Home About us Contact
|
Home About us Contact | ||
|
|
||
Dermal Collagen (dermal + collagen)
Selected AbstractsFractional Photothermolysis for Photoaging of HandsDERMATOLOGIC SURGERY, Issue 1 2008MING H. JIH MD BACKGROUND Laser treatment for photoaging of the hands should ideally address pigmentary alteration as well as associated skin roughness and wrinkling. Fractional resurfacing has been previously shown to effectively treat facial rhytids and dyschromia. OBJECTIVE We examined the effect of fractional resurfacing for photoaging of the hands. METHODS AND MATERIALS Ten patients (skin phototypes II to IV) with hand photodamage were randomized to receive five treatments with a 1,550-nm diode-pumped erbium fiber laser (Fraxel SR, Reliant Technologies) laser on either the right or left hand. Treatments were performed at settings of 8 to 9 mJ/microscopic treatment zone and density of 2,500 microscopic treatment zones/cm2. Subjective assessments by the patients and investigator were performed for skin roughness, wrinkling, and pigmentation using a 5-point scale. Skin biopsies were taken at baseline and at 1 and 3 months. RESULTS Patient subjective assessment and physician clinical assessment at 1 and 3 months revealed a mean 51% to 75% improvement in skin pigmentation and 25% to 50% improvement in skin roughness and wrinkling. Biopsies of the skin showed increased density of dermal collagen. Patients experienced transient erythema and edema and none had scarring or other adverse effects. LIMITATIONS This was a small study. CONCLUSION Fractional resurfacing appears to be an effective and safe treatment modality for correcting both the pigmentary and the textural aspects of photoaging of the hand. [source] Autologous Cultured Fibroblast Injection for Facial Contour Deformities: A Prospective, Placebo-Controlled, Phase III Clinical TrialDERMATOLOGIC SURGERY, Issue 3 2007ROBERT A. WEISS MD BACKGROUND Previous data indicate that injections of autologous fibroblasts increase collagen formation, accompanied by a concomitant increase in thickness and density of dermal collagen. OBJECTIVE The purpose of this study was to determine efficacy and side effects of autologous living fibroblast injections versus placebo in a randomized Phase III trial for the treatment of various facial contour defects. METHODS This was a double-blind, randomized comparison of injectable living autologous fibroblast cells and placebo for the treatment of facial contour defects (N=215). Live fibroblasts (20 million/mL) or placebo (the transport medium without living cells) were given as three doses administered at 1- to 2-week intervals. Efficacy evaluations were performed 1, 2, 4, 6, 9, and 12 months after the first injection. RESULTS Living fibroblasts produced statistically significantly greater improvements in dermal deformities and acne scars than did placebo. The difference between live fibroblast injections and placebo achieved statistical significance at 6 months (p<.0001). At 9- and 12-month follow-up, live fibroblast,treated patients continued to demonstrate benefit from treatment with response rates of 75.0 and 81.6%, respectively. No serious treatment-related adverse events were reported. CONCLUSIONS Our results indicate that autologous fibroblast injections can safely and effectively produce improvements in rhytids, acne scars, and other dermal defects continuing for at least 12 months after injection. [source] The Effect of Full-Face Broadband Light Treatments Alone and in Combination With Bilateral Crow's Feet Botulinum Toxin Type A ChemodenervationDERMATOLOGIC SURGERY, Issue 3 2004Jean Carruthers MD Background. Broadband light (BBL; Intense Pulsed Light; Lumenis Ltd., Yokneam, Israel) is a powerful, nonablative, light-based technology that targets melanin and hemoglobin and stimulates the formation of collagen and elastin. Botulinum toxin type A (BTX-A; BOTOX; Allergan Inc., Irvine, CA) treatment of the lateral periocular region relaxes the vertical fibers of the orbicularis oculi and results in softening of the lateral orbital crow's feet rhytides and widening of the palpebral aperture. Objective. To compare the effects of full-face BBL in combination with BTX-A and BBL alone in female subjects with Fitzpatrick I,III skin types, Glogau II,III rhytides, and significant associated facial lentigines and telangiectasia. Methods. This was a prospective, randomized study of 30 women with moderate to severe crow's feet rhytides. Half of the subjects were treated with BTX-A and BBL and the other half with BBL alone. Their response was assessed clinically and