Shin Kyung-Sook,J 대한위암학회 2003 대한위암학회지 Vol.3 No.3
Purpose: The incidence rate and the mortality rate of gastric cancer have decreased in developed countries over the last several decades. On the other hand, they remain high in far eastern countries such as Korea, Japan, China and in many developing countries. The cure of patients with gastric carcinomas can be achieved mostly through complete surgical resection, but most gastric cancer patients are in advanced stages when diagnosed and have poor prognoses. therefore, the development of an effective systemic therapy is essential for far advanced gastric cancer patients. Until recently, the most commonly used combination chemotherapy was based on 5-flurouracil or cisplatin, but the results were not satisfactory, so recently etoposide, adriamycin and cisplatin (EAP-II) combination chemotherapy was introduced in patients with advanced gastric cancer. Early studies showed a high response rate and the ability to convert unresectable cases to resectable ones, but later studies couldn't duplicate the result. the purpose of this study was to evaluate the relative efficacy & toxicity of EAP-II chemotherapy and ELF chemotherapy which is based on 5-flurouracil. Materials and Methods: Between July 1992 and July 2002, sixty-five patients with inoperable advanced gastric cancer were enrolled for this study. Thirty-seven patient received EAP-II chemotherapy:etoposide (20 mg/$m^{2}$ IV for $1\∼5 days$), adriamycin (20 mg/$m^{2}$ IV for $1\∼5 days$) and cisplatin (20 mg/$m^{2}$ IV for $1\∼5 days$) and Twenty-eight patients receieved ELF chemotherapy : etoposide (100 mg/$m^{2}$ IV for $1\∼3 days$), leucovorin (20 mg/$m^{2}$ IV for $1\∼5 days$) and 5-FU (500 mg/$m^{2}$ IV for $1\∼5 days$). Each treatment schedule for each group was repeated every four weeks: EAP-II means 3.4 cycles per patient..ELF means 4.1 cycles per patient Results: Total respones rates were $5.4\%$ in the ELF group and $3.6\%$ in the EAP group (P-value>0.05). The median times to progression were 144 days in the ELF group and 92 days in the EAP-II group (P-value<0.05), and themedian overall survival times were 189 days in the ELF group and 139 days in the EAP-II group (P-value>0.05). The difference in the survival curves for the two regimens was not statistically significant. Non-hematologic toxicitis & hematologic toxicitis were more frequently observed for the EAP-II regimen. Anemia: $27.6\%$ in ELF vs $54\%$ in EAP-II; Leukopenia: $8.5\%$ in ELF vs $19\%$ in EAP-II; nausea & vomiting: $45.9\%$ in ELF vs $67.8\%$ in EAP-II. Conclusion: EAP-II regimen is not superior to ELF regimen in the tratment of inoperable advanced gastric cancer (J Korean Gastric Cancer Assoc 2003;3:122-127)
문희석,Hee Seok Moon 대한소화기암연구학회 2014 Journal of digestive cancer reports Vol.2 No.2
Gastric cancer is the second most common cancer and the third leading cause of cancer-related deaths in Korea. Many cases of gastric cancer are detected in the early stages on standard medical examinations; complete surgical and endoscopic resection is the most recommended treatment for early-stage gastric cancer. Nevertheless, many patients have already progressed to advanced gastric cancer (AGC) upon diagnosis, and the prognosis of such patients is very poor. Combination chemotherapy has been shown to produce a better quality of life (QOL) and to increase overall survival in AGC patients. However, approximately 50% of patients do not respond to the current first-line chemotherapy, while most patients who do respond eventually show disease progression. Accordingly, various second-line regimens have been investigated, and active salvage chemotherapy has been shown to improve the QOL and clinical outcomes in select AGS patients who can tolerate it. There is also an increasing need for neoadjuvant therapy for treating gastric cancer; therefore, various clinical trials have been set up to investigate different regimens. Neoadjuvant therapy is currently established as the standard treatment for locally AGC in Europe; it has contributed to lowering the nodal stages and has reduced overall mortality rates. Despite these benefits, many uncertainties remain. Therefore, further prospective, high quality randomized controlled trials for neoadjuvant therapies are needed to clarify their clinical benefits and to establish the most effective treatment strategies for AGC.
문희석,정현용,Hee Seok Moon,Hyun Yong Jeong 대한소화기암연구학회 2018 Journal of digestive cancer reports Vol.6 No.1
Gastric cancer is not a single, uniform disease, but rather heterogeneous in nature. It is generally not possible to cure patients with inoperable advanced or metastatic stomach cancer. In the absence of chemotherapy, the median survival time is 3 to 6 months. Therefore, several studies have confirmed the superiority of chemotherapy to the best supportive treatment, in terms of improving the quality of life and prolonging life. Various chemotherapies have been used in the past to treat advanced gastric cancer. Recently, various target therapies and immunotherapy have been introduced. However, compared to other malignancies, the quality of life and life expectancy remain relatively poor in patients with gastric cancer. We expect to overcome these difficulties in the future, with better elucidation of the molecular biology of gastric cancer.
