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BACKGROUND Atrophic scars can be induced by various causes, including severely inflamed acne, chicken pox, and trauma. Many treatment modalities are used for reconstructing and improving the appearance of scars with various treatment results. OBJECTIVE A recent report shows the clinical efficacy of the chemical reconstruction of skin scars (CROSS) method, which consists of the focal application of trichloroacetic acid (TCA) in a higher concentration. Histometric analysis of the CROSS method, however, has not yet been established. METHODS In this study, five hairless mice were used to evaluate the effect of the CROSS method and to analyze the difference between the CROSS method and simple TCA application. RESULTS Similar histologic changes were observed in the two methods, including epidermal and dermal rejuvenation with new collagen deposition. These changes, however, were more prominent in the CROSS method-treated areas, particularly when 100% TCA was used. CONCLUSION The results of this study suggest that treatment of atrophic scars using the CROSS method is more effective than simple application of TCA in activating fibroblasts in the dermis and increasing the amount of collagen.

Background. Benign pigmented lesions, including seborrheic keratosis, solar lentigines, melasma, and freckles, are common disorders, and various treatment modalities have been tried. We suggest a technique consisting of focal trichloroacetic acid (TCA) peel applied by pressing firmly onto the focal lesions. Objective. To evaluate the clinical effects of focal TCA peel on pigmented lesions in dark-skinned patients. Methods. An analysis was conducted of 106 patients with benign pigmented lesions who were treated using focal TCA peel. Seborrheic keratosis was treated with 65% focal TCA peel, solar lentigines, and freckles with 50% to 65% focal TCA peel, and melasmas with 10% to 50% focal TCA peel. Patients had Fitzpatrick skin types IV–V. Results. Patient treatment data indicated that 19 of 23 (83%) patients with seborrheic keratosis, 42 of 49 (86%) patients with solar lentigines, 8 of 14 (58%) patients with freckles, and 11 of 20 (55%) patients with melasma experienced a good clinical response. Good satisfaction rates in the seborrheic keratosis, solar lentigines, freckles, and melasma groups were recorded. No significant complications were observed. Conclusion. The focal TCA peel method presented in this study is a safe and effective modality for the treatment of benign pigmented lesions with no significant complications.

In this study we investigated the capability of Treponema pallidum to stimulate human dermal fibroblasts to produce interstitial collagenase (MMP-1), which is needed to degrade type I collagen, the most abundant component of the human dermis. When T. pallidum was added to human dermal fibroblast culture, both the amount of secreted MMP-1 and its mRNA levels were increased. Our results show that T. pallidum can stimulate host human fibroblasts to increase the synthesis of MMP-1, which may act as a virulence factor of the organism.

Bowen's disease can be treated by various methods, including surgical excision, cryosurgery, laser ablation, curettage, Mohs' microsurgery and ionizing radiation. Radiotherapy has been a useful therapeutic modality in the treatment of Bowen's disease and other skin cancers in areas which are difficult to excise, especially the central areas of the face, including eyelids, nose and lips. To overcome some of the disadvantages of external radiotherapy, a specially designed skin patch coated with high-energy beta-emitter holmium-166 was made for topical application at our institute. Twenty-nine sites of Bowen's disease in eight patients, confirmed by skin biopsy, were treated with 166Ho patches. The patches were applied to the surface of skin cancers for 30-60 min for a total radiation dose of 35 Gy (3500 rads). One to two weeks after application of the 166Ho patch, desquamation, erythema or erosion developed in treated sites, but these acute radiation reactions healed gradually with epithelial regeneration, and they showed good functional and cosmetic results without any complications. Follow-up biopsies were performed 1-5 months after 166Ho patch therapy, and they did not show any signs of Bowen's disease. One to two years after treatment with 166Ho skin patches, there were no recurrences of Bowen's diseases and no late complications. The 166Ho patch is an effective and convenient alternative method for the treatment of Bowen's disease that yields good cosmetic and functional results.

