Pinnacle Medicine amp Medical SciencesISSN 2360-9516

httpwwwpjpuborgcopy Author(s) 2015 CC Attribution 30 License

Research Article

Clinical And Histological Presentation After Plexr Application Needle Shaping (Vibrance) AndOFF

Tsioumas G Sotiris sup1 Vlachodimitropoulos Dimitris sup2 amp Goutas Nikolaossup3

sup1Private ClinicDiagnostic Clinic and Aesthetic Surgery Ophthalmology

Eye Surgeon - OculoplasticPresident of Hellenic Society of Aesthetic Medicine and Non Invasive Surgery

Greece

sup2sup3Laboratory of Forensic Medicine and ToxicologyAthens Medical School

GreeceAccepted 4 March 2015

ABSTRACT

This study was written after three years of implementation of the innovative techniques Plexr Needle Shaping (Vibrance) and OFF (lipolysis)where it was found these devices is the latest technology for Blepharoplasty and Non Invasive Eye Lid Surgery body reshaping and lipolysisThese techniques have been applied to hundreds of patients who were completely happy with the results (treatments on the face or body)After the desired results in clinical presentation of the patients we wanted to test if histology presentation is consistent Therefore we tookbiopsies (human tissue) for each of the techniques which were examined by the Laboratory of Forensic Medicine and Toxicology in AthensMedical School

Keywords Plexr Needle Shaping Vibrance OFF lipolysis biopsy elastic fibres histological clinical staining skin tissue

Corresponding Author Tsioumas G Sotirissup1Private Clinic Diagnostic Clinic and Aesthetic Surgery Ophthalmology Eye surgeon ndash Oculoplastic President of Hellenic Society of Aesthetic Medicine and NonInvasive Surgery GreeceEmail address s_tsioumashotmailcom

Introduction

What is Plexr

Plexr is a cordless micro-surgical hand operated device thattransfers concentrated heat to the treated skin tissues It usesthe difference in voltage between the device and the patientsskin The difference in voltage generates a small electrical arcsimilar to a minute lighting The small lighting causes thesublimation of the fluids contained in superficial part of theskin without unwanted heat transmission to the adjacenttissues Additionally it acts on the superficial layer of the skinpreserving the lower layers this will reduce drastically anypotential permanent skin damage that could be caused by themisuse of conventional lasers

What is Needle Shaping (Vibrance)

Needle Shaping is the only microsurgery technique which isable to perform a subcutaneous micro trans-plant and at thesame time a bio stimulation by Prof Giorgio Fippi (Lecturerof Non Ablative Surgery SIMENCA) With this microsurgerytechnique it is possible to increase the volume of the lips thecheekbones and sunken scars without injecting any kind ofmaterial or chemical This is an autotransplantation of tissueby traction though it might be more appropriate to speak ofit as an acupuncture through which high tension and limitedgalvanic current are passed The mixed currents strengthenedby their synergic action regulated at such intensity so as tonot be perceived by the patient except in particularlysensitive parts slightly dehydrate the elastic fibres of thederma and this way they hook onto the needle and principallybind to each other creating a lasting effect At this point they

are delicately wound up into a sort of spindle of autologousmaterial which is visible when moving the needle The tractionexercised must be such as to obtain a certain volume of fibreswithout these tearing Liquids are climinated by osmosis dueto the saline deprivation caused by the currents to preventthe fibres and the collagen from unwinding

What is OFF

OFF is an electromedical apparatus that uses sinusoidal wavewith a fixed frequency of 1230 kHz fractional flow ofemission This frequency was chosen because it produces aseries of biological effects that are perfectly suitable fortreating a great variety of skin blemished otherwise nottreatable by other apparatuses This same frequency is usedfor both therapeutic ultrasound and for radio frequency butin this case only one active electrode is used without therelative earth departing thus from the effects of ultrasoundand radio frequency We only use the thermal effect of thisprogrammed flow current to selectively increase thetemperature of the tissues without the earth electrode theprogrammed electric currents supplied by the OFF radiatealong the external surface of the treated body This apparatusis totally autonomous from electric mains and this makes ithandy to use and not subject to routine annual servicing

Vol 2 (3) 2015

Pinnacle Medicine amp Medical Sciences ISSN 2360-9516 Page 2

Before After

Source Tsioumas Sotiris MD

Methodology

Mr Chorozidis Ioannis (Dermatologist-Venereologist) tookbiopsy from the brachial region a) we did xylocaine andadrenaline anesthesia around the area that is painted withoutgoing into the dots of which will took biopsies (photo 1) b)

At the bottom of the rectangle (photo 2) we took a sample forbiopsy without applying any of the devices In the middle spotbiopsy was taken immediately after application of NeedleShaping (Vibrance) in which we observe intense hyperemiaAt the top (first spot) biopsy was taken immediately afterapplying Plexr (microspots)

We observe the stitches after five days and the withdrawal ofcrusts (photo 3) After 15 days while the stitches are not cutthe crusts have left (photo 4) At the point which was appliedPlexr we notice a pinkish color In the middle of the same

photo (photo 4) second biopsy was taken after application ofNeedle Shaping because of intense hyperemia in the firstbiopsy We stitched the second scar after taking the biopsy(photo 5)

Photo 1 Photo 2

Source Tsioumas Sotiris MD

How to Cite this Article Tsioumas G Sotiris Vlachodimitropoulos Dimitris amp Goutas Nikolaos Clinical And Histological Presentation After Plexr ApplicationNeedle Shaping (Vibrance) And OFF Pinnacle Medicine amp Medical Sciences ISSN 2360-9516 Vol 2 (3) 2014 Article ID pmms_178 522-530 2015

Pinnacle Medicine amp Medical Sciences ISSN 2360-9516 Page 3

Photo 3 Photo 4 Photo 4

Biopsies were also taken from the abdomen after applying the OFF (lipolysis) Technique of lipolysis was applied (photo 6) andimmediately after doctor took biopsy (photo 7)

Photo 6 Photo 7

Source Tsioumas Sotiris MD

Source Tsioumas Sotiris MD

How to Cite this Article Tsioumas G Sotiris Vlachodimitropoulos Dimitris amp Goutas Nikolaos Clinical And Histological Presentation After Plexr ApplicationNeedle Shaping (Vibrance) And OFF Pinnacle Medicine amp Medical Sciences ISSN 2360-9516 Vol 2 (3) 2014 Article ID pmms_178 522-530 2015

Pinnacle Medicine amp Medical Sciences ISSN 2360-9516 Page 4

Stitching of the scar after taking the biopsy (photo 8)Photo 8

Resumption of lipolysis (OFF) after one week (photo 9)

Photo 9

Source Tsioumas Sotiris MD

Source Tsioumas Sotiris MD

How to Cite this Article Tsioumas G Sotiris Vlachodimitropoulos Dimitris amp Goutas Nikolaos Clinical And Histological Presentation After Plexr ApplicationNeedle Shaping (Vibrance) And OFF Pinnacle Medicine amp Medical Sciences ISSN 2360-9516 Vol 2 (3) 2014 Article ID pmms_178 522-530 2015

Pinnacle Medicine amp Medical Sciences ISSN 2360-9516 Page 5

ResultsFindings

Plexr

Normal skin Elastic fibers stain x200 (photo 10)

Photo 10

It is the area in which the technique of Plexr was applied Inthe left lower part (photo 11) is observed loss of theepidermis but not the basal membrane and increasedpresence of fibrous tissue (acidophilia of the dermis due to

heat which produced protein denaturation) so injury isreversible Respectively in the left upper part skin ismaintained ( x200)

Photo 11

Source Vlachodimitropoulos Dimitrios MD

Source Vlachodimitropoulos Dimitrios MD

How to Cite this Article Tsioumas G Sotiris Vlachodimitropoulos Dimitris amp Goutas Nikolaos Clinical And Histological Presentation After Plexr ApplicationNeedle Shaping (Vibrance) And OFF Pinnacle Medicine amp Medical Sciences ISSN 2360-9516 Vol 2 (3) 2014 Article ID pmms_178 522-530 2015

