Heating of metallic orthodontic devices during anti-aging treatment with vacuum and electromagnetic fields: In vitro study.

BACKGROUND: The physical appearance of an individual plays a primary role as it influences the opinion of the viewer. For this reason, orthodontic therapy to improve perceived aesthetics is in high demand among patients. This factor, combined with the increase in the number of non-invasive facial aesthetic treatments, has led to the need to understand potential risk factors in the application of medical devices to the perioral skin in patients with fixed orthodontic appliances. The aim of this study was to evaluate in vitro heating of the orthodontic bracket following electromagnetic fields and negative pressure (V-EMF) used as an anti-aging treatment. METHODS: Two different types of titanium alloy wires, one made of "beta-Titanium" alloy and the other "Ni-Ti" (DW Lingual Systems GmbH-Bad Essen-Germany) were used. The orthodontic wires and brackets mounted on a resin mouth were covered with porcine muscle tissue, then subjected to anti-aging therapy with a Bi-one LifeTouchTherapy medical device (Expo Italia Srl-Florence-Italy) which generates a combination of vacuum and electromagnetic fields (V-EMF) already adopted for antiaging therapy. During administration of the therapy, the orthodontic brackets and porcine tissue were thermally monitored using a Wavetek Materman TMD90 thermal probe (Willtek Communications GmbH-Germany). In total 20 orthodontic mouths were used, 10 with Beta Titanium wires and 10 with Nickel Titanium wires. RESULTS: A temperature increase of about 1°C was recorded in each group. The outcome of the present research shows that the absolute temperatures measured on orthodontic appliances, which, despite having a slightly different curve, both show an increase in temperature of 1.1°C at the end of the session, thus falling well within the safety range of 2°C as specified by the standard CENELEC EN 45502-1. Therefore, V-EMF therapy can be considered safe for the entire dental system and for metal prostheses, which tend to heat up at most as much as biological tissue (+0.9°C/1.1°C vs. 1.1°C/1.1°C). CONCLUSION: In conclusion, anti-aging therapy with V-EMF causes a thermal increase on orthodontic brackets that is not harmful to pulp health.

Gluteal femoral subcutaneous and dermal adipose tissue in female.

BACKGROUND: During the sexual maturation, gluteal femoral adipose tissue is subjected to numerous modifications, not observable in other regions, in particular in women and less in men. Other authors described this region, but they used imaging techniques having lower resolution, than MRI proposed in this study. High resolution imaging techniques might provide important and more detailed information about the anatomy of gluteal femoral region. METHODS: This study has been performed using 7 T-magnetic resonance imaging and ultrastructural analysis in order to provide accurate description of the subcutaneous adipose tissue and dermis of gluteal femoral region. In this study specimens harvested from cadavers and form living patients have been analyzed. RESULTS: The results showed the presence of three layers: superficial, middle, and deep, characterized by different organization of fat lobules. High resolution imaging showed the adipose papilla that originates from dermis and protrude in subcutaneous adipose tissue. Adipose papilla is characterized by a peculiar morphology with a basement, a neck and a head and these elements represent the functional subunits of adipose papilla. Moreover, ultrastructural study evidenced the relationship between adipocytes and sweat glands, regulated by lipid vesicles. CONCLUSIONS: This study provides important information about subcutaneous and dermal fat anatomy of gluteal femoral region, improving the past knowledge, and move toward a better understanding of the cellulite physiopathology.

High-Speed and High-Temperature Calorimetric Solid-State Thermal Mass Flow Sensor for Aerospace Application: A Sensitivity Analysis.

