생쥐의 창상모델에서 Celecoxib이 창상치유에 미치는 영향

노종렬,나기상,박찬일,성명훈,김광현,박석원,오승준,김영덕 대한이비인후과학회 2004 대한이비인후과학회지 두경부외과학 Vol.47 No.10

종양과 구강각질세포주에서 Celecoxib과 Indomethacin의 Cyclooxygenase-2 비의존적 기전에 의한 억제 효과

노종렬,성명훈,김광현,김동영,하정훈,박찬일 충남대학교 암공동연구소 2005 암공동연구소 업적집 Vol.4 No.

Background and Objectives : Overexpression of cyclooxygenase-2 (COX-2), a rate-limiting enyme in the generation of prostanoids from arachidonic acid, has known to be closely related to tumorigenesis, tumor growth, angiogenesis, and metastasis. Selective or non-selective COX-2 inhibitors have been used for the growth inhibition of cancers with preventative intents ; however, it has been suggested recently that cancer cells have COX-2-independent mechanisms. Materials and Method : Using MTT assat and cell counts, we observed the growth inhibition of SCC VII, CT-26 and B16F10 murine cancer cell lines when treated by celecoxib and indomethacin. SNU-1041 and HOK 16B were used as controls for comparing with the murine cell lines. The COX-2 expression of these cell lines was analyzed by western blotting and compared with the degree of inhibition by the drugs. Results : The growth inhibition of the cell lines by the drugs was clearly demonstrated in a concentration-dependent manner and depended on the type of cell lines and test drug. The in vitro viability assay revealed that CT-26 expressing COX-2 protein was slightly inhibited but SCC Vn and B16F10 without COX-2 expression were moderate-to-highly inhibited by the drug treatment. Celecoxib and indomethacin appeared to have no close relation with the COX-2 expression of cell lines in their growth inhibition, HOK 16B showed a resistance by concentrations less than 25 μM of celecoxib, which implies that celecoxib has a more selective effect on tumor cells and is safer than indomethacin Conclusion : The growth of cancer cells was inhibited by celecoxib and indomethacin treatment, which depends on the type of cancer, treated drug, and its concentration. Their suppressive effect is not closely related to the COX-2 expression of cancer cells. (Korean J Otolaryngol 2004;47:562-8)

Use of 18F-Fluorodeoxyglucose Positron Emission Tomography in Patients with Rare Head and Neck Cancers

노종렬,문병재,Jae Seung Kim,Jeong Hyun Lee,Kyung-Ja Cho,최승호,남순열,이봉재,김상윤 대한이비인후과학회 2008 Clinical and Experimental Otorhinolaryngology Vol.1 No.2

Objectives. The clinical utility of 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET) has been demonstrated in major head and neck cancers (HNCs) but is unclear in rare HNCs. We therefore evaluated FDG PET in the management of patients with rare HNCs. Methods. FDG PET and CT/MRI scanning were performed at the initial staging and/or the follow-up in 24 patients with rare HNCs, 10 with melanoma, 9 with sarcoma, 3 with olfactory neuroblastomas, and 2 with basal cell carcinoma. The diagnostic accuracy of CT and FDG PET for detecting primary tumors and metastases were compared with a histopathologic reference. The association between the PET results and the clinicopathologic parameters predicting tumor invasion, histologic grade and disease-free survival (DFS), was assessed. Results. The overall accuracies of FDG PET and CT/MRI were 92% and 79%, respectively, for detecting primary tumors and 91% and 74%, respectively, for nodal metastases, but the differences were not significant due to the small number of patients. The sensitivity and specificity of FDG PET for detecting distant metastases and second primary tumors were 100% and 87%, respectively. Follow-up FDG PET correctly diagnosed locoregional recurrence in all 12 patients, as shown by biopsy, and distant metastases in 6 patients. However, thickness of melanoma, histologic grade of sarcoma, and DFS were not associated with tumor FDG uptake. Conclusion. FDG PET may be useful for staging, posttreatment monitoring, and detection of distant metastases and second primary tumors in patients with rare HNCs. Objectives. The clinical utility of 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET) has been demonstrated in major head and neck cancers (HNCs) but is unclear in rare HNCs. We therefore evaluated FDG PET in the management of patients with rare HNCs. Methods. FDG PET and CT/MRI scanning were performed at the initial staging and/or the follow-up in 24 patients with rare HNCs, 10 with melanoma, 9 with sarcoma, 3 with olfactory neuroblastomas, and 2 with basal cell carcinoma. The diagnostic accuracy of CT and FDG PET for detecting primary tumors and metastases were compared with a histopathologic reference. The association between the PET results and the clinicopathologic parameters predicting tumor invasion, histologic grade and disease-free survival (DFS), was assessed. Results. The overall accuracies of FDG PET and CT/MRI were 92% and 79%, respectively, for detecting primary tumors and 91% and 74%, respectively, for nodal metastases, but the differences were not significant due to the small number of patients. The sensitivity and specificity of FDG PET for detecting distant metastases and second primary tumors were 100% and 87%, respectively. Follow-up FDG PET correctly diagnosed locoregional recurrence in all 12 patients, as shown by biopsy, and distant metastases in 6 patients. However, thickness of melanoma, histologic grade of sarcoma, and DFS were not associated with tumor FDG uptake. Conclusion. FDG PET may be useful for staging, posttreatment monitoring, and detection of distant metastases and second primary tumors in patients with rare HNCs.

