Blastic Natural Killer-Cell Lymphoma Presenting in the Skin

AbstractBlastic natural killer (NK)-cell lymphoma is a clinically aggressive hemato-logic neoplasm with a high incidence of cutaneous involvement. We report a 19-year-old man who presented with asymptomatic, erythematous, infiltrated bean plaques and nodules of various sizes, scattered over the face, trunk and extremities. A skin biopsy specimen revealed diffuse dermal infiltration of medium-sized pleomorphic cells with a blastic appearance. Immunohistochemical studies showed that the tumor cells were positive for CD56, CD43, CD123, and terminal deoxynucleotidyl trans-ferase (TdT). The neoplastic cells were negative for B-cell, T-cell, and myeloid cell markers. In situ hybridization for Epstein-Barr virus encoded RNA (EBER) gave a negative result. Flow cytometric analysis of bone marrow aspirate demonstrated a CD56 positive population of blastic cells. A diagnosis of blastic NK-cell lymphoma was made and the skin lesions regressed after treatment with L-asparaginase-based chemotherapy (L-asparaginase, cyclophosphamide, etoposide). The skin lesions regressed after two sessions of chemotherapy

Tumor-Associated Macrophage-Induced Invasion and Angiogenesis of Human Basal Cell Carcinoma Cells by Cyclooxygenase-2 Induction

Tumor-associated macrophages (TAMs) and cyclooxygenase-2 (COX-2) are associated with invasion, angiogenesis, and poor prognosis in many human cancers. However, the role of TAMs in human basal cell carcinoma (BCC) remains elusive. We found that the number of TAMs infiltrating the tumor is correlated with the depth of invasion, microvessel density, and COX-2 expression in human BCC cells. TAMs also aggregate near COX-2 expressing BCC tumor nests. We hypothesize that TAMs might activate COX-2 in BCC cells and subsequently increase their invasion and angiogenesis. TAMs are a kind of M2 macrophage derived from macrophages exposed to Th2 cytokines. M2-polarized macrophages derived from peripheral blood monocytes were cocultured with BCC cells without direct contact. Coculture with the M2 macrophages induced COX-2-dependent invasion and angiogenesis of BCC cells. Human THP-1 cell line cells, after treated with phorbol myristate acetate (PMA), differentiated to macrophages with M2 functional profiles. Coculture with PMA-treated THP-1 macrophages induced COX-2-dependent release of matrix metalloproteinase-9 and subsequent increased invasion of BCC cells. Macrophages also induced COX-2-dependent secretion of basic fibroblast growth factor and vascular endothelial growth factor-A, and increased angiogenesis in BCC cells

1,2-Ethanedithiol-Induced Erythema Multiforme-Like Contact Dermatitis

Contact dermatitis simulating erythema multiforme can be caused by many allergens. The chemical agent 1,2- ethanedithiol, which serves as a protective group in chemical synthesis, has hitherto only been implicated as an irritant. We report on a 22-year-old female chemistry student who developed widespread erythema multiforme-like lesions after local contact with 1,2-ethanedithiol. Many target lesions were observed bilaterally on her hands, forearms, arms, and on her forehead. One such lesion was histologically compatible with erythema multiforme. The patient had a positive patch test to 1,2-ethanedithiol, whereas none of 30 healthy subjects showed a positive reaction. However, eight of the 30 controls (26 .7%) developed irritant reactions to 1,2-ethanedithiol. Cautious handling of the compound is a prudent precaution

Business Model of Cosmetic Center in Public Hospital--- Illustrated by a Medical Center