This study was attempted to produce the monoclonal antibodies specific for Treponema pallidum and to investigate their characteristics, thereby contributing to identify the antigenic structure and to apply the diagnosis of syphilis. The seven clones (YS 3, YS 75, YS 307, YS 481, YS 343, YS 1 and YS 406) secreting monoclonal antibodies reactive with T. pallidum were produced. The isotypes of the seven monoclonal antibodies produced were defined. Optical densities of the 7 monoclonal antibodies were ranged from 0.59 to 1.48 as measured by ELISA. Monoclonal antibodies from 5 of the 7 clones which could agglutinate sheep RBC sensitized with T. pallidum, showed strong fluorescences. The monoclonal antibody from YS 343 was cross-reactive with non-pathogenic treponemes, but the other 6 monoclonal antibodies reacted with T. pallidum specifically. On immunoblotting, monoclonal antibodies from 5 of the 7 clones reacted with a polypeptide of a molecular weight of 47 kDa, and monoclonal antibodies from YS 343 reacted with a polypeptide of 64 kDa common to both T. pallidum and T. phagedenis. The above results revealed that 7 clones secreting monoclonal antibodies reactive to T. pallidum were produced successfully, and specific antibodies reacting with major antigenic polypeptides of a molecular weight of 47 kDa would be useful in the diagnosis of syphilis in the future.

This pilot study compared the relative effectiveness of hand acupuncture and moxibustion in relieving pain and decreasing "coldness" in certain body parts experienced by subjects who have undergone a hysterectomy. The study participants were 10 women between 40 and 65 years, whose hysterectomies had been performed within 5 years before the study. The 10 subjects were divided randomly into two independent experimental groups, with one group being treated with hand moxibustion, whereas the other group received hand acupuncture therapy. The visual analogue scale evaluation tool was used to measure the pain and digital infrared thermographic imaging to measure "coldness" and blood circulation. When measuring the degree of pain, it was noted that pain scores decreased conspicuously over time. The responses of the two groups did not differ significantly, but moxibustion therapy was found to increase the temperature of internal parts of the body (i.e., abdominal and waist areas), whereas acupuncture affected the peripheral parts of the body.

Pathogenicity of Treponema pallidum may depend upon the binding of Treponema pallidum to matrix proteins, especially to fibronectin. Infectious organism or cell to matrix interactions are mediated by a family of adhesion molecule receptors known as integrins. Once in the host, the pathogenic Treponema pallidumdum adheres to the vascular endothelium and readily penetrates surrounding tissues. Fibronectin plays an important role in the mediation of the attachment of Treponema pallidum to host cells, including endothelial cells. We found that the binding of Treponema pallidum to human dermal microvascular endothelial cells and to a glass surface coated with fibronectin is inhibited by the presence of arginine-glycine- aspartic acid (RGD), and analysis of the surface receptor revealed an antigenic similarity to an integrin molecule, namely alpha5. This ability to adhere to host endothelium and fibronectin is quite unique to T. pallidum among the treponemes, and may be a key pathogenic factor.

background. Acne scarring is a common complication of acne and yet no appropriate and effective single treatment modality has been developed. We suggest a technique consisting of the focal application of higher trichloroacetic acid (TCA) concentrations by pressing hard on the entire depressed area of atrophic acne scars. This technique is called chemical reconstruction of skin scars (CROSS) by the authors. objective. To evaluate the clinical effects of CROSS on atrophic acne scars in dark-complexioned patients. methods. An analysis was conducted of 65 patients with atrophic acne scars who were treated with CROSS in our hospitals between July 1996 and July 2001. Thirty-three patients were treated with 65% TCA CROSS and 32 patients were treated with 100% TCA CROSS. All patients had Fitzpatrick skin types IV–V. results. Patient treatment data indicated that 27 of 33 patients (82%) (the 65% TCA group) and 30 of 32 patients (94%) (the 100% TCA group) experienced a good clinical response. All patients in the 100% TCA group who received five or six courses of treatment showed excellent results. Good satisfaction rates in the 65% and 100% TCA groups were recorded. There were no cases of significant complication. conclusion. CROSS is a safe and very effective single modality for the treatment of atrophic acne scars with no significant complications.