photographically. Skin biopsies of the temporal skin were taken from two subjects in each group and were stained with Masson trichrome. Results. Patients treated with a combination of BTX-A and BBL experienced a better response to treatment, both at rest and on maximum smile, as well as a slightly improved response in associated lentigines, telangiectasia, pore size, and facial skin texture compared with patients who received BBL treatment alone. Skin biopsies showed an increase in dermal collagen in each group. Conclusions. The patients in this study benefited from both treatments. Although BBL led to a remarkable improvement in full-face telangiectasias, lentigines, and skin texture, the improvement increased in all categories with combination therapy. In addition, an added improvement in the full-face aesthetic with both BTX-A and BBL therapy combined was obvious. These results suggest that both treatments,although evidently complementary,may also act synergistically to produce optimal clinical effects, revolutionizing the treatment of facial aging. [source] Collagen Remodeling After 585-nm Pulsed Dye Laser Irradiation: An Ultrasonographic AnalysisDERMATOLOGIC SURGERY, Issue 10 2003Brent R. Moody MD Background and Objectives. Nonablative dermal remodeling is an evolving technology that has generated great interest among both laser surgeons and patients. Evidence indicates that dermal collagen formation is the key mechanism of action for the nonablative techniques. We studied, with ultrasound, new collagen formation after nonablative laser irradiation. Methods. Ten patients with facial rhytids underwent a single treatment with a 585-nm pulsed dye laser. The patients were all female, ranging in age from 47 to 67, and were Fitzpatrick skin types I,III. Laser parameters were as follows: an energy fluence of 2.4 to 3.0 J/cm2, a pulse duration of 350 ,sec, and a spot size of 5 mm with no overlap. Ultrasonographic assessments of dermal collagen were taken at baseline and at 30 and 90 days after treatment. Results. Ultrasonography demonstrated an increase in dermal collagen after a single treatment with the 585-nm pulsed dye laser. The greatest degree of neocollagenesis occurred periocularly. Conclusion. A single treatment with a 585-nm pulsed dye laser appears to increase dermal collagen. This increase in dermal collagen can be assessed with noninvasive cutaneous ultrasound. [source] 3D In-Vivo Optical Skin Imaging for Topographical Quantitative Assessment of Non-Ablative Laser TechnologyDERMATOLOGIC SURGERY, Issue 3 2002Paul M. Friedman MD background. A new method for treating facial rhytides and acne scars with nonablative laser and light source techniques has recently been introduced. Given the inherent limitations of photographic and clinical evaluation to assess subtle changes in rhytides and surface topography, a new noninvasive objective assessment is required to accurately assess the outcomes of these procedures. objective. The purpose of this study was to measure and objectively quantify facial skin using a novel, noninvasive, In-vivo method for assessing three-dimensional topography. This device was used to quantify the efficacy of five treatment sessions with the 1064 nm QS Nd:YAG laser for rhytides and acne scarring, for up to six months following laser treatment. methods. Two subjects undergoing facial rejuvenation procedures were analyzed before and after therapy using a 30-mm, three-dimensional microtopography imaging system (PRIMOS, GFM, Teltow, Germany). The imaging system projects light on to a specific surface of the skin using a Digital Micromirror Device (DMDÔ Texas Instruments, Irving, TX) and records the image with a CCD camera. Skin Surface microtopography is reconstructed using temporal phase shift algorithms to generate three-dimensional images. Measurements were taken at baseline, at various times during the treatment protocol, and then at three and six-month follow-up visits. Silicone skin replicas (FLEXICO, Herts, England) were also made before and after the laser treatment protocol for comparison to In-vivo acquisition. results. Skin roughness decreased by 11% from baseline after three treatment sessions in the wrinkles subject, while a 26% improvement of skin roughness was recorded by 3D In-vivo assessment six months following the fifth treatment session. The subject with acne scarring demonstrated a 33% decrease in roughness analysis after three treatment sessions by 3D In-vivo assessment. A 61% improvement in surface topography was recorded 3-months following the fifth treatment session, which was