Pinnacle Medicine amp Medical Sciences ISSN 2360-9516 Page 6

The same area showing fuzzyfication and shrinkage of the elastic fibers x 200 (photo 12)

Needle Shaping (Vibrance)

First picture (photo 13) is by staining of elastic fibers x100the second (photo 14) x200 (enlarged) shows the change of

direction and the vertical integration in comparison with theepidermis Biopsy that we received after 15 days showed usthat the elastic fibers are organized and fatten

Photo 12

Photo 13

Source Vlachodimitropoulos Dimitrios MD

Source Vlachodimitropoulos Dimitrios MD

How to Cite this Article Tsioumas G Sotiris Vlachodimitropoulos Dimitris amp Goutas Nikolaos Clinical And Histological Presentation After Plexr ApplicationNeedle Shaping (Vibrance) And OFF Pinnacle Medicine amp Medical Sciences ISSN 2360-9516 Vol 2 (3) 2014 Article ID pmms_178 522-530 2015

Pinnacle Medicine amp Medical Sciences ISSN 2360-9516 Page 7

Lipolysis (OFF)

Photos 15 16 amp 17 are by staining of elastic fibers x200 (photo15) x100 (photo 16) and x200 (photo 17) from the first andsecond application of lipolysis It is distinguished fuzzyfication

of the cellular membrane and cellular limits which means celldeath by apoptosis because we do not see reactive fibrosis orinflammatory population Therefore the death mechanism islocated within the physiological death

Photo 14

Photo 15

Source Vlachodimitropoulos Dimitrios MD

Source Vlachodimitropoulos Dimitrios MD

How to Cite this Article Tsioumas G Sotiris Vlachodimitropoulos Dimitris amp Goutas Nikolaos Clinical And Histological Presentation After Plexr ApplicationNeedle Shaping (Vibrance) And OFF Pinnacle Medicine amp Medical Sciences ISSN 2360-9516 Vol 2 (3) 2014 Article ID pmms_178 522-530 2015

Photo 16

Photo 16

References

1 M Ceccarelli Invecchiamento generale e cutaneo in medicinaestetica

2 Trattato di medicina estetica Professor Alberto Massironeedizioni Piccin

3 Chang YC Yang SF Tai KW Chou MY Hsieh YS Increased tissueinhibitor of metalloproteinase-1 expression and inhibition ofgelatinase A activity in buccal mucosal fibroblasts by arecolineas possible mechanisms for oral submucous fibrosis

4 Denton CP Abraham DJ Transforming growth factor-beta andconnective tissue growth factor key cytokines in sclerodermapathogenesis

5 Jelaska A Strehlow D Korn JH Fibrotic and normal fibroblastof type I and type III procollagen mRNA in cultured fibroblastsof patients with incisional hernia

6 Leask A Holmes A Abraham DJ Connective tissue growth factora new and important player in the pathogenesis of fibrosis

7 Lesley J Hascall VC Tammi M Hyman R Hyaluronan binding bycell surface CD44

Pinnacle Medicine amp Medical Sciences ISSN 2360-9516 Page 8

Source Vlachodimitropoulos Dimitrios MD

Source Vlachodimitropoulos Dimitrios MD

How to Cite this Article Tsioumas G Sotiris Vlachodimitropoulos Dimitris amp Goutas Nikolaos Clinical And Histological Presentation After Plexr ApplicationNeedle Shaping (Vibrance) And OFF Pinnacle Medicine amp Medical Sciences ISSN 2360-9516 Vol 2 (3) 2014 Article ID pmms_178 522-530 2015

8 Lu Y Luo S Liu J The influence of transforming growth factorbeta 1 (TGF beta 1) on fibroblast proliferation and collagensynthesis

9 Sato M Shegogue D Gore EA Smith EA McDermott PJTrojanowska M Role of p38 MAPK in transforming growthfactor beta stimulation of collagen production by sclerodermaand healthy dermal fibroblasts

10 Si Z Rhanjit B Rosch R Rene PM Klosterhalfen B Klinge UImpaired balance

11 Fisher GJ (2005) ldquoThe Pathophysiology of Photoaging of theSkinrdquo Cutis 75(2S)5-9

12 Fisher GJ Wang ZQ Datta SC et al (1977) Pathophysiologyof premature skin aging induced by ultraviolet light N Engl JMed 337(20) 419-29

13 GJ Wang ZQ Datta SC Varani J Kang S Voorhees JJ(1997) Pathophysiology of premature skin aging induced byultraviolet light N Engl J Med 337(20) 1419-28

14 Hackenbrock CR Chazotte B Gupte SS (1986) The randomcollision model and a critical assessment of diffusion andcollision in mitochondrial electron transport J BioenergBiomembr 18 331-368

15 Chan DC (2006) Mitochondria dynamic organelles in diseaseaging and development Cell 125 1241-1252

16 Lenaz G Baracca A Fato R Genova ML Solaini G (2006) Newinsights into structure and function of mitochondria and theirrole in ageing and disease Antioxid Redox Signal 8 417-437

17 McFarland R Taylor RW Turnbull DM (2007) Mitochondrialdisease--its impact etiology and Pathology Curr Top Dev Biol77 113-155

18 Reeve AK Krishnan KJ Turnbull DM (2008) Age relatedmitochondrial degenerative disorders in humans Biotechnol J3 750-756

19 Zeviani M Carelli V (2007) Mitochondrial disorders Curr OpinNeurol 20 564-571

20 Hirobe S Azukizawa H Matsuo K Zhai Y Quan YS Kamiyama FSuzuki H Katayama I Okada N Nakagawa S (2013)Development and clinical study of a self- dissolving microneedlepatch for transcutaneous immunization devicePharm Res30(10)2664-74 doi 101007s11095-013-1092-6 Epub

21 Huang X Cheng H Chen K Zhang Y Zhang Y Liu Y Zhu C OuyangSC Kong GW Yu C Huang Y Rogers J A (2013) Epidermalimpedance sensing sheets for precision hydration assessmentand spatial mappingIEEE Trans Biomed Eng 60(10)2848-57doi 101109TBME20132264879 Epub

22 Birgersson U Birgersson E Nicander I Ollmar S (2013) Amethodology for extracting the electrical properties of humanskinPhysiol Meas34(6)723-36 doi 1010880967-3334346723 Epub

23 Birgersson U Birgersson E Nicander I Ollmar S Szeleacutenyi AJourneacutee HL Herrlich S Galistu GM van den Berg J van Dijk JM(2012) Experimental study of the course of threshold currentvoltage and electrode impedance during stepwise stimulationfrom the skin surface to the human cortexBrainStimul6(4)482-9 doi 101016jbrs201210002 Epub

24 wwwfippinet

25 wwwfelcit

26 wwwchirurgianonablativait27 wwwofthalmoplastikigr

Pinnacle Medicine amp Medical Sciences ISSN 2360-9516 Page 9

How to Cite this Article Tsioumas G Sotiris Vlachodimitropoulos Dimitris amp Goutas Nikolaos Clinical And Histological Presentation After Plexr ApplicationNeedle Shaping (Vibrance) And OFF Pinnacle Medicine amp Medical Sciences ISSN 2360-9516 Vol 2 (3) 2014 Article ID pmms_178 522-530 2015

Pinnacle Medicine amp Medical Sciences ISSN 2360-9516 Page 3

Photo 3 Photo 4 Photo 4

Biopsies were also taken from the abdomen after applying the OFF (lipolysis) Technique of lipolysis was applied (photo 6) andimmediately after doctor took biopsy (photo 7)

Photo 6 Photo 7

Source Tsioumas Sotiris MD

Source Tsioumas Sotiris MD

How to Cite this Article Tsioumas G Sotiris Vlachodimitropoulos Dimitris amp Goutas Nikolaos Clinical And Histological Presentation After Plexr ApplicationNeedle Shaping (Vibrance) And OFF Pinnacle Medicine amp Medical Sciences ISSN 2360-9516 Vol 2 (3) 2014 Article ID pmms_178 522-530 2015

