A novel explanation for the healing effect of the Er:YAG laser during skin rejuvenation.

In the present short communication, we would like to suggest a possible mechanism for the healing effects exerted by the erbium:yttrium-aluminum-garnet (Er:YAG) laser with a wavelength of 2940 nm (which surprisingly is the exact vibrational OH stretch frequency of water).

A novel explanation for the healing effect of the Er:YAG laser during skin rejuvenation.

The popularity of cutaneous laser resurfacing has soared in recent years. Ablative laser skin rejuvenation with carbon dioxide (CO2) and erbium:yttrium-aluminum-garnet (Er:YAG) lasers has been popularized and their side effects individually reported. It has been suggested that initial collagen contraction and thermal damage modulate wound healing. Progress in laser technology permits precise tissue removal and minimal thermal damage. However, mechanisms for cosmetic improvement have not yet been completely determined. In the present short communication, we would like to suggest a possible mechanism for the healing effects exerted by the Er:YAG laser.

Endoscopic treatment of salivary gland injuries due to facial rejuvenation procedures.

OBJECTIVE: The purpose of this article is to describe innovative surgical techniques for treatment of salivary gland injuries caused by facial rejuvenation procedures. METHODS: Between 2001 and 2007, a total of 14 patients, all females ages 46 to 70 who suffered from salivary gland injuries caused by facial rejuvenation procedures, were treated, primarily by an endoscopic-guided technique that involved location of the injury and endoscopic repair. RESULTS: There were four types of postsurgical injuries of the salivary glands that were caused by operations for facial rejuvenation: 1) compression of salivary ducts with temporary swelling (n = 1); 2) laceration of the capsule of the salivary gland (n = 3); 3) stretching and compression of the ducts with penetration of the capsule of the duct leading to sialocele and long-term swelling (types 1 and 2 combined) (n = 5); and 4) complete cut or penetration of the main salivary duct or of one of its main branches resulting in sialocele (n = 5). The endoscopic technique treatment was successful in all cases. CONCLUSION: The main reasons for salivary gland injuries due to facial rejuvenation procedures in our patients were: poor anatomical identification of the border between the superficial muscular aponeurotic system (SMAS) and the parotid capsule; penetration of the salivary gland capsule by blunt or sharp dissection; unnecessary use of sharp-tip scissors; and a tear of the salivary duct by hooks during a face-lift procedure. Plastic surgeons should be aware of these complications and try to improve their techniques accordingly. To avoid atrophy of the salivary gland, once the diagnosis it made, it is advisable to send the patient to a maxillofacial or ENT surgeon skilled in endoscopy.

Intra-arterial infusion of nitric oxide (NO) - first animal trial.

OBJECTIVE: Nitric oxide (NO) is an important signaling molecule that acts in many tissues to regulate a diverse range of physiological processes. NO has been implicated in a number of cardiovascular diseases. Reduced basal NO synthesis or function may lead to: vasoconstriction, elevated blood pressure and thrombus formation. By contrast, overproduction of NO results in vasodilatation, hypotension, vascular leakage, and disruption of cell metabolism. The purpose of this study was to determine the effects of NO gas directly infused into the arteries. METHODS: The study was performed on 28 rabbits and 10 pigs. We developed a device that enables quantitatively controlled infusion of NO gas, directly into the arteries. RESULTS: We found that administration of NO gas via arteries caused widening of the blood vessels as well as increasing blood flow in the extremity. It emerges that. These effects persist up to 2-3 h after the NO infusion ceased. Although the NO breaks down when diffused in blood, its influence commences rapidly and continues for a relatively long time. CONCLUSIONS: Our findings indicate that, administration of NO into blood vessels causes a long lasting vasodilatation and enhanced blood flow. Despite the fact that NO is broken down rapidly.

A reasonable mechanism for visible light-induced skin rejuvenation.

In recent years, much research has been done in the field of non-ablative skin rejuvenation. This comes as a response to the continuous demand for a simple method of treating rhytides, UV exposure, and acne scars. Numerous researches involve visible light-pulsed systems (20-30 J/cm(2)). The mechanism of action is believed to be a selective heat-induced denaturalization of dermal collagen that leads to subsequent reactive synthesis (Bitter Jr., Dermatol. Surg., 26:836-843, 2000; Fitzpatrick et al., Arch. Dermatol., 132:395-402, 1996; Kauvar and Geronemus, Dermatol. Clin., 15:459-467, 1997; Negishi et al., Lasers Surg. Med., 30:298-305, 2002; Goldberg and Cutler, Lasers Surg. Med., 26:196-200, 2000; Hernandez-Perez and Ibeitt, Dermatol. Surg., 28:651-655, 2002). In this study, we suggest a different mechanism for photorejuvenation based on light-induced reactive oxygen species (ROS) formation. We irradiated collagen in vitro with a broadband of visible light (400-800 nm, 24-72 J/cm(2)) and used the spin trapping coupled with electron paramagnetic resonance spectroscopy to detect ROS. Irradiated collagen resulted in hydroxyl radicals formation. We propose, as a new concept, that visible light at the energy doses used for skin rejuvenation (20-30 J/cm(2)) produces high amounts of ROS, which destroy old collagen fibers, encouraging the formation of new ones. On the other hand, at inner depths of the skin, where the light intensity is much weaker, low amounts of ROS are formed, which are well known to stimulate fibroblast proliferation.

Burns in inpatients by simultaneous use of cigarettes and oxygen therapy.

Two inpatients with chronic obstructive pulmonary disease (COPD), treated with oxygen in the respiratory intensive care unit (RICU), sustained burns from explosion of oxygen delivery system while illicitly smoking. The authors discuss incidence and possible etiology with literature review.