maintained at the 6-month follow-up. conclusion. Three-dimensional In-vivo optical skin imaging provided a rapid and quantitative assessment of surface topography and facial fine lines following multiple treatment sessions with a 1064-nm QS Nd:YAG laser, correlating with clinical and subjective responses. This imaging technique provided objective verification and technical understanding of nonablative laser technology. Wrinkle depth and skin roughness decreased at the three and six-month follow-up evaluations by 3D In-vivo assessment, indicating ongoing dermal collagen remodeling after the laser treatment protocol. Future applications may include comparison of nonablative laser technology, optimization of treatment regimens, and objective evaluation of other aesthetic procedures performed by dermatologists. [source] On the vascularization and structure of the skin of a Korean bullhead Pseudobagrus brevicorpus (Bagridae, Teleostei) based on its entire body and appendagesJOURNAL OF APPLIED ICHTHYOLOGY, Issue 1 2010J. Y. Park Summary To investigate the vascularization and structure of the skin and its relationship to cutaneous respiration in Pseudobagrus brevicorpus, a histological study by light microscopy was carried out on 15 regions of the skin, including eight body regions, six fins and the barbel. The skin consisted of the epidermis, dermis and subcutis in all regions, except for the barbel that had a relatively thin dermis and subcutis. The epidermis was composed of the outermost layer, the middle layer and the stratum germinativum. There were two kinds of gland cells: the unicellular mucus cells and large club cells. The middle layer had a small number of fine blood capillaries accompanied by dermal collagen in all regions; the mean number of blood capillaries ranged from 0.9 to 5.9. The mean diffusion distance between the capillary endothelial cells and the surface of the epidermis ranged from 50.6 to 126.8 ,m. Based on these intra-epithelial blood capillaries, the relative surface area of the respiratory epithelium ranged from 0.1 to a maximum value of 1.2%. The dermis lacking scales had collagen bundles arranged parallel to each other, but vertical fiber bundles around the dorso-lateral regions were seen at intervals. Sensory organs such as taste buds, pit organs and lateral canals were found whereby the taste buds in particular were more abundant in the epidermis of the barbel. The vascularization of the skin may be closely related to an additional respiratory system used to deal with an extreme hypoxic condition during dry seasons. [source] Varying ratios of wavelengths in dual wavelength LED photomodulation alters gene expression profiles in human skin fibroblastsLASERS IN SURGERY AND MEDICINE, Issue 6 2010D.H. McDaniel MD Abstract Background and Objective LED photomodulation has been shown to profoundly influence cellular behavior. A variety of parameters with LED photomodulation can alter cellular response in vitro. The effects of one visible and one infrared wavelength were evaluated to determine the optimal ratio to produce a net increase in dermal collagen by altering the ratio of total energy output of each wavelength. The ratio between the two wavelengths (590 and 870,nm) was shifted in 25% increments. Study Design/Materials and Methods Human skin fibroblasts in culture were exposed to a 590/870,nm LED array with total combined energy density fixed at 4.0,mW/cm.. The ratio of 590/870,nm tested parameters were: 100/0%, 75/25%, 50/50%, 25/75%, and 0/100%. These ratios were delivered using pulsed duty cycle of exposure (250,milliseconds "on" time/100,milliseconds "off" time/100,pulses) for a total energy fluence of 0.1,J/cm.. Gene expression was examined using commercially available extra cellular matrix and adhesion molecule RT PCR Arrays (SA Biosciences, Fredrick, MD) at 24,hours post-exposure. Results Different expression profiles were noticed for each of the ratios studied. Overall, there was an average (in an 80 gene array) of 6% expression difference in up or downregulation between the arrays. The greatest increase in collagen I and decrease in collagenase (MMP-1) was observed with 75/25% ratio of 590/870,nm. The addition of increasing proportions of IR wavelengths causes alteration in gene expression profile. The ratios of the wavelengths caused variation in magnitude of expression. Conclusions Cell metabolism and gene expression can be altered by simultaneous exposure to multiple wavelengths of low energy light. Varying the ratios of specific wavelength intensity in both visible and near infrared light therapy