Clinical and color Doppler ultrasound evaluation of polyacrylamide injection in HIV patients with severe facial lipoatrophy secondary to antiretroviral therapy.

BACKGROUND/PURPOSE: Facial lipoatrophy in HIV patients, secondary to antiretroviral therapy (ART) with thymidine analogs, has been related to important psychosocial alterations and poor adherence to treatment. Polyacrylamide gel (PAAG) is a filler that has been used for treating facial lipoatrophy in HIV patients. The aim was to assess the clinical and sonographic anatomical changes after injection of PAAG in HIV patients with facial lipoatrophy secondary to ART. METHODS: HIV patients receiving ART and suffering from severe facial lipoatrophy were recruited and underwent clinical and color Doppler ultrasound evaluation prior to PAAG application (AQUAMID® ) and sonographically monitored at 18 months and clinically followed up for 36 months after the procedure. Adverse effects were recorded based on occurrence and complexity. RESULTS: A total of 33 patients were evaluated, 30 men (91%) and 3 women (9%) with an average age of 49.6 years (±8.4). Clinical improvement assessed by a dermatologist had an average score of 5.9 (±0.7) on a scale of 1-7. On color Doppler ultrasound there was a significant increase of the thickness of the subcutaneous tissue (SCT) in both nasofold lines when comparing before and after PAAG injection (P < 0.01) and no signs of inflammation (hypervascularity). User satisfaction was qualified as excellent or good in all cases. Only two patients experienced adverse effects (hematoma and puncture site infection), which was successfully managed without consequences. CONCLUSION: Treatment of facial lipoatrophy with PAAG seems to be effective in HIV patients and no signs of complications were observed in the monitoring at 36 months after injection. Color Doppler ultrasound can identify the filler deposits and the anatomical changes of the SCT non-invasively.

Site-specific structural investigations of oxidized nickel samples modified by plasma erosion processes.

A focused ion beam was employed for local target preparation for EBSD analysis. The volume of the ion-solid interaction is well below 50 nm at glancing incidence for metallic and transition metal oxide samples. Therefore, focused ion beam can successfully be used for electron backscatter diffraction (EBSD) sample preparation. The sample investigated consists of Ni covered with a NiO layer of approximately 5 microm thickness. Focused ion beam cross-sectioning of these layers and subsequent electron imaging in addition to EBSD maps shows a bimodal structure of the oxide layer. In order to test the potential of such oxidized samples as electrode materials, single spark erosion experiments were performed. The erosion craters have diameters up to 40 microm and have a depth corresponding to the thickness of the oxide layer. In addition, a deformation zone produced by thermoshock accompanies the formation of the crater. This deformation zone was further investigated by EBSD analysis using a new way of sample preparation employing the focused ion beam technology. This target preparation routine is called Volume of Interest Transfer and has the potential of providing a full three-dimensional characterization.