RESUMO
BACKGROUND: The tear trough represents a main aesthetic characteristic of the aging process, which leads many patients to the wish for a safe and efficient rejuvenation method to fill their eye rings. The authors analyzed results and complication rates of two methods for hollow eye ring treatment. METHODS: The authors used two methods on two patient collectives. Group A was treated using hyaluronic acid gel (Restylane; Q-Med, Uppsala, Sweden) and a reinforced 25-gauge Pix'l+ micro cannula. The authors developed a modified method for group B that included a combination of cooling of the periorbital area, no local anesthesia, preincision displacement of malar fat 10 mm below the orbital border, and postintervention corticoid therapy for 48 hours. RESULTS: Protocol B was associated with significantly lower complication rates. The authors also analyzed in how smoking, age, and skin properties might affect the clinical outcome. They found that choice of treatment and a history of blepharoplasty were significant predictive factors that correlated with complications. CONCLUSIONS: Tear trough treatment by hyalurostructure shows satisfying and efficient results with few complications. The revised technique used in group B combines multiple peri-interventional procedures including preinjection cooling of the periorbital area, preincision with displacement of the malar fat 10 mm below the orbital border, applying gentle back-and-forth movements while injecting, and oral corticosteroid therapy 48 hours after intervention. This technique makes hyalurostructure a competent and promising treatment for tear trough management. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, III.
Assuntos
Tecido Adiposo/transplante , Blefaroplastia/métodos , Ácido Hialurônico/análogos & derivados , Satisfação do Paciente , Envelhecimento da Pele/patologia , Adulto , Idoso , Feminino , Humanos , Ácido Hialurônico/administração & dosagem , Injeções , Masculino , Pessoa de Meia-Idade , Órbita , Complicações Pós-Operatórias/prevenção & controle , Rejuvenescimento , Estudos Retrospectivos , Resultado do TratamentoRESUMO
PURPOSE: To enhance lips ageing rejuvenation with specific microcannula and hyaluronic acid. METHOD: Clinical review was conducted from December 2010 to December 2011 among 46 patients complaining of predictable changes on lips and perioral region such as deficiency in contour definition, volume and projection. Lips rejuvenation injections were made using the hyalurostructure technique. RESULTS: Forty-two patients (92%) with a 6-month follow-up were satisfied or very satisfied with the aesthetic results after the hyalurostructure of the lips and the perioral region rejuvenation. The use of the specially designed cannula led to fewer complications. We noticed 40 oedemas (87%) that appeared 24-48 h after the injection and seven patients (15.2%) with haematomas. We noted fewer surface irregularities and a better distribution of the product. Patients' records showed the procedure was painless. CONCLUSION: The hyalurostructure technique reduces the number of punctures compared to that of the conventional method. The microcannula's blunt tip reduces the risks of intravascular injection of the substance and of reach and disruption of the key structures like vessels and nerves. Results revealed that the hyalurostructure used for lips rejuvenation and helps to maintain a natural effect and avoids pain.
