1. Wrinkles are a visible sign of skin aging on the face that appear as furrows or lines.
2. Wrinkles develop due to multiple intrinsic and extrinsic factors that cause thinning of the skin layers and breakdown of collagen and elastic fibers over time.
3. Histologically, wrinkled skin shows thinning of the epidermis, loss and degradation of collagen and elastic fibers, and changes in glycosaminoglycan composition compared to non-wrinkled skin.
The document discusses the genetics of cancer, including how certain genes can mutate and cause cancer. It describes several types of cancer-causing genes like tumour suppressor genes and oncogenes. It also discusses environmental factors that can increase cancer risk, such as viruses, tobacco smoke, radiation, chemicals and pollution. Several specific cancers are discussed in more detail, like retinoblastoma, breast cancer, and colorectal cancer. The roles of genes like RB1, p53, and genes involved in growth factors and growth factor receptors in cancer development are also explained.
- Clinical genetics provides diagnostic services and genetic counseling for individuals or families at risk of genetic conditions.
- People are referred to clinical geneticists for a variety of reasons, including having a known genetic condition in the family, a child with developmental issues possibly due to genetics, or a strong family history of cancer.
- Genetic screening can be targeted at high-risk individuals based on family history, or conducted more generally on low-risk populations to provide information and reproductive options. Risk calculation and the use of tools like pedigree charts, biochemical tests, and linked DNA markers are discussed.
This document summarizes the molecular biology of esophageal and gastric cancers. It discusses common genetic alterations in these cancers, including oncogenes and tumor suppressor genes. For esophageal cancer, it describes alterations in EGFR, cyclin D1, p53, E-cadherin and other genes. For gastric cancer, it discusses differences between intestinal and diffuse subtypes and common mutations in genes like p53, CDH1 and mismatch repair genes. The document also summarizes proposed molecular classifications of gastric cancer from TCGA and ACRG and their prognostic implications, along with targeted therapies in development or approved for treatment.
This document discusses a laboratory equipment training program implemented by I-TECH Ethiopia to improve the quality of laboratory services and patient care. The program provided theoretical and hands-on training to over 300 laboratory technicians on preventative maintenance of equipment. This resulted in less equipment downtime, improved performance, and shorter turnaround times for test results. 73 pieces of previously non-functioning equipment were repaired and returned to service through the program. The training helped laboratories improve their quality management systems and overall quality as measured by the SLIPTA scoring system. The document recommends establishing ongoing equipment management programs in laboratories, including proper staff training, monitoring, and preventative maintenance to ensure reliable test results.
This document discusses the application of Six Sigma methodology in clinical laboratories to improve quality. It defines Six Sigma and explains how it was developed from earlier statistical quality control methods. Six Sigma uses a measurement scale from 1-6 sigma to assess process error levels, with 3 sigma considered the minimum acceptable level. The document then discusses how Six Sigma methodology, including DMAIC and DMADV, can be applied in clinical labs to reduce errors. It also provides an example of using Six Sigma metrics to evaluate error levels for various analytes tested on an automated chemistry analyzer.
This document provides a nomenclature system for monoclonal antibodies (mAbs) based on suffixes added to the root "mab". The suffixes indicate the type and application of the mAb, such as "-mo-mab" denoting a mouse mAb, "-zu-mab" a humanized mAb that is 95% human, and suffixes like "-tu-xx-mab" indicating a tumor-directed mAb. The nomenclature system aims to concisely convey whether mAbs are mouse, chimeric, humanized, or human as well as their intended therapeutic area.
Opportunities for Immune Therapy and Preventionbkling
This document summarizes a presentation on opportunities for immunotherapy in breast cancer. It discusses how the immune system fights cancer, types of immunotherapy including checkpoint inhibitors and CAR T-cell therapy. Experience with immunotherapy in breast cancer has been underwhelming due to breast cancer typically having low numbers of immune cells, but responses have been seen in triple negative and HER2+ breast cancers. Future opportunities include increasing immune cells prior to standard treatments and engaging the immune system in the adjuvant setting to reduce recurrence risks.
The document discusses the genetics of cancer, including how certain genes can mutate and cause cancer. It describes several types of cancer-causing genes like tumour suppressor genes and oncogenes. It also discusses environmental factors that can increase cancer risk, such as viruses, tobacco smoke, radiation, chemicals and pollution. Several specific cancers are discussed in more detail, like retinoblastoma, breast cancer, and colorectal cancer. The roles of genes like RB1, p53, and genes involved in growth factors and growth factor receptors in cancer development are also explained.
- Clinical genetics provides diagnostic services and genetic counseling for individuals or families at risk of genetic conditions.
- People are referred to clinical geneticists for a variety of reasons, including having a known genetic condition in the family, a child with developmental issues possibly due to genetics, or a strong family history of cancer.
- Genetic screening can be targeted at high-risk individuals based on family history, or conducted more generally on low-risk populations to provide information and reproductive options. Risk calculation and the use of tools like pedigree charts, biochemical tests, and linked DNA markers are discussed.
This document summarizes the molecular biology of esophageal and gastric cancers. It discusses common genetic alterations in these cancers, including oncogenes and tumor suppressor genes. For esophageal cancer, it describes alterations in EGFR, cyclin D1, p53, E-cadherin and other genes. For gastric cancer, it discusses differences between intestinal and diffuse subtypes and common mutations in genes like p53, CDH1 and mismatch repair genes. The document also summarizes proposed molecular classifications of gastric cancer from TCGA and ACRG and their prognostic implications, along with targeted therapies in development or approved for treatment.
This document discusses a laboratory equipment training program implemented by I-TECH Ethiopia to improve the quality of laboratory services and patient care. The program provided theoretical and hands-on training to over 300 laboratory technicians on preventative maintenance of equipment. This resulted in less equipment downtime, improved performance, and shorter turnaround times for test results. 73 pieces of previously non-functioning equipment were repaired and returned to service through the program. The training helped laboratories improve their quality management systems and overall quality as measured by the SLIPTA scoring system. The document recommends establishing ongoing equipment management programs in laboratories, including proper staff training, monitoring, and preventative maintenance to ensure reliable test results.
