후두에 발생한 가육종성 암종 4예

배창훈,최승재,김용대,송시연 대한이비인후과학회 2012 대한이비인후과학회지 두경부외과학 Vol.55 No.7

Pseudosarcomatous carcinoma is a kind of squamous cell carcinoma having biphasic pattern, with both squamous and spindle cell components. Pseudosarcomatous carcinoma of head and neck mucosa is a very rare high-grade malignancy that may cause diagnostic and therapeutic controversies. The tools used for diagnosing pseudosarcomatous carcinoma are histopathological analysis and immunohistochemical analysis. We experienced four cases, a 60- year-old male patient with pseudosarcomatous carcinoma located at the left false vocal fold, a 68-year-old female patient with the same carcinoma located at both false vocal folds, 73-year-old male patient with the same carcinoma at the epiglottis, and a 69-year-old male patient with the same carcinoma at the left true vocal fold. We report these four cases with a brief review of literatures.

Clusterin Induces MUC5AC Expression via Activation of NF-κB in Human Airway Epithelial Cells

배창훈,나형균,최윤석,송시연,김용대 대한이비인후과학회 2018 Clinical and Experimental Otorhinolaryngology Vol.11 No.2

Objectives. Clusterin (CLU) is known as apolipoprotein J, and has three isoforms with different biological functions. CLU is associated with various diseases such as Alzheimer disease, atherosclerosis, and some malignancies. Recent studies report an association of CLU with inflammation and immune response in inflammatory airway diseases. However, the effect of CLU on mucin secretion of airway epithelial cells has not yet been understood. Therefore, the effect and brief signaling pathway of CLU on MUC5AC (as a major secreted mucin) expression were investigated in human airway epithelial cells. Methods. In the tissues of nasal polyp and normal inferior turbinate, the presence of MUC5AC and CLU was investigated using immunohistochemical stain and Western blot analysis. In mucin-producing human NCI-H292 airway epithelial cells and primary cultures of normal nasal epithelial cells, the effect and nuclear factor kappa-light-chain-enhancer of activated B cells (NF-κB) signaling pathway of CLU on MUC5AC expression were investigated using immunohistochemical stain, reverse transcription-polymerase chain reaction, real-time polymerase chain reaction, enzyme immunoassay, and Western blot analysis. Results. In the nasal polyps, MUC5AC and CLU were abundantly present in the epithelium on immunohistochemical stain, and nuclear CLU (nCLU) was strongly detected on Western blot analysis. In human NCI-H292 airway epithelial cells or the primary cultures of normal nasal epithelial cells, recombinant nCLU increased MUC5AC expression, and significantly activated phosphorylation of NF-κB. And BAY 11-7085 (a specific NF-κB inhibitor) and knockdown of NF-κB by NF-κB siRNA (small interfering RNA) significantly attenuated recombinant nCLU-induced MUC5AC expression. Conclusion. These results suggest that nCLU induces MUC5AC expression via the activation of NF-κB signaling pathway in human airway epithelial cells.

비강 및 부비동 양성종양의 비내시경적 치료의 장기간 추적관찰

배창훈,송시연,김용대 대한이비인후과학회 2005 대한이비인후과학회지 두경부외과학 Vol.48 No.7

Background and Objectives:Recently, rhinologists have increasingly applied their expertise in endoscopic sinus surgery to the resection of sinonasal neoplasms. However, there have not been many reports about long-term follow-up outcomes about endoscopic resection of sinonasal benign tumor. The purpose of this study is to evaluate long-term results of endoscopic management in sinonasal benign tumors. Subjects and Method:We reviewed retrospectively the medical records and radiologic findings of 35 patients with sinonasal benign tumors, who had been treated with transnasal endoscopic resection between January 1995 and December 1999 at Yeungnam University Medical Center and followed over a 5-year. Results:Inverted papilloma (22 cases, 62.8%) was the most common of benign tumor, followed by hemangioma (4 cases), fibrous dysplasia (2cases), angiofibroma (2 cases), etc. Among of the 22 cases of inverted papilloma, there were 4 cases of T1, 12 of T2 and 6 of T3 according to the Krause staging system. The most common chief complaint was unilaterally nasal obstruction. The mean follow-up period was 6.5 years (5-8 years). There was no major complications, with only one case (4.5%) of recurrent inverted papilloma observed during the following-up period. Conclusions:The transnasal endoscopic surgical procedure is less aggressive than other methods and except for massively extended cases of sinonasal benign tumors, it is a successful, therapeutic surgical method.