A high-speed and high-temperature calorimetric solid-state thermal mass flow sensor (TMFS) design was proposed and its sensitivity to temperature and airflow speed were numerically assessed. The sensor operates at 573.15 Kelvin (300 °C), measuring speeds up to 265 m/s, and is customized to be a transducer for an aircraft Air Data System (ADS). The aim was to enhance the system reliability against ice accretion on pitot tubes' pressure intakes, which causes the system to be inoperative and the aircraft to lose protections that ensure its safe operation. In this paper, the authors assess how the distance between heater and thermal sensors affects the overall TMFS sensitivity and how it can benefit from the inclusion of a thermal barrier between these elements. The results show that, by increasing the distance between the heater and temperature sensors from 0.1 to 0.6 mm, the sensitivity to temperature variation is improved by up to 80%, and that to airspeed variation is improved by up to 100%. In addition, adding a thermal barrier made of Parylene-N improves it even further, by nearly 6 times, for both temperature and air speed variations.

Pilot study of histology aspect of cellulite in seventy patients who differ in BMI and cellulite grading.

BACKGROUND: Cellulite is a topographic alteration of the skin with unknown etiology and is characterized by the presence of a dimpled or puckered aspect, as resembling an orange peel and cottage cheese or as having mattress-like appearance. AIM: The aim of this research was to find the different histological aspect of cellulite in sixty patients. MATERIALS AND METHODS: A total of 60 women, mean age 48.8 ( ± 11.08) were included in the study. Among these, 11 women were in menopause (18.33%). All patients after physical examination, aesthetic, and dermatological evaluation were subjected to five cellulite biopsies with a 2.0 mm diameter and 1.5 mm in length in the trochanteric region affected by cellulite. The descriptive statistics were performed for each study predictors demographic age, height, bmi, waist, belly, hip thigh, and knee. RESULTS: The histological analysis of the stained slides showed five different histological features were present in the most of patient. CONCLUSION: In conclusion, the outcome of this study shows that the histological evidence does not characterize the different states of cellulite, but several different histological aspects were present in the same patient, which effectively eliminates staging and could consider cellulite as a degenerative disease.

A New Treatment for Stretch Marks and Skin Ptosis with Electromagnetic Fields and Negative Pressure: A Clinical and Histological Study.

BACKGROUND: Stretch marks (SM) are nowadays the most common aesthetic pathology of the body; in the XX century, it mainly affected pregnant women, while today it also affects teenagers during puberty, boys and girls without distinction. The aim of this study was to evaluate possible variations in the histological structure of the skin-in terms of quality/quantity of the extracellular matrix and of the collagen and elastic fibers-following the electromagnetic fields and negative pressure (V-EMF) treatment as regards hypotonia and SMs. MATERIALS AND METHODS: For the current study, 60 women, aged between 25 and 45, were examined. All of them presented deep, white or pearly white colored SMs having had them for between 12 and 25 years. These were documented, asking patients their level of satisfaction, through pictures and biopsies. All patients underwent a cycle of 6 or 8 weekly sessions; everyone was highly satisfied with the results obtained. RESULTS: Biopsies proved that the tissue was reorganized and restored to the original volume, characterized by the production of new, high-quality collagen and elastin molecules, by the reorganization of the basement membrane and by the correct positioning of the melanocytes. No side effects were observed during the treatments. This synergy stands as the most suitable treatment of striae rubra and alba. CONCLUSION: V-EMF enhances the keratinocyte migration base, melanocytes, and promotes neoangiogenesis with the result of improvement in the SM.

Static Crow's Feet Treated with Voltaic Arc Dermabrasion (Atmospheric Plasma): Post-Operative Pain Assessment by Thermal Infrared Imaging.