Perivasculitis and endothelial cell abnormalities are prominent histopathologic features of syphilis. Various cutaneous lesions are the main clinical features of syphilis. We examined whether Treponema pallidum 47 kDa antigen regulates the expression of cell adhesion molecules on human dermal microvascular endothelial cells (HDMEC) and the regulation of T-lymphocytes binding to HDMEC. Using immunofluorescence flow cytometry and enzyme-linked immunosorbent assay (ELISA), we demonstrated that T. pallidum upregulated the expression of adhesion molecules, including intercellular adhesion molecule 1 (ICAM-1), vascular cell adhesion molecule 1 (VCAM-1) and E-selectin. The 47 kDa antigen of T. pallidum also activated endothelium as measured by the upregulation of the expression of adhesion molecules on HDMEC, and it also promoted an increased adherence of T-lymphocytes to HDMEC. The expressions of ICAM-1 and VCAM-1 on HDMEC and the adherence of T-lymphocytes to HDMEC were inhibited by treatment with anti-TNF-alpha antibody or anti-IL-1alpha antibody. These results show that T. pallidum or T. pallidum-specific 47 kDa antigen are capable of stimulating HDMEC to increase the expression of ICAM-1, VCAM-1 and E-selectin and thereby, promote the adherence of T-lymphocytes. The whole process may play an important role in the immunopathogenesis of syphilis and it is likely that TNF-alpha and IL-1alpha are involved.

BACKGROUND--IgG antibodies from mothers adequately treated for syphilis can cross the placenta and appear in the sera of healthy newborns without infection. In such infants, a false diagnosis of congenital syphilis is often made. We have designed a retrospective survey to determine the time of seroreversion of the serological tests for syphilis (STS) in uninfected newborns born to mothers who were adequately treated for syphilis. MATERIALS AND METHODS--Fifty two seropositive, untreated newborns born to 51 mothers treated for syphilis were studied. The newborns were followed at 1, 3, 6, 9, and 12 months of age until seroreversion was detected. The VDRL test was followed until 12 months in 12 of the 22 newborns who were positive at birth, the TPHA in 21 of the 46 newborns, and the FTA-ABS test in 22 of the 48 newborns. RESULTS--In the first serological tests done within 1 month after birth, the VDRL was positive in 22 newborns (42%), the TPHA in 46 (88%), and FTA-ABS in 48 (92%). The VDRL seroreverted within 6 months after birth in 84%, and within 1 year in 100%. The TPHA test seroreverted in 95% within 1 year after birth. The FTA-ABS test seroreverted in 100% within 1 year after birth. CONCLUSIONS--In most seropositive, untreated newborns born to treated mothers the VDRL became negative within 6 months after birth and the TPHA and FTA-ABS within 1 year. This result is consistent with current Centers for Disease Control (CDC) guidelines. However, although the CDC guidelines are adequate in general, we think that some revision is desirable concerning the IgM test and combination of the test results in order to rule out congenital syphilis in seropositive, nonsymptomatic newborns born to the treated mothers.

Objectives: To determine the current prevalence of syphilis in the general population of South Korea and its trend over the past 20 years. Methods: 15 402 adults, who all were aged over 20 (6888 blood donors, 4951 physical examinees, and 3563 pregnant women) were examined from January 1999 to December 2000. All subjects were screened using a VDRL test, and positive results were confirmed by a FTA-ABS test. The prevalence was compared with the results of previous surveys in similar population groups performed by same authors. Results: The prevalence of syphilis in South Korea was found to be 0.2%. Although has been consistent decreasing trend since 1977 (p

To find out if polymerase chain reaction could be used as a diagnostic tool for detecting neurosyphilis, we have applied the PCR for the detection of Treponema pallidum DNA in the cerebrospinal fluid (CSF) of syphilis patients. The results of the PCR of the CSF in 26 patients with at various stages of illness were compared with the results of other conventional tests used in the WHO criteria. T. pallidum was detected in the CSF of patients at all stages of syphilis, which indicates that they invade the central nervous system from the early stages of infection. However, the presence of T. pallidum in the CSF was not correlated with the results of other tests used in the WHO criteria, and its significance in the diagnosis of neurosyphilis should further be evaluated.

