비부비동 반전성 유두종의 전산화 단층촬영상과 자기공명영상의 분석

배창훈 ( Chang Hoon Bai ),서영중 ( Young Jung Seo ),이석춘 ( Seok Choon Lee ),천승민 ( Seung Min Chen ),백운회 ( Un Hoi Baek ),정은채 ( Eun Chae Jung ),송시연 ( Si Youn Song ),김용대 ( Yong Dae Kim ) 영남대학교 기초/임상의학연구소 2005 Yeungnam University Journal of Medicine Vol.22 No.2

Background: Computed tomography (CT) is commonly used to evaluate the degree of sinus involvement in cases of inverted papilloma (IP). However, CT cannot differentiate tumor from adjacent inflammatory mucosa or retained secretions. By contrast, magnetic resonance imaging (MRI) has been reported to be useful in distinguishing IP from paranasal sinusitis. This study investigated whether preoperative assessment with MRI and CT accurately predict the extent of IP.1) Materials and methods: CT and MRI were retrospectively reviewed in 9 cases of IP. Patients were categorized into stages based on CT and MRI findings, according to the staging system proposed by Krouse. The involvement of IP in each sinus was also assessed. Results: Differentiation of IP from inflammatory disease may be more successful in routine cases where the inflammatory mucosa has low signal intensity on T1-weighted images and very high signal intensity on T2-weighted images. CT imaging could not differentiate tumor from adjacent inflammatory mucosa or retained secretions. Conclusion: Preoperative MRI of IP can predict the location and extent of the tumor involvement in the paranasal sinuses and sometimes predicts malignant changes.

두경부 편평상피세포암 세포주에서 세포주기조절인자의 활성 및 이상 : 후두편평상피세포암에서 종양억제유전자 CDKN2 유전자의 발현이상

송시연 ( Si Youn Song ),한태희 ( Tae Hee Han ),배창훈 ( Chang Hoon Bai ),김용대 ( Yong Dae Kim ),송계원 ( Kei Won Song ) 영남대학교 기초/임상의학연구소 2005 Yeungnam University Journal of Medicine Vol.22 No.2

Background: Cyclin-dependent kinase (CDK) inhibitors are family of molecules that regulate the cell cycle. The CDKN2, a CDK4 inhibitor, also called p16, has been implicated in human tumorigenesis. The CDKN2 inhibits the cyclin/CDK complexes which regulate the transition from G1 to S phase of cell cycle. There is a previous report that homozygous deletion of CDKN2 region on chromosome 9p21 was detected frequently in astrocytoma, glioma and osteosarcoma, less frequently in lung cancer, leukemia and ovarian cancer, but not detected in colon cancer and neuroblastoma. However, little is known about the relationship between CDKN2 and laryngeal cancer. Therefore this study was initiated to investigate the role of CDKN2 in human laryngeal squamous cell carcinoma development.1) Materials and methods: We used 5 human laryngeal carcinoma cell lines whether they have deletions or losses of CDKN2 gene expression by DNA-PCR or RT-PCR, respectively. We examined 8 fresh frozen human laryngeal cancer tissues to detect the loss of heterozygosity (LOH) of CDKN2. PCR was performed by using microsatellite markers of short arm of human chromosome 9 (D9S126, D9S144, D9S156, D9S161, D9S162, D9S166, D9S171, D9S200 and D9SIFNA). For informative cases, allelic loss was scored if the signal of one allele was significantly decreased in tumor DNA when compared to the same allele in normal DNA. Results: The CDKN2 DNA deletion was observed in 3 cell lines. The CDKN2 mRNA expression was observed in only one cell line, which was very weak. LOH was detected in 7 cases (87.5%). Conclusion: These results suggest that CDKN2 plays a role in the carcinogenesis of human laryngeal squamous cell carcinoma.