Pinnacle Medicine amp Medical Sciences ISSN 2360-9516 Page 4

Stitching of the scar after taking the biopsy (photo 8)Photo 8

Resumption of lipolysis (OFF) after one week (photo 9)

Photo 9

Source Tsioumas Sotiris MD

Source Tsioumas Sotiris MD

How to Cite this Article Tsioumas G Sotiris Vlachodimitropoulos Dimitris amp Goutas Nikolaos Clinical And Histological Presentation After Plexr ApplicationNeedle Shaping (Vibrance) And OFF Pinnacle Medicine amp Medical Sciences ISSN 2360-9516 Vol 2 (3) 2014 Article ID pmms_178 522-530 2015

Pinnacle Medicine amp Medical Sciences ISSN 2360-9516 Page 5

ResultsFindings

Plexr

Normal skin Elastic fibers stain x200 (photo 10)

Photo 10

It is the area in which the technique of Plexr was applied Inthe left lower part (photo 11) is observed loss of theepidermis but not the basal membrane and increasedpresence of fibrous tissue (acidophilia of the dermis due to

heat which produced protein denaturation) so injury isreversible Respectively in the left upper part skin ismaintained ( x200)

Photo 11

Source Vlachodimitropoulos Dimitrios MD

Source Vlachodimitropoulos Dimitrios MD

How to Cite this Article Tsioumas G Sotiris Vlachodimitropoulos Dimitris amp Goutas Nikolaos Clinical And Histological Presentation After Plexr ApplicationNeedle Shaping (Vibrance) And OFF Pinnacle Medicine amp Medical Sciences ISSN 2360-9516 Vol 2 (3) 2014 Article ID pmms_178 522-530 2015

Pinnacle Medicine amp Medical Sciences ISSN 2360-9516 Page 6

The same area showing fuzzyfication and shrinkage of the elastic fibers x 200 (photo 12)

Needle Shaping (Vibrance)

First picture (photo 13) is by staining of elastic fibers x100the second (photo 14) x200 (enlarged) shows the change of

direction and the vertical integration in comparison with theepidermis Biopsy that we received after 15 days showed usthat the elastic fibers are organized and fatten

Photo 12

Photo 13

Source Vlachodimitropoulos Dimitrios MD

Source Vlachodimitropoulos Dimitrios MD

How to Cite this Article Tsioumas G Sotiris Vlachodimitropoulos Dimitris amp Goutas Nikolaos Clinical And Histological Presentation After Plexr ApplicationNeedle Shaping (Vibrance) And OFF Pinnacle Medicine amp Medical Sciences ISSN 2360-9516 Vol 2 (3) 2014 Article ID pmms_178 522-530 2015

Pinnacle Medicine amp Medical Sciences ISSN 2360-9516 Page 7

Lipolysis (OFF)

Photos 15 16 amp 17 are by staining of elastic fibers x200 (photo15) x100 (photo 16) and x200 (photo 17) from the first andsecond application of lipolysis It is distinguished fuzzyfication

of the cellular membrane and cellular limits which means celldeath by apoptosis because we do not see reactive fibrosis orinflammatory population Therefore the death mechanism islocated within the physiological death

Photo 14

Photo 15

Source Vlachodimitropoulos Dimitrios MD

Source Vlachodimitropoulos Dimitrios MD

How to Cite this Article Tsioumas G Sotiris Vlachodimitropoulos Dimitris amp Goutas Nikolaos Clinical And Histological Presentation After Plexr ApplicationNeedle Shaping (Vibrance) And OFF Pinnacle Medicine amp Medical Sciences ISSN 2360-9516 Vol 2 (3) 2014 Article ID pmms_178 522-530 2015

Photo 16

Photo 16

References

1 M Ceccarelli Invecchiamento generale e cutaneo in medicinaestetica

2 Trattato di medicina estetica Professor Alberto Massironeedizioni Piccin

3 Chang YC Yang SF Tai KW Chou MY Hsieh YS Increased tissueinhibitor of metalloproteinase-1 expression and inhibition ofgelatinase A activity in buccal mucosal fibroblasts by arecolineas possible mechanisms for oral submucous fibrosis

4 Denton CP Abraham DJ Transforming growth factor-beta andconnective tissue growth factor key cytokines in sclerodermapathogenesis

5 Jelaska A Strehlow D Korn JH Fibrotic and normal fibroblastof type I and type III procollagen mRNA in cultured fibroblastsof patients with incisional hernia

6 Leask A Holmes A Abraham DJ Connective tissue growth factora new and important player in the pathogenesis of fibrosis

7 Lesley J Hascall VC Tammi M Hyman R Hyaluronan binding bycell surface CD44

Pinnacle Medicine amp Medical Sciences ISSN 2360-9516 Page 8

Source Vlachodimitropoulos Dimitrios MD

Source Vlachodimitropoulos Dimitrios MD

How to Cite this Article Tsioumas G Sotiris Vlachodimitropoulos Dimitris amp Goutas Nikolaos Clinical And Histological Presentation After Plexr ApplicationNeedle Shaping (Vibrance) And OFF Pinnacle Medicine amp Medical Sciences ISSN 2360-9516 Vol 2 (3) 2014 Article ID pmms_178 522-530 2015

8 Lu Y Luo S Liu J The influence of transforming growth factorbeta 1 (TGF beta 1) on fibroblast proliferation and collagensynthesis

9 Sato M Shegogue D Gore EA Smith EA McDermott PJTrojanowska M Role of p38 MAPK in transforming growthfactor beta stimulation of collagen production by sclerodermaand healthy dermal fibroblasts

10 Si Z Rhanjit B Rosch R Rene PM Klosterhalfen B Klinge UImpaired balance

11 Fisher GJ (2005) ldquoThe Pathophysiology of Photoaging of theSkinrdquo Cutis 75(2S)5-9

12 Fisher GJ Wang ZQ Datta SC et al (1977) Pathophysiologyof premature skin aging induced by ultraviolet light N Engl JMed 337(20) 419-29

13 GJ Wang ZQ Datta SC Varani J Kang S Voorhees JJ(1997) Pathophysiology of premature skin aging induced byultraviolet light N Engl J Med 337(20) 1419-28

14 Hackenbrock CR Chazotte B Gupte SS (1986) The randomcollision model and a critical assessment of diffusion andcollision in mitochondrial electron transport J BioenergBiomembr 18 331-368

15 Chan DC (2006) Mitochondria dynamic organelles in diseaseaging and development Cell 125 1241-1252

16 Lenaz G Baracca A Fato R Genova ML Solaini G (2006) Newinsights into structure and function of mitochondria and theirrole in ageing and disease Antioxid Redox Signal 8 417-437

17 McFarland R Taylor RW Turnbull DM (2007) Mitochondrialdisease--its impact etiology and Pathology Curr Top Dev Biol77 113-155

18 Reeve AK Krishnan KJ Turnbull DM (2008) Age relatedmitochondrial degenerative disorders in humans Biotechnol J3 750-756

19 Zeviani M Carelli V (2007) Mitochondrial disorders Curr OpinNeurol 20 564-571

20 Hirobe S Azukizawa H Matsuo K Zhai Y Quan YS Kamiyama FSuzuki H Katayama I Okada N Nakagawa S (2013)Development and clinical study of a self- dissolving microneedlepatch for transcutaneous immunization devicePharm Res30(10)2664-74 doi 101007s11095-013-1092-6 Epub

21 Huang X Cheng H Chen K Zhang Y Zhang Y Liu Y Zhu C OuyangSC Kong GW Yu C Huang Y Rogers J A (2013) Epidermalimpedance sensing sheets for precision hydration assessmentand spatial mappingIEEE Trans Biomed Eng 60(10)2848-57doi 101109TBME20132264879 Epub

22 Birgersson U Birgersson E Nicander I Ollmar S (2013) Amethodology for extracting the electrical properties of humanskinPhysiol Meas34(6)723-36 doi 1010880967-3334346723 Epub

23 Birgersson U Birgersson E Nicander I Ollmar S Szeleacutenyi AJourneacutee HL Herrlich S Galistu GM van den Berg J van Dijk JM(2012) Experimental study of the course of threshold currentvoltage and electrode impedance during stepwise stimulationfrom the skin surface to the human cortexBrainStimul6(4)482-9 doi 101016jbrs201210002 Epub

