Novel Treatment of Neck Wrinkles with an Intradermal Radiofrequency Device

Neck wrinkles commonly develop owing to the aging process. However, recently, the number of patients with neck wrinkles has been increasing. Also, an increasing number of young patients have presented with this condition, possibly because of the effect of the head-down posture that they adopt when using their computer or smartphone. We report two cases of young adults with a prominent neck wrinkle. In case 1, a 29-year-old woman with a neck wrinkle was treated with six intradermal radiofrequency (RF) procedures. Her neck wrinkle was significantly improved with the RF treatment. In case 2, a 32-year-old woman with a wrinkle and generalized light brownish tiny papules on the neck was treated with three intradermal RF procedures simultaneously with 30% glycolic acid peeling. Her wrinkle and skin tone were improved dramatically. We conclude that intradermal RF has a considerable efficacy for reducing neck wrinkles.

Investigation of the Degradation-Retarding Effect Caused by the Low Swelling Capacity of a Novel Hyaluronic Acid Filler Developed by Solid-Phase Crosslinking Technology

BACKGROUND: A variety of hyaluronic acid (HA) fillers demonstrate unique physical characteristics, which affect the quality of the HA filler products. The critical factors that affect the degradation of HA gels have not yet been determined. OBJECTIVE: Our objective was to determine the characteristics of HA gels that affect their resistance to the degradation caused by radicals and enzymes. METHODS: Three types of HA fillers for repairing deep wrinkles, Juvederm Ultra Plus (J-U), Restylane Perlane (Perlane), and Cleviel, were tested in this study. The resistance of these HA fillers to enzymatic degradation was measured by carbazole and displacement assays using hyaluronidase as the enzyme. The resistance of these fillers to radical degradation was measured by the displacement assay using H2O2. RESULTS: Different tests for evaluating the degradation resistance of HA gels can yield different results. The filler most susceptible to enzymatic degradation was J-U, followed by Perlane and Cleviel. The HA filler showing the highest degree of degradation caused by H2O2 treatment was Perlane, followed by J-U, and then Cleviel. Cleviel showed higher enzymatic and radical resistances than J-U and Perlane did. Furthermore, it exhibited the highest resistance to heat and the lowest swelling ratio among all the fillers that were examined. CONCLUSION: The main factor determining the degradation of HA particles is the gel swelling ratio, which is related to the particle structure of the gel. Our in vitro assays suggest that the decrease in the swelling ratio will lead to a retarding effect on the degradation of HA fillers.

The Efficacy, Longevity, and Safety of Combined Radiofrequency Treatment and Hyaluronic Acid Filler for Skin Rejuvenation

BACKGROUND: Recent advances in hyaluronic acid (HA) fillers and radiofrequency (RF) devices have been made in the context of skin rejuvenation and cosmetic surgery. Moreover, combination regimens with both techniques are currently being developed. OBJECTIVE: The present study was designed to examine the clinical and histologic effects of a new needle that incorporates an RF device for HA injections. METHODS: A new intradermal needle RF device (INNOfill; Pacific Pharma, Korea) was assessed in the present study. In the animal arm, procollagen production was measured by using enzyme-linked immunosorbent assay, the filler volume was quantified by incorporating a dye with filler, and the filler distribution was assessed through the changes in tissue structure. In the human arm, the efficacy of the combination regimen was assessed by using the wrinkle severity rating scale (WSRS). RESULTS: In the animal study, RF treatment increased procollagen production in a time-dependent fashion. The total volume was significantly increased with the RF treatment when compared with the filler injections alone, and lasted for up to 7 weeks after treatment. Additionally, the filler distribution was reduced in animals treated with RF when compared with the untreated group. In the human study, the nasolabial folds of subjects treated with RF before filler injections exhibited a significantly greater change in the WSRS score from baseline when compared with the nasolabial folds treated with filler injections alone. CONCLUSION: A new device incorporating RF treatment before HA filler injection may represent a biocompatible and long-lasting advance in skin rejuvenation.

The Steroid-sparing Effect of an Emollient APDDR-0801 in Patients with Atopic Dermatitis / 대한피부과학회지