The integrated cell culture-PCR (ICC-PCR) method has been suggested as an improved method for detection of viruses in water environments. We tested 57 source waters including finished water samples in Gyeonggi-do for enteric viral contamination using total culturable virus assay (TCVA) using BGMK cells and ICC-PCR. Nineteen of the 57 source water samples (33.3%) exhibited the cytopathic effect (CPE) on BGMK cells and no finished water did exhibited CPE. Nineteen samples (33.3%) of the 57 were positive for reoviruses. For the enteroviruses, only 3 samples (5.3%) of the 57 samples showed positive results. By using ICC-PCR method, 202 flasks from source water samples were positive for enteroviruses and reoviruses. Three samples from source water were positive for both viruses. However, any flasks tested was not co-infected with two types of viruses. While the enteric viral frequencies in TCVA and ICC-PCR were similar, the viral frequency for reoviruses at first passage in two type of method was higher in ICC-PCR (94.7%) than TCVA (56.9%).

An immunoperoxidase technique was performed to detect keratinolytic proteinase (KPase) in sections of the skin taken from guinea pigs infected with Microsporum canis and in cultured M. canis using polyclonal antisera to purified KPase. Of tissue samples from guinea pigs infected with M. canis, all sections of erythematous lesions showed positive staining mainly in the horny layer and the hair follicles. Positive depositions were seen only at the level of the outer and inner root sheaths of the hair follicles in sections of skin lesions showing scales and crusts. However, sections from areas of alopecia following desquamation of the crust showed no depositions of bright red reaction products. The patterns of deposition of KPase according to the clinical course of experimental dermatophytosis were consistent with the existence of organisms observed by PAS and methenamine silver stains. These results suggest that KPase may be produced during infection with M. canis after the development of erythema and before desquamation of the crust.

With 37 formalin-fixed, paraffin embedded specimens from the lesions of 30 patients with primary, secondary or gastric syphilis, we performed avidin-biotin-peroxidase complex (ABC), indirect immunoperoxidase (IIP) and FTA-ABS complement techniques. Darkfield examination was done in 17 skin lesions. The immunoperoxidase technique, especially the ABC technique, revealed higher reactivity than the FTA-ABS complement technique and darkfield examination in detecting Treponema pallidum in tissues. Furthermore, the ABC technique produced less intense nonspecific background staining than the IIP technique. Histologically, most of the treponemes were located in the upper dermis, epidermis and vessel walls in the order named, and rarely in the lower dermis of the syphilitic skin lesions.

The changes of serum IgG antibody reactivity to protein antigens of Treponema pallidum after treatment of syphilis were observed using sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE) and Western blot. Until 9 to 12 months after treatment, it was seen that there was a loss of several antibodies and some diminution in their reactivity in primary, secondary and early latent syphilis, but no changes occurred in late latent and reinfected syphilis. In primary syphilis, there was a significant loss of two IgG antibodies to the treponemal antigens of molecular weights 68,500 and 47,000 at 11 months after treatment. According to our previous study, the treponemal antigen of molecular weight 68,500 was T. pallidum specific and appeared only in primary syphilis, and that of molecular weight 47,000 was one of the major antigens of T. pallidum. The reaction between serum IgG antibodies of 14 patients who had been treated for secondary, early latent and late latent syphilis 2 to 14 years ago and major antigens of T. pallidum was observed and any loss or decrease in reactivity was not discovered. From the results obtained, it was concluded that the observation of serum IgG antibody reactivity to protein antigens of T. pallidum is not helpful in evaluating the efficacy of treatment in secondary, early latent, late latent and reinfected syphilis. However, serum IgG antibodies to treponemal antigens of molecular weights 68,500 and 47,000 could possibly be useful in the assessment of the efficacy of treatment in primary syphilis.

The effects of toxic doses of vitamin A and its derivatives on the exocrine functions of the liver, pancreas and stomach of rats were observed. Vitamin A, retinoic acid or retinoid, an aromatic analog of retinoic acid, was given orally in a single large dose or in repeated doses. Excessive feeding of vitamin A or its derivatives, particularly retinoic acid, caused considerable toxicity and a change in the exocrine functions of the digestive glands. The mortality was high (37.5%) in rats treated with retinoic acid. Only one of 40 rats died in the retinoid group and none in the vitamin A or the control groups. The rats treated with retinoic acid or retinoid lost weight but recovered within 2 weeks after the completion of treatment.

