Efficacy of monopolar dielectric transmission radio frequency in panniculus adiposus and cellulite reduction

Introduction: Despite high incidence rate of cellulite, there are few studies regarding its treatment. Most of them present non-validated evaluation tools. Radio frequency is a focused treatment very used in aesthetics to reduce it. Objectives: To know the efficacy of Monopolar Dielectric Radio frequency (MDR) treatment in dynamic applications to reduce cellulite, panniculus adiposus and gluteal and posterior thigh regions. Methods: Experimental study consisting of inferior members of nine women. They received 10 sessions based on dynamic applications of MDR. Variables included the following: Cellulite Severity Scale (CSS), appearance of the cutaneous area, flaccidity and ultrasound measurement of the panniculus adiposus. Results: The final CSS score of the leg treated reflects statistically significative differences (p = 0.023) when compared with control leg (p = 0.622). Significant reductions of body perimeters at the level of the great trochanter (p = 0.02), the gluteal region (p = 0.03) and the midpoint of the posterior thigh (p = 0.01) are found. The reduction of the panniculus adiposus measured using ultrasound techniques shows significant changes in the midpoint of the posterior thigh (p = 0.028) as well as in the gluteal region (p = 0.03). Conclusions: The dynamic application of MDR seems to be effective in order to reduce not only the thickness of panniculus adiposus but also gluteal and posterior thigh perimeters.     

Optimal weekly frequency of 308-nm excimer laser treatment in vitiligo patients

BACKGROUND: Recently the beneficial effect of excimer laser treatment has been reported for patients with vitiligo. The influence of treatment frequency on this effect is not clear. OBJECTIVES: To determine the optimal frequency of 308-nm excimer laser therapy for vitiligo. METHODS: In this prospective, university-based hospital study over 12 weeks we enrolled 14 patients. Each had at least three stable vitiligo lesions in the same body area. The three stable vitiligo lesions in each subject were randomly assigned to receive excimer laser treatment once (1 x), twice (2 x) and three times (3 x) weekly, respectively. The initial ultraviolet (UV) dose was 50 mJ cm(-2) less than the 308-nm minimal erythematous dose in vitiligo skin. The UV dose was increased at each treatment session according to the erythematous response to the previous treatment. RESULTS: Thirteen subjects were treated for at least 6 weeks; seven were treated for all 12 weeks. At 6 weeks, the repigmentation rates for treated lesions were 8% (1/13) after 1 x weekly treatment, 23% (3/13) after 2 x weekly treatment and 62% (8/13) after 3 x weekly treatment (P = 0.0134; 3 x vs. 1 x weekly); at 12 weeks, these rates were 46% (6/13), 62% (8/13) and 69% (9/13), respectively (P = NS; 3 x vs. 1 x weekly). Repigmentation initiation correlated with treatment number, regardless of frequency (P = NS). As shown by Kaplan-Meier analysis, repigmentation occurred earliest in the most frequently treated lesions (P = 0.0336). At 12 weeks, the projected repigmentation rates for 1 x, 2 x and 3 x weekly treatment approached each other (60%, 79% and 82%, respectively); the mean repigmentation grades (on a scale of 0-5) for 1 x, 2 x and 3 x weekly treatment were 1.7, 2.4 and 3.3, respectively (P = 0.018; 3 x vs. 1 x weekly). Laser-induced repigmentation persisted in most cases over the entire follow-up of 12 months after the end of treatment. CONCLUSIONS: 308-nm excimer laser therapy is effective against vitiligo. Although repigmentation occurs fastest with 3 x weekly treatment, the ultimate repigmentation initiation seems to depend entirely on the total number of treatments, not their frequency. However, treatment periods of more than 12 weeks may be necessary to obtain a satisfactory clinical repigmentation, particularly when vitiligo lesions are treated only 1 x or 2 x compared with 3 x weekly.     

