ABSTRACT
Background@#This study aimed to evaluate the efficacy and safety of a topical antioxidant cream containing tocotrienol after 1064-nm picosecond neodymium-doped yttrium aluminum garnet (Nd:YAG) laser treatment for environment-induced skin pigmentation. @*Methods@#A split-face study was conducted between December 2020 and March 2021 in 26 patients (25 women and one man) who were treated with a 1064-nm picosecond Nd:YAG laser. On the right side of the face, an antioxidant cream containing tocotrienol was applied after picosecond laser treatment, and on the left side, only picosecond laser treatment was performed. We compared the right and left sides of the face at 4 weeks after laser treatment using an automatic skin analysis device to investigate skin pigmentation. The melasma severity scores of the two sides were evaluated before and 4 weeks after picosecond laser treatment. @*Results@#The skin pigmentation score showed a significant difference between pretreatment and 4 weeks after picosecond laser treatment on both sides of the face (P0.05). @*Conclusions@#Our results show that, for the treatment of environment-induced skin pigmentation, the application of a tocotrienol-containing antioxidant cream after 1064-nm picosecond laser treatment can provide good results without any complications.
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Background@#Ablative fractional CO2 laser treatment is popular for improving atrophic acne scars; however, complications after laser treatment are unavoidable. The purpose of this study was to investigate the efficacy and safety of a moisturizer containing Centella asiatica extract when applied after ablative fractional CO2 laser resurfacing. @*Methods@#A split-face study was conducted between September 2020 and December 2020 on 34 patients (16 females and 18 males) who were treated with ablative fractional CO2 laser resurfacing. After laser treatment, C. asiatica extract was applied to the right side of the face and purified water was applied to the left side. We compared the right and left sides of the face at various time points after laser treatment using an automatic skin analysis device to investigate the degree of moisture and post-inflammatory hyperpigmentation. @*Results@#No significant difference in the degree of moisture was found between the two sides of the face immediately after laser treatment (P=0.059), but there was a significant difference at 1 and 4 hours after post-laser treatment care (P<0.001). Regarding post-inflammatory hyperpigmentation, there was no significant difference between the two sides of the face before laser treatment (P=0.184), but a significant difference was found at 6 weeks after laser treatment (P<0.001). @*Conclusions@#Our results show that applying C. asiatica extract is a novel post-laser treatment modality that can provide satisfactory results without complications after ablative fractional CO2 laser resurfacing.
ABSTRACT
Background@#This study aimed to evaluate the efficacy and safety of a topical antioxidant cream containing tocotrienol after 1064-nm picosecond neodymium-doped yttrium aluminum garnet (Nd:YAG) laser treatment for environment-induced skin pigmentation. @*Methods@#A split-face study was conducted between December 2020 and March 2021 in 26 patients (25 women and one man) who were treated with a 1064-nm picosecond Nd:YAG laser. On the right side of the face, an antioxidant cream containing tocotrienol was applied after picosecond laser treatment, and on the left side, only picosecond laser treatment was performed. We compared the right and left sides of the face at 4 weeks after laser treatment using an automatic skin analysis device to investigate skin pigmentation. The melasma severity scores of the two sides were evaluated before and 4 weeks after picosecond laser treatment. @*Results@#The skin pigmentation score showed a significant difference between pretreatment and 4 weeks after picosecond laser treatment on both sides of the face (P0.05). @*Conclusions@#Our results show that, for the treatment of environment-induced skin pigmentation, the application of a tocotrienol-containing antioxidant cream after 1064-nm picosecond laser treatment can provide good results without any complications.
