소화기 난치병 환자의 이해: 유명인의 투병 사례

문정섭 ( Jeong Seop Moon ) 대한소화기학회 2012 대한소화기학회지 Vol.60 No.3

Diagnosis and treatment of gastroenterologic disease have been progressed after twentieth century. Nowdays a lot of diseases, which were called incurable diseases before have been treated or managed successfully. But, there are still many incurable diseases left, including advanced cancer and inflammatory bowel disease in gastroenterology. Here we reviewed some cases of celebrities` gastroenterologic incurable diseases. We hoped to widen our understandings of those diseases and give opportunities for the better treatment. Embracements of patients suffering from gastroenterologic incurable diseases were diverse. We can find out they ended their lives doing the most precious things. Among them, the love for their family members were the most universal and important concerns. We hope the patients suffering from gastroenterologic incurable diseases can have more opportunities for better treatments and to be understood in their situations. (Korean J Gastroenterol 2012;60:155-161)

십이지장염의 내시경소견과 병리조직소견의 비교

문정섭(Jeong Seop Moon),현진해(Jin Hae Hyun) 대한소화기학회 1994 대한소화기학회지 Vol.26 No.1

N/A By the development of gastrofiberscopy and biopsy procedure, the diagnosis of duodenitis became easier. In general, the endoscopic findings such as hyperemia, erosion or granularity of duodenal mucosa are suggestive of duodenitis. In this study, we compared the endoscopic findings with microscopic changes using duodenal biopsy specimens of 106 patients with duodenitis and 25 healthy people at Korea University Medical Center. In duodenum of healthy people, the ratio of villi length and crypt length was 2.19: 1 and the percentage of lymphocytes and plasma cells among inflammatory cells was 88.6% and neutro- phil only 1%. In duodenitis, the hyperemic type revealed flattening of villi and neutrophil in- filtration and the erosive type revealed rnarkedly decreased length of mucosal villi and promi- nent neutrophil infiltration as main histological alterations. In the mixed type (hyperemia with hypertrophy) of duodenitis, flattening of mucosal villi and increase of crypt depth were the main histological characteristics and in the mixed type (hyperernia with erosion) of duodenitis, there was only decrease of mucosal villi length, but no significant changes in cellularities. The histological changes in the mucosa near the lesion site of duodenitis were similar to the changes in the lesion site. (Korean J Gastroentero11994; 26: 25 38)

대장 통과 지연성 만성 특발성 변비에 대한 섬유소의 효과

정문기(Moon Gi Chun),송치욱(Chi Wook song),문정섭(Jeong Seop Moon),진윤태(Yoon Tae Jeen),엄순호(Soon Ho Um),김창덕(Chang Duck Kim),류호상(Ho Sang Ryu),현진해(Jin Hae Hyun) 대한소화기학회 1996 대한소화기학회지 Vol.28 No.4

N/A Background/Aims: Chronic idiopathic constipation has been thought to be related to decreased intake of dietary ttber, and high fiber diet was recommended as an initial therapy for consitipated patients. So we estimated the effects of dietary fiber(psyllium husk) on symptoms and colonic transit time in patients with slow transit constipation. Methods: We measured colonic transit time using radioopaque markers in 74 controls and 68 patients with chronic idiopathic constipation. After 4 week treatment of psy]lium husk(3.25g/pack, t.I.d.), we re-evaluated symptoms and colonic transit time in 37 patients with slow transit constipation. Results: In controls, mean bowel frequency was 5.1/week, total colonic transit time was 16.9 hours, and segmental colonic transits were 4.0 hours for right, 5.1 hours for left, and 7.8 hours for rectosigmoid colon. Among 68 patients with chronic idiopathic constipation, 37 patients had delayed total colonic transit time (mean-t 2SD). In these patients with slow transit constipation, mean bowel frequency was 2.0/week, total colonic transit time was 56.6 hours, and segmental colonic transits were 16.2 hours for right, 22.4 hours for left and 18.0 hours for rectosigmoid colon. After treatment, bowel frequency increased from 2.0/week to 4.3/week, and total colonic transit time decreased from 55.6 hours to 37.7 hours. Right, left, and rectosigmoid segmental colonic transit time also decreased from 16.2 to 9.8 hours, 22.4 to 15.0 hours and 18.0 to 12.5 hours, respectively. We found 3 patients with abdominal bloating and I patient with abdominal pain, but no patients had any serious complications. Conclusions: In patients with slow transit constipation, psyllium husk improved symptoms and colonic transit without serious side effect. (Korean J Gastroenterol 1996; 28:513 - 519)

