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Biomedical subjects

J L Levy

Publications and source records attributed to J L Levy.

At least 19 recordsLinked to original sources
PubMed2006

Management of the ageing eyebrow and forehead: an objective dose-response study with botulinum toxin.

OBJECTIVE: To determine if clinical use of two different doses of botulinum exotoxin A (BTX-A) injections to the forehead area result in wrinkle reduction and modifications of eyebrow position. DESIGN: Prospective study. SETTING: Private practice, Dermatologic Laser Centre, Marseille, France. SUBJECTS: Twenty-four adult patients treated with BTX-A (Vistabel) injections for forehead rhytides. INTERVENTION: Of the 24 patients, 12 received BTX-A injections of 5 U only and 12 received injections of 10 U into the forehead, with or without treatment of the lateral forehead. The eyebrow position, forehead height and number of forehead lines determine the number of injection points. Patients were evaluated before injection and every 2 months after treatment during next 8 months. RESULTS: In the two groups of 12 patients, we found no significant change between the two doses. At each time after injections (every 2 months until 8 months), both groups showed a statistically significant improvement except at 8 months. Both groups exhibited the same results on standardized photos and on 3D skin profilometry. CONCLUSIONS: The two doses of BTX-A injections into the forehead gave the same results. The duration of the effect is similar along 8 months. This study emphasizes the role of low doses of BTX-A injections to obtain good clinical results without freezing aspect.

Adult↗
PubMed2005

Assessment of the efficacy of nonablative long-pulsed 1064-nm Nd:YAG laser treatment of wrinkles compared at 2, 4, and 6 months.

Rhytides represent an aesthetic problem for a large percentage of the population. Many methods, both noninvasive and invasive, have been used for the treatment of wrinkles. Recently, the long-pulsed 1064-nm Nd:YAG laser has been shown to enhance dermal collagen synthesis without damaging the epidermis. The purpose of this preliminary study is to evaluate the use of the long-pulsed Nd:YAG laser in the nonablative treatment of periocular and perioral wrinkles. Ten patients with facial wrinkles were treated with the long-pulsed 1064-nm Nd:YAG laser, at a spot size of 5 mm in diameter, energy density of 13 J/cm2, exposure time per pulse of 300 microseconds, and a repetition rate of 7 Hz. All patients had a total of three treatments, once every 2 weeks. Subjective (patient satisfaction index [SI]) and objective (both physician- and computer program-based clinical index [CI]) assessments were performed before the first and third treatment sessions, and at 2, 4, and 6 months after the last treatment. At 6 months after the final treatment session, the patients' subjective SI was maintained at 40%, and had peaked at 50% 2 months after the final session. Physician assessment showed a CI of 40% at the 6-month assessment point and the computer program showed a 50% CI. The greatest level of effect with long-pulsed Nd:YAG laser nonablative skin rejuvenation for facial wrinkles was seen 2 months after the final treatment. Effects were still visible at the 6-month period, but showed a tendency to decrease. Maintenance treatments are required to achieve good patient satisfaction.

Adult↗
PubMed2004

Combined nonablative skin rejuvenation with the 595- and 1450-nm lasers.

BACKGROUND: Histologic findings are not echoed in the visible effect in the epidermis after skin rejuvenation. SUBJECTS AND METHODS: Ten women (Group A) received five treatment sessions with a 595-nm pulsed dye laser immediately followed by a 1450-nm diode laser. Two other demographically similar groups of 10 patients each, Groups B and C, were treated with the 595-nm pulsed dye laser or the 1450-nm diode laser alone, respectively. RESULTS: Good dermal collagen remodeling was observed in Group A. Overall better and faster results were seen in Group A. The 6-month clinical outcome was best in Group A followed by Group C and Group B. CONCLUSIONS: Wavelengths of 595 plus 1450 nm for skin rejuvenation produced good results with much higher patient satisfaction than those obtained with the 595- or 1450-nm wavelengths alone.

Adult↗
PubMed2003

Photography in dermatology: comparison between slides and digital imaging.