진단적 대장 내시경 시행 후 발생한 공기후복막, 종격동기종, 기흉, 피하공기증
이희성 ( Hee Sung Lee ),박환희 ( Hwan Hee Park ),김주석 ( Ju Seok Kim ),강선형 ( Sun Hyung Kang ),문희석 ( Hee Seok Moon ),성재규 ( Jae Kyu Sung ),이병석 ( Byung Seok Lee ),정현용 ( Hyun Yong Jeong ) 대한소화기학회 2017 대한소화기학회지 Vol.70 No.3
Colonoscopy is a commonly performed endoscopic procedure. Although it is generally considered to be safe, serious complications, such as colorectal perforation, can occur. Most colonic perforations are intraperitoneal and cause pneumoperitoneum with acute abdominal pain as the initial symptom. However, extraperitoneal perforations with pneumoretroperitoneum may happen, albeit rarely, with atypical initial symptoms. We report a rare case of rectosigmoid perforation occurring after diagnostic colonoscopy that developed into pneumoretroperitoneum, pneumomediastinum, pneumothorax, and subcutaneous emphysema, with a change in voice and neck swelling as the initial symptoms. The patient was successfully treated with endoscopic closure of the perforation and conservative management. (Korean J Gastroenterol 2017;70:145-149)
이희정 ( Hee Jung Lee ),정현용 ( Hyun Yong Jeong ),박남환 ( Nam Hwan Park ),홍순창 ( Sun Chang Hong ),남관우 ( Gwan Woo Nam ),문희석 ( Hee Seok Moon ),이엄석 ( Eaum Seok Lee ),김석현 ( Seok Hyun Kim ),성재규 ( Jae Kyu Sung ),이병 대한소화기학회 2011 대한소화기학회지 Vol.57 No.4
Background/Aims: Recently colonoscopy and screening programs have led to the detection and removal of increasing numbers of early colorectal cancer (ECC), which can reduce its related mortality. We analysed the clinical, endoscopic, and histologic findings, as well as the follow-up data, to evaluate the effectiveness and the long-term results of endoscopic mucosal resection (EMR) for ECC. Methods: We analysed, retrospectively, 94 lesions in 92 patients who underwent EMR for ECC from January 2002 to June 2009. Results: The overage age of patients was 60 years old. The mean follow-up period was 22.1 months (6-80). En bloc resection rate was 64.9%. Submucosal invasion was found in 30 cases (31.9%). De novo cancer rate was 26.6% which had higher submucosal invasion rate (60%, p=0.003). The complete resection rate was 87.2%, and there was no recurrence of cancer during follow-up (p=0.000). Twelve incomplete resection cases had received further surgical treatments. No procedure-related mortality was found and no recurrent malignancy was found except 1 case. Conclusions: This study shows that EMR is an effective and safe treatment for ECC. En bloc resection provides precise histologic information and prevention of tumor recurrence. (Korean J Gastroenterol 2011;57:230-236)
경피 내시경하 위루술 후 발생한 상장간막 동맥 손상 1예
이서희 ( Seo Hee Lee ),문희석 ( Hee Seok Moon ),박재호 ( Jae Ho Park ),김주석 ( Ju Seok Kim ),강선형 ( Sun Hyung Kang ),이엄석 ( Eaum Seok Lee ),김석현 ( Seok Hyun Kim ),성재규 ( Jae Kyu Sung ),이병석 ( Byung Seok Lee ),정현용 ( H 대한소화기학회 2018 대한소화기학회지 Vol.72 No.6
Percutaneous endoscopic gastrostomy (PEG) is widely used to provide nutritional support for patients with dysphagia and/or disturbed consciousness preventing oral ingestion, and PEG tube placement is a relatively safe and convenient non-surgical procedure performed under local anesthesia. However, the prevention of PEG-insertion-related complications is important. A 64-year-old man with recurrent pneumonia underwent tracheostomy and nasogastric tube placement for nutritional support and opted for PEG tube insertion for long-term nutrition. However, during the insertion procedure, needle puncture had to be attempted twice before successful PEG tube placement was achieved, and a day after the procedure his hemoglobin had fallen and he developed hypotension. Abdominal computed tomography revealed injury to a pancreatic branch of the superior mesenteric artery (SMA) associated with bleeding, hemoperitoneum, and pancreatitis. Transarterial embolization was performed using a microcatheter to treat hemorrhage from the injured branch of the SMA, and the acute pancreatitis was treated using antibiotics and supportive care. The patient was discharged after an uneventful recovery. Clinicians should be mindful of possible pancreatic injury and bleeding after PEG tube insertion. Possible complications, such as visceral injuries or bleeding, should be considered in patients requiring multiple puncture attempts during a PEG procedure. (Korean J Gastroenterol 2018;72:308-312)
복강경 담낭절제술 후 헤모락 클립의 이동으로 발생한 복통 1예
류우선 ( Woo Sun Rou ),주종석 ( Jong Seok Joo ),강선형 ( Sun Hyung Kang ),문희석 ( Hee Seok Moon ),김석현 ( Seok Hyun Kim ),성재규 ( Jae Kyu Sung ),이병석 ( Byung Seok Lee ),이엄석 ( Eaum Seok Lee ) 대한소화기학회 2018 대한소화기학회지 Vol.72 No.6