Hair removal using a combination radio‐frequency and intense pulsed light source

BACKGROUND AND OBJECTIVE: The long‐term removal of unwanted hair is achieved by many laser and intense pulse light sources. One limitation is the treatment of individuals with dark skin. The light energy with the current systems has to penetrate through the epidermis before being absorbed by the hair follicle. In individuals with dark skin the high melanin concentration in the epidermis absorbs high energies that can lead to complications. The objective of our study was to study a new system that combines optical energy, intense pulsed light (IPL), with radio frequency (RF). This allows for the use of less optical energy due to the addition of RF energy. The lower optical fluence allows for safer treatment of darker skin types. STUDY DESIGN/MATERIALS AND METHODS: This was a multicenter study, in which 87 patients were enrolled. A single treatment was performed on a specified body site. Twenty‐one of the 69 subjects that completed the study had skin types IV–VI. Each subject was evaluated at 1, 7, 30, and 90 days after the treatment session. RESULTS: Hair counts were significantly reduced from baseline after one treatment by an average of 46%. Individual patient data showed that the percentage in hair count reduction achieved ranged from 0 to 100%, with 43% of the patients having a 50% or greater decrease. CONCLUSIONS: The combination of optical energy and RF when delivered simultaneously achieves effective hair reduction with the use of less optical energy, allowing for the safe treatment of all skin types.     

高频电凝术治疗血管瘤和脉管畸形821例临床分析

目的探讨高频电凝治疗血管瘤和脉管畸形的疗效。方法采用高频电凝治疗血管瘤和脉管畸形患者821例,根据病变部位、大小、深度调整输出能量(10~50W)。治疗后随访6个月~3年。结果血管瘤治愈率78.64%,显效率14.08%;静脉畸形治愈率71.02%,显效率19.32%;混合型脉管畸形治愈率65.92%,显效率17.49%;动静脉畸形治愈率11.11%,显效率44.44%。其中动静脉畸形治愈率与其他3组比较差异有统计学意义(P0.05)。结论高频电凝是治疗血管瘤和脉管畸形的一种微创、安全、有效的新方法。     

Measuring depth depends on frequency in electrical skin impedance measurements

Background/aims: Multi-frequency electrical measurements in vivo on stratum corneum are frequently reported in the literature. It is well known that the measured volume of skin is dependent on measuring frequency, and we wanted to investigate to what extent viable skin influences the measured impedance as a function of frequency.
Methods: Finite element modelling (FEM) was used to investigate the current and potential distribution in the skin when measuring impedance with two concentric surface electrodes.
Results: The study showed that the impedance measured reflects mainly the stratum corneum at low frequencies, in this case below 1 kHz, and that the viable skin dominates at higher frequencies.
Conclusion: It is concluded that a multi-frequency measurement on isolated stratum corneum is not possible in vivo with conventional techniques, except within a very narrow and low frequency range.     

Topical bioavailability of triamcinolone acetonide: effect of dose and application frequency

The application frequency of topical corticosteroids is a recurrently debated topic. Multiple-daily applications are common, although a superior efficacy compared to once-daily application is not unequivocally proven. Only few pharmacokinetic studies investigating application frequency exist. The aim of the study was to investigate the effect of dose (Experiment 1) and application frequency (Experiment 2) on the penetration of triamcinolone acetonide (TACA) into human stratum corneum (SC) in vivo. The experiments were conducted on the forearms of 15 healthy volunteers. In Experiment 1, single TACA doses (300 μg/cm² and 100 μg/cm²) dissolved in acetone were applied on three sites per arm. In experiment 2, single (1 × 300 μg/cm²) and multiple (3 × 100 μg/cm²) TACA doses were similarly applied. SC samples were harvested by tape stripping after 0.5, 4 and 24 h (Experiment 1) and after 4, 8 and 24 h (Experiment 2). Corneocytes and TACA were quantified by UV/VIS spectroscopy and HPLC, respectively. TACA amounts penetrated into SC were statistically evaluated by a paired-sample t-test. In Experiment 1, TACA amounts within SC after application of 1 × 300 μg/cm² compared to 1 × 100 μg/cm² were only significantly different directly after application and similar at 4 and 24 h. In Experiment 2, multiple applications of 3×100 μg/cm² yielded higher TACA amounts compared to a single application of 1 × 300 μg/cm² at 4 and 8 h. At 24 h, no difference was observed. In conclusion, using this simple vehicle, considerable TACA amounts were retained within SC independently of dose and application frequency. A low TACA dose applied once should be preferred to a high dose, which may promote higher systemic exposure.     

