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BRAF(V600E) 돌연변이 갑상선 역형성암에서 BRAF(V600E) 억제에 의한 EGFR 발현 증가가 표적치료에 대한 저항성발현과 상피-간질세포이행과정에 미치는 영향분석
변형권(Hyung Kwon Byeon),나휘정(Hwi Jung Na),양연주(Yeon Ju Yang),박재홍(Jae Hong Park),권형주(Hyeong Ju Kwon),장재원(Jae Won Chang),반명진(Myung Jin Ban),김원식(Won Shik Kim),신동엽(Dong Yeob Shin),이은직(Eun Jig Lee),고윤우(Yoon Wo 대한두경부종양학회 2014 대한두경부 종양학회지 Vol.30 No.2
Background and Objectives:Anaplastic thyroid carcinoma(ATC) is a rare but highly aggressive thyroid ma-lignancy that is associated with an extremely poor survival despite the best multidisciplinary care. BRAF(V600E) mutation is detected in about a quarter of ATC, but unlike its high treatment response to selective BRAF inhibitor (PLX4032) in metastatic melanoma, the treatment response of ATC is reported to be low. The purpose of this study is to investigate the innate resistance mechanism responsible for this low treatment response to BRAF inhibitor and its effect on epithelial-mesenchymal transition(EMT). Materials and Methods:Two ATP cell lines, 8505C and FRO were selected and treated with PLX4032 and its drug sensitivity and effects on cell migration and EMT were examined and compared. Further investigation on the changes in signals responsible for the different treatment response to PLX4032 was carried out and the same ex-periment was performed on both orthotopic and ectopic xenograft mouse models. Results:FRO cell line was more sensitive to PLX4032 treatment compared to 8505C cell line. The resistance to BRAF inhibition in 8505C was due to increased expression of EGFR. Effective inhibition of both EGFR and p-AKT was achieved after dual treatment with BRAF inhibitor(PLX4032) and EGFR inhibitor(Erlotinib). Similar results were confirmed on in vivo study. Conclusion:EGFR-mediated reactivation of the PI3K/AKT pathway and MAPK pathway contributes to the relative insensitivity of BRAF(V600E) mutant ATC cells to PLX4032. Dual inhibition of BRAF and EGFR leads to sustained treatment response including cell invasiveness.
최병일,강민석,김민기,임범진,변형권,Choi, Byeong Il,Kang, Min Seok,Kim, Min Ki,Lim, Beom Jin,Byeon, Hyung Kwon 대한두경부종양학회 2015 대한두경부 종양학회지 Vol.31 No.2
$K{\ddot{u}}ttner$ tumor is a benign inflammatory disease of the salivary gland that clinically mimics a malignant tumor because of its presentation as a unilateral painless hard mass. However the precise cause of this disease is still unknown. Pathologically, it is characterized by infiltration of IgG4-positive plasma cells. Also, it is accompanied with an elevated level of plasma IgG4. We report one case of $K{\ddot{u}}ttner$ tumor of the right submandibular gland in a 37 year old woman.
후두 결핵의 임상 양상 분석: 최근 10년간 단일 기관의 경험
김지훈,공태훈,최홍식,변형권,Kim, Ji-Hoon,Kong, Tae Hoon,Choi, Hong-Shik,Byeon, Hyung Kwon 대한후두음성언어의학회 2020 대한후두음성언어의학회지 Vol.31 No.2
Background and Objectives The overall incidence of laryngeal tuberculosis (LT) has generally decreased over the recent years, yet there is still a discrete population of patients newly diagnosed with the disease. This study is aimed to examine the patients with LT over the recent 10 years and to investigate the changes in clinical pattern with respect to the past period. Materials and Method A retrospective review has been performed on 20 patients who have been initially diagnosed with LT between 2005 and 2015. Results The age of the patients ranged from 25 years to 95 years with an average age of 45.6 years. Seventeen patients (85%) showed hoarseness, which was the most common clinical symptom. Most affected lesion was the true vocal cord. Laryngoscopic examination showed various clinical manifestations: polypoid 30%, granulomatous 25%, nonspecific 25%, ulcerative 20%. A variety of methods were used for diagnostic confirmation of LT [acid-fast bacilli (AFB) smear 45%, AFB culture 40%, polymerase chain reaction 30%, surgical pathology 45%]. Coexisting pulmonary tuberculosis (PT) was detected in 10 patients (50%). Relative to the patients with inactive PT or normal lung status, those with active PT showed higher incidence of laryngeal lesions located in areas other than true vocal cord (p=0.050). Conclusion Based on the analytic results from this study, laryngologists should recognize the changes in the recent clinical patterns of LT and always be ready for clinical suspicion of this disease on such atypical laryngeal findings which can often mimic laryngeal malignancies to provide the pertinent treatment.