간세포암종으로 오인된 지방성분이 없는 간혈관근지방종 증례 보고

류수형 ( Yong Moon Woo ),우용문 ( Soo Hyung Ryu ),민정화 ( Jeong Wha Min ),김미령 ( Mi Ryeong Kim ),박태영 ( Tae Young Park ),문정섭 ( Jeong Seop Moon ),강윤경 ( Yun Kyung Kang ) 대한소화기학회 2018 대한소화기학회지 Vol.71 No.1

Angiomyolipoma (AML) is a rare benign mesenchymal tumor in the liver, which is composed of blood vessels, smooth muscle, and adipose cells. The proportion of each component varies, making a diagnosis difficult. This paper reports a case of AML in the liver without adipose tissue, mimicking a hepatocellular carcinoma (HCC), which was diagnosed by a surgical tissue biopsy. A 65-year-old woman was admitted for an evaluation of a hepatic mass that had been detected by ultrasonography. The serologic markers of viral hepatitis B and C were negative. The liver function tests and alpha fetoprotein level were within the normal limits. Magnetic resonance imaging revealed a 1.9 cm sized mass in segment 6 of the liver with early arterial enhancement and washout on the delayed phase accompanied by a rim-like enhancement, which is similar to the imaging findings of HCC. A frozen section examination during surgery indicated a hepatocellular neoplasm and suggested the possibility of HCC. On the other hand, the final pathologic diagnosis was epithelioid myoid type of AML with no adipose tissue component. The tumor cells were positive for human melanocyte B-45 and negative for cytokeratin and hepatocyte paraffin 1. This paper reports a very rare case of AML without adipose tissue in the liver mimicking HCC that was diagnosed by a surgical tissue biopsy. (Korean J Gastroenterol 2018;71:49-53)

급성 출혈을 동반한 간의 원발 평활근육종 1예

정태엽 ( Tae Yeob Jeong ),김유선 ( You Sun Kim ),박경준 ( Kyung Jun Park ),이종성 ( Jong Sung Lee ),허진국 ( Jin Gook Huh ),류수형 ( Soo Hyung Ryu ),이정환 ( Jung Hwan Lee ),문정섭 ( Jeong Seop Moon ) 대한소화기학회 2008 대한소화기학회지 Vol.51 No.3

Leiomyosarcoma is a rare tumor of the liver. It usually arises from many other organs including uterus, gastrointestinal tract, retroperitoneum, and soft tissues. Primary hepatic leiomyosarcoma progresses very slowly and is not associated with chronic liver disease. When the tumor is detected early enough to be treated by operation, the prognosis is favorable. While several cases of primary hepatic leiomyosarcoma have been reported in Korea, there was no case associated with acute bleeding. We report a 80-year old male patient with huge primary hepatic leiomyosarcoma, who presented with acute bleeding and IVC obstruction. The patient was treated by embolization and IVC stenting. (Korean J Gastroenterol 2008;51:194-198)

Comparison of Growth Characteristics of Aster scaber by Treatment of Soil Conditioners

Jin Ho Yang(양진호),Jeong Seop Moon(문정섭),Song Hui Ahn(안송희),Yong Mun Lee(이용문),Dong Won Kim(김동원),Min Sil Ahn(안민실) 한국약용작물학회 2018 한국약용작물학회 학술대회논문집 Vol.2018 No.2

소화성궤양 가이드라인 특수한 질환에서 소화성궤양 치료의 가이드라인

김지현 ( Ji Hyun Kim ),문정섭 ( Jeong Seop Moon ),지삼룡 ( Sam Ryong Jee ),신운건 ( Woon Geon Shin ),박수헌 ( Soo Heon Park ) 대한소화기학회 2009 대한소화기학회지 Vol.54 No.5