Assuntos
Técnicas Cosméticas , Ácido Hialurônico/administração & dosagem , Lábio , Rejuvenescimento , Adulto , Catéteres , Técnicas Cosméticas/efeitos adversos , Técnicas Cosméticas/instrumentação , Edema/etiologia , Feminino , Hematoma/etiologia , Humanos , Lábio/anatomia & histologia , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Envelhecimento da Pele , Inquéritos e Questionários , Adulto JovemAssuntos
Inibidores da Angiogênese/uso terapêutico , Anticorpos Monoclonais Humanizados/uso terapêutico , Neovascularização de Coroide/tratamento farmacológico , Drusas do Disco Óptico/complicações , Anestesia Geral , Inibidores da Angiogênese/administração & dosagem , Anticorpos Monoclonais Humanizados/administração & dosagem , Pré-Escolar , Neovascularização de Coroide/diagnóstico , Neovascularização de Coroide/etiologia , Angiofluoresceinografia , Seguimentos , Humanos , Injeções Intravítreas , Masculino , Drusas do Disco Óptico/diagnóstico , Ranibizumab , Tomografia de Coerência Óptica , Resultado do Tratamento , Fator A de Crescimento do Endotélio Vascular/antagonistas & inibidores , Acuidade VisualRESUMO
PURPOSE: To assess the long-term results of the treatment of oculofacial asymmetries using a combined injection schedule for injections of hyaluronic acid, with a specific micro cannula and botulinum toxin. METHOD: A retrospective study was conducted from January 2009 to January 2010. Patients were treated in the Alcazar Eye Clinic and Oculoplastic Department in Princess Grace Hospital, Monaco. We selected patients complaining of asymmetrical periorbital features who received treatment with hyalurostructure and botulinum toxin injection in one or more sessions. Nine patients were selected and presented with the following symptoms: asymmetry of eyebrow position (2 patients), superior orbital hollow (2 patients), tear trough (2 patients) and orbital volume (ocular prosthesis) (3 patients). The objective was to evaluate the efficiency of combined treatment in one or more sessions on these oculofacial asymmetries. Hyaluronic acid injections were done using hyalurostructure. Hyaluronic acid gel (Restylane Lidocaine) was used with a 25 gauge reinforced micro-cannula (pix'l +, Thiebaud). This was combined with injections of botulinum toxin (azzalure*) to areas of muscular hyperaction. Follow-up was done at 1 year by clinical examination, photography and patient satisfaction. Complications of this combined treatment have been identified. RESULTS: At 1-year follow-up, 88% of patients were satisfied or very satisfied with their results. There were no more complications secondary to both treatments in the same session. It was not noticed more hematomas and bruises than in classical injection method. The action of toxin is constant over time despite the association of hyaluronic acid injections. CONCLUSION: Combined treatments with toxin and hyaluronic acid in oculofacial asymmetries are efficient and can be proposed in the same session. These treatments must be repeated to maintain and optimize muscle contraction and volume loss. Use of hyalurostructure and botulinum toxin treatment in the same session is effective and safe.
Assuntos
Toxinas Botulínicas Tipo A/uso terapêutico , Fármacos Dermatológicos/uso terapêutico , Assimetria Facial/tratamento farmacológico , Ácido Hialurônico/análogos & derivados , Fármacos Neuromusculares/uso terapêutico , Adulto , Técnicas Cosméticas , Quimioterapia Combinada , Olho , Feminino , Humanos , Ácido Hialurônico/uso terapêutico , Masculino , Satisfação do Paciente , Estudos RetrospectivosAssuntos
Aspergilose/diagnóstico , Aspergillus fumigatus , Carcinoma de Células Escamosas/diagnóstico , Endoftalmite/diagnóstico , Endoftalmite/microbiologia , Neoplasias da Retina/diagnóstico , Adulto , Anticorpos Anti-Idiotípicos/análise , Anticorpos Antifúngicos/análise , Aspergilose/complicações , Aspergilose/patologia , Aspergillus fumigatus/isolamento & purificação , Carcinoma de Células Escamosas/secundário , Diagnóstico Diferencial , Endoftalmite/patologia , Olho/química , Olho/microbiologia , Olho/patologia , Neoplasias Palpebrais/diagnóstico , Neoplasias Palpebrais/patologia , Imunofluorescência , Células Gigantes/patologia , Humanos , Hifas , Masculino , Neoplasias da Retina/secundárioRESUMO