BACKGROUND: In the literature, several strategies have been described for the treatment of unaesthetic marks on the face resulting from the aging processes. The atmospheric plasma procedure is a non-invasive, inexpensive technique proposed for the rejuvenation of facial tissues. The aim of this study was to evaluate the performance of voltaic arc dermabrasion (VAD) for the treatment of static crow's feet of the periorbital area. METHODS: The crow's feet of 135 patients (127 female and 8 male) were treated using the VAD technique. The perioperative skin temperature measurement was assessed using an Infrared Temperature sensor. The pain was measured using the Visual Analogic Score (VAS) at 1 week, 1 month and 1 year. The patient's and surgeon's satisfaction were assessed using the Global Aesthetic Improvement Scale (GAIS) at 1 month and 1 year from the procedure. The severity of the crow's feet was rated using the Crow's Feet Grading Scale (CFGS). RESULTS: A complete epidermal healing of all the subjects treated was evident at 7 days. The atmospheric plasma technique showed an efficient treatment for the removal of the crow's feet, with a good aesthetic outcome, high surgeon and patient satisfaction, without clinical complications. CONCLUSIONS: The atmospheric plasma technique can be a useful modality in the cosmetic as well as therapeutic treatment of crow's feet.

The role of hyaluronic acid and amino acid against the aging of the human skin: A clinical and histological study.

BACKGROUND: In esthetic medicine, different techniques have been used against the aging of the human skin especially in the facial area. Hyaluronic acid is used for improving the quantity of water and extracellular matrix molecule. The aim of this study is a clinical and histological evaluation of the effect of low-molecular-weight hyaluronic acid fragments mixed with amino acid (HAAM) on the rejuvenation the face skin treated with intradermal microinjections. METHODS: Twenty women with mean age 45 range from 35 to 64 were studied, thereof 8 in menopause and 12 of childbearing age. The patients were treated with the HAAM products by mesotherapy technique; before and after 3 months of the therapeutic procedure, each patient underwent small biopsies with a circular punch biopsy. RESULTS: The clinical results of the present study showed that the administration of the dermal filler containing fragments of hyaluronic acid between 20 and 38 monomers and amino acid via dermis injection technique produces an esthetic improvement in the faces of the treated patients, while the histological evaluation shows an increased fibroblast activity with the production of type III reticular collagen and increased number of vessels and epidermis thickness. CONCLUSIONS: The clinical and histological assessment showed that subcutaneous HAAM infiltration has a significant impact on the dermis and clinical aspects of the face.

A New Treatment for Local Adiposity with Ascorbic Acid and Ascorbyl-Palmitate Solution: Clinical and Histological Study.

BACKGROUND: Localized adiposity (AL) is the accumulation of subcutaneous adipose tissue, placed in definite anatomic areas, building up an alteration of the body silhouette. The aim of the present clinical and histological study is to assess the effectiveness of an injectable solution containing sodium salt of ascorbic acid 0.24% and surfactant agent at 0.020% ascorbyl-palmitate (SAP) for treating local adiposity. METHODS: Eighty healthy female adult patients were selected, suffering from local adiposity in the abdominal region. The patients underwent a cycle of 6 sessions, with biweekly treatments, without the addition of any active ingredient. Direct infiltration of pharmacologically active SAP solutions into the adipose tissue with a long needle, very similar to the needles used for spinal anesthesia, was performed. This procedure is quick and painless (does not require any anesthesia) with moderate infiltration speed. RESULTS: All the patients treated showed good results with good satisfaction of the circumferential reductions. Before treatment: Waist (cm) 78.8 ± 10.6 and hip 93.6 ± 9.0 with WHR 0.84 ± 0.07. After treatment: Waist (cm) 70.8 ± 9.6 and hip 92.6 ± 8.0 with WHR 0.76 ± 0.06. Indeed, signs of adipocyte apoptosis were observed in subcutaneous skin after injection of SAP. CONCLUSION: The results showed in the present study suggest that the SAP utilized induces apoptosis of adipocytes and could be of use as a safe and effective method with which to eliminate subcutaneous abdominal fat. LEVEL OF EVIDENCE IV: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

The Feasibility of Remotely Piloted Aircrafts for VOR Flight Inspection.