派特灵与电灼结合干扰素治疗阴茎尖锐湿疣的临床效果对比观察

目的:探讨应用派特灵与应用高频电刀并结合干扰素治疗阴茎尖锐湿疣的临床疗效。方法:从治疗疼痛程度、术后复发率及术后瘢痕情况这几个方面对以上两种治疗方式进行比较。结果:派特灵治疗阴茎尖锐湿疣在疼痛程度、术后复发率及术后瘢痕方面比应用高频电刀并结合干扰素的方法具有明显优势。结论:派特灵治疗阴茎尖锐湿疣的临床疗效显著,患者不良反应较小,复发率较低,术后无瘢痕,值得推广应用。     

微等离子射频联合窄谱强脉冲光治疗浅表性和增生性瘢痕

目的探讨微等离子射频联合窄谱强脉冲光治疗浅表性和增生性瘢痕的临床价值。方法对32例面部和四肢浅表性瘢痕和轻度增生性瘢痕患者,进行微等离子射频治疗,每2个月治疗1次,治疗2~3次后,进行窄谱强脉冲光治疗,每月1次,共治疗2~3次;全疗程结束后3个月对瘢痕进行疗效评价和不良反应评价。结果瘢痕治疗痊愈率12.5%,显效率50%,有效率34.3%,无效率3.2%,总有效率为62.5%,无明显不良反应。结论微等离子射频联合窄谱强脉冲光治疗瘢痕安全有效,不良反应小。     

加替沙星联合体外高频热疗治疗男性非淋菌性尿道炎的临床效果观察

目的：探讨加替沙星配合局部高频热疗治疗男性非淋菌性尿道炎（NGU）的疗效以及安全性分析。方法：选取男性非淋菌性尿道炎患者120例,按数字表法随机分为两组,每组60例,对照组给予加替沙星治疗,观察组采用加替沙星联合高频热疗治疗,采用NIH—CPSI评分表量化,观察两组患者症状疗效以及药物与高频热疗的安全性。结果：治疗前两组CPSI评分无显著差异（P〉0．05）,治疗后两组CPSI评分均显著改善（P〈0．05）,且观察组有效率88．33％显著高于对照组有效率71．67％（P〈0．05）,两组患者均未出现严重不良反应。结论：加替沙星联合体外高频热疗治疗非淋菌性尿道炎效果显著优于单纯服用加替沙星,体外高频热疗为治疗NGU的有效物理疗法,对提高NGU的治愈率、提高患者生活质量有积极的意义。     

激光、强脉冲光及射频技术在皮肤美容治疗中的不良反应

近几十年来,激光技术的迅猛发展使以往一些难治的皮肤病有了治疗的可能,强脉冲光、射频技术的研发更是使人们多年以来"返老还童"的梦想得以实现.尽管现代激光比较安全可靠,但也会对人体造成一定的伤害,即使比较安全的激光在使用不当时也会引起潜在的风险和各种不良反应,这些新技术带来优势的同时也应该注意其在操作过程中和治疗后可能出现的不良反应.概述皮肤科常见的激光、强脉冲光以及射频技术在治疗中的不良反应类型.

Abstract：

In recent decades,the rapid development of laser technology has supplied treatment choices for refractory skin diseases.Moreover,intensive pulsed light and radio frequency have made the dream to rejuvenate skin come true.Although modern laser is relatively safe and reliable,it can still cause some damage to the human body.Even safe lasers have potential risks and side effects when inappropriately applied.Careful attention should be paid to the adverse reactions during and after laser treatment.This review overviews the adverse effects of common types of laser,intense pulsed light and radio frequency technology in the treatment of skin diseases.     