The proinflammatory effect of Afa/Dr diffusely adhering Escherichia coli (Afa/Dr DAEC) strains have been recently demonstrated in vitro by showing that polymorphonuclear leukocyte (PMN) transepithelial migration is induced after bacterial colonization of apical intestinal monolayers. The effect of Afa/Dr DAEC-PMN interaction on PMN behavior has been not investigated. Because of the putative virulence mechanism of PMN apoptosis during infectious diseases and taking into account the high level of expression of the decay-accelerating factor (DAF, or CD55), the receptor of Afa/Dr DAEC on PMNs, we sought to determine whether infection of PMNs by Afa/Dr DAEC strains could promote cell apoptosis. We looked at the behavior of PMNs incubated with Afa/Dr DAEC strains once they had transmigrated across polarized monolayers of intestinal (T84) cells. Infection of PMNs by Afa/Dr DAEC strains induced PMN apoptosis characterized by morphological nuclear changes, DNA fragmentation, caspase activation, and a high level of annexin V expression. However, transmigrated and nontransmigrated PMNs incubated with Afa/Dr DAEC strains showed similar elevated global caspase activities. PMN apoptosis depended on their agglutination, induced by Afa/Dr DAEC, and was still observed after preincubation of PMNs with anti-CD55 and/or anti-CD66 antibodies. Low levels of phagocytosis of Afa/Dr DAEC strains were observed both in nontransmigrated and in transmigrated PMNs compared to that observed with the control E. coli DH5alpha strain. Taken together, these data strongly suggest that interaction of Afa/Dr DAEC with PMNs may increase the bacterial virulence both by inducing PMN apoptosis through an agglutination process and by diminishing their phagocytic capacity.
Assuntos
Apoptose , Aderência Bacteriana , Escherichia coli/classificação , Escherichia coli/fisiologia , Neutrófilos/citologia , Neutrófilos/microbiologia , Fagocitose , Anexina A5/metabolismo , Anticorpos/imunologia , Anticorpos/farmacologia , Antígenos CD/imunologia , Antígenos CD/metabolismo , Antígenos de Diferenciação/imunologia , Antígenos de Diferenciação/metabolismo , Antígenos CD55/imunologia , Antígenos CD55/metabolismo , Caspase 3 , Caspases/metabolismo , Moléculas de Adesão Celular , Agregação Celular , Movimento Celular , Quimiotaxia de Leucócito , Ativação Enzimática/efeitos dos fármacos , Humanos , Neutrófilos/enzimologia , Neutrófilos/imunologiaRESUMO
AIMS: Rhinocerebral mucormycosis (RCM) is a well-described fulminant fungal infection that presents acutely in patients with ketoacidosis and immunosuppression. Very early diagnosis, established with the demonstration of characterised hyphae in tissues, greatly improves the prognosis of RCM. In this regard, the specificity and the sensitivity of frozen section for the diagnosis and the surgical debridement of RCM were evaluated in this study. METHODS AND RESULTS: Frozen section was performed for the diagnosis (six of seven cases) and surgical treatment (three of seven cases) of RCM. In all cases, diagnosis was made by frozen section and confirmed by histological examination. Frozen section allowed radical surgical excision of infected tissue. In all cases, invasive, broad-based non-septated hyphae with branching at right angles were well demonstrated on toluidine blue staining. Cultures were positive for Rhizopus oryzae in three of seven cases. Outcome was favourable for five of seven patients and two patients died after the diagnosis. CONCLUSIONS: Frozen section is a specific and sensitive method to make both a quick initial diagnosis of RCM and to successfully eradicate the tissue infected by organisms belonging to the order Mucorales.
Assuntos
Secções Congeladas , Mucorales/isolamento & purificação , Mucormicose/patologia , Sinusite/patologia , Adulto , Idoso , Anfotericina B/uso terapêutico , Desbridamento , Feminino , Técnicas de Preparação Histocitológica , Humanos , Lipossomos/uso terapêutico , Masculino , Pessoa de Meia-Idade , Mucorales/fisiologia , Mucormicose/etiologia , Mucormicose/terapia , Sensibilidade e Especificidade , Sinusite/etiologia , Sinusite/terapiaRESUMO
Proliferative membranes of the posterior segment of the eye correspond to the formation of scar tissue in the periretinal area which arise in various pathological conditions. These membranes result from the migration of retinal and choroidal cells beyond their anatomic focus inducing the production of mutilating fibrous tissue. They are a major cause of blindness in children and adults. The development of surgical procedures reaching the posterior segment, has enabled excision of these tissues. In this review, we describe the different histological features of these membranes as well as the different etiological factors inducing their development. We propose a clinicopathological classification of these membranes.