24 wwwfippinet

25 wwwfelcit

26 wwwchirurgianonablativait27 wwwofthalmoplastikigr

Pinnacle Medicine amp Medical Sciences ISSN 2360-9516 Page 9

How to Cite this Article Tsioumas G Sotiris Vlachodimitropoulos Dimitris amp Goutas Nikolaos Clinical And Histological Presentation After Plexr ApplicationNeedle Shaping (Vibrance) And OFF Pinnacle Medicine amp Medical Sciences ISSN 2360-9516 Vol 2 (3) 2014 Article ID pmms_178 522-530 2015

Pinnacle Medicine amp Medical Sciences ISSN 2360-9516 Page 4

Stitching of the scar after taking the biopsy (photo 8)Photo 8

Resumption of lipolysis (OFF) after one week (photo 9)

Photo 9

Source Tsioumas Sotiris MD

Source Tsioumas Sotiris MD

How to Cite this Article Tsioumas G Sotiris Vlachodimitropoulos Dimitris amp Goutas Nikolaos Clinical And Histological Presentation After Plexr ApplicationNeedle Shaping (Vibrance) And OFF Pinnacle Medicine amp Medical Sciences ISSN 2360-9516 Vol 2 (3) 2014 Article ID pmms_178 522-530 2015

Pinnacle Medicine amp Medical Sciences ISSN 2360-9516 Page 5

ResultsFindings

Plexr

Normal skin Elastic fibers stain x200 (photo 10)

Photo 10

It is the area in which the technique of Plexr was applied Inthe left lower part (photo 11) is observed loss of theepidermis but not the basal membrane and increasedpresence of fibrous tissue (acidophilia of the dermis due to

heat which produced protein denaturation) so injury isreversible Respectively in the left upper part skin ismaintained ( x200)

Photo 11

Source Vlachodimitropoulos Dimitrios MD

Source Vlachodimitropoulos Dimitrios MD

How to Cite this Article Tsioumas G Sotiris Vlachodimitropoulos Dimitris amp Goutas Nikolaos Clinical And Histological Presentation After Plexr ApplicationNeedle Shaping (Vibrance) And OFF Pinnacle Medicine amp Medical Sciences ISSN 2360-9516 Vol 2 (3) 2014 Article ID pmms_178 522-530 2015

Pinnacle Medicine amp Medical Sciences ISSN 2360-9516 Page 6

The same area showing fuzzyfication and shrinkage of the elastic fibers x 200 (photo 12)

Needle Shaping (Vibrance)

First picture (photo 13) is by staining of elastic fibers x100the second (photo 14) x200 (enlarged) shows the change of

direction and the vertical integration in comparison with theepidermis Biopsy that we received after 15 days showed usthat the elastic fibers are organized and fatten

Photo 12

Photo 13

Source Vlachodimitropoulos Dimitrios MD

Source Vlachodimitropoulos Dimitrios MD

How to Cite this Article Tsioumas G Sotiris Vlachodimitropoulos Dimitris amp Goutas Nikolaos Clinical And Histological Presentation After Plexr ApplicationNeedle Shaping (Vibrance) And OFF Pinnacle Medicine amp Medical Sciences ISSN 2360-9516 Vol 2 (3) 2014 Article ID pmms_178 522-530 2015

Pinnacle Medicine amp Medical Sciences ISSN 2360-9516 Page 7

Lipolysis (OFF)

Photos 15 16 amp 17 are by staining of elastic fibers x200 (photo15) x100 (photo 16) and x200 (photo 17) from the first andsecond application of lipolysis It is distinguished fuzzyfication

of the cellular membrane and cellular limits which means celldeath by apoptosis because we do not see reactive fibrosis orinflammatory population Therefore the death mechanism islocated within the physiological death

Photo 14

Photo 15

Source Vlachodimitropoulos Dimitrios MD

Source Vlachodimitropoulos Dimitrios MD

How to Cite this Article Tsioumas G Sotiris Vlachodimitropoulos Dimitris amp Goutas Nikolaos Clinical And Histological Presentation After Plexr ApplicationNeedle Shaping (Vibrance) And OFF Pinnacle Medicine amp Medical Sciences ISSN 2360-9516 Vol 2 (3) 2014 Article ID pmms_178 522-530 2015

Photo 16

Photo 16

References

1 M Ceccarelli Invecchiamento generale e cutaneo in medicinaestetica

2 Trattato di medicina estetica Professor Alberto Massironeedizioni Piccin

3 Chang YC Yang SF Tai KW Chou MY Hsieh YS Increased tissueinhibitor of metalloproteinase-1 expression and inhibition ofgelatinase A activity in buccal mucosal fibroblasts by arecolineas possible mechanisms for oral submucous fibrosis

4 Denton CP Abraham DJ Transforming growth factor-beta andconnective tissue growth factor key cytokines in sclerodermapathogenesis

5 Jelaska A Strehlow D Korn JH Fibrotic and normal fibroblastof type I and type III procollagen mRNA in cultured fibroblastsof patients with incisional hernia

6 Leask A Holmes A Abraham DJ Connective tissue growth factora new and important player in the pathogenesis of fibrosis

7 Lesley J Hascall VC Tammi M Hyman R Hyaluronan binding bycell surface CD44

Pinnacle Medicine amp Medical Sciences ISSN 2360-9516 Page 8

Source Vlachodimitropoulos Dimitrios MD

Source Vlachodimitropoulos Dimitrios MD

How to Cite this Article Tsioumas G Sotiris Vlachodimitropoulos Dimitris amp Goutas Nikolaos Clinical And Histological Presentation After Plexr ApplicationNeedle Shaping (Vibrance) And OFF Pinnacle Medicine amp Medical Sciences ISSN 2360-9516 Vol 2 (3) 2014 Article ID pmms_178 522-530 2015

8 Lu Y Luo S Liu J The influence of transforming growth factorbeta 1 (TGF beta 1) on fibroblast proliferation and collagensynthesis

9 Sato M Shegogue D Gore EA Smith EA McDermott PJTrojanowska M Role of p38 MAPK in transforming growthfactor beta stimulation of collagen production by sclerodermaand healthy dermal fibroblasts

10 Si Z Rhanjit B Rosch R Rene PM Klosterhalfen B Klinge UImpaired balance

11 Fisher GJ (2005) ldquoThe Pathophysiology of Photoaging of theSkinrdquo Cutis 75(2S)5-9

12 Fisher GJ Wang ZQ Datta SC et al (1977) Pathophysiologyof premature skin aging induced by ultraviolet light N Engl JMed 337(20) 419-29

13 GJ Wang ZQ Datta SC Varani J Kang S Voorhees JJ(1997) Pathophysiology of premature skin aging induced byultraviolet light N Engl J Med 337(20) 1419-28

14 Hackenbrock CR Chazotte B Gupte SS (1986) The randomcollision model and a critical assessment of diffusion andcollision in mitochondrial electron transport J BioenergBiomembr 18 331-368

15 Chan DC (2006) Mitochondria dynamic organelles in diseaseaging and development Cell 125 1241-1252

16 Lenaz G Baracca A Fato R Genova ML Solaini G (2006) Newinsights into structure and function of mitochondria and theirrole in ageing and disease Antioxid Redox Signal 8 417-437

17 McFarland R Taylor RW Turnbull DM (2007) Mitochondrialdisease--its impact etiology and Pathology Curr Top Dev Biol77 113-155

18 Reeve AK Krishnan KJ Turnbull DM (2008) Age relatedmitochondrial degenerative disorders in humans Biotechnol J3 750-756

19 Zeviani M Carelli V (2007) Mitochondrial disorders Curr OpinNeurol 20 564-571

20 Hirobe S Azukizawa H Matsuo K Zhai Y Quan YS Kamiyama FSuzuki H Katayama I Okada N Nakagawa S (2013)Development and clinical study of a self- dissolving microneedlepatch for transcutaneous immunization devicePharm Res30(10)2664-74 doi 101007s11095-013-1092-6 Epub