BACKGROUND: Defective skin barrier function is a well recognized feature in atopic dermatitis (AD) and causes symptoms such as xerosis, pruritus and erythematous lesions. Since moisturizers can strengthen a defective skin barrier and reduce the usage of corticosteroid cream, the choice of moisturizer is very significant for AD patients. OBJECTIVE: This study was done to compare the steroid-sparing effects of a ceramide-containing moisturizer, APDDR-0801, with a control moisturizer without ceramide, for relieving symptoms associated with AD. METHODS: A randomized, controlled, double-blinded 6-week study was conducted. Patients with mild to moderate AD topically applied APDDR-0801 or the control moisturizer on the whole body for 6 weeks. They also applied corticosteroid cream (Zemaderm(R)) on the lesion twice daily for 6 weeks. The amount of corticosteroid used was measured by weighing the tubes. Disease severity was evaluated by eczema severity, area index (EASI), and investigator global assessment (IGA). Transepidermal water loss (TEWL) and skin capacitance were also measured. RESULTS: Of the 40 patients enrolled, 32 completed the protocol. The mean age was (12.95+/-1.92) and the average baseline EASI score was (10.45+/-1.17). EASI score, IGA, TEWL and skin capacitance improved in both groups at 3 weeks and 6 weeks. Compared to the control group, the amount of steroid cream used at 3 weeks and 6 weeks decreased by 0.14 g (-18.78%) and 0.76 g (-7.46%), respectively, in the test group. The difference was larger in patients with moderate AD. The consumption of steroids was lower in the test group at 3 weeks [2.65 g (-34.64%)] and at 6 weeks [2.60 g (-19.38%)], respectively. CONCLUSION: The moisturizer APDDR-0801 (Atobarrier cream(R)) which contains physiologic lipid granules including ceramide, has superior steroid-sparing effects than moisturizers without ceramide.

In Vitro Evaluation Method to Monitor Pathogenic Acne Vulgaris by Culturing Keratinocytes with Sebocytes / 대한피부과학회지

BACKGROUND: Acne vulgaris is a chronic inflammatory disease of the pilosebaceous unit. Keratinocytes and sebocytes are the two major cell types involved in the induction of acne within the pilosebaceous unit. Thus, keratinocytes or sebocytes cultured alone may not accurately reflect the physiology of the acne lesion. OBJECTIVE: The aim of this study was to examine inflammatory cytokine production and neutral lipid content in keratinocyte and sebocyte co-cultures treated with acne etiologic stimulants. METHODS: Spontaneously immortalized, non-tumorigenic human HaCaT keratinocytes and immortalized human facial SZ95 sebocytes were seeded in 24-well culture plates (Nunc, Wiesbaden, Germany). Secretion of inflammatory cytokines by each cell type was analyzed by enzyme-linked immunosorbent assay, and neutral lipid production in the cells was measured by Oil Red O staining. Cells were then simultaneously treated with multiple stimulants at various concentrations, and triglyceride and interleukin 8 (IL-8) levels were measured. RESULTS: Arachidonic acid, linoleic acid, dihydrotestosterone and P. acnes extract all induced IL-8 production. De novo synthesis of sebaceous lipids was observed more frequently in the keratinocyte/sebocyte co-culture than that in the sebocyte monoculture. Higher levels of IL-8 were detected in the multi-stimulant system than those in the mono stimulant system. CONCLUSION: The results suggest that co-culture of keratinocytes and sebocytes is more representative of the clinical condition associated with the development of acne lesions than culture of either cell type alone. The co-culture system used in this study is applicable to research acne vulgaris pathogenesis and to screen active drugs for treating this condition.

The Therapeutic Efficacy of the Moisturizer APDDR-0801 for Patients with Atopic Dermatitis / 대한피부과학회지

BACKGROUND: The patients with atopic dermatitis (AD) show a defective barrier function of the skin and symptoms such as xerosis, pruritus and erythematous lesions with increased transepidermal water loss (TEWL). The choice of topical moisturizer is very significant for AD patients because these symptoms could be relieved by a local moisturizing agent that strengthens the epidermal barrier function. OBJECTIVE: This study was performed to evaluate the effects of the moisturizer APDDR-0801, which contains physiologic lipid granules (DermaON(R)), for relieving the symptoms associated with AD. METHODS: 128 patients (17.8+/-12.1 years) who were suffering from mild to moderate AD topically applied the test moisturizer twice daily for up to 4 weeks. The treatment efficacy was evaluated by the investigator global assessment (IGA) score, the eczema area and severity index (EASI) score, the transepidermal water loss (TEWL), the visual analogue scale (VAS) for pruritus and sleep disturbance, and the level of inflammatory cytokines in the horny layer of the flexural areas. RESULTS: The test moisturizer was well-tolerated and 58.6% of the patients achieved clinical improvements (over moderate) after the application of the test moisturizer for 4 weeks. The significant relief of AD symptoms was observed from 2 week to 4 week in a time-dependent manner. Significant improvements in the signs and symptoms of AD were observed at 4 week, such as the EASI score (37.8% improvement), the TEWL (20.3% improvement in the antecubital fossa lesion), the VAS score for pruritus (26.2% improvement), and VAS score for insomnia (39.7% improvement). CONCLUSION: The moisturizer APDDR-0801 (Atobarrier Cream(R), which contains physiologic lipid granules, effectively relieved the symptoms associated with AD.