During laparoscopic cholecystectomy, a surgical clip is used to control the cystic duct and cystic artery. In the past, metallic clips were usually used, but over recent years, interest in the use of Hem-o-lok clips has increased. Surgical clip migration into the common bile duct (CBD) after laparoscopic cholecystectomy has rarely been reported and the majority of reported cases involved metallic clips. In this report, we describe the case of a 53-year-old woman who presented with abdominal pain caused by migration of a Hem-o-lok clip into the CBD. The patient had undergone laparoscopic cholecystectomy 10 months previously. Abdominal CT revealed an indistinct, minute, radiation-impermeable object in the distal CBD. The object was successfully removed by sphincterotomy via ERCP using a stone basket and was identified as a Hem-o-lok clip. (Korean J Gastroenterol 2018;72:313-317)
증례 : 소화기 ; 위 MALT 림프종 완전관해 6개월 후 진단된 대장 MALT 림프종 1예
김석원 ( Seok Won Kim ),강성훈 ( Sung Hoon Kang ),강선형 ( Sun Hyoung Kang ),문희석 ( Hee Seok Moon ),성재규 ( Jae Kyu Sung ),정현용 ( Hyun Yong Jeong ),송규상 ( Gyu Sang Song ) 대한내과학회 2016 대한내과학회지 Vol.90 No.5
Most mucosa-associated lymphoid tissue (MALT) lymphomas are found in the gastrointestinal tract. The most common site is the stomach, whereas colon MALT lymphomas are rare. There are a few reports of simultaneously diagnosed stomach and colon MALT lymphomas. However, diagnosis of primary colonic MALT lymphoma after complete remission of gastric MALT lymphoma is extremely rare. Although the treatment protocol for gastric MALT lymphoma is well established, there is no consensus protocol for colonic MALT lymphoma owing to its rarity. Herein, we report a case of colonic MALT lymphoma incidentally diagnosed 6 months after completion of radiation therapy for gastric MALT lymphoma and treated via polypectomy, with no recurrence for 3 years. (Korean J Med 2016;90:416-420)
고식적 항암화학요법으로 완치가 된 진행성 식도암 환자 1예
탁대현,문희석,정현용,성재규,강선형,Dae Hyun Tak,Hee Seok Moon,Hyun Yong Jeong,Jae Kyu Sung,Sun Hyung Kang 대한소화기암연구학회 2014 Journal of digestive cancer reports Vol.2 No.2
Esophageal cancer has a poor prognosis, because the progression rate is faster compared to that of other cancers, Up to 30-40% of cases are inoperable at diagnosis, and most cases occur in the elderly. By this time, surgery has been regarded as the treatment of choice in patients suffering esophageal cancer and recent improvements in surgical techniques and perioperative management have significantly increased the resection rate and reduced the operative mortality. And Although the combination of chemotherapy and radiation therapy has been reported to be an effective treatment for esophageal cancer, most cases show only partial remission. Moreover, radiation therapy alone or chemotherapy alone has limited efficacy. We report a rare case of an 80-year-old man who presented with a chief complaint of dysphasia and was diagnosed with advanced esophageal cancer, with a review of the literature. Considering his advanced age, generally poor performance status, and the risk of fistula development after radiation therapy due to indentation of esophageal cancer into the main bronchus, palliative, rather than therapeutic, chemotherapy was performed, and complete remission was obtained.
다발성 간 전이가 동반된 진행성 위암의 고식적 항암치료 1례
신해진,정현용,문희석,성재규,강선형,Hae Jin Shin,Hyun Yong Jeong,Hee Seok Moon,Jae Kyu Sung,Sun Hyung Kang 대한소화기암연구학회 2015 Journal of digestive cancer reports Vol.3 No.1
We report a case of a 55-year-old man who diagnosed with advanced gastric cancer (AGC), with A review of the literature. A 55-year old man was transferred to our hospital for further evaluation and treatment after being diagnosed with adenocarcinoma through endoscopic biopsy during a regular health examination. An abdominal computed tomography (CT) showed AGC, stage IIA (T3N3M0), while an endoscopic examination showed AGC, Borrmann type 2. The patient is currently under observation after undergoing radical subtotal gastrectomy with gastroduodenostomy and subsequent administration of oral chemotherapeutic agents. As an abdominal CT response assessment performed after surgery revealed new metastasis to the liver, the patient received palliative chemotherapy as progressive disease was suspected. After receiving chemotherapy in the order of FOLFOX (5-fluorouracil (5-FU)) + Leucovorin + Oxaliplatin), FOLFIRI (5-FU + Leucovorin + Irinotecan), EAP-II (Etoposide + Doxorubicin + Cisplatin), ELF (Etoposide + Leucovorin + 5-FU), TS-1 (Tegafur + Gimeracil) + Cisplatin, an abdominal CT response assessment showed progressive disease for which the regimen was altered to PFL (Paclitaxel + 5-FU + Leucovorin). The patient has currently completed his second cycle of chemotherapy and after an abdominal CT response assessment, further course of therapy will be decided.