• Archives of Craniofacial Surgery
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• v.20 no.3
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• pp.203-206
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• 2019

Merkel cell carcinoma (MCC) is a rare and highly aggressive neuroectodermal carcinoma arising from mechanoreceptor Merkel cells. Multiple MCCs are even rarer. We report a case of two independent MCCs simultaneously present in the cheek of a patient, which were effectively and esthetically treated using a cheek flap. Punch biopsy performed in a 60-year-old woman admitted with a chief complaint of two skin-colored hard nodules in her left cheek, accompanied by an itching sensation, was suggestive of MCC. Accordingly, we performed sentinel lymph node biopsy through the modified Blair incision under general anesthesia, in cooperation with the head and neck surgery department. The defect was covered with a cheek flap by slightly extending the existing incision following wide excision with a safety margin of 1 cm. This paper is significant in that it introduces an effective reconstruction technique that maintains function using a cheek flap for the management of this rare case. In addition, this paper is the first to classify multiple MCCs according to the time of onset. We believe that this paper presents an effective alternative reconstruction technique with sentinel node biopsy through the modified Blair incision.

• Archives of Plastic Surgery
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• v.33 no.2
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• pp.233-236
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• 2006

Merkel cell carcinoma is rare skin malignancy originated from epidermal mechanoreceptor of neural origin. The tumor usually affects older individuals at sun exposed area such as head, neck and extremity. Subclinical involvement of regional lymph node is reported frequently at the time of initial treatment. Thus even asymptomatic patients who present with clinically localized tumor should undergo evaluation with computed tomography and lymphangiography. Positron emission tomography(PET) scans can imaging the metabolic difference of malignant tumors. Increased glucose uptake of malignant tumor cells are detected by PET scanner. PET scans can provide qualitative and quantitative informations about systemic metastasis of tumors. Although there are no data that define the efficacy of PET scans in the initial diagnostic evaluation of head and neck cancer, they could be considered. Current standards of treatment of Merkel cell carcinoma is wide surgical excision and regional lymphadenectomy if there are suspicious lymph nodes. The author reported a patient with Merkel cell carcinoma of cheek. Wide surgical excision and postoperative PET/CT was done for evaluation of regional lymph node and distant metastasis. There were two hot-uptakes in patient's neck, so they were considered as metastatic node, but finally they were proved to be tuberculosis lymphadenitis after excision.

• The Korean Journal of Zoology
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• v.37 no.2
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• pp.281-288
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• 1994

한국산 거머리(Erpobdella lineate)의 전, 후 흠반을 광학현미경과 투과전자현미경을 사용하여 조직화학적 및 미세구조적 연구를 수행한 결과 다음과 같았다. 거머리 전, 후 홍안에서 관찰된 상피세포는 불규칙한 단층원주형 상피로 되어 있으며, 상피세포의 상단에는 큐티를층이 있고 측면원형질 막은 거치상을 이루면서 여러개의 desmosome이 관찰되 었다. 큐티클층은 projection eplcuticularis, amorphorous stratum 및 fibrous stratum 등 3부분으로 구분되었다. 전, 후 출반의 상피조직 사이에서 공히 a형 분비과립과 b혐 분비과립 등이 관찰되었는데, 이 세포에서 분비된 과립들은 중성점액다당류로 확인되었다. 전 흠반의 횡단면 상피조직 밑에서 많은 근육세포들조 형성된 원형의 집단들이 다수 관찰되었는데, 이는 흠반의 흡수기능과 밀접한 관계가 있었다 비교적 통근형태의 근육세포들은 세포의 원형질막 내측에 많은 근섬유 다발을 지니고 있고 그 중앙에는 cristae가 발달된 많은 수의 사립체들이 모여 있었다. 전, 후 출반의 결합조직 내에서 5종류(A, B, C, D 및 I 등)의 분비과립들이 관찰되었다. 그 중 C, D 과립은 전, 후 흡반에서 공통으로 관찰되고, A, B 과립은 전 흠반에서, E 과립은 후 흠반에서만 각각 관찰되었는데, 이들 역시 모두 중성점액다당류로 확인되었다.

• International Journal of Vascular Biomedical Engineering
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• v.3 no.2
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• pp.1-9
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• 2005

Flow-induced dilation of blood vessel is the result of a series of bioreaction in vascular endothelial cells(VEC). Shear stress change by blood flow in human artery or vein is sensed by the mechanoreceptor and responsible for such a chain reaction. The inositol(1,4,5)-triphophate($IP_3$) is produced in the first stage to elevate permeability of the intercellular membrane to calcium ions by which the cytosolic calcium concentration is consequently increased. This intracellular calcium transient triggers synthesis of EDRF and prostacyclin. The mathematical model of this VEC calcium dynamics is reproduced from the literature. We then use the Computational Fluid Dynamics(CFD) technique to investigate the blood stream dictating the VEC calcium dynamics. The pulsatile blood flow in a stenosed blood vessel is considered here as a part of study on thrombogenesis. We calculate the pulsating shear stress (thus its temporal change) distributed over the stenosed artery that is implemented to the VEC calcium dynamics model. It has been found that the pulsatile shear stress induces larger intracellular $Ca^{2+}$ transient plus much higher amount of EDRF and prostacyclin release in comparison with the steady shear stress case. It is concluded that pulsatility of the physiological shear stress is important to keep the vasodilation function in the stenosed part of the blood vessel.