Korean Version of the Voice Activity and Participation Profile (K-VAPP):
Seung Jin Lee(이승진),Hong-Shik Choi(최홍식),HyangHee Kim(김향희),Hyung Kwon Byeon(변형권),Sung-Eun Lim(임성은),Min Kyo Yang(양민교) 한국언어청각임상학회 2016 Communication Sciences and Disorders Vol.21 No.4
배경 및 목적: 우리나라 음성 클리닉의 임상 현장에서는 환자 보고에 의한 심리측정적 평가도구가 부족하며, 활동 및 참여 측면까지 고려한 검사도구는 전무하다. 이에, 본 연구에서는 ‘음성 활동 및 참여 프로파일-한국판(K-VAPP)’의 타당성을 검증하고자 하였다. 방법: 개념적 및 언어적 등가성을 위해 권고되는 절차에 따라 ‘음성 활동 및 참여 프로파일’을 한국어로 번역하여 300명의 대상자(음성장애 환자 150명 및 대조군 150명)에게 시행하였다. 타당도 검증을 위해 5년 이상 경력의 언어재활사 4인의 검증과 예비시행, 집단 간 점수 비교, 문항변별도 산출과 음성장애지수와의 상관관계 검증을 실시하였다. 신뢰도 검증을 위해 내적 일치도, 검사-재검사 신뢰도를 산출하고, 절단점을 확인하였다. 결과: 환자군의 총점, 활동 제한 점수, 참여 제약 점수, 하위영역별 점수가 대조군에 비해 높았으며, 충분한 수준의 신뢰도 및 타당도를 갖춘 검사도구임이 확인되었다. 총점, 활동 제한 점수, 참여 제약 점수의 절단점은 각각 14.5점, 4.5점, 1.5점이었다. 논의 및 결론: K-VAPP가 우리나라 음성장애 임상현장에서 충분한 타당도와 신뢰도를 갖춘 도구로 활용될 수 있음을 확인하였다. Objectives: The purpose of this study was to confirm the validity and reliability of the Korean version of the Voice Activity and Participation Profile (K-VAPP), which is a self-reported questionnaire to measure activity limitation and participation restriction caused by voice disorders. Methods: The original version of the VAPP was translated into Korean to achieve conceptual and linguistic equivalence and to evaluate measurement properties. The K-VAPP was administered to 300 participants (150 with vocal complaints, 150 without vocal complaints). The instrument was evaluated with regards to its validity, reliability and cutoff scores for the total score, activity limitation score (ALS), and participation restriction score (PRS). Results: The total score, ALS, PRS, and five subscale scores of the patient group were higher than those of the control group. Concurrent validity, internal consistency, test-retest reliability, and item discrimination were satisfactory. The cutoff scores of the total score, ALS, and PRS were 14.5, 4.5, and 1.5, respectively. The clinical implications of these findings are discussed. Conclusion: The K-VAPP was proven to have sufficient validity and reliability to be used in Korean voice clinics and research. Further studies related to its responsiveness and various profiles with different etiologies or profession groups are needed.
단일성 안와 골병변으로 확인된 갑상선 여포암의 원격 전이 1예
전경화(Gyeong Hwa Jeon),오현석(Hyeon Seok Oh),최인호(In Ho Choi),변형권(Hyung Kwon Byeon) 대한두경부종양학회 2021 대한두경부 종양학회지 Vol.37 No.2
Follicular thyroid carcinoma (FTC) is the second most common thyroid cancer, following papillary carcinoma. Metastasis to the orbital rim from FTC is very rare. We recently experienced a case of FTC with metastasis to the orbital rim in a 74-year-old woman, who initially presented with a huge thyroid mass and an asymptomatic solitary orbital rim lesion. The solitary orbital rim lesion was suspected to be a separate disease entity such as lymphoma from the preoperative imaging, but bone metastasis from FTC was finally confirmed after orbital rim resection and total thyroidectomy. During follow-up, the patient presented multiple bone metastasis, so the solitary orbital rim lesion was considered a clinical sign of systemic metastasis from FTC. Therefore, we present this unique case with a review of the literature.