This article analyzes the use of Remotely Piloted Aircrafts (RPA) in VOR (Very High Frequency Omnidirectional Range) flight inspection. Initially, tests were performed to check whether the Autopilot Positioning System (APS) met the regulatory requirements. The results of these tests indicated that the APS provided information within the standard regulations. A Hardware in the Loop (HIL) platform was implemented to perform flight tests following the waypoints generated by a mission automation routine. One test was performed without introducing disturbance into the proposed test platform. The other four tests were performed introducing errors in latitude and longitude in the APS into the platform. The errors introduced had the same characteristics as those measured in the initial tests, in order for the simulation tests to be as similar as possible to the real situation. The tests performed with positioning errors only did not lead to false misalignment detection. However, introducing positioning errors and a 4° VOR misalignment error, a misalignment of 3.99° was observed during the flight test. This is a value greater than the maximum one allowed by the regulations, and the system indicates the VOR misalignment. Five flight inspection tests were performed. In addition to the APS errors, tests with a modulation error were also conducted. Introducing a 4° VOR misalignment in conjunction with modulation error, a misalignment of 4.02° was observed, resulting in successful misalignment detection.

Proteomic and Ultrastructural Analysis of Cellulite-New Findings on an Old Topic.

: Background: Cellulite is a condition in which the skin has a dimpled lumpy appearance. The main causes of cellulite development, studied until now, comprehends modified sensitivity to estrogens, the damage of microvasculature present among dermis and hypodermis. The differences of adipose tissue architecture between male and female might make female more susceptible to cellulite. Adipose tissue is seen to be deeply modified during cellulite development. Our study tried to understand the overall features within and surrounding cellulite to apply the best therapeutic approach. METHODS: Samples of gluteal femoral area were collected from cadavers and women who had undergone surgical treatment to remove orange peel characteristics on the skin. Samples from cadavers were employed for an accurate study of cellulite using magnetic resonance imaging at 7 Tesla and for light microscopy. Specimens from patients were employed for the proteomic analysis, which was performed using high resolution mass spectroscopy (MS). Stromal vascular fraction (SVF) was obtained from the samples, which was studied using MS and flow cytometry. RESULTS: light and electron microscopy of the cellulite affected area showed a morphology completely different from the other usual adipose depots. In cellulite affected tissues, sweat glands associated with adipocytes were found. In particular, there were vesicles in the extracellular matrix, indicating a crosstalk between the two different components. Proteomic analysis showed that adipose tissue affected by cellulite is characterized by high degree of oxidative stress and by remodeling phenomena. CONCLUSIONS: The novel aspects of this study are the peculiar morphology of adipose tissue affected by cellulite, which could influence the surgical procedures finalized to the reduction of dimpling, based on the collagen fibers cutting. The second novel aspect is the role played by the mesenchymal stem cells isolated from stromal vascular fraction of adipose tissue affected by cellulite.

Periauricular wrinkles removed with voltaic arc dermabrasion (Atmospheric Plasma technique).

BACKGROUND: In recent literature, different approaches have been proposed to improve the long-lasting treatment of age-related alterations on the human face with decreased invasiveness and side effects such as scar tissue. Voltaic arc dermabrasion is a minimally painful procedure that does not create discomfort to the patient and requires no anaesthesia. AIMS: The aim of this investigation was to evaluate the voltaic arc technique for the treatment of skin wrinkles in the periauricular area. METHODS: A total of 80 patients were treated in this study, 56 females and 24 males. The population was visited at 1 week, 1 month, and 2 months postoperative follow-ups to evaluate the healing of the treated regions. RESULTS: All subjects showed evidence of tissue contraction related to the skin of the periauricular region with a cosmetic reduction of wrinkles in the treated area. No scars, complications, or pigmentary alterations were reported. At 1 month, all treated areas showed complete healing. CONCLUSIONS: The voltaic arc dermabrasion can be considered a useful tool for a noninvasive treatment of wrinkles related to the periauricular skin, with no discomfort for the patient or complications related to the procedure.

Evaluation of Safe and Effectiveness of an Injectable Solution Acid Deoxycholic Based for Reduction of Localized Adiposities.