Assuntos
Cicatriz/patologia , Olho/patologia , Membrana Celular/patologia , Cicatriz/etiologia , Oftalmopatias/etiologia , Oftalmopatias/patologia , HumanosRESUMO
Ulcerative colitis and Crohn's disease are inflammatory bowel diseases thought to involve strains of Escherichia coli. We report here that two wild-type Afa/Dr diffusely adhering E. coli (DAEC) strains, C1845 and IH11128, which harbor the fimbrial F1845 adhesin and the Dr hemagglutinin, respectively, and the E. coli laboratory strain HB101, transformed with the pSSS1 plasmid to produce Afa/Dr F1845 adhesin, all induced interleukin-8 (IL-8) production and transepithelial migration of polymorphonuclear leukocytes (PMNL) in polarized monolayers of the human intestinal cell line T84 grown on semipermeable filters. We observed that after PMNL migration, expression of decay-accelerating factor (DAF, or CD55), the brush border-associated receptor for Afa/Dr adhesins, was strongly enhanced, increasing the adhesion of Afa/Dr DAEC bacteria. When examining the mechanism by which DAF expression was enhanced, we observed that the PMNL transepithelial migration induced epithelial synthesis of tumor necrosis factor alpha and IL-1beta, which in turn promoted the upregulation of DAF.
Assuntos
Adesinas de Escherichia coli/metabolismo , Aderência Bacteriana , Antígenos CD55/metabolismo , Escherichia coli/patogenicidade , Infiltração de Neutrófilos , Regulação para Cima , Adesinas de Escherichia coli/genética , Adesinas de Escherichia coli/fisiologia , Polaridade Celular , Citocinas/metabolismo , Escherichia coli/genética , Escherichia coli/imunologia , Escherichia coli/fisiologia , Proteínas de Escherichia coli/genética , Proteínas de Escherichia coli/metabolismo , Células HeLa , Hemaglutininas/genética , Hemaglutininas/metabolismo , Humanos , Microscopia Eletrônica , Neutrófilos/imunologia , Células Tumorais CultivadasRESUMO
Afa/Dr diffusely adhering Escherichia coli (Afa/Dr DAEC) strains cause symptomatic urinary tract and intestinal infections. The proinflammatory effects of Afa/Dr DAEC strains in vitro have been not investigated to date. In the present study, we used confluent polarized monolayers of intestinal cell line T84 to evaluate the consequences of epithelial infection by Afa/Dr DAEC strains in terms of proinflammatory response. Polymorphonuclear leukocyte (PMNL) migration across the epithelial barrier was induced after incubation of the T84 monolayers with the wild-type Afa/Dr DAEC strain C1845 harboring the fimbrial F1845 adhesin and strain IH11128 harboring the Dr hemagglutinin, and the E. coli laboratory strain HB101 was transformed with the pSSS1 plasmid, producing Afa/Dr F1845 adhesin. PMNL migrations were correlated with a basolateral secretion of interleukin-8 by T84 cells and were abolished after incubation of epithelial cells with an anti-decay accelerating factor (DAF) antibody that recognized the short consensus repeat 3 domain of DAF (monoclonal antibody 1H4). Moreover, Afa/Dr DAEC strains induced tyrosine phosphorylation of several T84 proteins and activated the mitogen-activated protein kinases (ERK1/2 mitogen-activated protein, P38, and Jun-C kinases). These data demonstrated for the first time that, in vitro, Afa/Dr DAEC strains exert a proinflammatory signal in intestinal epithelial cells.