can strongly influence resulting fibroblast gene expression patterns. Lasers Surg. Med. 42:540,545, 2010. © 2010 Wiley,Liss, Inc. [source] Non-ablative laser treatment of facial rhytides: A comparison of 1450-nm diode laser treatment with dynamic cooling as opposed to treatment with dynamic cooling aloneLASERS IN SURGERY AND MEDICINE, Issue 2 2002David J. Goldberg MD Abstract Background and Objective Non-ablative dermal remodeling has been shown to create new dermal collagen. This is thought to occur secondary to a laser-induced injury to the skin. Other mechanisms of injury may lead to similar results. The aim of this study was to evaluate the efficacy and complication rate of a 1450-nm diode laser and compare clinical effect when the laser is used in conjunction with cryogen cooling as compared to the use of cryogen cooling alone. Study Design/Materials and Methods Twenty subjects, skin types I,IV, age range 42,70 years, with Class I and II rhytides were enrolled in the study. Subjects were treated with 2,4 laser treatments and cryogen cooling on one side of their face, while the contralateral side was treated with cryogen cooling alone. Subjects were evaluated six months after their final treatment. Results Thirteen subjects showed clinical improvement on the laser/cryogen treated side. No subjects were noted to have any improvement at the cryogen alone side. Conclusion The 1450-nm diode laser can lead to non-ablative improvement of rhytides. This effect appears to be a direct laser induced effect. Lasers Surg. Med. 30:79,81, 2002. © 2002 Wiley-Liss, Inc. [source] Sacrocolpopexy using xenogenic acellular collagen in patients at increased risk for graft-related complications,,NEUROUROLOGY AND URODYNAMICS, Issue 4 2010Filip Claerhout Abstract Aims We studied the long-term anatomical and functional outcome following sacrocolpopexy for apical vaginal prolapse using xenogenic grafts in a population at increased risk for graft-related complications (GRCs). Methods Twenty-two consecutive patients with symptomatic apical prolapse were scheduled for laparoscopic sacrocolpopexy (LSC) with porcine grafts because they were presumed to be at risk for GRC, because of pre-existing vaginal ulcerations (n,=,4), concomitant vaginal prolapse repair (n,=,15), total hysterectomy (n,=,1), or intra-operative abdominal contamination due to accidental laceration of the vagina, bowel perforation (n,=,1) or the presence of infection (n,=,1). Either small intestinal submucosa (n,=,8) or dermal collagen (n,=,14) was used. Outcome measures were GRCs, anatomical cure (,Stage I at any compartment), subjective cure, impact on bowel, bladder, and sexual function measured by a standardized interview. Results At study closure 20 (91%) patients were available for functional evaluation and 16 (73%) for anatomical evaluation at a mean follow-up period of 27.4 months. The GRC rate was 25% (n,=,4) prompting reintervention in half, and including two patients with spondylodiscitis. The anatomical cure rate was 31.5%. Failures at the vault, anterior, and posterior compartments occurred in, respectively, 31%, 18.8%, and 50% of patients. The subjective cure rate was 60% and three patients (15%) underwent redo-LSC. Conclusion The strategy of using xenografts in patients at risk for GRC, did not prevent these to occur and was associated with a high anatomical and functional failure rate as well as reoperation rate. Neurourol. Urodynam. 29:563,567, 2010. © 2009 Wiley-Liss, Inc. [source] Acquired reactive perforating collagenosis: Current statusTHE JOURNAL OF DERMATOLOGY, Issue 7 2010Anthony KARPOUZIS Abstract Acquired reactive perforating collagenosis is a unique perforating dermatosis, characterized clinically by umbilicated hyperkeratotic papules or nodules and histologically by a focal hyperkeratosis in direct contact with transepidermal perforating dermal collagen. Several inflammatory or malignant systemic diseases may coexist with acquired reactive perforating collagenosis. The possible biochemical or immunological mechanisms of the systemic diseases, potentially responsible for the development and appearance of acquired reactive perforating collagenosis, are still under investigation. Several topical treatments, ultraviolet B phototherapy and allopurinol p.o. administration may be effective. [source] Nephrogenic systemic fibrosis in a gadolinium-naive renal transplant recipientAUSTRALASIAN JOURNAL OF DERMATOLOGY, Issue 1 2008Namrata S Anavekar SUMMARY A 36-year-old woman presented with a 2-year history of multiple, raised, brown papules and indurated skin over her lower