This document discusses the application of Six Sigma methodology in clinical laboratories to improve quality. It defines Six Sigma and explains how it was developed from earlier statistical quality control methods. Six Sigma uses a measurement scale from 1-6 sigma to assess process error levels, with 3 sigma considered the minimum acceptable level. The document then discusses how Six Sigma methodology, including DMAIC and DMADV, can be applied in clinical labs to reduce errors. It also provides an example of using Six Sigma metrics to evaluate error levels for various analytes tested on an automated chemistry analyzer.
This document provides a nomenclature system for monoclonal antibodies (mAbs) based on suffixes added to the root "mab". The suffixes indicate the type and application of the mAb, such as "-mo-mab" denoting a mouse mAb, "-zu-mab" a humanized mAb that is 95% human, and suffixes like "-tu-xx-mab" indicating a tumor-directed mAb. The nomenclature system aims to concisely convey whether mAbs are mouse, chimeric, humanized, or human as well as their intended therapeutic area.
Opportunities for Immune Therapy and Preventionbkling
This document summarizes a presentation on opportunities for immunotherapy in breast cancer. It discusses how the immune system fights cancer, types of immunotherapy including checkpoint inhibitors and CAR T-cell therapy. Experience with immunotherapy in breast cancer has been underwhelming due to breast cancer typically having low numbers of immune cells, but responses have been seen in triple negative and HER2+ breast cancers. Future opportunities include increasing immune cells prior to standard treatments and engaging the immune system in the adjuvant setting to reduce recurrence risks.
Acute graft versus host disease (GVHD) is a common complication following allogeneic hematopoietic stem cell transplantation. It occurs when the donated cells from a non-identical donor recognize the recipient's cells as foreign and attack them. GVHD is clinically graded from 1 to 4 based on its severity. Grade 1 GVHD is treated with topical steroids while grades 2-4 require systemic corticosteroids as first line therapy. For patients unresponsive to steroids, second line treatments include mycophenolate mofetil, etanercept, pentostatin, sirolimus, basiliximab, and extracorporeal photopheresis. Steroid tapering must be
The document discusses various targeted therapies used in oncology including monoclonal antibodies, small molecule inhibitors, and tyrosine kinase inhibitors. It provides information on drug indications, mechanisms of action, FDA approvals, and common adverse effects for several targeted agents such as palbociclib, bortezomib, imatinib, crizotinib, ceritinib, osimertinib, and vemurafenib. The document is intended to educate medical practitioners on modern targeted therapies for cancer treatment.
This document provides a summary of key cell surface markers (CD markers) for different immune cell types in humans and mice. It lists the main CD markers used to identify T cells, B cells, dendritic cells, NK cells, stem/precursor cells, macrophages/monocytes, granulocytes, platelets, erythrocytes, endothelial cells and epithelial cells in both species. It also provides some information on the functions of the Human Leukocyte Differentiation Antigens (HLDA) workshop which aims to standardize CD marker nomenclature.
QUALITY
Conformance to the requirements of users or customers satisfaction of their needs and expectations.
Total Quality Management
A management approach that focuses on processes and their improvement.
Dr. Angela Christiano presents an update on genetic and immunological studies in alopecia areata. Dr. Christiano’s research has helped clarify the immunologic mechanisms behind the disease. Now, early clinical trials with existing drugs that specifically target these mechanisms are showing promising hair regrowth. Dr. Christiano is the Richard and Mildred Rhodebeck Professor of Dermatology and Professor of Genetics & Development, and Vice Chair for Basic Science Research in Dermatology at Columbia University.
This document discusses different types of genetic tests. It provides examples of molecular tests like testing the DMD gene for muscular dystrophy and KRAS gene testing for colon cancer. Cytogenetic tests like karyotyping and arrayCGH are explained. Biochemical tests like newborn screening for phenylketonuria are also summarized. The uses and implications of genetic testing for various clinical purposes are covered.
The document discusses aging of the face and its underlying pathophysiology. It states that facial aging begins with structural changes in multiple facial tissue layers, including skin, fat, muscle and bone. Intrinsic aging is the inevitable natural aging process that occurs due to telomere shortening and reduced cell division over time. Extrinsic aging like photoaging and smoking further accelerate the natural aging process. Key changes include thinning and sagging of skin with reduced collagen, redistribution and loss of facial fat, loss of facial bone volume, and prominence of lines and wrinkles.
Barrier function & biomechanical properties of the skin Ahmed Amer
This document summarizes the structure and function of the skin barrier. It describes the epidermis, stratum corneum, dermis, and basement membrane zone. The stratum corneum consists of corneocytes bound by lipid mortar, forming the skin's barrier against water loss and insults. Defects in corneocytes or lipids cause skin diseases. The dermis contains collagen, elastin, and glycosaminoglycans that provide mechanical strength, elasticity, and resistance to compression. Inherited disorders impact these structures, altering the skin's biomechanical properties.
This presentation is on functions of skin and physiology of skin including thermoregulatory function, barrier function, vitamin D synthesis, cosmetic functions.
The document discusses the various functions of skin which include barrier functions, thermoregulatory functions, sensory and autonomic functions, immunological functions, vitamin D synthesis, vitamin E secretion, xenobiotic metabolism, and antioxidant function. The key barrier functions of skin are its permeability barrier, protection from UV radiation, prevention of microbial penetration, and provision of mechanical protection. Skin regulates body temperature through vasodilation and vasoconstriction of cutaneous vasculature and by sweating. It also acts as a barrier against microorganisms through antimicrobial peptides and the acidic pH of the stratum corneum.
Facial aging is caused by changes in the skin, fat, and bone tissues over time. As people age, their skin becomes thinner, loses collagen, and becomes drier. Facial fat redistributes from some areas like the forehead and cheeks to areas like the mouth and jaw. Bone resorption leads to volume loss in the face. Intrinsic aging is due to natural cellular degeneration, while extrinsic factors like sun exposure, smoking, and gravity accelerate the aging process by damaging skin tissue through oxidative stress and decreased blood flow and nutrient supply. Photoaging from UV radiation generates free radicals that break down collagen and DNA, and stimulate matrix metalloproteinase enzymes that degrade collagen.