21 Huang X Cheng H Chen K Zhang Y Zhang Y Liu Y Zhu C OuyangSC Kong GW Yu C Huang Y Rogers J A (2013) Epidermalimpedance sensing sheets for precision hydration assessmentand spatial mappingIEEE Trans Biomed Eng 60(10)2848-57doi 101109TBME20132264879 Epub

22 Birgersson U Birgersson E Nicander I Ollmar S (2013) Amethodology for extracting the electrical properties of humanskinPhysiol Meas34(6)723-36 doi 1010880967-3334346723 Epub

23 Birgersson U Birgersson E Nicander I Ollmar S Szeleacutenyi AJourneacutee HL Herrlich S Galistu GM van den Berg J van Dijk JM(2012) Experimental study of the course of threshold currentvoltage and electrode impedance during stepwise stimulationfrom the skin surface to the human cortexBrainStimul6(4)482-9 doi 101016jbrs201210002 Epub

24 wwwfippinet

25 wwwfelcit

26 wwwchirurgianonablativait27 wwwofthalmoplastikigr

Pinnacle Medicine amp Medical Sciences ISSN 2360-9516 Page 9

How to Cite this Article Tsioumas G Sotiris Vlachodimitropoulos Dimitris amp Goutas Nikolaos Clinical And Histological Presentation After Plexr ApplicationNeedle Shaping (Vibrance) And OFF Pinnacle Medicine amp Medical Sciences ISSN 2360-9516 Vol 2 (3) 2014 Article ID pmms_178 522-530 2015

Pinnacle Medicine amp Medical Sciences ISSN 2360-9516 Page 5

ResultsFindings

Plexr

Normal skin Elastic fibers stain x200 (photo 10)

Photo 10

It is the area in which the technique of Plexr was applied Inthe left lower part (photo 11) is observed loss of theepidermis but not the basal membrane and increasedpresence of fibrous tissue (acidophilia of the dermis due to

heat which produced protein denaturation) so injury isreversible Respectively in the left upper part skin ismaintained ( x200)

Photo 11

Source Vlachodimitropoulos Dimitrios MD

Source Vlachodimitropoulos Dimitrios MD

How to Cite this Article Tsioumas G Sotiris Vlachodimitropoulos Dimitris amp Goutas Nikolaos Clinical And Histological Presentation After Plexr ApplicationNeedle Shaping (Vibrance) And OFF Pinnacle Medicine amp Medical Sciences ISSN 2360-9516 Vol 2 (3) 2014 Article ID pmms_178 522-530 2015

Pinnacle Medicine amp Medical Sciences ISSN 2360-9516 Page 6

The same area showing fuzzyfication and shrinkage of the elastic fibers x 200 (photo 12)

Needle Shaping (Vibrance)

First picture (photo 13) is by staining of elastic fibers x100the second (photo 14) x200 (enlarged) shows the change of

direction and the vertical integration in comparison with theepidermis Biopsy that we received after 15 days showed usthat the elastic fibers are organized and fatten

Photo 12

Photo 13

Source Vlachodimitropoulos Dimitrios MD

Source Vlachodimitropoulos Dimitrios MD

How to Cite this Article Tsioumas G Sotiris Vlachodimitropoulos Dimitris amp Goutas Nikolaos Clinical And Histological Presentation After Plexr ApplicationNeedle Shaping (Vibrance) And OFF Pinnacle Medicine amp Medical Sciences ISSN 2360-9516 Vol 2 (3) 2014 Article ID pmms_178 522-530 2015

Pinnacle Medicine amp Medical Sciences ISSN 2360-9516 Page 7

Lipolysis (OFF)

Photos 15 16 amp 17 are by staining of elastic fibers x200 (photo15) x100 (photo 16) and x200 (photo 17) from the first andsecond application of lipolysis It is distinguished fuzzyfication

of the cellular membrane and cellular limits which means celldeath by apoptosis because we do not see reactive fibrosis orinflammatory population Therefore the death mechanism islocated within the physiological death

Photo 14

Photo 15

Source Vlachodimitropoulos Dimitrios MD

Source Vlachodimitropoulos Dimitrios MD

How to Cite this Article Tsioumas G Sotiris Vlachodimitropoulos Dimitris amp Goutas Nikolaos Clinical And Histological Presentation After Plexr ApplicationNeedle Shaping (Vibrance) And OFF Pinnacle Medicine amp Medical Sciences ISSN 2360-9516 Vol 2 (3) 2014 Article ID pmms_178 522-530 2015

Photo 16

Photo 16

References

1 M Ceccarelli Invecchiamento generale e cutaneo in medicinaestetica

2 Trattato di medicina estetica Professor Alberto Massironeedizioni Piccin

3 Chang YC Yang SF Tai KW Chou MY Hsieh YS Increased tissueinhibitor of metalloproteinase-1 expression and inhibition ofgelatinase A activity in buccal mucosal fibroblasts by arecolineas possible mechanisms for oral submucous fibrosis

4 Denton CP Abraham DJ Transforming growth factor-beta andconnective tissue growth factor key cytokines in sclerodermapathogenesis

5 Jelaska A Strehlow D Korn JH Fibrotic and normal fibroblastof type I and type III procollagen mRNA in cultured fibroblastsof patients with incisional hernia

6 Leask A Holmes A Abraham DJ Connective tissue growth factora new and important player in the pathogenesis of fibrosis

7 Lesley J Hascall VC Tammi M Hyman R Hyaluronan binding bycell surface CD44

Pinnacle Medicine amp Medical Sciences ISSN 2360-9516 Page 8

Source Vlachodimitropoulos Dimitrios MD

Source Vlachodimitropoulos Dimitrios MD

How to Cite this Article Tsioumas G Sotiris Vlachodimitropoulos Dimitris amp Goutas Nikolaos Clinical And Histological Presentation After Plexr ApplicationNeedle Shaping (Vibrance) And OFF Pinnacle Medicine amp Medical Sciences ISSN 2360-9516 Vol 2 (3) 2014 Article ID pmms_178 522-530 2015

8 Lu Y Luo S Liu J The influence of transforming growth factorbeta 1 (TGF beta 1) on fibroblast proliferation and collagensynthesis

9 Sato M Shegogue D Gore EA Smith EA McDermott PJTrojanowska M Role of p38 MAPK in transforming growthfactor beta stimulation of collagen production by sclerodermaand healthy dermal fibroblasts

10 Si Z Rhanjit B Rosch R Rene PM Klosterhalfen B Klinge UImpaired balance

11 Fisher GJ (2005) ldquoThe Pathophysiology of Photoaging of theSkinrdquo Cutis 75(2S)5-9

12 Fisher GJ Wang ZQ Datta SC et al (1977) Pathophysiologyof premature skin aging induced by ultraviolet light N Engl JMed 337(20) 419-29

13 GJ Wang ZQ Datta SC Varani J Kang S Voorhees JJ(1997) Pathophysiology of premature skin aging induced byultraviolet light N Engl J Med 337(20) 1419-28

14 Hackenbrock CR Chazotte B Gupte SS (1986) The randomcollision model and a critical assessment of diffusion andcollision in mitochondrial electron transport J BioenergBiomembr 18 331-368

15 Chan DC (2006) Mitochondria dynamic organelles in diseaseaging and development Cell 125 1241-1252

16 Lenaz G Baracca A Fato R Genova ML Solaini G (2006) Newinsights into structure and function of mitochondria and theirrole in ageing and disease Antioxid Redox Signal 8 417-437

17 McFarland R Taylor RW Turnbull DM (2007) Mitochondrialdisease--its impact etiology and Pathology Curr Top Dev Biol77 113-155

18 Reeve AK Krishnan KJ Turnbull DM (2008) Age relatedmitochondrial degenerative disorders in humans Biotechnol J3 750-756