BACKGROUND: The use of deoxycholic acid to reduce localized fat deposits is a procedure that has been in use for about 30 years. Its effectiveness as treatment is due to emulsification of phospholipids and therefore, solubilization of the biological membranes with resulting fat necrosis. The purpose of the study was to assess the effectiveness and the safety of an injectable solution containing sodium deoxycholtate 1.25% (DB125), used as intralipotherapy. METHODS: The effectiveness and safety of DB125 solution have been assessed with a multicentre observational prospective study carried out between February and October 2017. The 221 selected patients presented with various forms and degrees of localized fat in several areas. Intralipotherapy treatments were performed 6 weeks apart and until the clinical result was obtained. Aesthetic outcomes were evaluated by the authors using preoperative and postoperative photographic documentation and by the patients with their level of satisfaction by filling out an anonymous form. Major adverse events were reported by each doctor who performed the treatment. RESULTS: Two hundred twenty-one patients treated in 273 cases of different localized fat deposits. One hundred eighty-five patients who could be assessed for final results gave the effectiveness of the treatment an average score of 7.4. The failure percentage of the treatment was 3.8%. The medical evaluation showed treatment success in 93.5% of cases. Adverse events can be divided into 2 groups: minor adverse events, which are very frequent and major ones, which are extremely rare. For both groups, the adverse events can be ascribed to localized problems in the treatment area. CONCLUSION: Studies have shown that the second-generation solution containing sodium deoxycholate 1.25% is effective and safe to treat different localized fat deposits. The high degree of effectiveness shown in the study was not associated with a lesser degree of handling because, at the doses indicated and with the use of intralipotherapy, the occurrence of adverse events was minimal.

Treatment of Dimpling from Cellulite.

BACKGROUND: Cellulite can be seen on the skin in widespread alterations of the skin surface and dimpling. The purpose of this study was to assess the effectiveness and safety of the manual subcision technique to treat dimpling from cellulite, using a specific class IIA medical device (Celluerase). METHODS: The multi-center observational study assessed 200 women treated in a single session for different dimpling, using manual subcision administered by Celluerase. Aesthetic outcomes were evaluated by the authors, and the patients assessed satisfaction levels. RESULTS: Two hundred women between 20 and 55 years were treated. The medical evaluation of patients saw improvements with an average score of 8.1, whereas the subjective evaluation by patients gave an average improvement score of 7.8. Adverse events were reported. DISCUSSION: Women have septa orientation at right angels to the skin surface, and those with cellulite have an irregular septa conformation, with some septa being hypertrophic-thickened, and others being narrowed-lysed. Magnetic resonance imaging has confirmed that cellulite depressions are associated with a significant increase of thickness of underlying subcutaneous fibrous septa. Subcision has immediate results because it eliminates traction on the skin. CONCLUSION: The study has shown the effectiveness and safety of the manual subcision in the treatment of dimpling. The device used, designed specifically for this technique, has shown itself to be very helpful and effective in terms of practical use, aesthetic outcome and safety, with various advantages compared with other commonly used devices.

Intralipotherapy, the State of the Art.

BACKGROUND: Reconstruction intralipotherapy is a term commonly used in the field of aesthetic medicine, above all in Europe, which defines a specific injection technique developed for the treatment of localized fat with substances that provoke the lysis of adipocytes by means of an injection directly into the adipose tissue with a long needle. The aim of this study is to define the technique in detail and everything that is associated with it, on the basis of years of multicenter experience by doctors who perform it. MATERIALS AND METHODS: From January 2010 to December 2014, 3,080 European physicians were trained in intralipotherapy technique, and approximately 152,500 patients were treated. The adipocytolytic agent used is a Conformité Européene-certified device. The technique, equipment, protocol, posology, postoperative management, and adverse events are described below. RESULTS: The intralipotherapy technique combined with the appropriate adipocytolytic agent has been shown to be effective in every zone on the average of 76.7% of the cases. The variability is due to the area treated and the patient. The standardization of the technique, homogeneity of the protocol, and the posttreatment management have been essential for standardizing the results and minimizing any adverse events. The latter occurred only in a small percentage of the cases, while those more serious have been extremely rare. CONCLUSION: This study shows how the intralipotherapic technique, when performed properly with an appropriate adipocytolytic device and when proper precautions are taken, can be effective and safe for reducing undesirable subcutaneous fat deposits.