This document provides an overview of temporomandibular joint disorders (TMD). It begins with an introduction to the temporomandibular joint and discusses its anatomy, functions, and age-related changes. It then covers various TMD conditions such as developmental disorders, arthritis, and myofascial pain. Treatment approaches are also summarized, including splint therapy and management of specific disorders like arthritis. The document contains sections on applied anatomy, disorders, and treatment of TMD.
New Technologies for Successfully Managing Ocular Surface InflammationJessica Griego
This document discusses new technologies for managing ocular surface inflammation. It begins by defining ocular surface disease and noting its prevalence. Various causes of ocular surface disease are described, including infectious, immune-related, traumatic/systemic, and iatrogenic factors. Current treatment paradigms focus on passive therapies to reduce inflammation like bandage contact lenses and topical steroids, but these can delay healing. Emerging options aim to control inflammation, prevent tissue damage, and stimulate regenerative healing using amniotic membrane biologics which promote healing and reduce inflammation. Cryopreserved amniotic membrane is presented as a safe and effective option to treat various ocular surface conditions.
This document discusses care of aging skin. It begins by outlining objectives related to summarizing effects of aging on skin, distinguishing age-related skin changes from disease-related changes, and describing good skin care practices and common skin conditions in older adults. Key terms are defined. The document then discusses normal age-related changes to the epidermis, dermis, subcutaneous tissue, glands, and hair and nails. Common skin conditions in older adults like xerosis, pruritus, actinic keratoses, seborrheic keratoses, and skin cancers are described. Treatment options for dry skin, itching, and various skin cancers are provided.
Skin grafting has been performed for over 2500 years, with early uses in India and developments in the 19th century. Today, skin grafts are commonly used in dermatologic surgery to reconstruct skin defects from various causes when primary closure, second-intention healing, or local flaps are not suitable options. There are two main types of skin grafts: full-thickness skin grafts which include both the epidermis and dermis, and split-thickness skin grafts which include varying thin layers of the epidermis and dermis. Proper wound preparation, hemostasis, and fixation of the graft are important for successful revascularization and graft survival.
Systemic sclerosis is a rare autoimmune disease characterized by fibrosis of the skin and internal organs. It can be classified as either limited or diffuse cutaneous systemic sclerosis. The disease mainly affects women in their 30s-50s and is characterized by Raynaud's phenomenon, skin thickening, and organ involvement such as pulmonary fibrosis, gastrointestinal issues, and renal crisis. Prognosis depends on the subtype, with diffuse disease having a worse prognosis and higher mortality rates due to organ complications.
This document discusses the dermo-epidermal junction (DEJ) and dermis. It describes the four layers of the basement membrane zone (BMZ) of the DEJ - the basal keratinocyte layer containing hemidesmosomes, the lamina lucida, lamina densa containing type IV collagen and laminins, and the lamina fibroreticularis containing anchoring fibrils made of type VII collagen. It also discusses the cells and extracellular matrix components of the dermis, including collagen, elastic fibers, proteoglycans, fibroblasts, macrophages, dendrocytes and mast cells. Disorders of the DEJ like epidermolysis bullosa are also mentioned.
Ageing of the skin can occur intrinsically through natural biological processes like telomere shortening over time or extrinsically from external factors like ultraviolet radiation exposure, which can cause histological changes like thinning of the epidermis and dermis, breakdown of collagen and elastic fibers, and alterations to fibroblasts. Physiological changes in aged skin include dryness, loss of elasticity and wrinkling due to reduced collagen and elastic fiber production, as well as increased risk of infections and skin cancers. Common dermatological conditions seen in older patients include xerosis, pruritus, pressure sores, viral and fungal infections,
Minimal Invasive treatment for Aged EyelidsYong Hyun KWON
This is about minimal invasive procedure to lift drooped eyelids.
This presentation was spoken in 3rd Int`l congress of Korea-Japan-China Aesthetic Surgery & Medicine on 25, Oct, 2015
You can watch procedure video on YouTube.
https://youtu.be/lOITt9fk5Bw
This document discusses the anatomy of facial retaining ligaments or retinacula. It describes the true and false retaining ligaments that anchor the skin and soft tissues to the underlying skeleton. The true ligaments are short fibrous bands that directly attach the dermis to bone. The false ligaments attach the superficial fascia to the deep fascia. With aging, the ligaments become lax leading to ptosis of midface tissues and formation of nasolabial folds, marionette lines, and jowls. Understanding the distribution of subcutaneous fat and retaining ligaments is important for safe and effective dermal filler injections.
Collagen is the most abundant protein in the human body, making up 25-30% of total protein content. It forms connective tissues like skin, bone, cartilage and is classified into different types based on structure and function. There are at least 28 types of collagen coded by 42 genes. Collagen provides structure and strength to tissues, supports skin and basement membranes. Its biosynthesis involves post-translational modifications within cells and extracellular cross-linking. Disorders can result from deficient or defective collagen synthesis, including scurvy, Menkes disease, osteogenesis imperfecta and Ehlers-Danlos syndrome. Excess collagen deposition can cause keloids and scleroderma. Cosmetic procedures use collagen fillers for wrink
Acute graft versus host disease (GVHD) is a common complication following allogeneic hematopoietic stem cell transplantation. It occurs when the donated cells from a non-identical donor recognize the recipient's cells as foreign and attack them. GVHD is clinically graded from 1 to 4 based on its severity. Grade 1 GVHD is treated with topical steroids while grades 2-4 require systemic corticosteroids as first line therapy. For patients unresponsive to steroids, second line treatments include mycophenolate mofetil, etanercept, pentostatin, sirolimus, basiliximab, and extracorporeal photopheresis. Steroid tapering must be
The document discusses various targeted therapies used in oncology including monoclonal antibodies, small molecule inhibitors, and tyrosine kinase inhibitors. It provides information on drug indications, mechanisms of action, FDA approvals, and common adverse effects for several targeted agents such as palbociclib, bortezomib, imatinib, crizotinib, ceritinib, osimertinib, and vemurafenib. The document is intended to educate medical practitioners on modern targeted therapies for cancer treatment.