19 Zeviani M Carelli V (2007) Mitochondrial disorders Curr OpinNeurol 20 564-571

20 Hirobe S Azukizawa H Matsuo K Zhai Y Quan YS Kamiyama FSuzuki H Katayama I Okada N Nakagawa S (2013)Development and clinical study of a self- dissolving microneedlepatch for transcutaneous immunization devicePharm Res30(10)2664-74 doi 101007s11095-013-1092-6 Epub

21 Huang X Cheng H Chen K Zhang Y Zhang Y Liu Y Zhu C OuyangSC Kong GW Yu C Huang Y Rogers J A (2013) Epidermalimpedance sensing sheets for precision hydration assessmentand spatial mappingIEEE Trans Biomed Eng 60(10)2848-57doi 101109TBME20132264879 Epub

22 Birgersson U Birgersson E Nicander I Ollmar S (2013) Amethodology for extracting the electrical properties of humanskinPhysiol Meas34(6)723-36 doi 1010880967-3334346723 Epub

23 Birgersson U Birgersson E Nicander I Ollmar S Szeleacutenyi AJourneacutee HL Herrlich S Galistu GM van den Berg J van Dijk JM(2012) Experimental study of the course of threshold currentvoltage and electrode impedance during stepwise stimulationfrom the skin surface to the human cortexBrainStimul6(4)482-9 doi 101016jbrs201210002 Epub

24 wwwfippinet

25 wwwfelcit

26 wwwchirurgianonablativait27 wwwofthalmoplastikigr

Pinnacle Medicine amp Medical Sciences ISSN 2360-9516 Page 9

How to Cite this Article Tsioumas G Sotiris Vlachodimitropoulos Dimitris amp Goutas Nikolaos Clinical And Histological Presentation After Plexr ApplicationNeedle Shaping (Vibrance) And OFF Pinnacle Medicine amp Medical Sciences ISSN 2360-9516 Vol 2 (3) 2014 Article ID pmms_178 522-530 2015

Pinnacle Medicine amp Medical Sciences ISSN 2360-9516 Page 6

The same area showing fuzzyfication and shrinkage of the elastic fibers x 200 (photo 12)

Needle Shaping (Vibrance)

First picture (photo 13) is by staining of elastic fibers x100the second (photo 14) x200 (enlarged) shows the change of

direction and the vertical integration in comparison with theepidermis Biopsy that we received after 15 days showed usthat the elastic fibers are organized and fatten

Photo 12

Photo 13

Source Vlachodimitropoulos Dimitrios MD

Source Vlachodimitropoulos Dimitrios MD

How to Cite this Article Tsioumas G Sotiris Vlachodimitropoulos Dimitris amp Goutas Nikolaos Clinical And Histological Presentation After Plexr ApplicationNeedle Shaping (Vibrance) And OFF Pinnacle Medicine amp Medical Sciences ISSN 2360-9516 Vol 2 (3) 2014 Article ID pmms_178 522-530 2015

Pinnacle Medicine amp Medical Sciences ISSN 2360-9516 Page 7

Lipolysis (OFF)

Photos 15 16 amp 17 are by staining of elastic fibers x200 (photo15) x100 (photo 16) and x200 (photo 17) from the first andsecond application of lipolysis It is distinguished fuzzyfication

of the cellular membrane and cellular limits which means celldeath by apoptosis because we do not see reactive fibrosis orinflammatory population Therefore the death mechanism islocated within the physiological death

Photo 14

Photo 15

Source Vlachodimitropoulos Dimitrios MD

Source Vlachodimitropoulos Dimitrios MD

How to Cite this Article Tsioumas G Sotiris Vlachodimitropoulos Dimitris amp Goutas Nikolaos Clinical And Histological Presentation After Plexr ApplicationNeedle Shaping (Vibrance) And OFF Pinnacle Medicine amp Medical Sciences ISSN 2360-9516 Vol 2 (3) 2014 Article ID pmms_178 522-530 2015

Photo 16

Photo 16

References

1 M Ceccarelli Invecchiamento generale e cutaneo in medicinaestetica

2 Trattato di medicina estetica Professor Alberto Massironeedizioni Piccin

3 Chang YC Yang SF Tai KW Chou MY Hsieh YS Increased tissueinhibitor of metalloproteinase-1 expression and inhibition ofgelatinase A activity in buccal mucosal fibroblasts by arecolineas possible mechanisms for oral submucous fibrosis

4 Denton CP Abraham DJ Transforming growth factor-beta andconnective tissue growth factor key cytokines in sclerodermapathogenesis

5 Jelaska A Strehlow D Korn JH Fibrotic and normal fibroblastof type I and type III procollagen mRNA in cultured fibroblastsof patients with incisional hernia

6 Leask A Holmes A Abraham DJ Connective tissue growth factora new and important player in the pathogenesis of fibrosis

7 Lesley J Hascall VC Tammi M Hyman R Hyaluronan binding bycell surface CD44

Pinnacle Medicine amp Medical Sciences ISSN 2360-9516 Page 8

Source Vlachodimitropoulos Dimitrios MD

Source Vlachodimitropoulos Dimitrios MD

How to Cite this Article Tsioumas G Sotiris Vlachodimitropoulos Dimitris amp Goutas Nikolaos Clinical And Histological Presentation After Plexr ApplicationNeedle Shaping (Vibrance) And OFF Pinnacle Medicine amp Medical Sciences ISSN 2360-9516 Vol 2 (3) 2014 Article ID pmms_178 522-530 2015

8 Lu Y Luo S Liu J The influence of transforming growth factorbeta 1 (TGF beta 1) on fibroblast proliferation and collagensynthesis

9 Sato M Shegogue D Gore EA Smith EA McDermott PJTrojanowska M Role of p38 MAPK in transforming growthfactor beta stimulation of collagen production by sclerodermaand healthy dermal fibroblasts

10 Si Z Rhanjit B Rosch R Rene PM Klosterhalfen B Klinge UImpaired balance

11 Fisher GJ (2005) ldquoThe Pathophysiology of Photoaging of theSkinrdquo Cutis 75(2S)5-9

12 Fisher GJ Wang ZQ Datta SC et al (1977) Pathophysiologyof premature skin aging induced by ultraviolet light N Engl JMed 337(20) 419-29

13 GJ Wang ZQ Datta SC Varani J Kang S Voorhees JJ(1997) Pathophysiology of premature skin aging induced byultraviolet light N Engl J Med 337(20) 1419-28

14 Hackenbrock CR Chazotte B Gupte SS (1986) The randomcollision model and a critical assessment of diffusion andcollision in mitochondrial electron transport J BioenergBiomembr 18 331-368

15 Chan DC (2006) Mitochondria dynamic organelles in diseaseaging and development Cell 125 1241-1252

16 Lenaz G Baracca A Fato R Genova ML Solaini G (2006) Newinsights into structure and function of mitochondria and theirrole in ageing and disease Antioxid Redox Signal 8 417-437

17 McFarland R Taylor RW Turnbull DM (2007) Mitochondrialdisease--its impact etiology and Pathology Curr Top Dev Biol77 113-155

18 Reeve AK Krishnan KJ Turnbull DM (2008) Age relatedmitochondrial degenerative disorders in humans Biotechnol J3 750-756

19 Zeviani M Carelli V (2007) Mitochondrial disorders Curr OpinNeurol 20 564-571

20 Hirobe S Azukizawa H Matsuo K Zhai Y Quan YS Kamiyama FSuzuki H Katayama I Okada N Nakagawa S (2013)Development and clinical study of a self- dissolving microneedlepatch for transcutaneous immunization devicePharm Res30(10)2664-74 doi 101007s11095-013-1092-6 Epub

21 Huang X Cheng H Chen K Zhang Y Zhang Y Liu Y Zhu C OuyangSC Kong GW Yu C Huang Y Rogers J A (2013) Epidermalimpedance sensing sheets for precision hydration assessmentand spatial mappingIEEE Trans Biomed Eng 60(10)2848-57doi 101109TBME20132264879 Epub

22 Birgersson U Birgersson E Nicander I Ollmar S (2013) Amethodology for extracting the electrical properties of humanskinPhysiol Meas34(6)723-36 doi 1010880967-3334346723 Epub