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Background@#Ablative fractional CO2 laser treatment is popular for improving atrophic acne scars; however, complications after laser treatment are unavoidable. The purpose of this study was to investigate the efficacy and safety of a moisturizer containing Centella asiatica extract when applied after ablative fractional CO2 laser resurfacing. @*Methods@#A split-face study was conducted between September 2020 and December 2020 on 34 patients (16 females and 18 males) who were treated with ablative fractional CO2 laser resurfacing. After laser treatment, C. asiatica extract was applied to the right side of the face and purified water was applied to the left side. We compared the right and left sides of the face at various time points after laser treatment using an automatic skin analysis device to investigate the degree of moisture and post-inflammatory hyperpigmentation. @*Results@#No significant difference in the degree of moisture was found between the two sides of the face immediately after laser treatment (P=0.059), but there was a significant difference at 1 and 4 hours after post-laser treatment care (P<0.001). Regarding post-inflammatory hyperpigmentation, there was no significant difference between the two sides of the face before laser treatment (P=0.184), but a significant difference was found at 6 weeks after laser treatment (P<0.001). @*Conclusions@#Our results show that applying C. asiatica extract is a novel post-laser treatment modality that can provide satisfactory results without complications after ablative fractional CO2 laser resurfacing.
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BACKGROUND: Few scales are currently available to evaluate changes in hand volume. We aimed to develop a hand grading scale for quantitative assessments of dorsal hand volume with additional consideration of changes in skin texture; to validate and prove the precision and reproducibility of the new scale; and to demonstrate the presence of clinically significant differences between grades on the scale. METHODS: Five experienced plastic surgeons developed the Hand Volume Rating Scale (HVRS) and rated 91 images. Another five plastic surgeons validated the scale using 50 randomly selected images. Intra- and inter-rater agreement was calculated using the weighted kappa statistic and intraclass correlation coefficients (ICCs). Paired images were also evaluated to verify whether the scale reflected clinical differences. RESULTS: The intra-rater agreement was 0.95 (95% confidence interval, 0.922–0.974). The interrater ICCs were excellent (first rating, 0.94; second rating, 0.94). Image pairs that differed by 1, 2, and 3 grades were considered to contain clinically relevant differences in 80%, 100%, and 100% of cases, respectively, while 84% of image pairs of the same grade were found not to show clinically relevant differences. This confirmed that the scale of the HVRS corresponded to clinically relevant distinctions. CONCLUSIONS: The scale was proven to be precise, reproducible, and reflective of clinical differences.
Subject(s)
Humans , Asian People , Hand , Plastics , Rejuvenation , Skin , Skin Aging , Surgeons , Weights and MeasuresABSTRACT
BACKGROUND: Thread lift is a minimally invasive procedure for facial rejuvenation, but complications of thread lift have been reported. The purpose of this study was to evaluate outcomes and safety associated with elastic lift in relation to midface and upper mandibular region lifting. METHODS: Thirty-eight patients with sagging and laxity of the facial skin treated with elastic lift from September 2015 to October 2015 were enrolled in this study. Treatment was performed following the manufacturer's recommended protocol that called for 300 treatment lines. To evaluate elastic lift safety, a retrospective chart review was conducted. We used an automatic skin diagnosis system to evaluate the efficacy of elastic lift. RESULTS: Thirty-seven patients were female, and one patient was male. The mean age of the patients was 40.4 years, and their mean follow-up period was 3 months. There were no major complications manifesting in removal of the elastic thread during the follow-up period. The median skin laxity grade score was 5 (3-6) before surgery; the median skin laxity grade score was 3 (2-4) 3 months post-surgery, resulting in a statistically significant difference in skin grade score (P<0.01). CONCLUSIONS: Facial rejuvenation using elastic lift is an effective and safe procedure in select patients with midface ptosis and moderate jowls.
Subject(s)
Female , Humans , Male , Diagnosis , Follow-Up Studies , Lifting , Rejuvenation , Retrospective Studies , SkinABSTRACT
BACKGROUND: The neck is not only the first area to show aging but it also represents the persona of the individual. The understanding of the aging process of the neck is essential for neck rejuvenation. The purpose of this study was to evaluate the outcomes and safety of elastic lift in relation to neck region lifting. METHODS: Forty-seven patients with sagging and laxity of the neck skin treated by elastic lift were enrolled in this study from November 2015 to February 2016. To evaluate the safety of elastic lift, a retrospective chart review was conducted. We used an automatic skin diagnosis system to evaluate the efficacy of elastic lift. RESULTS: Forty-five patients were female and 2 patients were male. The mean age of the patients was 45.3 years and their mean follow-up period was 3 months. There were no major complications requiring the removal of the elastic thread during the follow-up period. The median skin laxity grade score was 5 (4-5) preoperatively; the median skin laxity grade score was 3 at 3 months postoperatively. In comparing the skin grade score at these two points in time, there was a statistically significant difference (P < 0.01). CONCLUSIONS: Neck rejuvenation using elastic lift is a safe and effective procedure in selected patients with moderate sagging and laxity of the neck skin.