두경부에 발생한 중복암에 대한 임상적 고찰 70예

배창훈,천승민,이석춘,정은채,백운회,최성원,최윤석,김용대,송시연 대한이비인후과학회 2007 대한이비인후과학회지 두경부외과학 Vol.50 No.8

Background and Objectives:Recent advances in medical management, along with increased life span, have contributed to the increased oportunity for detecting multiple primary malignancy (MPM)and clinical characteristics of MPM in the head and neck region. Subjects and Method:We reviewed retrospectively the med-ical records of 984 patients with malignant tumors of head and neck who had been diagnosed histopathologicaly and treated be-tween August 1985 to July 2005. Results:Seventy patients (7.11%) were diagnosed as having MPM (double, n= 66;triple, n= 4). This group consisted of 67 men and 3 women (p<0.01). Twenty-five patients (36% ) had synchronous double primary malig-nancy (SDPM) and 45 patients (64% ) had metachronous double primary malignancy (MDPM). The hypopharynx was the most fre-quently involved site of the index tumor. The most common index tumors were squamous cell carcinoma histopathologically. Second primary malignancies were found in esophagus, stomach and lung. Fifty-five patients were found with first primary ma-lignancy in head and neck, and 25 were with second primary malignancy. The patients with first and second primary malignancy (average of survival 11.1 months) was very por. Patients with MPM have high cigaretes smoking and alcohol drinking habit. Conclusion:Patients with head and neck malignancies will require care-ful folow up for prevention, early detection, and the treatment of second primary malignancy. (Korean J Otorhinolaryngol Head Neck Surg 2007 ;50 :694-8)

안와내벽 외향골절의 비내시경적 치료

배창훈,예상백,박강식,송시연,김용대 대한이비인후과학회 2005 대한이비인후과학회지 두경부외과학 Vol.48 No.12

Background and Objectives:Before introducing transnasal endoscopic sinus surgery, surgical repair of the blowout fracture includes the transorbital approach with an external incision and/or the maxilloethmoidal approach. The advantages of the transnasal endoscopic technique include magnified direct visualization and easy access to the medial orbital walls. Gelfoam is a slowly absorbable material and is rigid enough to provide support where Silastic sheet is to be placed. The purpose of this study was to evaluate outcomes of transnasal endoscopic reconstruction with Gelfoam and Silastic sheet of medial orbital wall fracture. Subjects and Method:This study was a retrospective analysis 27 patients who underwent transnasal endoscopic reduction of blowout fracture from February 1999 to April 2004. The follow-up period was at least over than 12 months. Results:The study population included 18 males and 9 female patients ranging from 13 to 54 years (mean, 33.3 years) of age. Twenty of 23 patients with diplopia showed a complete improvement of diplopia and 3 patients showed an incomplete improvement. All of 13 patients with limitation of ocular movement and 2 patients with enophthalmos revealed a complete resolution of their symptoms. There were no significant complications in all patients although ocular pain and epiphora were observed temporally after operation. Conclusion:Transnasal endoscopic reconstruction with Gelfoam and Silastic sheet for medial orbital wall fracture is a very successful technique that does not accompany major complications and has definite cosmetic advantage of causing no external scarring.

이성대상포진에서 성상신경차단술의 치료 효과에 대한 고찰

배창훈,이석춘,최영호,천승민,백운회,정은채,송시연,김용대 대한이비인후과학회 2006 대한이비인후과학회지 두경부외과학 Vol.49 No.11

Background and Objectives:Facial palsy of herpes zoster oticus has rapid onset, is usually severe in degree, and poorer inprognosis than Bells palsy. In the past, herpes zoster oticus has usually been treated with acyclovir and steroid, but recently,applying stellate ganglion block for herpes zoster oticus has been recognized as an additional treatment that may improvefacial palsy. This study was designed to evaluate the effect of stellate ganglion block on herpes zoster oticus. Subjects andMethod:We reviewed retrospectively the medical records of 30 patients with herpes zoster oticus who were treated withacyclovir, steroid and stellate ganglion block between January 1995 and December 2004. The follow-up period was at leastover than 6 months. Results:All patients suffered from otalgia, vesicle, and facial palsy. The average degree of House-Brackmann classification on admission was 3.26 in the complete recovery patients and 4.61 in the incomplete recovery patients.Seventeen patients were completely recovered from facial palsy (56.7%), and 13 showed residual facial palsy 13 patients(43.3%). The poor prognosis may be related with early onset of facial palsy, high degree of House-Brackmann classificationon admission and high degenerative ratio on electroneurography of facial nerve. Conclusion:The additional treatment ofstellate ganglion block in herpes zoster oticus may not be effective on improving the complete recovery rate and prognosis.(Korean J Otolaryngol 2006;49:1065-70)

