Jung Bock Lee

Treatment of Bowen's disease with a specially designed radioactive skin patch

Abstract.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.

Syphilitic gastritis: Demonstration of Treponema pallidum with the use of fluorescent treponemal antibody absorption complement and immunoperoxidase stains

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.

Treponema pallidum induces up-regulation of interstitial collagenase in human dermal fibroblasts

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.