特发性性早熟女童乳腺高频超声显像特征分析

目的:分析研究乳腺高频超声在特发性性早熟女童诊断中应用的价值,为特发性性早熟女童的临床诊断提供新的思路及理论支持。方法:抽取2014年1月至2015年12月我院接收的51例特发性性早熟女童作为研究组,另选取51例同期体检健康者作为对照组。选用Aloka SSD-3500超声显像仪对两组研究对象进行检查,并对盆腔实施常规超声检测,对比观察两组研究对象乳腺大小及组成、超声参数Logistic回归分析结果和血清雌二醇、促卵泡生长激素和黄体生成素水平。结果:采用独立样本t检验可知,研究组周围腺体回声和乳腺中央低回声区长径与厚度相比差异均有统计学意义(P0.05);两组卵泡直径、卵巢容积、卵巢前后径、卵巢横径、卵巢长径相比差异有统计学意义(P0.05),而宫颈长径、子宫容积、子宫体前后径、子宫体横径、子宫体长径相比差异无统计学意义(P0.05);研究组血清雌二醇、促卵泡生长激素和黄体生成素水平均显著高于对照组,差异均有统计学意义(P0.05)。结论:乳腺高频超声在特发性性早熟女童的临床诊断与鉴别中可发挥重大价值,其中卵泡和卵巢形态学参数诊断具有较大价值,且该检查方式具有无创性,操作简单,安全性较高。     

External vascular compression by hyaluronic acid filler documented with high‐frequency ultrasound

We present a case report of a hyaluronic acid filler‐induced complication documented using high‐frequency ultrasound. We regard the scientific value of the case as indicating the benefit that ultrasound provides for the management and documentation of this complication. This technology has been becoming increasingly widespread in the care of patients who experience unwanted effects of hyaluronic acid filler because it can be used for the high‐resolution visualization of skin layers as well as the differentiation of filler types and their relationships with adjacent tissues (via gray scale or B‐mode ultrasound) and blood vessels (via color Doppler ultrasound). In addition, it was possible to conclude that external vascular compression causes clinical repercussions, a fact that is often questioned by some dermatologists. This questioning is based on the vast vascularization and anastomosis of arteries of the face, which should permit compensation for vascular compression. However, in this case, there was no doubt that compression caused a region of low output with the clinical manifestation of peri‐oral pallor. Ultrasound was used to document the compression of a vessel by the filler; after application of hyaluronidase, increased vessel lumen and clinical reversal of hypoperfusion in the affected area were observed.     

高频振荡通气在严重肺挫伤所致顽固性低氧血症中应用研究

目的：研究应用高频振荡通气（HFOV）治疗严重肺挫伤所致顽固性低氧血症的疗效。方法在不影响正常临床治疗前提下，首先采用常频呼吸机无创通气，当出现顽固性低氧血症时，给予充分镇静、肌松，气管插管或气管切开，使用HFOV行有创通气。并对18例肺挫伤患者使用HFOV前后的PCO2、PO2、MAP、EVLW、平均气道压、SpO2、呼吸道血性分泌物；床边胸片以及患者的气管插管时间、使用呼吸机时间、住ICU时间、抢救成功率等重要临床参数进行监测统计，并与常频通气进行对照。结果严重肺挫伤使用HFOV前后的PCO2、PO2、MAP、EVLW、平均气道压、SpO2以及呼吸道血性分泌物、床边胸片、气管插管时间、使用呼吸机时间、住ICU时间等重要临床参数均有改善，但远期抢救成功率与常频通气（CMV）对照差异无统计学意义。结论 HFOV对严重肺挫伤所致顽固性低氧血症有显著治疗作用。不仅可以降低气道压力，改善肺氧合而且还可以减少呼吸运动幅度使肺泡处于相对稳定的扩张状态，减少肺出血、渗出，有利于肺挫伤的愈合，对提高治疗顽固性低氧血症有重要临床指导意义。     