Subject(s)
Female , Humans , Male , Aging , Diagnosis , Follow-Up Studies , Lifting , Neck , Rejuvenation , Retrospective Studies , SkinABSTRACT
Excessive microglial activation and subsequent neuroinflammation lead to synaptic loss and dysfunction as well as neuronal cell death, which are involved in the pathogenesis and progression of several neurodegenerative diseases. Thus, the regulation of microglial activation has been evaluated as effective therapeutic strategies. Although dieckol (DEK), one of the phlorotannins isolated from marine brown alga Ecklonia cava, has been previously reported to inhibit microglial activation, the molecular mechanism is still unclear. Therefore, we investigated here molecular mechanism of DEK via extracellular signal-regulated kinase (ERK), Akt and nicotinamide adenine dinuclelotide phosphate (NADPH) oxidase-mediated pathways. In addition, the neuroprotective mechanism of DEK was investigated in microglia-mediated neurotoxicity models such as neuron-microglia co-culture and microglial conditioned media system. Our results demonstrated that treatment of anti-oxidant DEK potently suppressed phosphorylation of ERK in lipopolysaccharide (LPS, 1 microg/ml)-stimulated BV-2 microglia. In addition, DEK markedly attenuated Akt phosphorylation and increased expression of gp91(phox), which is the catalytic component of NADPH oxidase complex responsible for microglial reactive oxygen species (ROS) generation. Finally, DEK significantly attenuated neuronal cell death that is induced by treatment of microglial conditioned media containing neurotoxic secretary molecules. These neuroprotective effects of DEK were also confirmed in a neuron-microglia co-culture system using enhanced green fluorescent protein (EGFP)-transfected B35 neuroblastoma cell line. Taken together, these results suggest that DEK suppresses excessive microglial activation and microglia-mediated neuronal cell death via downregulation of ERK, Akt and NADPH oxidase-mediated pathways.
Subject(s)
Adenine , Cell Death , Cell Line , Coculture Techniques , Culture Media, Conditioned , Down-Regulation , Microglia , NADP , NADPH Oxidases , Neuroblastoma , Neurodegenerative Diseases , Neurons , Neuroprotective Agents , Niacinamide , Phosphorylation , Phosphotransferases , Reactive Oxygen SpeciesABSTRACT
The downregulation of A-type K+ channels (IA channels) accompanying enhanced somatic excitability can mediate epileptogenic conditions in mammalian central nervous system. As IA channels are dominantly targeted by dendritic and postsynaptic processings during synaptic plasticity, it is presumable that they may act as cellular linkers between synaptic responses and somatic processings under various excitable conditions. In the present study, we electrophysiologically tested if the downregulation of somatic IA channels was sensitive to synaptic activities in young hippocampal neurons. In primarily cultured hippocampal neurons (DIV 6~9), the peak of IA recorded by a whole-cell patch was significantly reduced by high KCl or exogenous glutamate treatment to enhance synaptic activities. However, the pretreatment of MK801 to block synaptic NMDA receptors abolished the glutamate-induced reduction of the IA peak, indicating the necessity of synaptic activation for the reduction of somatic IA. This was again confirmed by glycine treatment, showing a significant reduction of the somatic IA peak. Additionally, the gating property of IA channels was also sensitive to the activation of synaptic NMDA receptors, showing the hyperpolarizing shift in inactivation kinetics. These results suggest that synaptic LTP possibly potentiates somatic excitability via downregulating IA channels in expression and gating kinetics. The consequential changes of somatic excitability following the activity-dependent modulation of synaptic responses may be a series of processings for neuronal functions to determine outputs in memory mechanisms or pathogenic conditions.