두경부암의 기능보존수술

노종렬,한명월 대한이비인후과학회 2011 대한이비인후과학회지 두경부외과학 Vol.54 No.1

Organ preservation strategy in treatment of the head and neck cancer (HNC) has led to an increase in the use of primary chemoradiation in both laryngeal and extralaryngeal sites for recent two decades. Primary non-surgical chemoradiotherpay has replaced the traditional gold standard of surgery followed by postoperative radiation with saving the organ and no compromising oncological outcomes. In accompany with wide clinical extension of primary chemoradiation, organ preservation surgery through open transcervical or transoral route has been increasingly used in the patients with HNC at both primary and salvage settings. Minimally invasive transoral approach using lasers or robots has been more spotlighted as a sensible strategy for organ preservation of the HNC patients. There is, however, a paucity of randomized controlled clinical trial data comparing primary organ-preserving chemoradiation to organ preservation surgery. Future direction leads to conduct well-designed clinical trials to establish the functional and oncological benefits of the organ preservation surgery. This article reviews the role of organ preservation surgery in head and neck cancer.

Spontaneous Pharyngeal Perforation After Forceful Vomiting: The Difference from Classic Boerhaave’s Syndrome

노종렬,박찬일 대한이비인후과학회 2008 Clinical and Experimental Otorhinolaryngology Vol.1 No.3

Boerhaave’s syndrome is spontaneous transmural perforation of the esophagus, which occurs most often after forceful vomiting or retching. This commonly occurs in the lower third of the esophagus but spontaneous perforation of the pharynx or cervical esophagus is extremely rare. This case presented a 20-yr-old healthy man with spontaneous pharyngeal perforation after forceful vomiting who had no history of instrumentation, cervical trauma, or having eaten anything sharp. Cervical pain and crepitus were the early symptom and sign of pharyngeal perforation and the rupture was detected on gastrografin swallow and CT examinations. The rupture site was higher than the upper esophageal sphincter, differing from Boerhaave’s syndrome. The patient was conservatively managed without significant morbidity and mortality. Although this may resolve without surgical intervention, the pharyngeal rupture should receive early detection and clinical attention for preventing potential morbidity by late diagnosis. Boerhaave’s syndrome is spontaneous transmural perforation of the esophagus, which occurs most often after forceful vomiting or retching. This commonly occurs in the lower third of the esophagus but spontaneous perforation of the pharynx or cervical esophagus is extremely rare. This case presented a 20-yr-old healthy man with spontaneous pharyngeal perforation after forceful vomiting who had no history of instrumentation, cervical trauma, or having eaten anything sharp. Cervical pain and crepitus were the early symptom and sign of pharyngeal perforation and the rupture was detected on gastrografin swallow and CT examinations. The rupture site was higher than the upper esophageal sphincter, differing from Boerhaave’s syndrome. The patient was conservatively managed without significant morbidity and mortality. Although this may resolve without surgical intervention, the pharyngeal rupture should receive early detection and clinical attention for preventing potential morbidity by late diagnosis.