두경부 편평상피세포암에서 종양억제유전자들의 변이

송시연(Si Youn Song),박강식(Kang Shik Park),배창훈(Chang Hoon Bai) 대한두경부종양학회 2004 대한두경부 종양학회지 Vol.20 No.2

Objectives: Head and neck squamous cell carcinoma (HNSCC) is the most common head and neck malignant tumor. The molecular genetic changes involving both oncogenes and tumor suppressor genes are known to be involved in head and neck squamous cell carcinogenesis, but the roles of the known tumor suppressor genes in carcinogenesis are not fully elucidated. The objectives of this study are to demonstrate the genetic alterations including the loss of heterozygosity (LOH) , amplification, and microsatellite instability of known tumor suppressor genes in HNSCC and to evaluate the relationship between genetic alterations of tumor suppressor genes and clinicopathologic features. Materials and Methods: Genetic alterations of 10 micro satellite markers of the 6 known tumor suppressor genes (APC, EXT1, DPC4, p16, FHIT, and PTEN) were analysed by DNA-PCR in paraffin-embedded histologically confirmed HNSCC specimens. Results: The genetic alterations of tumor suppressor genes were found frequently. Among the genetic alterations, LOH was most frequently found one. LOH was found frequently in APC (45.4%), EXT1 (36.4%), DPC4 (54.5%), and p16 (50%), but not found in FHIT. Also, the author found that abnormalities of APC gene was related to cervical lymph node metastasis and recurrence and that abnormalities of EXT1 gene were coexisted with those of APC gene or DPC4 gene. But these coexistences had no correlation with clinical features. Conclusion: These results suggested that APC, EXT1, p16, and DPC4 genes might play important roles and multiple tumor suppressor genes may participate dependently or independently in the carcinogenesis of HNSCC. These results also suggested that APC gene might relate to prognosis.

비인강암의 임상적 고찰과 예후인자

배창훈,서영중,예상백,최영호,김용대,송시연 영남대학교 의과대학 2005 Yeungnam University Journal of Medicine Vol.22 No.1

본 연구에서는 1993년 1월부터 2002년 12월까지 10년간 비인강암으로 진단받은 환자 54예를 환자의 의무기록과 전화상담을 통하여 후향 적으로 분석하여 비인강암의 임상적인 특징과 생존율에 미치는 인자에 대하여 알아보고자 하였다. 환자의 연령분포는 16~78세로 평균 연령은 46.9세였다. 40대(26.0%)와 50대(27.8%)에서 호발하였으며, 남자가 여자보다 3.5배 많았다. 경부 종물을 주소로 내원한 환자가 30예(55.5%)로 가장 많았으며, 조직학적 유형은 WHO 제3형이 29예(53.7%)로 가장 많은 분포를 나타내었다. 조직학적 유형에 따른 5년 생존율은 제1형은 40.0% 제 2형은 45.5% 제 3형은 54.1%였다. 비인강암의 발생위치는 Rosenmu¨ller fossa를 포함한 측벽에서 35예(64.8%)로 가장 많이 발생하였다. 진단 시 Ⅲ, Ⅳ기의 진행된 병기군이 79.6%로 비인강암은 비교적 늦게 발견됨을 알 수 있었다. 전체적인 5년 누적 생존율은 46.5%였으며, 초기 병기군과 진행된 병기군의 5년 누적 생존율은 각각 58.3%, 44.2%로 초기 병기군의 생존율이 높은 것을 알 수 있었으나 통계학적 의의는 없었다. 원격전이의 경우 17예(31.5%)에서 발생 하였으며 골, 폐, 뇌, 척추, 간 등의 순서였다. 원발 부위의 완전관해 후 6예(11.1%)에서 국소 재발하여 다시 방사선치료를 시행하거나 항암화학요법과 방사선치료를 병행하여 치료하였다. 이상의 결과에서 보면 비인강암은 50대의남자에서 호발하며, 국내에서는 WHO 제 3형이 가장 빈발한다는 것을 알 수 있었다. 또한 TNM 병기는 비인강암의 생존율을 예측하는데 적절하지 않다고 생각되며, 생존율과 연관된 인자를 찾기 위해 향후 더 많은 연구가 시행되어야 하며 그에 따라 새로운 분류법이 제시되어야 할 것으로 사료된다. Background: Nasopharyngeal cancer is a rare disease with a relatively poor prognosis because it tends to be diagnosed at an advanced stage. The aim of this study was to establish the clinical characteristics of nasopharyngeal cancer. Materials and Methods: The medical records of 54 patients with nasopharyngeal cancer from January 1993 to December 2002 were reviewed retrospectively. Forty one cases were male (75.9%) and thirteen were female (24.1%). The average age was of 46.9 (range 16 to 78 years) years. The majority of patients (79.6%) were diagnosed in the advanced stage. The most common complaints were a neck mass (55.5%) and the WHO type 11I (53.7%) was the most frequent histological type. Results: The cumulative survival rate for a 5-year period was 46.5% and the T stage, N stage, pathologic type, and clinical stage were not significantly related to the survival rate. Sixteen of 54 (31.5%) cases presented with a distant metastasis of the bone, lung, brain, spine, and liver, and six cases (11.1%) presented with a locoregional recurrence. Conclusion: TNM staging is not appropriate for predicting survival rate of nasopharyngeal carcinoma patients. Therefore, a newer staging system, which includes new factors, is needed to predict the prognosis.