23 Birgersson U Birgersson E Nicander I Ollmar S Szeleacutenyi AJourneacutee HL Herrlich S Galistu GM van den Berg J van Dijk JM(2012) Experimental study of the course of threshold currentvoltage and electrode impedance during stepwise stimulationfrom the skin surface to the human cortexBrainStimul6(4)482-9 doi 101016jbrs201210002 Epub

24 wwwfippinet

25 wwwfelcit

26 wwwchirurgianonablativait27 wwwofthalmoplastikigr

Pinnacle Medicine amp Medical Sciences ISSN 2360-9516 Page 9

How to Cite this Article Tsioumas G Sotiris Vlachodimitropoulos Dimitris amp Goutas Nikolaos Clinical And Histological Presentation After Plexr ApplicationNeedle Shaping (Vibrance) And OFF Pinnacle Medicine amp Medical Sciences ISSN 2360-9516 Vol 2 (3) 2014 Article ID pmms_178 522-530 2015

Pinnacle Medicine amp Medical Sciences ISSN 2360-9516 Page 7

Lipolysis (OFF)

Photos 15 16 amp 17 are by staining of elastic fibers x200 (photo15) x100 (photo 16) and x200 (photo 17) from the first andsecond application of lipolysis It is distinguished fuzzyfication

of the cellular membrane and cellular limits which means celldeath by apoptosis because we do not see reactive fibrosis orinflammatory population Therefore the death mechanism islocated within the physiological death

Photo 14

Photo 15

Source Vlachodimitropoulos Dimitrios MD

Source Vlachodimitropoulos Dimitrios MD

How to Cite this Article Tsioumas G Sotiris Vlachodimitropoulos Dimitris amp Goutas Nikolaos Clinical And Histological Presentation After Plexr ApplicationNeedle Shaping (Vibrance) And OFF Pinnacle Medicine amp Medical Sciences ISSN 2360-9516 Vol 2 (3) 2014 Article ID pmms_178 522-530 2015

Photo 16

Photo 16

References

1 M Ceccarelli Invecchiamento generale e cutaneo in medicinaestetica

2 Trattato di medicina estetica Professor Alberto Massironeedizioni Piccin

3 Chang YC Yang SF Tai KW Chou MY Hsieh YS Increased tissueinhibitor of metalloproteinase-1 expression and inhibition ofgelatinase A activity in buccal mucosal fibroblasts by arecolineas possible mechanisms for oral submucous fibrosis

4 Denton CP Abraham DJ Transforming growth factor-beta andconnective tissue growth factor key cytokines in sclerodermapathogenesis

5 Jelaska A Strehlow D Korn JH Fibrotic and normal fibroblastof type I and type III procollagen mRNA in cultured fibroblastsof patients with incisional hernia

6 Leask A Holmes A Abraham DJ Connective tissue growth factora new and important player in the pathogenesis of fibrosis

7 Lesley J Hascall VC Tammi M Hyman R Hyaluronan binding bycell surface CD44

Pinnacle Medicine amp Medical Sciences ISSN 2360-9516 Page 8

Source Vlachodimitropoulos Dimitrios MD

Source Vlachodimitropoulos Dimitrios MD

How to Cite this Article Tsioumas G Sotiris Vlachodimitropoulos Dimitris amp Goutas Nikolaos Clinical And Histological Presentation After Plexr ApplicationNeedle Shaping (Vibrance) And OFF Pinnacle Medicine amp Medical Sciences ISSN 2360-9516 Vol 2 (3) 2014 Article ID pmms_178 522-530 2015

8 Lu Y Luo S Liu J The influence of transforming growth factorbeta 1 (TGF beta 1) on fibroblast proliferation and collagensynthesis

9 Sato M Shegogue D Gore EA Smith EA McDermott PJTrojanowska M Role of p38 MAPK in transforming growthfactor beta stimulation of collagen production by sclerodermaand healthy dermal fibroblasts

10 Si Z Rhanjit B Rosch R Rene PM Klosterhalfen B Klinge UImpaired balance

11 Fisher GJ (2005) ldquoThe Pathophysiology of Photoaging of theSkinrdquo Cutis 75(2S)5-9

12 Fisher GJ Wang ZQ Datta SC et al (1977) Pathophysiologyof premature skin aging induced by ultraviolet light N Engl JMed 337(20) 419-29

13 GJ Wang ZQ Datta SC Varani J Kang S Voorhees JJ(1997) Pathophysiology of premature skin aging induced byultraviolet light N Engl J Med 337(20) 1419-28

14 Hackenbrock CR Chazotte B Gupte SS (1986) The randomcollision model and a critical assessment of diffusion andcollision in mitochondrial electron transport J BioenergBiomembr 18 331-368

15 Chan DC (2006) Mitochondria dynamic organelles in diseaseaging and development Cell 125 1241-1252

16 Lenaz G Baracca A Fato R Genova ML Solaini G (2006) Newinsights into structure and function of mitochondria and theirrole in ageing and disease Antioxid Redox Signal 8 417-437

17 McFarland R Taylor RW Turnbull DM (2007) Mitochondrialdisease--its impact etiology and Pathology Curr Top Dev Biol77 113-155

18 Reeve AK Krishnan KJ Turnbull DM (2008) Age relatedmitochondrial degenerative disorders in humans Biotechnol J3 750-756

19 Zeviani M Carelli V (2007) Mitochondrial disorders Curr OpinNeurol 20 564-571

20 Hirobe S Azukizawa H Matsuo K Zhai Y Quan YS Kamiyama FSuzuki H Katayama I Okada N Nakagawa S (2013)Development and clinical study of a self- dissolving microneedlepatch for transcutaneous immunization devicePharm Res30(10)2664-74 doi 101007s11095-013-1092-6 Epub

21 Huang X Cheng H Chen K Zhang Y Zhang Y Liu Y Zhu C OuyangSC Kong GW Yu C Huang Y Rogers J A (2013) Epidermalimpedance sensing sheets for precision hydration assessmentand spatial mappingIEEE Trans Biomed Eng 60(10)2848-57doi 101109TBME20132264879 Epub

22 Birgersson U Birgersson E Nicander I Ollmar S (2013) Amethodology for extracting the electrical properties of humanskinPhysiol Meas34(6)723-36 doi 1010880967-3334346723 Epub

23 Birgersson U Birgersson E Nicander I Ollmar S Szeleacutenyi AJourneacutee HL Herrlich S Galistu GM van den Berg J van Dijk JM(2012) Experimental study of the course of threshold currentvoltage and electrode impedance during stepwise stimulationfrom the skin surface to the human cortexBrainStimul6(4)482-9 doi 101016jbrs201210002 Epub

24 wwwfippinet

25 wwwfelcit

26 wwwchirurgianonablativait27 wwwofthalmoplastikigr

Pinnacle Medicine amp Medical Sciences ISSN 2360-9516 Page 9

How to Cite this Article Tsioumas G Sotiris Vlachodimitropoulos Dimitris amp Goutas Nikolaos Clinical And Histological Presentation After Plexr ApplicationNeedle Shaping (Vibrance) And OFF Pinnacle Medicine amp Medical Sciences ISSN 2360-9516 Vol 2 (3) 2014 Article ID pmms_178 522-530 2015

Photo 16

Photo 16

References

1 M Ceccarelli Invecchiamento generale e cutaneo in medicinaestetica

2 Trattato di medicina estetica Professor Alberto Massironeedizioni Piccin

3 Chang YC Yang SF Tai KW Chou MY Hsieh YS Increased tissueinhibitor of metalloproteinase-1 expression and inhibition ofgelatinase A activity in buccal mucosal fibroblasts by arecolineas possible mechanisms for oral submucous fibrosis

4 Denton CP Abraham DJ Transforming growth factor-beta andconnective tissue growth factor key cytokines in sclerodermapathogenesis

5 Jelaska A Strehlow D Korn JH Fibrotic and normal fibroblastof type I and type III procollagen mRNA in cultured fibroblastsof patients with incisional hernia