This document provides a summary of key cell surface markers (CD markers) for different immune cell types in humans and mice. It lists the main CD markers used to identify T cells, B cells, dendritic cells, NK cells, stem/precursor cells, macrophages/monocytes, granulocytes, platelets, erythrocytes, endothelial cells and epithelial cells in both species. It also provides some information on the functions of the Human Leukocyte Differentiation Antigens (HLDA) workshop which aims to standardize CD marker nomenclature.
QUALITY
Conformance to the requirements of users or customers satisfaction of their needs and expectations.
Total Quality Management
A management approach that focuses on processes and their improvement.
Dr. Angela Christiano presents an update on genetic and immunological studies in alopecia areata. Dr. Christiano’s research has helped clarify the immunologic mechanisms behind the disease. Now, early clinical trials with existing drugs that specifically target these mechanisms are showing promising hair regrowth. Dr. Christiano is the Richard and Mildred Rhodebeck Professor of Dermatology and Professor of Genetics & Development, and Vice Chair for Basic Science Research in Dermatology at Columbia University.
This document discusses different types of genetic tests. It provides examples of molecular tests like testing the DMD gene for muscular dystrophy and KRAS gene testing for colon cancer. Cytogenetic tests like karyotyping and arrayCGH are explained. Biochemical tests like newborn screening for phenylketonuria are also summarized. The uses and implications of genetic testing for various clinical purposes are covered.
The document discusses aging of the face and its underlying pathophysiology. It states that facial aging begins with structural changes in multiple facial tissue layers, including skin, fat, muscle and bone. Intrinsic aging is the inevitable natural aging process that occurs due to telomere shortening and reduced cell division over time. Extrinsic aging like photoaging and smoking further accelerate the natural aging process. Key changes include thinning and sagging of skin with reduced collagen, redistribution and loss of facial fat, loss of facial bone volume, and prominence of lines and wrinkles.
Barrier function & biomechanical properties of the skin Ahmed Amer
This document summarizes the structure and function of the skin barrier. It describes the epidermis, stratum corneum, dermis, and basement membrane zone. The stratum corneum consists of corneocytes bound by lipid mortar, forming the skin's barrier against water loss and insults. Defects in corneocytes or lipids cause skin diseases. The dermis contains collagen, elastin, and glycosaminoglycans that provide mechanical strength, elasticity, and resistance to compression. Inherited disorders impact these structures, altering the skin's biomechanical properties.
This presentation is on functions of skin and physiology of skin including thermoregulatory function, barrier function, vitamin D synthesis, cosmetic functions.
The document discusses the various functions of skin which include barrier functions, thermoregulatory functions, sensory and autonomic functions, immunological functions, vitamin D synthesis, vitamin E secretion, xenobiotic metabolism, and antioxidant function. The key barrier functions of skin are its permeability barrier, protection from UV radiation, prevention of microbial penetration, and provision of mechanical protection. Skin regulates body temperature through vasodilation and vasoconstriction of cutaneous vasculature and by sweating. It also acts as a barrier against microorganisms through antimicrobial peptides and the acidic pH of the stratum corneum.
Facial aging is caused by changes in the skin, fat, and bone tissues over time. As people age, their skin becomes thinner, loses collagen, and becomes drier. Facial fat redistributes from some areas like the forehead and cheeks to areas like the mouth and jaw. Bone resorption leads to volume loss in the face. Intrinsic aging is due to natural cellular degeneration, while extrinsic factors like sun exposure, smoking, and gravity accelerate the aging process by damaging skin tissue through oxidative stress and decreased blood flow and nutrient supply. Photoaging from UV radiation generates free radicals that break down collagen and DNA, and stimulate matrix metalloproteinase enzymes that degrade collagen.
This document provides an overview of temporomandibular joint disorders (TMD). It begins with an introduction to the temporomandibular joint and discusses its anatomy, functions, and age-related changes. It then covers various TMD conditions such as developmental disorders, arthritis, and myofascial pain. Treatment approaches are also summarized, including splint therapy and management of specific disorders like arthritis. The document contains sections on applied anatomy, disorders, and treatment of TMD.
New Technologies for Successfully Managing Ocular Surface InflammationJessica Griego
This document discusses new technologies for managing ocular surface inflammation. It begins by defining ocular surface disease and noting its prevalence. Various causes of ocular surface disease are described, including infectious, immune-related, traumatic/systemic, and iatrogenic factors. Current treatment paradigms focus on passive therapies to reduce inflammation like bandage contact lenses and topical steroids, but these can delay healing. Emerging options aim to control inflammation, prevent tissue damage, and stimulate regenerative healing using amniotic membrane biologics which promote healing and reduce inflammation. Cryopreserved amniotic membrane is presented as a safe and effective option to treat various ocular surface conditions.
This document discusses care of aging skin. It begins by outlining objectives related to summarizing effects of aging on skin, distinguishing age-related skin changes from disease-related changes, and describing good skin care practices and common skin conditions in older adults. Key terms are defined. The document then discusses normal age-related changes to the epidermis, dermis, subcutaneous tissue, glands, and hair and nails. Common skin conditions in older adults like xerosis, pruritus, actinic keratoses, seborrheic keratoses, and skin cancers are described. Treatment options for dry skin, itching, and various skin cancers are provided.
Skin grafting has been performed for over 2500 years, with early uses in India and developments in the 19th century. Today, skin grafts are commonly used in dermatologic surgery to reconstruct skin defects from various causes when primary closure, second-intention healing, or local flaps are not suitable options. There are two main types of skin grafts: full-thickness skin grafts which include both the epidermis and dermis, and split-thickness skin grafts which include varying thin layers of the epidermis and dermis. Proper wound preparation, hemostasis, and fixation of the graft are important for successful revascularization and graft survival.