The pathogenesis, incidence, complication rates, response to acid suppression and Helicobacter pylori (H. pylori) eradication therapy in peptic ulcer associated with chronic disease such as liver cirrhosis, chronic renal failure, diabetes mellitus, and critically ill conditions are different from those with general population, so that the management strategies also should be differentiated. The eradication of H. pylori are not so effective for preventing recurrence of peptic ulcer in liver cirrhosis patients as shown in general population, and conservative managements such as preventing deterioration of hepatic function and decrease in portal pressure are mandatory to reduce the risk of ulcer recurrence. The standard triple therapy for H. pylori eradication are as effective in chronic renal failure patients as in normal population, but the frequency of side effects of amoxicillin is higher in the patients not receiving dialysis therapy. Delay in eradication therapy until beginning of dialysis therapy or modification of eradication regimen should be considered in such cases. High prevalence of asymptomatic peptic ulcers and increased mortality in complicated peptic ulcer disease warrant regular endoscopic surveillance in diabetic patients, especially with angiopathy. The prolongation of duration of eradication therapy also should be considered in diabetic patients with angiopathic complication because of lower eradication rate with standard triple regimens as compared to normal population. Prophylactic acid suppressive therapy is highly recommended in critically ill patients with multiple risk factors. Herein, we propose evidence-based treatment guidelines for the management of peptic ulcer disease in special conditions based on literature review and experts opinion. (Korean J Gastroenterol 2009;54:318-327)

췌장염에서 발생한 가성동맥류에 의한 하부 소화관 출혈

유권(Kwon Yoo),문정섭(Jeong Seop Moon),전영빈(Young Bin Jeon),양대원(Dae Won Yang),정성광(Sung Kwang Chung) 대한소화기학회 1997 대한소화기학회지 Vol.30 No.2

Gastrointestinal hemorrhage is an infrequent but well recognized complication in patients with pancreatitis. Pancreatitis, peripancreatic inflammation and established pseudocysts can lead to pseudoaneurysm formation of contiguous splanchnic arteries which may cause significant gastrointestinal hemorrhage. Hemorrhage from a ruptured pseudoaneurysm may occur into various parts of gastrointestinal tract and present major clinical problems, both in terms of timely diagnosis and appropriate surgical therapy. Lower Gastrointestinal hemorrhage caused by ruptured pseudoaneurysm is extremely rare and has a worse prognosis, mainly because of the high incidence of fulminating sepsis and massive bleeding. We experienced a case of massive lower gastrointestinal bleeding caused by pseudoaneurysrnal rupture of splenic artery into colon in a patient with chronic pancreatitis. (Korean J Gastroenterol 1997; 30:268-272)

수술로 절제한 위장관기질종양에서 Ki-67 발현의 예후적 중요성

정성연 ( Seong Yeon Jeong ),박원우 ( Won Wo Park ),김유선 ( You Sun Kim ),박영일 ( Young Il Park ),김승협 ( Seung Hyup Kim ),윤원재 ( Won Jae Yoon ),문정섭 ( Jeong Seop Moon ),이병모 ( Byung Mo Lee ),홍성우 ( Seong Woo Hong ),강 대한소화기학회 2014 대한소화기학회지 Vol.64 No.2