The frequency of contact allergy in atopic patients with dermatitis

A prospective study was performed to establish the frequency of contact allergy in atopic patients presenting with dermatitis, compared with non-atopics suffering from dermatitis. During 1987-1988, all new patients aged 15 years or older, who consulted us for dermatitis, were investigated. They were patch tested with the European standard series, methyl(chloro)isothiazolinone and other relevant allergens. In addition, they were prick tested with 24 inhalant and 11 food allergens. Patients having at least 2 positive prick tests, and patients with 1 positive prick test and a (family) history of atopic diseases were defined as atopics, as were those who presented with classic atopic dermatitis but with negative prick tests. 499 patients were evaluated: 159 men and 340 women. 214 patients (43%) were atopic, the other 285 (57%) were non-atopic. In the atopic group, 79 persons (37%) had at least 1 positive patch test reaction. In the group of non-atopics, 149 patients (52%) had contact allergies. The difference is statistically significant (chi 2; p less than 0.05). It is concluded that adult atopics seen in dermatological practice who present with dermatitis are less frequently contact sensitized than such patients who are non-atopic. Nevertheless, a yield of nearly 40% positive patch test reactions in this group still makes routine patch testing necessary.     

High‐frequency sonography of temporary and permanent dermal fillers

Background: Dermal fillers are used widely; some have a permanent effect, whereas others are temporary. The aim of this study is to describe the ultrasonographic features of permanent and temporary fillers injected into patients for cosmetic purposes. Materials and methods: Between December 2006 and April 2009, 36 subjects, aged 25–45, who had received lips or nasolabial fold filler augmentation, were enrolled for a high‐frequency sonographic examination by a blinded investigator. The criteria for exclusion were a history of autoimmunity, infection, neoplastic diseases or episodes of local reactions to the injected filler. Twenty patients underwent a sonographic exam after the injection of a temporary filler (collagen or hyaluronic acid) by FRG; the rest were enrolled among patients seeking a consultation for further cosmetic reasons, but had been treated with an identifiable filler before. Results: It was always possible to identify the filler at the site of injection. Seldom was it possible to discover a silent inflammatory reaction, otherwise unsuspected. The sonographic images differed according to the temporary or the permanent nature of the filler. Conclusion: Ultrasonography has proved to be a useful, non‐invasive tool for the identification of the presence and type of the filler injected.     

脉冲振荡响应频率与肺通气功能的相关性分析

目的探讨脉冲振荡响应频率（RD与第一秒用力呼其容积（FEV1）及用力肺活量（forced vital capacity,FVC）的相关性。方法对99例呼吸系统疾病患者进行肺通气功能及响应频率测试。对RF与FEV1占预计值的百分比（FEV1％）及RF与一秒率（FEV1／FVC％）作相关性分析。结果RF与FEV1、FEV1／FVC均有非常显著的相关性,相关系数分别为0．877（P〈0．001）和0．799（P〈0．001）;在气道可逆实验中,RF的下降值与FEV1改善率呈直线相关。结论RF是反映通气功能的可靠指标,在气道可逆试验中也可得到应用。     

Imaging of the skin and subcutaneous tissue using classical and high‐frequency ultrasonographies in anti‐cellulite therapy

Background: The development of ultrasonography allowed for skin imaging used in dermatology and esthetic medicine. By means of classic and high‐frequency ultrasonographies, changes within the dermis and subcutaneous tissue can be presented. Objective: The aim of this study was to show the possibilities of applying classic and high‐frequency ultrasonographies in esthetic dermatology based on monitoring various types of anti‐cellulite therapies. Methods: Sixty‐one women with cellulite were assigned to two smaller groups. One group was using anti‐cellulite cream and the second group was a placebo group. The ultrasound examination was carried out before the initiation and after the completion of the treatment and evaluated epidermal echoes, the thickness of the subcutaneous tissue and the dermis, dermis echogenicity, the length and surface area of the subcutaneous tissue fascicles growing into the dermis, and the presence or absence of edemas. Results: After the completion of the treatment, a statistically significant difference was observed. The most useful parameters were as follows: the thickness of the subcutaneous tissue, echogenicity, the surface area and length of the subcutaneous tissue, as well as the presence of edemas. The discussed changes were not observed in the placebo group. Conclusion: Classic and high‐frequency ultrasonographies are useful methods for monitoring anti‐cellulite therapies.