Systemic sclerosis is a rare autoimmune disease characterized by fibrosis of the skin and internal organs. It can be classified as either limited or diffuse cutaneous systemic sclerosis. The disease mainly affects women in their 30s-50s and is characterized by Raynaud's phenomenon, skin thickening, and organ involvement such as pulmonary fibrosis, gastrointestinal issues, and renal crisis. Prognosis depends on the subtype, with diffuse disease having a worse prognosis and higher mortality rates due to organ complications.
This document discusses the dermo-epidermal junction (DEJ) and dermis. It describes the four layers of the basement membrane zone (BMZ) of the DEJ - the basal keratinocyte layer containing hemidesmosomes, the lamina lucida, lamina densa containing type IV collagen and laminins, and the lamina fibroreticularis containing anchoring fibrils made of type VII collagen. It also discusses the cells and extracellular matrix components of the dermis, including collagen, elastic fibers, proteoglycans, fibroblasts, macrophages, dendrocytes and mast cells. Disorders of the DEJ like epidermolysis bullosa are also mentioned.
Ageing of the skin can occur intrinsically through natural biological processes like telomere shortening over time or extrinsically from external factors like ultraviolet radiation exposure, which can cause histological changes like thinning of the epidermis and dermis, breakdown of collagen and elastic fibers, and alterations to fibroblasts. Physiological changes in aged skin include dryness, loss of elasticity and wrinkling due to reduced collagen and elastic fiber production, as well as increased risk of infections and skin cancers. Common dermatological conditions seen in older patients include xerosis, pruritus, pressure sores, viral and fungal infections,
Minimal Invasive treatment for Aged EyelidsYong Hyun KWON
This is about minimal invasive procedure to lift drooped eyelids.
This presentation was spoken in 3rd Int`l congress of Korea-Japan-China Aesthetic Surgery & Medicine on 25, Oct, 2015
You can watch procedure video on YouTube.
https://youtu.be/lOITt9fk5Bw
This document discusses the anatomy of facial retaining ligaments or retinacula. It describes the true and false retaining ligaments that anchor the skin and soft tissues to the underlying skeleton. The true ligaments are short fibrous bands that directly attach the dermis to bone. The false ligaments attach the superficial fascia to the deep fascia. With aging, the ligaments become lax leading to ptosis of midface tissues and formation of nasolabial folds, marionette lines, and jowls. Understanding the distribution of subcutaneous fat and retaining ligaments is important for safe and effective dermal filler injections.
Collagen is the most abundant protein in the human body, making up 25-30% of total protein content. It forms connective tissues like skin, bone, cartilage and is classified into different types based on structure and function. There are at least 28 types of collagen coded by 42 genes. Collagen provides structure and strength to tissues, supports skin and basement membranes. Its biosynthesis involves post-translational modifications within cells and extracellular cross-linking. Disorders can result from deficient or defective collagen synthesis, including scurvy, Menkes disease, osteogenesis imperfecta and Ehlers-Danlos syndrome. Excess collagen deposition can cause keloids and scleroderma. Cosmetic procedures use collagen fillers for wrink
Mechanical stretching of facial skin for 5-20 minutes using Beauty Band induces proliferation of cells in the epidermal layers by activating cellular mechanisms and growth factors. A study found that applying mechanical stretching to human skin equivalents in vitro using Beauty Band increased epidermal thickness and basement membrane development. Beauty Band enables mechanical stretching of all facial areas simultaneously, increasing the surface area treated and potentially enhancing permeability and effectiveness of topical products by exposing the bottoms of wrinkles.
This document provides an overview of a course on demystifying skin care for massage therapists. The course is structured into 6 chapters with a test at the end of each chapter. Upon completing all chapters and tests, the student will receive a certificate for 4 CEUs. The document then covers various topics related to skin including the structure of skin, causes of aging, common skin conditions and concerns for both the body and face, how to determine skin type and create a skin care routine, and differences between natural, synthetic and organic ingredients.
The hand has remained a considerable treatment challenge, as new soft tissue fillers
have arrived in the esthetic marketplace. The challenge has been the result of both the multiple visits
required for treatment in, for example, autologous fat grafting and the simple management of pain in
the innervated areas of the hand between the bones.
This paper introduces a novel, noticeably less painful approach to treatment of the hand with
calcium hydroxylapatite (CaHA; Radiesse®, BioForm Medical, San Mateo, CA). Anesthetic is added to
the compound prior to injection, resulting in a homogenous admixture of CaHA and anesthetic. A
bolus of the mixture is injected into the skin, using tenting, and then spread throughout the hand.
The result of this approach – mixing anesthetic with CaHA – is treatment that is easier to massage
and disseminate, less painful to the patient than conventional hand injection, and characterized by
less swelling and bruising, with minimal post-treatment downtime.
The document provides an overview of the anatomy and physiology of skin. It discusses the structure of skin, which consists of two main layers - the epidermis and dermis. The epidermis contains 5 layers (from superficial to deep): stratum corneum, stratum lucidum, stratum granulosum, stratum spinosum, and stratum basale. The dermis lies beneath and contains two layers - the papillary layer and reticular layer. It also describes the blood supply, skin appendages like hair follicles and glands, and main functions of the skin like providing a barrier and sensing.
Similar to 1. dr. Hendra - Basic Knowledge of The Wrinkles Final A .ppt.pdf (20)
Chapter wise All Notes of First year Basic Civil Engineering.pptxDenish Jangid
Chapter wise All Notes of First year Basic Civil Engineering
Syllabus
Chapter-1
Introduction to objective, scope and outcome the subject
Chapter 2
Introduction: Scope and Specialization of Civil Engineering, Role of civil Engineer in Society, Impact of infrastructural development on economy of country.
Chapter 3
Surveying: Object Principles & Types of Surveying; Site Plans, Plans & Maps; Scales & Unit of different Measurements.
Linear Measurements: Instruments used. Linear Measurement by Tape, Ranging out Survey Lines and overcoming Obstructions; Measurements on sloping ground; Tape corrections, conventional symbols. Angular Measurements: Instruments used; Introduction to Compass Surveying, Bearings and Longitude & Latitude of a Line, Introduction to total station.