6 Leask A Holmes A Abraham DJ Connective tissue growth factora new and important player in the pathogenesis of fibrosis

7 Lesley J Hascall VC Tammi M Hyman R Hyaluronan binding bycell surface CD44

Pinnacle Medicine amp Medical Sciences ISSN 2360-9516 Page 8

Source Vlachodimitropoulos Dimitrios MD

Source Vlachodimitropoulos Dimitrios MD

How to Cite this Article Tsioumas G Sotiris Vlachodimitropoulos Dimitris amp Goutas Nikolaos Clinical And Histological Presentation After Plexr ApplicationNeedle Shaping (Vibrance) And OFF Pinnacle Medicine amp Medical Sciences ISSN 2360-9516 Vol 2 (3) 2014 Article ID pmms_178 522-530 2015

8 Lu Y Luo S Liu J The influence of transforming growth factorbeta 1 (TGF beta 1) on fibroblast proliferation and collagensynthesis

9 Sato M Shegogue D Gore EA Smith EA McDermott PJTrojanowska M Role of p38 MAPK in transforming growthfactor beta stimulation of collagen production by sclerodermaand healthy dermal fibroblasts

10 Si Z Rhanjit B Rosch R Rene PM Klosterhalfen B Klinge UImpaired balance

11 Fisher GJ (2005) ldquoThe Pathophysiology of Photoaging of theSkinrdquo Cutis 75(2S)5-9

12 Fisher GJ Wang ZQ Datta SC et al (1977) Pathophysiologyof premature skin aging induced by ultraviolet light N Engl JMed 337(20) 419-29

13 GJ Wang ZQ Datta SC Varani J Kang S Voorhees JJ(1997) Pathophysiology of premature skin aging induced byultraviolet light N Engl J Med 337(20) 1419-28

14 Hackenbrock CR Chazotte B Gupte SS (1986) The randomcollision model and a critical assessment of diffusion andcollision in mitochondrial electron transport J BioenergBiomembr 18 331-368

15 Chan DC (2006) Mitochondria dynamic organelles in diseaseaging and development Cell 125 1241-1252

16 Lenaz G Baracca A Fato R Genova ML Solaini G (2006) Newinsights into structure and function of mitochondria and theirrole in ageing and disease Antioxid Redox Signal 8 417-437

17 McFarland R Taylor RW Turnbull DM (2007) Mitochondrialdisease--its impact etiology and Pathology Curr Top Dev Biol77 113-155

18 Reeve AK Krishnan KJ Turnbull DM (2008) Age relatedmitochondrial degenerative disorders in humans Biotechnol J3 750-756

19 Zeviani M Carelli V (2007) Mitochondrial disorders Curr OpinNeurol 20 564-571

20 Hirobe S Azukizawa H Matsuo K Zhai Y Quan YS Kamiyama FSuzuki H Katayama I Okada N Nakagawa S (2013)Development and clinical study of a self- dissolving microneedlepatch for transcutaneous immunization devicePharm Res30(10)2664-74 doi 101007s11095-013-1092-6 Epub

21 Huang X Cheng H Chen K Zhang Y Zhang Y Liu Y Zhu C OuyangSC Kong GW Yu C Huang Y Rogers J A (2013) Epidermalimpedance sensing sheets for precision hydration assessmentand spatial mappingIEEE Trans Biomed Eng 60(10)2848-57doi 101109TBME20132264879 Epub

22 Birgersson U Birgersson E Nicander I Ollmar S (2013) Amethodology for extracting the electrical properties of humanskinPhysiol Meas34(6)723-36 doi 1010880967-3334346723 Epub

23 Birgersson U Birgersson E Nicander I Ollmar S Szeleacutenyi AJourneacutee HL Herrlich S Galistu GM van den Berg J van Dijk JM(2012) Experimental study of the course of threshold currentvoltage and electrode impedance during stepwise stimulationfrom the skin surface to the human cortexBrainStimul6(4)482-9 doi 101016jbrs201210002 Epub

24 wwwfippinet

25 wwwfelcit

26 wwwchirurgianonablativait27 wwwofthalmoplastikigr

Pinnacle Medicine amp Medical Sciences ISSN 2360-9516 Page 9

How to Cite this Article Tsioumas G Sotiris Vlachodimitropoulos Dimitris amp Goutas Nikolaos Clinical And Histological Presentation After Plexr ApplicationNeedle Shaping (Vibrance) And OFF Pinnacle Medicine amp Medical Sciences ISSN 2360-9516 Vol 2 (3) 2014 Article ID pmms_178 522-530 2015

8 Lu Y Luo S Liu J The influence of transforming growth factorbeta 1 (TGF beta 1) on fibroblast proliferation and collagensynthesis

9 Sato M Shegogue D Gore EA Smith EA McDermott PJTrojanowska M Role of p38 MAPK in transforming growthfactor beta stimulation of collagen production by sclerodermaand healthy dermal fibroblasts

10 Si Z Rhanjit B Rosch R Rene PM Klosterhalfen B Klinge UImpaired balance

11 Fisher GJ (2005) ldquoThe Pathophysiology of Photoaging of theSkinrdquo Cutis 75(2S)5-9

12 Fisher GJ Wang ZQ Datta SC et al (1977) Pathophysiologyof premature skin aging induced by ultraviolet light N Engl JMed 337(20) 419-29

13 GJ Wang ZQ Datta SC Varani J Kang S Voorhees JJ(1997) Pathophysiology of premature skin aging induced byultraviolet light N Engl J Med 337(20) 1419-28

14 Hackenbrock CR Chazotte B Gupte SS (1986) The randomcollision model and a critical assessment of diffusion andcollision in mitochondrial electron transport J BioenergBiomembr 18 331-368

15 Chan DC (2006) Mitochondria dynamic organelles in diseaseaging and development Cell 125 1241-1252

16 Lenaz G Baracca A Fato R Genova ML Solaini G (2006) Newinsights into structure and function of mitochondria and theirrole in ageing and disease Antioxid Redox Signal 8 417-437

17 McFarland R Taylor RW Turnbull DM (2007) Mitochondrialdisease--its impact etiology and Pathology Curr Top Dev Biol77 113-155

18 Reeve AK Krishnan KJ Turnbull DM (2008) Age relatedmitochondrial degenerative disorders in humans Biotechnol J3 750-756

19 Zeviani M Carelli V (2007) Mitochondrial disorders Curr OpinNeurol 20 564-571

20 Hirobe S Azukizawa H Matsuo K Zhai Y Quan YS Kamiyama FSuzuki H Katayama I Okada N Nakagawa S (2013)Development and clinical study of a self- dissolving microneedlepatch for transcutaneous immunization devicePharm Res30(10)2664-74 doi 101007s11095-013-1092-6 Epub

21 Huang X Cheng H Chen K Zhang Y Zhang Y Liu Y Zhu C OuyangSC Kong GW Yu C Huang Y Rogers J A (2013) Epidermalimpedance sensing sheets for precision hydration assessmentand spatial mappingIEEE Trans Biomed Eng 60(10)2848-57doi 101109TBME20132264879 Epub

22 Birgersson U Birgersson E Nicander I Ollmar S (2013) Amethodology for extracting the electrical properties of humanskinPhysiol Meas34(6)723-36 doi 1010880967-3334346723 Epub

23 Birgersson U Birgersson E Nicander I Ollmar S Szeleacutenyi AJourneacutee HL Herrlich S Galistu GM van den Berg J van Dijk JM(2012) Experimental study of the course of threshold currentvoltage and electrode impedance during stepwise stimulationfrom the skin surface to the human cortexBrainStimul6(4)482-9 doi 101016jbrs201210002 Epub

24 wwwfippinet

25 wwwfelcit

26 wwwchirurgianonablativait27 wwwofthalmoplastikigr

Pinnacle Medicine amp Medical Sciences ISSN 2360-9516 Page 9

How to Cite this Article Tsioumas G Sotiris Vlachodimitropoulos Dimitris amp Goutas Nikolaos Clinical And Histological Presentation After Plexr ApplicationNeedle Shaping (Vibrance) And OFF Pinnacle Medicine amp Medical Sciences ISSN 2360-9516 Vol 2 (3) 2014 Article ID pmms_178 522-530 2015