醫學美容產業最近十年來在台灣蓬勃的發展。主要原因是(1)非侵襲性醫學美容科技(如雷射光療、注射美容)的進步；(2)另外因為健保給付偏低，醫院需開發自費收益；(3)政府政策引導醫療服務產業化，例如自由經濟示範區、推動國際醫療、觀光醫療等政策。雖然醫學美容有產業化的趨勢，不過醫美服務目前被認定是醫療行為(非單純商業交易)，因此受到醫療相關法規的嚴格管控。許多公私立醫院均設立醫學美容中心，加上專門醫美診所不斷設立，市場漸趨飽和，競爭也日趨激烈。彼得‧杜拉克曾說：『二十一世紀的競爭是商業模式的競爭。』公立醫療院所因為受限於法令規定的限制，其應變速度與靈活度相較於私立院所來的小。如何在激烈的兢爭中生存，有賴於商業模式設計。本研究先從文獻探討著手，了解企業轉型的利基策略，分析各種利潤模式與利潤區。進一步在對於商業模式做分拆解析，並探討Johnson等人提出的商業模式在創新理論。本研究將運用個案研究法，深入剖析商業模式再創新的四個連動要素：(1)顧客價值主張；(2)利潤公式；(3)關鍵資源；(4)關鍵流程。基於本研究的結果，希望可以提供公立醫療院所在競爭激烈的美容市場中佔住利基市場，穩定與持續的成長，發揮商業模式的整體綜效。Medical cosmetics are booming in Taiwan in the past decade. The main reasons includes: (1) Development of new non-invasive technology (i.e. lasers and injectables); (2) Poor insurance reimbursement prompts hospitals to generate new revenue stream; (3) Healthcare industrialization policy: Free economics pilot zones promotes international healthcare and bundled with tourism. However, medical cosmetics are still regarded as a medical practice and under strict regulations. Numerous public or private hospitals have increased their exposures to medical cosmetics, along with specialized cosmetic clinics, the market becomes increasingly crowded and intensive competitive. Peter F. Drucker once said: “Business model competition is the major management challenge in 21st century.” Restrained by regulations, public hospital are less agile in maneuver. To survive in this keen competition, rely on business model design. Started from literature review, current trends of value migration and profit zones shifts are illustrated. How to reinvent profitable business models are thoroughly discussed. The four components of successful business model, i.e. customer value proposition, profit formula, key resources, and key process, are demonstrated in our case study. The proposed model is also applicable to other public hospital to ensure a sustainable growth in medical cosmetic field.口試委員審定書…………………………………………………i 誌謝………………………………………………………………ii 中文摘要…………………………………………………………iii 英文摘要…………………………………………………………iv 目 錄 …………………………………………………………v 圖目錄 …………………………………………………………viii 表目錄 …………………………………………………………ix 第一章 緒論 ………………………………………………1 第一節 研究背景與動機………………………………………1 第二節 研究目的………………………………………………4 第三節 研究方法與設計………………………………………5 第四節 論文架構………………………………………………6 第二章 文獻探討……………………………………………7 第一節 商業設計與企業價值轉移……………………………7 第二節 利潤區與利潤模式...………………………………11 第三節 商業模式建立……………………………………….17 第四節 商業模式再創新理論……………………………….20 第三章 產業分析……………………………………………23 第一節 全球醫學美容產業現況與趨勢……………………23 第二節 台灣美容醫學服務市場之法令規範………………32 第三節 台灣美容醫學產業環境概況分析…………………36 第四節 五力分析……………………………………………41 第四章 個案研究分析與討論……………………………44 第一節 個案醫學美容中心及其經營策略…………………45 第二節 商業模式關鍵成功因素：顧客價值主張…………56 第三節 商業模式關鍵成功因素：利潤公式………………62 第四節 商業模式關鍵成功因素：關鍵資產………………68 第五節 商業模式關鍵成功因素：關鍵流程………………74 第六節 個案『美容中心』經營困境與因應策略…………78 第五章 結論與建議………………………………………80 第一節 研究結論……………………………………………80 第二節 研究貢獻……………………………………………81 第三節 實務研究建議………………………………………82 第四節 後續相關研究建議…………………………………83 參考文獻……………………………………………………85. 一、中文文獻…………………………………………………85 二、英文文獻…………………………………………………87 三、參考網站…………………………………………………87 附錄……………………………………………………………8

Tumor-Associated Macrophage-Induced Invasion and Angiogenesis of Human Basal Cell Carcinoma Cells by Cyclooxygenase-2 Induction

Tumor-associated macrophages (TAMs) and cyclooxygenase-2 ( COX-2) are associated with invasion, angiogenesis, and poor prognosis in many human cancers. However, the role of TAMs in human basal cell carcinoma (BCC) remains elusive. We found that the number of TAMs infiltrating the tumor is correlated with the depth of invasion, microvessel density, and COX-2 expression in human BCC cells. TAMs also aggregate near COX-2 expressing BCC tumor nests. We hypothesize that TAMs might activate COX-2 in BCC cells and subsequently increase their invasion and angiogenesis. TAMs are a kind of M2 macrophage derived from macrophages exposed to Th2 cytokines. M2-polarized macrophages derived from peripheral blood monocytes were cocultured with BCC cells without direct contact. Coculture with the M2 macrophages induced COX-2-dependent invasion and angiogenesis of BCC cells . Human THP-1 cell line cells, after treated with phorbol myristate acetate (PMA), differentiated to macrophages with M2 functional profiles. Coculture with PMA-treated THP-1 macrophages induced COX-2-dependent release of matrix metalloproteinase-9 and subsequent increased invasion of BCC cells. Macrophages also induced COX-2-dependent secretion of basic fibroblast growth factor and vascular endothelial growth factor-A, and increased angiogenesis in BCC cells