legs. She had received a renal transplant 11 years earlier, and had a history of recurrent deep vein thromboses despite a negative thrombophilic screen. The patient had no history of exposure to gadolinium. Histology at this time revealed a light perivascular lymphoid infiltrate, activated fibroblasts and prominent capillary vessels. The patient re-presented 1 year later with persistence of these lesions, in the setting of worsening renal function requiring haemodialysis. Repeat skin biopsies demonstrated increased dermal collagen and angiogenesis. The dermatopathological findings, in association with renal insufficiency and multiple deep vein thromboses, led to the diagnosis of nephrogenic systemic fibrosis. [source] Intralesional triamcinolone alone or in combination with 5-fluorouracil for the treatment of keloid and hypertrophic scarsCLINICAL & EXPERIMENTAL DERMATOLOGY, Issue 2 2009A. Darougheh Summary Background., Keloids and hypertrophic scars are benign growths of dermal collagen that can cause physical and psychological (cosmetic) problems for patients. Methods., In this 12-week, double-blind, clinical trial, 40 patients were randomized into two study groups. Patients in group 1 were given intralesional triamcinolone acetonide (TAC), and patients in group 2 were given a combination of TAC and 5-fluorouracil (5-FU); both groups received injections at weekly intervals for 8 weeks. Lesions were assessed for erythema, pruritus, pliability, height, length and width. Results., Four patients in group 1 and three patients in group 2 failed to complete the study. At the 8-week and 12-week follow-up visits, both groups showed an acceptable improvement in nearly all parameters, but these were more significant in the TAC + 5-FU group (P < 0.05 for all except pruritus and percentage of itch reduction). Good to excellent (> 50%) improvement were reported by 20% of the patients in group 1 and 55% of the patients in group 2, which was significantly different (P = 0.02). Good to excellent responses was reported by trained observers as 15% in group 1 and 40% in group 2. Their difference was not significant (P = 0.08). Conclusion., The overall efficacy of TAC + 5-FU was comparable with TAC, but the TAC + 5-FU combination was more acceptable to patients and produced better results. [source] Old habits tie hard: an in vitro comparison of first-throw tension holding in Polyglycolic acid (Dexon S) and Polyglactin 910 (Coated Vicryl)CLINICAL & EXPERIMENTAL OPHTHALMOLOGY, Issue 2 2006Thomas L Kersey MB BS Abstract Purpose:, To compare the first-throw tension holding property of two braided absorbable sutures commonly used in oculoplastic surgery. Methods:, The study was an in vitro experimental model. 6/0 Polyglycolic acid (Dexon S) and 6/0 Polyglactin 910 (Coated Vicryl) were compared using an experimental model to determine first-throw knot security. A polypropylene suture (Surgipro 2) was included as a benchmark to judge the apparatus by, ensuring that our experiment could be designed independently of the test suture materials. Increasing metric loads were applied to the first double throw of a surgical knot. Each suture was tested to the point of knot slipping and the critical tension recorded. All the sutures were kept wet during use. Three variations of the experiment were undertaken: experiment 1 , two metal loops brought together by the test suture; experiment 2 , two strips of tissue brought together by the test suture; and experiment 3 , a knot tied over a metal bar coated in tissue. The tissue used was processed cross-linked porcine dermal collagen (Permacol). Each experiment was repeated three times for each suture type and the mean value taken. Results:, Experiment 1: Dexon S 12.2 g (11, 12, 13.5), Coated Vicryl 2.5 g (2.5, 2.5, 2.5) and Surgipro 2 2.3 g (2, 2, 3); experiment 2: Dexon S 33.33 g (30, 35, 35), Coated Vicryl 25 g (25, 25, 25) and Surgipro 2 5 g (5, 5, 5); experiment 3: Dexon S 100 g (100, 100, 100), Coated Vicryl 56.667 g (60, 55, 55) and Surgipro 2 5 g (5, 5, 5). Conclusions:, Dexon S-braided absorbable suture has significantly better first-throw knot security when compared with Coated Vicryl. This is an important property when suturing tissues under tension as it minimizes slippage before the locking throw is tied. [source] Small bowel obstruction after reconstruction of the pelvic floor with porcine dermal collagen (Permacol) after extended abdominoperineal extirpation for rectal cancer: report of two casesCOLORECTAL DISEASE, Issue 7Online 2010P. Jess No abstract is available for this article. [source] | ||||||||||