(1980). The Professional and Economic Structure of the Japanese Press. Journal of East and West Studies: Vol. 9, No. 1, pp. 77-95.

This study was designed to investigate the influence of d-α-tocopheryl acetate on the toxic effect of retinoic acid and retinoid (Ro 10-9359) on pancreaticobiliary and gastric secretion after the administration of large doses for 3 weeks to albino rats. The toxicity of retinoic acid on body weight and exocrine function, and the morphologic changes in the main digestive glands of the rat are greater than with retinoid. It is clear that vitamin E may suppress or counteract the undesirable toxic effects of retinoic acid and retinoid and appears to promote the function of the main digestive glands of rats.

A keratinolytic proteinase (KPase) which is regarded as an important factor in the pathogenesis of dermatophytosis was isolated and purified from Microsporum (M.) canis culture filtrates. Enzyme-linked immunosorbent assay (ELISA) was used to determine the occurrence of circulating antibodies to this enzyme in sera samples from guinea pigs with superficial fungal infections caused by M. canis. Of sera samples from guinea pigs infected with M. canis, 75% were reactive within 10 weeks, however, those ELISA values were relatively low compared with those from guinea pigs immunized with KPase. The presence of circulating antibodies was first detected 2 weeks post inoculation with M. canis, corresponding to the period when the lesions were most severe. The titers of the ELISA antibodies reached a peak at 4 weeks; at that time the lesions had disappeared completely.

Because of the decrease in the overall incidence of syphilis, syphilitic involvement of stomach is seldom reported in the modern literature. Because of the nonspecific symptoms and signs of the disease, it is necessary to demonstrate Treponema pallidum in the gastric lesions to confirm the diagnosis. With the use of immunofluorescence and immunoperoxidase methods we have succeeded in identifying T. pallidum in the gastric wall of a patient who initially had cutaneous manifestations of secondary syphilis and gastric symptoms.

• Blood samples and skin biopsy specimens from 13 male patients with Darier's disease (DD) and 11 healthy male controls were analyzed for carotene, retinol (vitamin A1), dehydroretinol (vitamin A2), and retinol-binding protein (RBP). The serum carotene level was lower in the patients than in the controls, but the vitamin A and RBP levels did not differ from those of the controls regardless of the severity of the disease. The RBP could be visualized by immunofluorescence microscopy in the epidermis of both unaffected and lesional skin of patients with DD. In the epidermis of patients with DD (uninvolved and lesional), the carotene content was similar to that of the controls. The retinol content was probably higher than in the controls. By contrast, the dehydroretinol concentration was normal in the uninvolved skin but markedly higher than normal in the lesions, especially in the severe cases. The abnormal distribution of retinoids in DD may reflect localized disturbances of epidermal vitamin A metabolism rather than a defect in serum vitamin A transport. (Arch Dermatol1982;118:389-392)

The 6,097 blood donors in Seoul area, the 1,883 pregnant women delivered at Severance Hospital and the 5,136 physical examinees were evaluated for VDRL reactivity. Also, the FTA-ABS and TPHA tests were performed on those who were VDRL-positive, and the 19S (IgM)-FTA test were done on the subjects who were reactive for the FTA-ABS and TPHA tests. All the subjects were over the age of 20 and the study period was conducted from January of 1986 through December of 1986. The results are summarized as follows: 1. VDRL-positive rates were 0.5% in the blood donors, 0.6% in the pregnant women and 0.8% in the physical examinees. 2. The quantitative test of VDRL resulted in low titer below 1:4 in 96% of VDRL-positive pregnant women and physical examinees. 3. The 19S (IgM)-FTA test was reactive in 3 of 12 treated subjects (25%) and 4 of 10 untreated subjects (40%). From the results it is clear that the prevalence of syphilis is continually decreasing compared to the mid 1970's and the early 1980's.