비부비동 반정성 유두종의 전산화 단층촬영상과 자기공명영상의 분석

배창훈,서영중,이석춘,천승민,백운희,정은채,송시연,김용대 영남대학교 의과대학 2005 Yeungnam University Journal of Medicine Vol.22 No.2

Background: Computed tomography (CT) is commonly used to evaluate the degree of sinus involvement in case of inverted papilloma (IP). However, CT cannot differentiate tumor from adjacent inflammatory mucosa or retained secretions. By contrast, magnetic resonance imaging (MRI) has been reported to be useful in distinguishing IP from paranasal sinusitis. This study investigated whether preoperative assessment with MRI and CT accurately predict the extent of IP. Materials and methods: CT and MRI were retrospectively reviewed in 9 case of IP. Patients were categorized into staged based on CT and MRI findings according to the staging system proposed by Krouse. The involvement of IP in each sinus was also assessed. Results: Differentiation of IP from inflammatory disease may be more successful in routine case where the inflammatory mucosa has low signal intensity on T1-weighted images and very high signal intensity on T2-weighted images. CT imaging could not differentiate tumor from adjacent inflammatory mucosa or retained secretions. Conclusion: Preoperative MRI of IP can predict the location and extent of the tumor involvement in the paranasal sinuses and sometimes predicts malignant changes.

두경부 편팡상피세포암 세포주에서 세포주기 조절인자의 활성 및 이상:후두편평상피세포암에서 종양억제 유전자 CDKN2 유전자 발현이상

송시연,한태희,배창훈,김용대,송계원 영남대학교 의과대학 2005 Yeungnam University Journal of Medicine Vol.22 No.2

Background: Cyclin-dependent kinase (CDK) inhibitors are family of molecules that regulate the cell cycle. The CDKN2, a CDK4 inhibitor, also called p16, has been implicated in human tumorigenesis. The CDKN2, inhibits the cyclin/CDK complexes which regulate the transition from G1 to S phase of cell cycle. There is a previous repot that homozygous deletion of CDKN2 region on chromosome 9p21 was detected frequently in astrocytoma, glioma and osteosarcoma, less frequently in lung cancer, leukemia and ovarian cancer, but not detected in colon cancer and neuroblastoma. However, little is known about the relationship between CDKN2 and laryngeal cancer. Therefore this study was initiated to investigate the role of CDKN2 in human laryngeal squamous cell carcinoma development. Materials and methods: We used 5 human laryngeal carcinoma cell lines whether they have deletion or losses of CDKN2 gene expression by DNA-PCR or RT-PCR, respectively. We examined 8 fresh frozen human laryngeal cancer tissues to detect the loss of heterozygosity(LOH) of CDKN2 PCR was performed by using micosatellite markers of short arm of human chromosome 9 (D9S126, D9S144, D9S156, D9S161, D9S162,D9S166, D9S166, D9S171,D9S200 and D9SIFNA).For informative cases, allelic loss was scored of the signal of one allele was significantly decreased in tumor DNA when compared to eh same allele in normal DNA. Results: the CDKN2 DNA deletion was observed in 3 cell lines. The CDKN2 mRNA expression was observed in only one cell line, which was very weak. LOH was detected in 7 cases(87.5%) Conclusion: These results suggest that CDKN2 plays a role in the carcinogenesis of human laryngeal squamous cell carcinoma