구개편도와 아데노이드에서 자연면역 림프구의 빈도와 분포

노종렬,성원진,성명훈,이동욱,박범정,박성우,김광현 대한이비인후과학회 2001 대한이비인후과학회지 두경부외과학 Vol.44 No.10

종양과 구강각질세포주에서 Celecoxib과 Indomethacin의 Cyclooxygenase-2 비의존적 기전에 의한 억제 효과

노종렬,성명훈,김광현,김동영,하정훈,박찬일 충남대학교 암연구소 2005 암연구소 업적집 Vol.4 No.-

Background and Objectives : Overexpression of cyclooxygenase-2 (COX-2), a rate-limiting enyme in the generation of prostanoids from arachidonic acid, has known to be closely related to tumorigenesis, tumor growth, angiogenesis, and metastasis. Selective or non-selective COX-2 inhibitors have been used for the growth inhibition of cancers with preventative intents ; however, it has been suggested recently that cancer cells have COX-2-independent mechanisms. Materials and Method : Using MTT assat and cell counts, we observed the growth inhibition of SCC VII, CT-26 and B16F10 murine cancer cell lines when treated by celecoxib and indomethacin. SNU-1041 and HOK 16B were used as controls for comparing with the murine cell lines. The COX-2 expression of these cell lines was analyzed by western blotting and compared with the degree of inhibition by the drugs. Results : The growth inhibition of the cell lines by the drugs was clearly demonstrated in a concentration-dependent manner and depended on the type of cell lines and test drug. The in vitro viability assay revealed that CT-26 expressing COX-2 protein was slightly inhibited but SCC Vn and B16F10 without COX-2 expression were moderate-to-highly inhibited by the drug treatment. Celecoxib and indomethacin appeared to have no close relation with the COX-2 expression of cell lines in their growth inhibition, HOK 16B showed a resistance by concentrations less than 25 μM of celecoxib, which implies that celecoxib has a more selective effect on tumor cells and is safer than indomethacin Conclusion : The growth of cancer cells was inhibited by celecoxib and indomethacin treatment, which depends on the type of cancer, treated drug, and its concentration. Their suppressive effect is not closely related to the COX-2 expression of cancer cells. (Korean J Otolaryngol 2004;47:562-8)

토끼의 후성문 창상모델에서 Mitomycin-C 도포를 통한후성문협착의 예방효과

노종렬,구본석,윤여훈,나기상,박찬일 대한이비인후과학회 2005 대한이비인후과학회지 두경부외과학 Vol.48 No.10

Background and Objectives:Posterior glottic stenosis (PGS) is a disabling disease and most commonly induced by trauma from endotracheal intubation. We performed a randomized, controlled study with three animal groups to investigate the preventive effect of mitomycin-C on the posterior glottis undergone laser injury. Materials and Method:Twenty rabbits were available for evaluation. Group 1 (n=7) and 2 (n=6) were treated with topical mitomycin-C of 0.4 and 1.0 mg/ml, respectively, with the group 3 (n=7) used as the control. All animals underwent laser injury of 6 W, continuous mode on the posterior glottis. Group 1 and 2 were treated by a single topical use of cottonoid soaked in mitomycin-C solution on the injured posterior glottis for 5 minutes and the group 3 by saline. The posterior glottis of all groups was evaluated by telescopic examinations under direct laryngoscopy 2 months after the injury and was harvested for histological staining with hematoxylin-eosin and Masson trichrome. Results:The scar, granulation tissue and synechia formation of the posterior glottis was clearly induced by laser injury. Microscopic examinations showed increased collagen content and fibroblast proliferation in the region. Topical use of mitomycin- C significantly decreased the incidence of such gross and microscopic changes of the posterior glottis (p<.05). Conclusion: Mitomycin-C prevents PGS via its anti-proliferative effect on fibroblasts. The use of Mitomycin-C is warranted for patients witha history of prolonged intubation or for those who have undergone surgery of the posterior glottis.