Subject(s)
Animals , Rats , Central Nervous System , Dizocilpine Maleate , Down-Regulation , Glutamic Acid , Glycine , Kinetics , Long-Term Potentiation , Memory , N-Methylaspartate , Neurons , Plastics , Receptors, N-Methyl-D-AspartateABSTRACT
People with ordinary faces want their faces more attractive, and thus various attempts have been made to reduce the size of the upper and lower face. We therefore have designed the shortening foreheadplasty, in which an excision was made on the part of the upper face skin using a trichophytic incision and the defect was widely avulsed and pulled forward down to be sutured. Participants included 115 patients who had visited our hospitals from January 2006 to June 2012. As a preoperative evaluation, we performed a gliding test to decide the size of the forehead skin laxity. As an operation method, a zigzag incision was designed and the skin was excised using a trichophytic incision, and the scalp flap was fixed using Endotine(R). Of a total of 115 patients, the shortening of forehead was in the range of 7mm to 20mm with the average 14.19mm. In order to help patients have small faces that meet the condition for the beauty, we performed a shortening foreheadplasty. In this surgery, the forehead skin was excised using a trichophytic incision and the scalp flap was dissected in the subgaleal plane, we could obtain favorable outcomes by minimizing the tension by sufficiently avulsing the scalp flap after the incision and fixing the flap with Endotine(R), and minimizing the formation of postoperative scar.
Subject(s)
Humans , Beauty , Cicatrix , Forehead , Scalp , Skin , Surgical FlapsABSTRACT
BACKGROUND: The most common complication of latissimus dorsi myocutaneous flap in breast reconstruction is seroma formation in the back. Many clinical studies have shown that fibrin sealant reduces seroma formation. We investigated any statistically significant differences in postoperative drainage and seroma formation when utilizing the fibrin sealant on the site of the latissimus dorsi myocutaneous flap harvested for immediate breast reconstruction after skin-sparing partial mastectomy. METHODS: A total of 46 patients underwent immediate breast reconstruction utilizing a latissimus dorsi myocutaneous island flap. Of those, 23 patients underwent the procedure without fibrin sealant and the other 23 were administered the fibrin sealant. All flaps were elevated with manual dissection by the same surgeon and were analyzed to evaluate the potential benefits of the fibrin sealant. The correlation analysis and Mann-Whitney U test were used for analyzing the drainage volume according to age, weight of the breast specimen, and body mass index. RESULTS: Although not statistically significant, the cumulative drainage fluid volume was higher in the control group until postoperative day 2 (530.1 mL compared to 502.3 mL), but the fibrin sealant group showed more drainage beginning on postoperative day 3. The donor site comparisons showed the fibrin sealant group had more drainage beginning on postoperative day 3 and the drain was removed 1 day earlier in the control group. CONCLUSIONS: The use of fibrin sealant resulted in no reduction of seroma formation. Because the benefits of the fibrin sealant are not clear, the use of fibrin sealant must be fully discussed with patients before its use as a part of informed consent.
Subject(s)
Female , Humans , Breast , Drainage , Fibrin , Fibrin Tissue Adhesive , Informed Consent , Mammaplasty , Mastectomy , Seroma , Tissue DonorsABSTRACT
PURPOSE: Neurofibromas may present as multiple or solitary lesions. Although there is no predilection site for solitary lesions, they are rare on the hand. In addition, solitary intramuscular neurofibromas are a very rare pathological type. Here, we report a rare solitary intramuscular neurofibroma in the hand. This paper examines the clinical characteristics of intramuscular neurofibroma arising from the lumbricalis in order to enable a correct diagnosis and treatment. METHODS: A 32-year-old male presented with a painless mass on the palm. The physical examination revealed a 3 x 2cm protruding mass that was non-tender to palpation. The vascular and sensory examinations were unremarkable, while the motor examination showed mild difficulty with flexion and extension. Magnetic resonance imaging demonstrated an enhancing solid mass between the thenar eminence and second metacarpophalangeal joint. The diagnosis of an intramuscular neurofibroma was confirmed following surgical excision and histological evaluation. RESULTS: The pathological examination was consistent with a neurofibroma, with delicate fascicles and loose fusiform cells in a fibrous stroma, with oval or spindle-shaped nuclei and scant cytoplasm. The background matrix was pale staining and had focal myxoid stroma. There was no significant nuclear pleomorphism and no mitoses. Immunohistochemistry with S-100 was slightly positive. At the 6-month follow-up, motor and sensory function were intact and the range of motion was full. CONCLUSION: A neurofibroma is a rare tumor of the hand, especially the intramuscular type. Hand surgeons should consider the diagnosis of this tumor based on the examination and imaging.