Levelling: Instrument used Object of levelling, Methods of levelling in brief, and Contour maps.
Chapter 4
Buildings: Selection of site for Buildings, Layout of Building Plan, Types of buildings, Plinth area, carpet area, floor space index, Introduction to building byelaws, concept of sun light & ventilation. Components of Buildings & their functions, Basic concept of R.C.C., Introduction to types of foundation
Chapter 5
Transportation: Introduction to Transportation Engineering; Traffic and Road Safety: Types and Characteristics of Various Modes of Transportation; Various Road Traffic Signs, Causes of Accidents and Road Safety Measures.
Chapter 6
Environmental Engineering: Environmental Pollution, Environmental Acts and Regulations, Functional Concepts of Ecology, Basics of Species, Biodiversity, Ecosystem, Hydrological Cycle; Chemical Cycles: Carbon, Nitrogen & Phosphorus; Energy Flow in Ecosystems.
Water Pollution: Water Quality standards, Introduction to Treatment & Disposal of Waste Water. Reuse and Saving of Water, Rain Water Harvesting. Solid Waste Management: Classification of Solid Waste, Collection, Transportation and Disposal of Solid. Recycling of Solid Waste: Energy Recovery, Sanitary Landfill, On-Site Sanitation. Air & Noise Pollution: Primary and Secondary air pollutants, Harmful effects of Air Pollution, Control of Air Pollution. . Noise Pollution Harmful Effects of noise pollution, control of noise pollution, Global warming & Climate Change, Ozone depletion, Greenhouse effect
Text Books:
1. Palancharmy, Basic Civil Engineering, McGraw Hill publishers.
2. Satheesh Gopi, Basic Civil Engineering, Pearson Publishers.
3. Ketki Rangwala Dalal, Essentials of Civil Engineering, Charotar Publishing House.
4. BCP, Surveying volume 1
ISO/IEC 27001, ISO/IEC 42001, and GDPR: Best Practices for Implementation and...PECB
Denis is a dynamic and results-driven Chief Information Officer (CIO) with a distinguished career spanning information systems analysis and technical project management. With a proven track record of spearheading the design and delivery of cutting-edge Information Management solutions, he has consistently elevated business operations, streamlined reporting functions, and maximized process efficiency.
Certified as an ISO/IEC 27001: Information Security Management Systems (ISMS) Lead Implementer, Data Protection Officer, and Cyber Risks Analyst, Denis brings a heightened focus on data security, privacy, and cyber resilience to every endeavor.
His expertise extends across a diverse spectrum of reporting, database, and web development applications, underpinned by an exceptional grasp of data storage and virtualization technologies. His proficiency in application testing, database administration, and data cleansing ensures seamless execution of complex projects.
What sets Denis apart is his comprehensive understanding of Business and Systems Analysis technologies, honed through involvement in all phases of the Software Development Lifecycle (SDLC). From meticulous requirements gathering to precise analysis, innovative design, rigorous development, thorough testing, and successful implementation, he has consistently delivered exceptional results.
Throughout his career, he has taken on multifaceted roles, from leading technical project management teams to owning solutions that drive operational excellence. His conscientious and proactive approach is unwavering, whether he is working independently or collaboratively within a team. His ability to connect with colleagues on a personal level underscores his commitment to fostering a harmonious and productive workplace environment.
Date: May 29, 2024
Tags: Information Security, ISO/IEC 27001, ISO/IEC 42001, Artificial Intelligence, GDPR
-------------------------------------------------------------------------------
Find out more about ISO training and certification services
Training: ISO/IEC 27001 Information Security Management System - EN | PECB
ISO/IEC 42001 Artificial Intelligence Management System - EN | PECB
General Data Protection Regulation (GDPR) - Training Courses - EN | PECB
Webinars: https://pecb.com/webinars
Article: https://pecb.com/article
-------------------------------------------------------------------------------
For more information about PECB:
Website: https://pecb.com/
LinkedIn: https://www.linkedin.com/company/pecb/
Facebook: https://www.facebook.com/PECBInternational/
Slideshare: http://www.slideshare.net/PECBCERTIFICATION
Gender and Mental Health - Counselling and Family Therapy Applications and In...PsychoTech Services
A proprietary approach developed by bringing together the best of learning theories from Psychology, design principles from the world of visualization, and pedagogical methods from over a decade of training experience, that enables you to: Learn better, faster!
This presentation was provided by Rebecca Benner, Ph.D., of the American Society of Anesthesiologists, for the second session of NISO's 2024 Training Series "DEIA in the Scholarly Landscape." Session Two: 'Expanding Pathways to Publishing Careers,' was held June 13, 2024.
Walmart Business+ and Spark Good for Nonprofits.pdfTechSoup
"Learn about all the ways Walmart supports nonprofit organizations.
You will hear from Liz Willett, the Head of Nonprofits, and hear about what Walmart is doing to help nonprofits, including Walmart Business and Spark Good. Walmart Business+ is a new offer for nonprofits that offers discounts and also streamlines nonprofits order and expense tracking, saving time and money.
The webinar may also give some examples on how nonprofits can best leverage Walmart Business+.
The event will cover the following::
Walmart Business + (https://business.walmart.com/plus) is a new shopping experience for nonprofits, schools, and local business customers that connects an exclusive online shopping experience to stores. Benefits include free delivery and shipping, a 'Spend Analytics” feature, special discounts, deals and tax-exempt shopping.
Special TechSoup offer for a free 180 days membership, and up to $150 in discounts on eligible orders.
Spark Good (walmart.com/sparkgood) is a charitable platform that enables nonprofits to receive donations directly from customers and associates.
Answers about how you can do more with Walmart!"
How to Make a Field Mandatory in Odoo 17Celine George
In Odoo, making a field required can be done through both Python code and XML views. When you set the required attribute to True in Python code, it makes the field required across all views where it's used. Conversely, when you set the required attribute in XML views, it makes the field required only in the context of that particular view.