종양과 구강각질세포주에서 Celecoxib과 Indomethacin의 Cyclooxygenase-2 비의존적 기전에 의한 억제 효과

노종렬,성명훈,김광현,김동영,하정훈,박찬일 대한이비인후과학회 2004 대한이비인후과학회지 두경부외과학 Vol.47 No.6

Background and Objectives:Overexpression of cyclooxygenase-2 (COX-2), a rate-limiting enzyme in the generation of pro-stanoids from arachidonic acid, has known to be closely related to tumorigenesis, tumor growth, angiogenesis, and metastasis. Selective or non-selective COX-2 inhibitors have been used for the growth inhibition of cancers with preventative intents;how-ever, it has been sugested recently that cancer cels have COX-2-independent mechanisms. Materials and Method:Using MT assat and cel counts, we observed the growth inhibition of SC VI, CT-26 and B16F10 murine cancer cel lines when treated COX-2 expression of these cel lines was analyzed by western bloting and compared with the degree of inhibition by the drugs. Results:The growth inhibition of the cell lines by the drugs was clearly demonstrated in a concentration-dependent maner and depended on the type of cell lines and test drug. The in vitro viability asay revealed that CT-26 expresing COX-2 protein was slightly inhibited but SC VI and B16F10 without COX-2 expression were moderate-to-highly inhibited by the drug treatment. n. HOK 16B showed a resistance by concentrations les than 25 μM of celecoxib, which implies that celecoxib has a more selective effect on tumor cells and is safer than indomethacin. Conclusion:The growth of cancer cels was inhibited by celecoxib and indomethacin treatment, which depends on the type of cancer, treated drug, and its concentration. Their suppresive efect is not closely related to the COX-2 expression of cancer cells.

Chondroradionecrosis of the Larynx: Diagnostic and Therapeutic Measures for Saving the Organ from Radiotherapy Sequelae

노종렬 대한이비인후과학회 2009 Clinical and Experimental Otorhinolaryngology Vol.2 No.3

Objectives. Chondroradionecrosis (CRN) of the larynx is a rare but fatal complication of radiotherapy. We determined the optimal diagnostic methodology and management of laryngeal CRN in six patients. Methods. We retrospectively reviewed the records of six patients with Chandler grade IV laryngeal CRN who had received prior radiotherapy (mean total radiation dose, 66.7±4.5 Gy) at a tertiary care hospital. Two patients underwent transoral laser microresection of their laryngeal carcinoma plus postoperative radiotherapy. All patients underwent endoscopy, computed tomography (CT), positron emission tomography (PET), removal of necrotic tissue, biopsy under suspension laryngoscopy, administration of antibiotics, and hyperbaric oxygen therapy (HBO). Their diagnostic and therapeutic results were assessed. Results. CT showed CRN of the anterior larynx in three patients and CRN of the posterior larynx in three patients, with one patient having a false-positive result on PET. HBO consisted of a mean of 36±6 dives. After early debridement and HBO, five patients showed CRN improvement, but one had aggravation and subsequently underwent total laryngectomy. None of these patients showed local tumor recurrence on pathologic examination or during a mean follow-up of 24 months. Conclusion. Although CRN of the larynx may be detected by endoscopic and imaging work-ups, detection may require pathologic examination. Early debridement and HBO may effectively treat CRN, saving the functional larynx. Objectives. Chondroradionecrosis (CRN) of the larynx is a rare but fatal complication of radiotherapy. We determined the optimal diagnostic methodology and management of laryngeal CRN in six patients. Methods. We retrospectively reviewed the records of six patients with Chandler grade IV laryngeal CRN who had received prior radiotherapy (mean total radiation dose, 66.7±4.5 Gy) at a tertiary care hospital. Two patients underwent transoral laser microresection of their laryngeal carcinoma plus postoperative radiotherapy. All patients underwent endoscopy, computed tomography (CT), positron emission tomography (PET), removal of necrotic tissue, biopsy under suspension laryngoscopy, administration of antibiotics, and hyperbaric oxygen therapy (HBO). Their diagnostic and therapeutic results were assessed. Results. CT showed CRN of the anterior larynx in three patients and CRN of the posterior larynx in three patients, with one patient having a false-positive result on PET. HBO consisted of a mean of 36±6 dives. After early debridement and HBO, five patients showed CRN improvement, but one had aggravation and subsequently underwent total laryngectomy. None of these patients showed local tumor recurrence on pathologic examination or during a mean follow-up of 24 months. Conclusion. Although CRN of the larynx may be detected by endoscopic and imaging work-ups, detection may require pathologic examination. Early debridement and HBO may effectively treat CRN, saving the functional larynx.