상악동 후비공 비용의 내시경적 치료

김용대,배창훈,김준우,정유선,서장수,송계원 대한이비인후과학회 1998 대한이비인후과학회지 두경부외과학 Vol.41 No.2

진행성 두경부암의 Docetaxel과 Cisplatin의 항암화학요법의 치료효과

최성원,최영호,배창훈,김용대,송시연 영남대학교 기초/임상의학연구소 2006 Yeungnam University Journal of Medicine Vol.23 No.2

결론적으로 docetaxel과 cisplatin의 항암화학요법은 진행성 두경부암에서 비교적 높은 반응률과 낮은 부작용을 보이는 효과적인 치료로 생각되며 후두 보존 등의 기관 보존의 가능성도 가지고 있어 수술 후 방사선 치료의 대안으로 적용될 수 있을 것으로 사료된다. 그러나 현재까지는 환자의 대상수가 적고 추적관찰기간이 짧아 추후 더 많은 연구를 시행해야 할 것이다. Background: Head and neck cancer is curable at early stages with local-regional therapy. However, most patients are diagnosed with advanced stage disease that requires combination therapy. The aim of this study was to determine the efficacy of docetaxel and cisplatin combination chemotherapy, in patients with advanced head and neck cancer by evaluating the response, survival and organ preservation rates. Materials and Methods: We reviewed retrospectively the medical records of 39 patients with advanced head and neck cancer who received docetaxel and cisplatin combination chemotherapy from March 2000 to July 2004. Results: The average age of the 39 patients was 53.4 (range 30 to 73 years) years and the most common primary site was the hypopharynx (23.0%). There were 36 patients who had stage Ⅳ disease and three patients with stage Ⅲ disease. The overall response rate was 76.9% (30/39), including 12 complete responses (30.8%) and 18 partial responses (46.1%). The response rate based on the primary cancer and neck metastasis was 74.4% and 69.3%; the differences were not significant. Among 16 patients with laryngeal and hypopharyngeal cancer, 13 (81.2%) had their larynx preserved after chemotherapy followed by radiotherapy and a survival rate of 61.5%; three patients (18.8%) received a total laryngectomy and had a survival rate of 66.7%. The overall survival rate from the start of chemotherapy was 56.4% with a median survival of 30 months. The common toxicities observed were alopecia, vomiting, diarrhea, hepatotoxicity and anemia but they were all generally manageable. Conclusion: Docetaxel and cisplatin combination chemotherapy is an effective regimen with a relatively high response rate and acceptable toxicity.

부비강미분화암종 3예

김용대,곽동석,이형중,신재흔,배창훈,송시연 영남대학교 의과대학 2004 Yeungnam University Journal of Medicine Vol.21 No.1

Sinonasal Undifferentiated Carcinoma (SNUC) is a very rare, highly aggressive malignant tumor of the nasal cavity and paranasal sinuses. SNUC tends to present with advanced-stage disease, often with intracranial invasion. It requires an aggressive multimodality therapy that includes surgical resection. A cure rate of less than 20% is generally reported in the literature, with most patients dying within 1 year of onset of the disease. Three patients diagnosed as SNUC were treated at the Yeungnam University Medical Center between the years 2000 and 2003 were analyzed retrospectively. All patients presented with the disease very advanced. The three cases were given chemotherapy or chemotherapy with radiotherapy. Two patients died of the disease, surviving only 6 and 11 months following treatment, respectively. We did a follow-up on just the one remaining case with incomplete controlled disease for 27 months. The overall prognosis of SNUC is very poor. We consider that more intensive multimodality therapies are recommended for all patients with SNUC.

반전성 유두종의 내시경적 비내수술법과 비외수술법의 치료성적 비교

김용대,박준철,지덕환,장근영,조길성,배창훈,송시연 대한이비인후과학회 2000 대한이비인후과학회지 두경부외과학 Vol.43 No.3