Phorbol 12-Myristate 13-Acetate Induces MUC16 Expression via PKCδ and p38 in Human Airway Epithelial Cells

배창훈,김학수,송시연,김용대 대한이비인후과학회 2012 Clinical and Experimental Otorhinolaryngology Vol.5 No.3

Objectives. Phorbol 12-myristate 13-acetate (PMA) is widely used as a protein kinase C (PKC) activator, PKC is involved in the secretion of mucins. MUC16, one of the membrane-bound mucins, is produced in human airway epithelial cells. However, the effect and signaling pathway of PMA on MUC16 expression in human airway epithelial cells has not been reported. Therefore, the effect and brief signaling pathway of PMA on MUC16 expression were investigated in human airway epithelial cells in this study. Methods. In the mucin-producing human NCI-H292 airway epithelial cells and the primary cultures of normal nasal epithelial cells, the effect and signaling pathway of PMA on MUC16 expression were investigated using reverse transcriptase-polymerase chain reaction (RT-PCR), real-time PCR, enzyme immunoassay, and immunoblot analysis with several specific inhibitors and small interfering RNA (siRNA) for p38 mitogen-activated protein kinase (MAPK). Results. PMA increased MUC16 expression, and activated phosphorylation of p38 MAPK. However, it did not activate phosphorylation of extracellular signal-regulated kinase 1/2 (ERK1/2). SB203580 (p38 MAPK inhibitor) inhibited PMA-induced MUC16 expression, while U0126 (ERK1/2 inhibitor) did not. In addition, the knockdown of p38 MAPK by p38MAPK siRNA significantly blocked PMA-induced MUC16 mRNA expression. Rottlerin (PKCδ inhibitor) inhibited PMA-induced MUC16 expression, and also inhibited the phosphorylation of activated p38 MAPK by PMA. Conclusion. These results show for the first time that PMA-induced MUC16 expression is regulated by activation of the PKCδ and p38 MAPK signaling pathway in human airway epithelial cells. Objectives. Phorbol 12-myristate 13-acetate (PMA) is widely used as a protein kinase C (PKC) activator, PKC is involved in the secretion of mucins. MUC16, one of the membrane-bound mucins, is produced in human airway epithelial cells. However, the effect and signaling pathway of PMA on MUC16 expression in human airway epithelial cells has not been reported. Therefore, the effect and brief signaling pathway of PMA on MUC16 expression were investigated in human airway epithelial cells in this study. Methods. In the mucin-producing human NCI-H292 airway epithelial cells and the primary cultures of normal nasal epithelial cells, the effect and signaling pathway of PMA on MUC16 expression were investigated using reverse transcriptase-polymerase chain reaction (RT-PCR), real-time PCR, enzyme immunoassay, and immunoblot analysis with several specific inhibitors and small interfering RNA (siRNA) for p38 mitogen-activated protein kinase (MAPK). Results. PMA increased MUC16 expression, and activated phosphorylation of p38 MAPK. However, it did not activate phosphorylation of extracellular signal-regulated kinase 1/2 (ERK1/2). SB203580 (p38 MAPK inhibitor) inhibited PMA-induced MUC16 expression, while U0126 (ERK1/2 inhibitor) did not. In addition, the knockdown of p38 MAPK by p38MAPK siRNA significantly blocked PMA-induced MUC16 mRNA expression. Rottlerin (PKCδ inhibitor) inhibited PMA-induced MUC16 expression, and also inhibited the phosphorylation of activated p38 MAPK by PMA. Conclusion. These results show for the first time that PMA-induced MUC16 expression is regulated by activation of the PKCδ and p38 MAPK signaling pathway in human airway epithelial cells.