Regulatory mechanisms of angiotensin II on the Na+/H+ antiport system in rabbit renal proximal tubule cells. I. Stimulatory effects of ANG II on Na+ uptake

The importance of the kidney in the development of hypertension was first demonstrated by Goldblatt and his colleagues more than fifty years ago. Many hormones and other regulatory factors have been proposed to play a major role in the development of hypertension. Among these factors angiotensin II (ANG II) is closely involved in renal hypertension development since it directly regulates Na+ reabsorption in the renal proximal tubule. Thus the aim of the present study was to examine signaling pathways of low dose of ANG II on the Na+ uptake of primary cultured rabbit renal proximal tubule cells (PTCs) in hormonally defined serum-free medium. The results were as follows: 1) 10-11 M ANG II has a significant stimulatory effect on growth as compared with control. Alkaline phosphatase exhibited significantly increased activity. However, leucine aminopeptidase and gamma-glutamyl transpeptidase activity were not significant as compared with control. In contrast to 10(-11) ANG II stimulated Na+ uptake (108.03 +/- 2.16% of that of control), 10(-9) M ANG II inhibited (92.42+/-2.23% of that of control). The stimulatory effect of ANG II on Na+ uptake was amiloride-sensitive and inhibited by losartan (ANG II receptor subtype 1 antagonist) and not by PD123319 (ANG II receptor subtype 2 antagonist). 2) Pertussis toxin (PTX) alone inhibited Na+ uptake by 85.52+/-3.52% of that of control. In addition, PTX pretreatment prevented the ANG II-induced stimulation of Na+ uptake. 8-Bromoadenosine 3',5'-cyclic monophosphate (8-Br-cAMP), forskolin, and isobutylmethylxanthine (IBMX) alone inhibited Na+ uptake by 88.79+/-2.56, 80.63+/-4.38, and 84.47+/-4.74% of that of control, respectively, and prevented the ANG II-induced stimulation of Na+ uptake. However, 10(-11) M ANG II did not stimulate cAMP production. 3) The addition of 12-O-tetradecanoylphorbol-13-acetate (TPA, 0.01 ng/ml) to the PTCs produced significant increase in Na+ uptake (114.43+/-4.05% of that of control). When ANG II and TPA were added together to the PTCs, there was no additive effect on Na+ uptake. Staurosporine alone had no effect on Na+ uptake, but led to a complete inhibition of ANG II- or TPA-induced stimulation of Na+ uptake. ANG II treatment resulted in a 111.83 +/- 4.51% increase in total protein kinase C (PKC) activity. In conclusion, the PTX-sensitive PKC pathway is the main signaling cascade involved in the stimulatory effects of ANG II on Na+ uptake in the PTCs.

Regulatory mechanisms of angiotensin II on the Na+/H+ antiport system in rabbit renal proximal tubule cells. II. Inhibitory effects of ANG II on Na+ uptake

Many reports represent that angiotensin II (ANG II) caused a dose dependent biphasic effects on fluid transport in the proximal tubule. However, respective roles of different signaling pathways in mediating these effects remain unsettled. The aim of the present study was to examine signaling pathways at high doses of ANG II on the Na+ uptake of primary cultured rabbit renal proximal tubule cells(PTCs) in hormonally defined serum-free medium. High concentrations of ANG II (> 10(-9) M) inhibited Na+ uptake and increased (Ca2+)i level in the PTCs. However, low concentrations of (< 10(-11) ANG II) stimulated Na+ uptake and did not affect (Ca2+)i level. 8-(N, N-diethylamino)-octyl-3,3,5- trimethoxybenzoate (TMB-8), ethylene glycol-bis(beta-amino ethyl ether)-N,N,N', N'-tetra acetic acid (EGTA), and nifedifine partially blocked the inhibitory effects of ANG II on Na+ uptake. When ANG II and bradykinin (BK) were treated together, Na+ uptake was further reduced (88.47 +/- 1.98% of that of ANG II, 81.85 +/- 1.84% of that of BK). In addition, W-7 and KN-62 blocked the ANG II-induced inhibition of Na+ uptake. Arachidonic acid reduced Na+ uptake in a dose-dependent manner. When ANG II and arachidonic acid were treated together, inhibitory effects on Na+ uptake significantly exhibited greater reduction than that of each group, respectively. When PTCs were treated by mepacrine (10(-6) M) and AACOCF, (10-5 M) for 1 hr before the addition of 10(-9) M ANG II, the inhibitory effect of ANG II was reversed. In addition, econazole (10(-6) M) blocked ANG II-induced inhibition of Na+ uptake. In conclusion, the (Ca2+)i (calcium-calmodulin-dependent kinase) and phospholipase A2 (PLA2) metabolites are involved in the inhibitory effects of ANG II on Na+ uptake in the PTCs.