Subject(s)
Adult , Humans , Male , Cytoplasm , Follow-Up Studies , Hand , Immunohistochemistry , Magnetic Resonance Imaging , Metacarpophalangeal Joint , Mitosis , Neurofibroma , Palpation , Physical Examination , Range of Motion, Articular , SensationABSTRACT
PURPOSE: Hands are the chief organs for physically manipulating the environment, using anywhere from the roughest motor skills to the finest, and since the fingertips contain some of the densest areas of nerve endings on the human body, they are continuously used organ with complex functions, and therefore, often gets injured. To prevent any functional loss, a detailed anatomical knowledge is required to have a perfect surgical treatment. Also it is necessary to have a thorough understanding of arrangements of the human extensor tendons and intertendinous connections when tenoplasty or tendon transfer is required. We performed a study of the arrangements of the human extensor tendons and the configuration of the intertendinous connections over the dorsum of the wrist and hand. METHODS: A total of 58 hands from Korean cadavers were dissected. The arrangements of extensor indicis proprius, extensor digitorum communis, and extensor digiti minimi tendons and intertendinous connections were studied. RESULTS: The most common distribution patterns of the extensor tendons of the fingers were as follows: a single extensor indicis proprius(EIP) tendon which inserted ulnar to the extensor digitorum-index(EDC-index); a single EDC-index; a single EDC-middle; a double EDC-ring; an absent EDC-little; a double extensor digiti minimi(EDM), a single EDC-index(98.3%), a single EDC-middle(62%), a double EDC-ring(50%), and an absent(65.5%) or a single (32.8%) EDC-little. A double(70.6%) EDM tendons were seen. Intertendinous connections were classified into 3 types: type 1 with thin filamentous type, type 2 with a thick filamentous type, and type 3 with a tendinous type subdivided to r shaped 3r type and y shaped 3y type. The most common patterns were type 1 in the 2nd intermetacarpal space, type 2 in the 3rd intermetacarpal space, and type 3r in the 4th intermetacarpal space. And in the present study, we observed one case of the extensor digitorum brevis manus(EDBM) on the boht side. CONCLUSION: A knowledge of both the usual and possible variations of the extensor tendon and the intertendinous connection is useful in the identification and repair of these structures.
Subject(s)
Humans , Cadaver , Fingers , Hand , Human Body , Motor Skills , Nerve Endings , Tendon Transfer , Tendons , WristABSTRACT
Augmentation rhinoplasty is one of the most common aesthetic procedures in Asian countries. For this procedure, a variety of implants are used. Nasal bone fracture is one of the common facial bone fracture, and patients who have nasal bone fracture often need secondary rhinoplasty because of certain complications such as nasal deviation and depression. Unfortunately, the management protocol has not yet been established. Depending on whether the previous implant is removed or not, therefore, this may lead to partial decompression of the nasal bone, mobility of the implant, or reposition of the implant. For these reasons, we corrected fractured nasal bone, removed silicon implants and capsules, and employed immediate secondary rhinoplasty with dermofat graft for the patient who had had rhinoplasty. The height and appearance of the patient's nose were maintained as before surgery. The patient appealed a little depression of the nasal dorsum, but was very satisfied with its natural appearance. There were no complications such as nasal tip deformity, chronic inflammation, or partial depression deformity. We report herein the usefulness of this procedure; doing non-invasive closed reduction, removing silicon implants, and employing immediate secondary rhinoplasty with dermofat graft of the patients who had rhinoplasty previously.