Benign Pleomorphic Adenoma of the Soft Palate Metastasizing to the Sphenoid Sinus

배창훈,김용대,송시연 대한이비인후과학회 2010 Clinical and Experimental Otorhinolaryngology Vol.3 No.3

A benign pleomorphic adenoma is the most common tumor of the salivary glands. This tumor has the potential to metastasize to bone, the head and neck region, visceral organs and skin. Although there a few reports about a benign pleomorphic adenoma metastasizing to the maxillary sinus in the paranasal sinuses, there are no reports about a metastatic benign pleomorphic adenoma in the sphenoid sinus. We report here on a case of a benign pleomorphic adenoma of the soft palate that metastasized to the sphenoid sinus, and we briefly review the relevant clinical literature.

후두 점막의 염증성 질환, 형성이상과 암종에서Cyclin D1 단백의 검출

배창훈,최영호,천승민,김용대,심영란,송시연 대한이비인후과학회 2006 대한이비인후과학회지 두경부외과학 Vol.49 No.4

Background and Objectives:Cyclin D1 is one of the proteins regulating G1-S transition in the cell cycle and is considered to play an important role in subsequent mitotic division. So it is a candidate of a proto-oncogene implicated in the pathogenesis of several human tumor types, including laryngeal squamous cell carcinomas. The purpose of this study was to investigate the development of tumorigenesis and clinicopathologic means of cyclin D1 protein in squamous cell carcinoma of the larynx. Subjects and Method:Sixty two patients, who have been treated with benign lesion (keratosis and chronic inflammation), dysplasia or squamous cell carcinoma of the larynx from March 1994 to December 1996 were investigated for this purpose. cyclin D1 protein was detected by immunohistochemical technique in the paraffin embedded tissues. Results:The expression of cyclin D1 protein was detected in 6 out of 11 cases (54.5%) in benign lesion, 3 out of 5 cases (60.0%) in mild to moderate dysplasia, 12 out of 18 cases (66.7%) in severe dysplasia and carcinoma in situ, and 36 out of 44 cases (81.8%) in invasive squamous cell carcinoma of the larynx. Of these, the expression of cyclin D1 protein in invasive squamous cell carcinoma was the highest positive rate, and there was significant difference (p<0.05). However, the expression of cyclin D1 protein was not correlated with degree of differentiation, anatomical site, T-stage and N-stage in invasive squamous cell carcinoma of the larynx (p>0.05). Conclusion:Cyclin D1 protein may be considered to play an important role in the development of the tumorigenesis in invasive squamous cell carcinoma of the larynx. (Korean J Otolaryngol 2006;49:415-9)

The Effect of Doxycycline on PMA-Induced MUC5B Expression via MMP-9 and p38 in NCI-H292 Cells

배창훈,천승민,이흥만,송시연,김용대 대한이비인후과학회 2011 Clinical and Experimental Otorhinolaryngology Vol.4 No.4

Objectives. Doxycycline is commonly used in medicine for its bacteriostatic antimicrobial properties. Recent studies have reported that doxycycline also has anti-inflammatory effects. Matrix metalloproteinase (MMP)-9 has been found to be involved in the physiological and pathological process of inflammatory airway disease. Phorbol 12-myristate 13-acetate (PMA), a protein kinase C activator, is known to stimulate the expression of MMP and mucin genes in the airway and intestinal epithelial cells. Therefore, the effects and signal pathways of doxycycline on PMA-induced MUC5B expression dependent MMP-9 in human airway epithelial cells were investigated. Methods. In human NCI-H292 airway epithelial cells, MUC5B and MMP-9 mRNA expression, MUC5B protein expression,and MMP-9 protein activity after the treatment with PMA, MMP-9 or doxycycline were determined by reverse transcriptase-polymerase chain reaction, enzyme immunoassay, gelatin zymography, and Western blot analysis. Results. PMA increased MMP-9 and MUC5B expression. MMP-9 increased MUC5B expression. Doxycycline inhibited PMA-induced MUC5B expression, and PMA-induced MMP-9 mRNA expression and protein activity. Doxycycline inhibited phosphorylation of p38 induced by PMA and MMP-9. Conclusion. The results of this study suggest that doxycycline inhibited PMA-induced MUC5B mRNA expression and protein production through the MMP-9 and p38 pathways in human NCI-H292 airway epithelial cells.