서영욱(Young Wook Seo),신승호(Seung Ho Shin),서자영(Ja Yeong Seo),변형권(Hyung Kwon Byeon) 대한두경부종양학회 2017 대한두경부 종양학회지 Vol.33 No.1
Hemangioma is the most common benign tumor in neonatal and infant stage. In the head and neck region, the lesion mostly occurs in the masseter, trapezoidal or sternocleidomastoid muscle. Due to its rarity and non-specific symptoms, it is difficult to diagnose precisely. Intramuscular hemangioma can be misdiagnosed as sialolithiasis of the parotid gland. There are several treatment options for hemangiomas such as sclerotherapy, radiotherapy, embolization, and surgery. Of all these, definitive surgical resection is considered most effective in preventing future recurrence. Here we report a case of intramuscular hemangioma that was detected in the patient’s right masseter muscle which was initially misdiagnosed as parotid sialolithiasis and was consequently managed with surgical resection.
반명진(Myung Jin Ban),정혜연 (Hae Yoen Jung),홍현준(Hyun Jun Hong),변형권(Hyung Kwon Byeon),김원식(Won Shik Kim),박재홍(Jae Hong Park) 대한두경부종양학회 2015 대한두경부 종양학회지 Vol.31 No.1
Basal cell adenocarcinoma is a extremely rare low grade malignancy of the salivary gland. It is composed of ba-saloid cells with dark cell, light cells and pale cytoplasm which shows infiltrative growth pattern into adjacent glandular parenchyme. The pathophysiology of basal cell adenocarcinoma is not well known. First hypothesis is a malignant transformation of the monomorphic adenoma and second one is a de novo origin. Metastasis to the re-gional lymph nodes is rare. Recently, we have experienced a case of basal cell adenocarcinoma with neck metasta- sis after previous superficial parotidectomy. For this reason we report this rare case discussed with references.
수술 전 세침흡인세포검사에서 악성으로 의심되었던 이하선 양성 종양 1예
이은정(Eun Jung Lee),황혜진(Hye Jin Hwang),변형권(Hyung Kwon Byeon) 대한두경부종양학회 2015 대한두경부 종양학회지 Vol.31 No.1
Fine needle aspiration cytology as a diagnostic workup of parotid gland tumor is a simple and useful method. Although fine needle aspiration cytology could not predict accurate diagnosis in all cases, it is usually helpful in differentiating malignancy and benign lesions. A 35-year-old female was found to have a parotid mass for 1 year. Preoperative evaluation including computed tomography and magnetic resonance imaging were non-diag- nostic, but, fine needle aspiration cytology on parotid mass showed the suspicion of a low-grade mucoepider-moid carcinoma. Superficial parotidectomy and selective neck node dissection were done based on cytology. However, final pathological examination confirmed benign pleomorphic adenoma. Here, the diagnostic accuracy and cautions in interpretation of result of fine needle aspiration cytology is discussed with respect to the case.
전경화(Gyeong Hwa Jeon),오현석(Hyeon Seok Oh),변형권(Hyung Kwon Byeon) 대한두경부종양학회 2021 대한두경부 종양학회지 Vol.37 No.2
Spontaneous cervical hematomas could lead to life-threatening complications, and aneurysms, retopharyngeal abscesses, parathyroid adenomas, laryngeal cysts, and neurogenic tumors should be distinguished as possible underlying causes. Symptoms accompanying spontaneous cervical hematoma include cervical swelling, ecchymosis, dysphagia, dyspnea and hoarseness. We recently experienced a case of spontaneous cervical hematoma in a 52-year-old woman, who initially presented with cervical swelling after severe coughing two days ago. Resultingly parathyroid adenoma was finally confirmed after mass excision. Therefore, we present this unique case with a review of the literature.
김민기(Min Ki Kim),강민석(Min Seok Kang),신유주(Yoo-Ju Shin),노경진(Kyung-jin Roh),변형권(Hyung Kwon Byeon) 대한두경부종양학회 2015 대한두경부 종양학회지 Vol.31 No.2
Sweat gland cancer is very rare with a reported incidence of less than 0.005% of all tumor specimens resected surgically. Diagnosis and management of these cancers are difficult, due to the limited reports in the literature. Here we present a case of an eccrine adenocarcinoma in the retroauricular area and report this case with a review of the literature.