Safety and efficacy of one-step rehabilitation of human immunodeficiency virus-related facial lipoatrophy using an injectable calcium hydroxylapatite dermal filler.

BACKGROUND: Human immunodeficiency virus (HIV)-related facial lipoatrophy seems to be the most distressing manifestation for individuals with HIV. It can be stigmatizing, severely affecting quality of life and self-esteem. Ever-increasing numbers of individuals with HIV receiving medication for HIV infection are presenting to plastic surgeons and requesting reconstructive surgery to counteract the unwanted side effects of their treatment protocols, for example facial lipoatrophy. The authors show their results with a one-step rehabilitation in cases of facial lipoatrophy using an injectable calcium hydroxylapatite dermal filler mixed with local anesthetic and adrenaline. MATERIALS AND METHODS: This study was conducted as a clinical prospective study; 26 individuals with HIV receiving antiretroviral therapy and with facial lipoatrophy received injections of an injectable calcium hydroxylapatite dermal filler mixed with local anesthetic and adrenaline. RESULTS: No major complications were registered. A stable result was observed in all the cases at the end of follow-up (3 months). High patient satisfaction was achieved in all cases. CONCLUSION: The outcomes of this study confirm that calcium hydroxylapatite dermal filler safely and effectively ameliorates the appearance of patients with HIV-related facial lipoatrophy, and mixing it with local anaesthetic and adrenaline can reduce pain during injection and ecchymosis.

Intraoral approach for nasal tip upturning.

BACKGROUND: The nose is an important landmark in facial beauty, and slight modifications lead to dramatic changes. The authors describe their surgical technique to upturn the tip of the nose with an intraoral approach sectioning the fibers of muscle depressor septi. METHODS: There were 14 patients (5 male and 9 female patients) in this study. All patients complained of nasal tip ptosis. The surgical procedure was explained to the patients, and the informed consent was obtained; preoperative frontal and lateral photographs were taken. The same surgical procedure was performed in all patients. RESULTS: No complications were observed. Tip upturning, with satisfaction of the patients, was observed in all cases and was confirmed comparing preoperative and 6-month postoperative photographs. CONCLUSIONS: From the outcomes of this short case series, the surgical technique described to upturn the tip of the nose with an intraoral approach sectioning the fibers of muscle depressor septi and with the skeletization of the premaxilla is an easy, safe, and inexpensive technique that can be easily performed at the office.

Polyacrylamide gel injection for treatment of human immunodeficiency virus-associated facial lipoatrophy: 18 months follow-up.

BACKGROUND: Lipoatrophy of the face affects the quality of life and body image of individuals receiving antiretroviral therapy. The objective of this study was to assess the safety and efficacy of a permanent nonbiodegradable polyacrylamide gel filler, used for facial wasting rehabilitation. METHODS: Thirty-two individuals positive for the human immunodeficiency virus (HIV) were enrolled in the study between January 2007 and January 2009 and treated using nonbiodegradable polyacrylamide gel injections for a facial wasting rehabilitation. RESULTS: Local infection, foreign body reaction, and migration of the product were not observed during follow-up (18 months). Small, palpable, nonvisible nodules were recorded in 13 cases at the end of follow-up. CONCLUSIONS: Polyacrylamide hydrogel is an appropriate treatment option in restoring facial contours in immunocompromised people with HIV. Injections of large volumes of polyacrylamide gel (8 to 12 mL) are not associated with a high rate of complications such as infection and foreign body reaction and allow improvement in quality of life in a limited time.