ABSTRACT
OBJECTIVE: This study presents clinical results of Tixel, a new fractional skin resurfacing system based on thermo-mechanical ablation technology. Tixel employs a hot (400°C) metallic tip consisting of 81 pyramids. Treatment is performed by rapidly advancing the tip to the skin for a preset tip-skin contact duration. Thermal energy transfer to the skin creates micro-craters by evaporation. METHODS: Treatment results with tip types, D and S, with high and low thermal conductivity, were evaluated. Twenty-six subjects received three facial treatments, with 4-5-week intervals between treatments, without analgesia or cooling. In addition, histopathologies of Tixel and CO2 laser were performed. RESULTS: Crater properties are related to contact duration and to thermal conductivity. The D tip created char-free ablative craters 100-320 µm wide with a thermal zone 100-170 µm deep. The S tip created non-ablative coagulation preserving the epidermis. Skin complexion improvement was achieved in all subjects; average treatment pain of 3.1/10, downtime of 0-1 days, and erythema clearance of 3.5 days. Subject's satisfaction was 75% and wrinkle attenuation was achieved in 75% of the cases. There was no incidence of bleeding, scarring, or post-inflammatory hyperpigmentation. CONCLUSIONS: Tixel may be used safely for ablative and non-ablative resurfacing with low pain, low downtime, and quick healing.
Subject(s)
Ablation Techniques/methods , Hyperthermia, Induced/methods , Skin Aging , Ablation Techniques/adverse effects , Ablation Techniques/instrumentation , Adult , Aged , Animals , Energy Transfer , Female , Humans , Hyperthermia, Induced/adverse effects , Hyperthermia, Induced/instrumentation , Lasers, Gas/therapeutic use , Middle Aged , Pain/etiology , Patient Satisfaction , Skin Aging/pathology , Swine , Wound HealingABSTRACT
The management of pT1a-bN0M0 breast cancer remains an area of controversy. Data from 714 patients classified as having pT1a-bN0M0 breast cancer and treated, from 1999 to 2004 in the Languedoc-Roussillon France, were analyzed. The human epidermal growth factor receptor 2 (HER2) status analyses were centralized. The objective of this study was to describe the prognosis of pT1a-bN0M0 breast cancer according to HER2 distribution and hormonal status. The median follow-up was 6.4 years. Ten-year overall survival was 94%. HER2 overexpression was observed in 6.1% of the patients. The 10-year prognosis of patients with HER2-positive tumors was worse than that of those with HER2-negative (disease-free survival 73% vs. 89%, P < 0.0001). Tumor size (T1a/T1b) was not a relevant prognostic factor. The co-expression of HER2 with hormonal receptors (HR) was associated with high recurrence at 10 years. In both univariate and multivariate analyses, the most relevant prognostic factor for this population was HER2 amplification. In multivariate analysis, patients with HER2-positive tumors had higher risk of mortality (HR, 3.89; 95% CI, 1.58-9.56). In pT1a-bN0M0 breast cancers, HER2 amplification or overexpression is a risk factor for recurrence. In HER2-positive breast cancers, HR expression is associated with a poor prognosis despite the hormone therapy. For this population, a personalized management may be required.
Subject(s)
Breast Neoplasms/drug therapy , Breast Neoplasms/genetics , Neoplasm Recurrence, Local/drug therapy , Receptor, ErbB-2/genetics , Adult , Aged , Aged, 80 and over , Breast Neoplasms/pathology , Chemotherapy, Adjuvant , Disease-Free Survival , Female , France , Gene Expression Regulation, Neoplastic , Humans , Middle Aged , Neoplasm Recurrence, Local/genetics , Neoplasm Recurrence, Local/pathology , Prognosis , Receptors, Estrogen/metabolism , Receptors, Progesterone/metabolism , Risk Factors , Treatment OutcomeABSTRACT
BACKGROUND: Nonablative remodeling has been recently proposed as a new antiaging treatment with no downtime. OBJECTIVE: To evaluate the efficacy and safety of nonablative skin remodeling with a 1540 nm Er:glass laser and contact cooling on perioral and periorbital rhytides at 14 months follow-up. METHODS: Forty-two female patients (mean age 47 years), Fitzpatrick skin types I-IV were treated five times at 6-week intervals and checked 6 months after the last treatment. Patients were evaluated using clinical data, patient satisfaction (scale 1-4), digital pictures, ultrasound imaging, and profilometry data from silicone imprints in order to quantify the degree of improvement. RESULTS: All subjects reported an improvement in the quality and visual aspect of their skin at 6 months (mean patient satisfaction 3.06/4) and at 14 months after enrollment (mean patient satisfaction 2.90/4). This was confirmed by a 43.41% reduction of anisotropy (P < 0.001) 6 weeks after the fourth treatment, reaching 44.85% reduction 6 months after the fifth treatment (P <.001). Ultrasound imaging demonstrated a 17% increase in dermal thickness (P <.001) at 6 months and 11% 6 months after the last treatment (P <.05). A lack of immediate or late adverse effects was noted at all stages of the procedure. CONCLUSION: This study demonstrated that irradiation with a 1540 nm Er:glass laser emitting in a pulsed mode and coupled with an efficient cooling system increased dermal thickness, reduced the anisotropy of the skin, and improved clinical aspects. The lack of adverse effects within the 14 months confirmed that this procedure was safe. Overall the stability of the results many months after the treatment was remarkable.