The chapter Lifelines of National Economy in Class 10 Geography focuses on the various modes of transportation and communication that play a vital role in the economic development of a country. These lifelines are crucial for the movement of goods, services, and people, thereby connecting different regions and promoting economic activities.
Philippine Edukasyong Pantahanan at Pangkabuhayan (EPP) CurriculumMJDuyan
(𝐓𝐋𝐄 𝟏𝟎𝟎) (𝐋𝐞𝐬𝐬𝐨𝐧 𝟏)-𝐏𝐫𝐞𝐥𝐢𝐦𝐬
𝐃𝐢𝐬𝐜𝐮𝐬𝐬 𝐭𝐡𝐞 𝐄𝐏𝐏 𝐂𝐮𝐫𝐫𝐢𝐜𝐮𝐥𝐮𝐦 𝐢𝐧 𝐭𝐡𝐞 𝐏𝐡𝐢𝐥𝐢𝐩𝐩𝐢𝐧𝐞𝐬:
- Understand the goals and objectives of the Edukasyong Pantahanan at Pangkabuhayan (EPP) curriculum, recognizing its importance in fostering practical life skills and values among students. Students will also be able to identify the key components and subjects covered, such as agriculture, home economics, industrial arts, and information and communication technology.
𝐄𝐱𝐩𝐥𝐚𝐢𝐧 𝐭𝐡𝐞 𝐍𝐚𝐭𝐮𝐫𝐞 𝐚𝐧𝐝 𝐒𝐜𝐨𝐩𝐞 𝐨𝐟 𝐚𝐧 𝐄𝐧𝐭𝐫𝐞𝐩𝐫𝐞𝐧𝐞𝐮𝐫:
-Define entrepreneurship, distinguishing it from general business activities by emphasizing its focus on innovation, risk-taking, and value creation. Students will describe the characteristics and traits of successful entrepreneurs, including their roles and responsibilities, and discuss the broader economic and social impacts of entrepreneurial activities on both local and global scales.
1. dr. Hendra - Basic Knowledge of The Wrinkles Final A .ppt.pdf
1. CURICULUM VITAE
Nama
Tempat dan tanggal lahir
Alamat Rumah
Status Kepegawaian
Jabatan
: HENDRA GUNAWAN, dr. SpKK(K), Ph.D, FINSDV
: Jakarta, 15 September 1969
: Jl. Tambak C No. 28 Jakarta Pusat 10320
: Pegawai Negeri Sipil Departemen Kesehatan
: Kepala Divisi Dermatologi Infeksi
Departemen Ilmu Kesehatan Kulit dan Kelamin
Fakultas Kedokteran Universitas Padjadjaran/
RSUP Dr. Hasan Sadikin Bandung
: Departemen Ilmu Kesehatan Kulit dan Kelamin
Faklutas Kedokteran Universitas Padjadjaran/RSHS Jl. Pasteur No. 38
Bandung
Alamat Kantor
Riwayat Pendidikan
Fakultas Kedokteran UNPAD Bandung
Diploma Course in Dermatology Bangkok, Thailand PPDS I.K.
Kulit dan Kelamin FK UNPAD, Bandung Program Doktoral
Juntendo University Tokyo, Jepang Fellowship in
Dermatopathology and Dermoscopy
Toranomon Hospital Tokyo, Jepang
Lulus tahun
Lulus tahun
Lulus tahun
Lulus tahun
Tahun 2014
1994
2002
2005
2008
Riwayat Pekerjaan
Dokter BPPKA Pertamina
Kepala Puskesmas Mapin Kebak Sumbawa
Dokter RS M.H. Thamrin Pondok Gede Jakarta
Staf Departemen I.K. Kulit dan Kelamin RSHS
Tahun
Tahun
Tahun
Tahun
1994-1995
1995-1998
1998-1999
2006-sekarang
3. 5. Manifestation of facial wrinkle
4. Histology of wrinkle
3. Pathogenesis of wrinkle
2. Factors in developing wrinkle
1. Nature of wrinkle
OVERVIEW
4. • When the effects of skin aging on face are addressed,
what is really being discussed is …
INTRODUCTION
• Aging process that occurs in all organs,
but most visible in the skin
7. One indicator of skin aging that appear as
furrows or lines on the facial skin surface.
INTRODUCTION
Multifactorial
etiology Consequence
intrinsic &
extrinsic aging
Baumann L. Wrinled skin. In: Cosmetic dermatology.. 2009. p. 145-7.
8. • Fine wrinkles flattening epidermis & atrophy
dermal papilla
Wells
(1954)
• Wrinkling worsened by brittleness of
horny layer with aging
Lorincz
(1960)
• Histologically couldn’t differentiate
wrinkle from surrounding skin
Wright &
Shellow
(1965)
NATURE OF WRINKLE
9. Is the wrinkle a histological non-entity?
NATURE OF WRINKLE
Montagna and Carlisel (1979)
Nothing peculiar can be seen in histological
preparations of wrinkle
15. TELOMERE SHORTENING
• Telomeres:
– Terminal portions of mammmalian chromosomes
– Composed of hundreds short sequences of repeats base pairs TTAGGG
– Cap the ends of chromosomes preventing fusion
Yaar M, et al. Br J Derm 2007; 157:877
16. TELOMERE SHORTENING
• During cell division:
– DNA polymerase cannot
replicate terminal base pairs
of chromosome
– Continuously lost on
replication shortening
chromosome Telomeres get “too short”
APOPTOSIS or SENESCENCE
Play a role in AGING
“Biological Clock”
17. Yaar M, et al. Br J Derm 2007; 157:877
TELOMERE SHORTENING
21. • Abnormal collagen Collagen Glycation
Nonenzymatic
process
Reactions
between sugar
to ECM collagen
Advanced
glycation end/
AGE product
(pentosidine)
Deposited on
collagen
Stiffer & less
susceptible to
remodeling
COLLAGEN LOSS
23. ELASTIN DEGRADATION
• Solar radiation enhances fibres degradation
• UV exposure increased elastase ELASTOSIS !
Structural deterioration & collapse of elastic
network loss & resorption of fine elastic fibres
• Abnormal elastic fibres decreased resilience
wrinkle.