목적: 현재까지 위장관기질종양(GIST)을 양성과 악성으로 분류할 수 있는 명확한 조직학적 기준은 없지만, 전이나 재발을 일으킬 수 있는 위험도를 종양세포의 유사분열 수와 종양의 크기를 기준으로 나누고 있다. Ki-67은 세포 증식의 표지자로 사용되는 단백질로, GIST의 예후 인자로의 가능성이 주목되고 있다. 이에 저자들은 수술 치료를 시행한 GIST 환자 중 Ki-67 면역조직화학염색을 시행한 32예의 Ki-67 지수와 유사 분열 지수와의 관련성, GIST의 재발률 및 무병 생존율에 대하여 분석 검토하여 보았다. 대상 및 방법: 인제대학교 서울백병원에서 수술 치료를 통하여 GIST를 제거한 32명의 환자를 대상으로 연구를 시행하였고 환자들의 의무기록을 통하여 성별, 연령, 증상 등의 임상적 특징과, 종양의 크기, 위치 등의 조직학적 특징 및 재발률에 대하여 조사하였다. 결과: NIH 진단기준으로 very low risk는 4예, low risk는 9예, intermediate risk는 14예, high risk는 5예였다. Ki-67 지수는 1-18%의 범위 내에 있었고, 평균은 5.56±4.48%였다. 평균 추적관찰 기간은 35.72±29.04개월이었고 관찰 도중 6 예(18.7%)에서 재발 혹은 전이가 발견되었다. Ki-67 지수가 5% 이하인 군의 누적 무병 생존율은 12개월, 24개월, 60개월에 각각 100%, 100%, 86%였다. 반면 Ki-67 지수가 5% 초과인 군의 누적 무병 생존율은 12개월, 24개월, 60개월에 각각 82.1%, 70.3%, 46.9%로 Ki-67 지수가 5% 이하인 환자에 비하여 무병 생존율에 유의한 차이를 보였다(p=0.007) 결론: Ki-67 지수가 5% 초과할 경우 GIST 재발의 고위험성을 시사한다. 향후 Ki-67 지수의 표준화와 치료 방향의 결정에 미치는 Ki-67 지수의 역할에 대한 연구가 필요하다. Background/Aims: Assessment of malignant potential in gastrointestinal stromal tumor (GIST) is still problematic. The maximum tumor diameter and the mitotic index are generally used as an index of malignancy of GISTs. The Ki-67 labeling index has recently been used as an index of cell growth. The aim of this study was to investigate the prognostic value of K -67 in GIST. Methods: We retrospectively reviewed the medical records of 32 patients with GIST who underwent surgical resection at Inje University Seoul Paik Hospital. We analyzed their Ki-67 expression, histologic finding, and prognosis. Results: According to the tumor size and mitotic count, 4 patients were classified as very low risk, 9 patients as low risk, 14 patients as intermediate risk and 5 patients as high risk. The average Ki-67 index was 5.56±4.48%. The median follow-up duration was 35.72±29.04 months, and local/distant recurrences were observed in 6 (18.7%) patients. The overall cumulative disease free survival rates in patients with Ki-67 index ≤5% at 1 year, 2 years, and 5 years were 100%, 100%, and 86%, respectively. The overall cumulative disease free survival rates in patients with Ki-67 index >5% were at 1 year, 2 years, and 5 years were 82.1%, 70.3%, and 46.9%, respectively. There was significant relationship between elevated Ki-67 and disease free survival rate (p=0.007). Conclusions: Our study suggests that Ki-67 index >5% confers a higher risk of relapse in patients with GIST. Future work should focus on standardization of Ki-67 assessment and specification of its role in making treatment decisions.(Korean J Gastroenterol 2014,64:87-92)

세줄콩들명나방 Omiodes indicatus (포충나방과)의 온도별 발육과 콩에서의 발생소장

최규환,홍윤기,장영직,문정섭,김치선,최동칠,김태흥,Choi, Kyu-Hwan,Hong, Yoon-Ki,Chang, Young-Jik,Moon, Jeong-Seop,Kim, Chi-Sun,Choi, Dong-Chil,Kim, Tae-Heung 한국응용곤충학회 2008 한국응용곤충학회지 Vol.47 No.4

The bean pyralid, Omiodes indicatus (Fabricius), moulted 4 times during larval period. When temperature increased from 15 to 20, 25, and $30^{\circ}C$, the developmental period of immature stages was shortened; 18.2, 7.5, 5.0, and 4.1 days of egg period; 51.8, 20.0, 12.7, and 9.9 days of larval period; 29.5, 12.0, 8.0, and 5.9 days of pupal period, respectively. Adult longevity was 16.0, 14.7, 11.2, and 7.5 days at respective temperatures. A female adult layed 57.0, 63.3, 82.2, and 31.7 eggs in 3.7, 6.0, 5.8, and 3.0 days of oviposition period at the same temperature regimes, respectively. Field survey in 2006 and 2007 showed that leaf damage on paddy field and upland soybeans began to appear in mid July, reaching its peaks in mid August and late September. Adults of the bean pyralid appeared in mid July and peaked in late August and early October. 세줄콩들명나방은 15, 20, 25 및 $30^{\circ}C$에서 온도가 높아질수록 미성숙단계의 발육기간은 짧아졌다. 즉 각 온도에서 알기간은 18.2, 7.5, 5.0 및 4.1일, 유충은 4회 탈피하며, 유충기간은 51.8, 20.0, 12.7 및 9.9일, 용기간은 29.5, 12.0, 8.0 및 5.9일이었다. 성충수명은 16.0, 14.7, 11.2 및 7.5일이었고, 3.7, 6.0, 5.8 및 3.0일의 산란기간 동안 암컷성충은 한 마리당 57.0, 63.3, 82.2 및 31.7개의 알을 산란하였다. 2006년과 2007년 논재배 콩과 밭재배 콩에서의 발생소장을 조사한 결과, 피해엽(권엽)은 모두 7월 중순부터 발견되기 시작하여 8월 중순과 9월 하순에 피해엽이 가장 많았고, 성충은 7월 중순에 발견되기 시작하여 8월 하순, 10월 상순에 발생 최성기를 보였다.