24. ELASTIN DEGRADATION
• Degraded elastic fibres lose their 'snap‘ when
deformed they do not recover.
– The skin consequently sags.
• Numerous fibres serve an anchoring function &
keep epidermis in tight fit with dermis
– When lost dermis becomes more lax & surface is
then thrown into many foldings WRINKLE.
25. • Skin atrophy
– Thinning epidermis
– Flattening of DEJ telltale signs
– Dermal atrophy
• Muscle contraction
– Muscles of face are inserted into the skin itself
– Function: Open & close orifices: eyes & mouth
– Forces & repeated contraction permanent wrinkle
• Skeletal resorption
– Maxillary resorption excess soft tissue of upper lip
perioral wrinkling.
DMS STRUCTURE
27. •Aging of facial skeleton may be due to bone resorption
•Without structural support of bone noticeable changes in
other layers of overlying soft tissue and skin
BONE RESORPTION
28.
29. • There are no histological difference between
wrinkles and surrounding tissues.
Histochemical stains
• Histological findings appropriate to skin
aging subject and skin region.
HISTOLOGY OF WRINKLE
30. • Epidermal thinning & flattening of DEJ
• Loss collagen, elastic fibres, glycosaminoglycans (GAG)
HISTOLOGY OF AGING SKIN
Laga AC, et al. The human cutaneous photoaging. AJP. 2009;174(2):357-60
31. Naylor EC, et al. Molecular aspects of skin ageing. Maturitas. 2011;69:249–56.
COMPONENTS OF YOUNG SKIN
34. • Epidermis thin with age reduced barrier repair &
elasticity
– Causing fine lines early signs of wrinkle
formation being 1 to 2 millimeters in depth
Nagwa H, et al. IJD. 2012;57(3):181-6.
HISTOLOGY OF AGING SKIN
35. • Collagen fibers thin, looese, and less well organized
• Collagen undergoes chemical changes reduce its
mechanical flexibility.
– Imperfect collagen repair “scar-like” patches of stiff
(Masson-Trichrome ×100)
Nagwa H, et al. IJD. 2012;57(3):181-6.
HISTOLOGY OF AGING SKIN
36. • Elastic fiber network in dermis degrades & is replaced
by poorly organized elastin
– Loss of resiliency: ability skin to quickly return to its
original shape after distortion.
HISTOLOGY OF AGING SKIN
Nagwa H, et al. IJD. 2012;57(3):181-6.
(Orcein ×100)
Large elastin deposits:
elastosis cause skin look
37. • Glycosaminoglycan (GAG) composition changes
• In aging skin with chronic photodamage Hyaluronic acid
– These changes affect water content of dermis
HISTOLOGY OF AGING SKIN
Low hyaluronic acid
High
hyaluronic acid
38. • Subcutaneous fat layer decreases markedly in thickness
HISTOLOGY OF AGING SKIN
YOUNGER SKIN AGING SKIN
41. It’s a configurational change result of mechanical stresses
acting on lax & excessive skin aged skin
Glove which heavy
duty over the years
New: Smooth
Old: Fabric grooves at
sites of stress
Fabric acquires creases
conformational
change
No chemical or
architectural
alteration
42. “Like the grooves worn into an old glove”
repeated movement
is configurational change
43. Type of Wrinkles
1= receding hairline
2= forehead rhytidosis
3= glabellar rhytidosis
4= brow ptosis
5= temple rhytidosis
6= upper lid redundancy and ptosis
7= lateral canthal rhytidosis
8= nasal root rhytidosis
9= lower lid redundancy and rhytidosis
10= lower lid fat pseudoherniation
11= malar bag formation
12= cheek rhytidosis
13= preauricular rhytidosis
14= nasal tip ptosis
15= cheek sagging
16= deepening nasolabial crease
17= facial rhytidosis
18= perioral rhytidosis
19= upper lip flattening and lengthening
20= thinning and atrophy of vermillion
21= chin pad ptosis
22= jowl formation
23= cervical rhytidosis
24= submental fat accumulation
25= platysmal banding
26= rhytidosis and midneck hollowing
27= submaxillary gland ptosis.
Zimbler MS, et al. Facial Plast Surg. 2001;9:179-87
44. Summary
• There are role of genetic, intrinsic & extrinsic aging, DMS
structures in wrinkles.
• Features of wrinkle: thinning epidermis, loss collagen,
degrading elastic fiber,, changing GAG composition,
thinning subcutan fat layer.
• Variables that influence aging:
– Repeated movement skin (facial expression)
• Much remains to be learned regarding science and
biomechanics of wrinkle further study is needed.
45. • Kligman AM. The anatomy and pathogenesis of wrinkles. British J Dermat. 1985;113:37-42.
• Zimbler MS, et al. Anatomy and pathophysiology of facial aging. Facial Plast Surg. 2001;9:179-87.
• Saghari S, et al. Wrinled skin. In: Baumann L. Cosmetic dermatology. 2nd ed. McGraw Hill: New
York. 2009. p. 145-7.
• Anson G, et al. Sleep wrinkles: Facial aging and facial distortion during sleep. Aesth Surg J. 2016;
36(8): 931–40.
• Green MR. The periorbital wrinkle. In: Baran R, et al. Textbook of cosmetic dermatology. 4th ed.
Informa: London. 2010. p.242-6
• Clinical Anatomy. Plastic Surgery Key. http://plasticsurgerykey.com/clinical-anatomy.
• Makrantonaki E, et al. Genetics and skin aging. Dermato-Endocrinol. 2012;4(3):280–4.
• Laga AC, at al. The translational basis of human cutaneous photoaging. The AJP. 2009;174(2):357-
60.
• Naylor EC, et al. Molecular aspects of skin ageing. Maturitas. 2011;69:249–56.
• Nagwa H, et al. Morphometry and epidermal fas expression of unexposed aged versus young skin.
IJD. 2012;57(3):181-6.
• Pittayapruek P, et al. Role of matrix metalloproteinases in photoaging and Photocarcinogenesis.
Int. J. Mol. Sci. 2016,;17,:868.
References