BACKGROUND: Clinical photography is an essential tool for any medical speciality, such as dermatology, wherein accurate records are required of pre, intra and postoperative findings, plus quick access to these records for comparison and evaluation purposes. Clinical photography is important not only to the surgeon, but also to the patient, so that a realistic objective assessment of improvement may be made. Conventional emulsion film-based prints from negatives and positive colour transparencies revolutionised clinical records when they first appeared. Now the appearance and rapid development of digital photography is bringing about yet another revolution. AIM: To compare conventional with digital photography from the standpoints of cost-effectiveness, ease of archiving and ease of retrieval. The quality of the imaging was not dealt with. METHODS: A professional clinical photographer took images using: Nikon F3 (conventional emulsion based photography); FotoFinder Derma (digital photography). RESULTS: Although traditional emulsion-based photographs are quicker to take, digital imaging provides an almost immediately available image and is much swifter to use for classification, later retrieval and comparison between serial images. CONCLUSIONS: Despite the initial expense of acquiring digital equipment compared with traditional photographic apparatus, when examined over a five-year period, both formats cost approximately the same. Digital photography offers advantages in ease of archiving and storage, savings in time and space, extremely quick retrieval and very easy comparison of images. Digital photography is very much the way of the future in dermatological clinical imaging.

Journal Article↗
PubMed2001

Er:YAG laser resurfacing using combined ablation and coagulation modes.

BACKGROUND: The two main laser types used in resurfacing, the CO2 and the Er:YAG lasers, have their supporters and detractors, and each system has clear advantages and disadvantages. OBJECTIVE: The Er:YAG laser can be used in the usual efficient ablative mode, followed by reprogramming to achieve nonablative deeper dermal coagulation associated with the CO2 laser, thereby achieving the main advantages of both laser types. PATIENTS AND METHODS: Twenty-three female patients, ages 42-72 yrs, skin types I-IV, were treated. The epidermis was first removed in the ablative settings in a single pass with 50% overlap. The Er:YAG laser was reprogrammed for the subablative mode, and several passes produced controlled residual thermal damage (RTD) without further ablation. RESULTS: At 2 months postresurfacing the results were assessed. Thirteen patients were rated "very good," eight as "good," and two as "fair." CONCLUSION: The dual mode Er:YAG laser can first be used in the ablative mode to remove the epidermis with minimal RTD, following which, in the subablative mode, the same laser induces a controlled layer of dermal RTD, stimulating the dermis to achieve collagenesis and collagen remodeling and giving good long-term results.

Adult↗
PubMed2001

Treatment of wrinkles with the nonablative 1,320-nm Nd:YAG laser.

Ablative laser resurfacing with the CO2 and Er:YAG lasers has become a well-accepted and well-reported modality for skin rejuvenation of photoaged and photodamaged skin. However, the side effects associated with these lasers, such as exudation and crusting followed by prolonged erythema, are often socially disturbing for the patient. A nonablative 1,320-nm pulsed Nd:YAG system has been developed that controls dermal collagen damage while preserving the epidermis. Thirteen patients are presented on whom periocular wrinkle treatment was carried out during two sessions 1 month apart. Side effects were minimal. Histology showed improvement in the previously typical sun-damaged dermis. However, although physician assessment noted a trend toward macroscopic improvement, almost all patients failed to see any improvement. The authors conclude that further studies of the ideal parameters are required before the 1,320-nm Nd:YAG laser can be indicated successfully in stand-alone, nonablative wrinkle removal. In addition, patients should be selected carefully, and a complementary minimally aggressive technique should be used to restore a youthful appearance to the epidermis.

Adult↗
PubMed2000

Intense pulsed light treatment for chronic facial erythema of systemic lupus erythematosus: a case report.

BACKGROUND: A 33-year-old woman, who had been diagnosed previously with systemic lupus erythematosus, presented with chronic erythema and rosacea of the face. The patient suffered from flushing and burning of the facial skin and sought prior treatment with anti-malarial drugs. METHOD: After various treatment options were discussed with the patient, she agreed to undergo intense pulsed light therapy. RESULTS: Improvement was noted after the first session and 75% clearance was observed at 1 month after a second session. There were no adverse effects associated with the treatment. One year later it was observed that the results of the two treatments had been maintained. CONCLUSION: This case report suggests that there is another safe and efficacious alternative for treatment of chronic erythema and rosacea.

Adult↗
PubMed1999

Treatment of individual café au lait macules with the Q-switched Nd:YAG: a clinicopathologic correlation.

BACKGROUND: Café au lait macules (CALMs) respond variably to treatment with lasers. This study was carried out to identify which individual features of CALMs could predict a good clinical response to treatment. METHODS: Twenty-two patients aged 3-43 years were treated with the frequency-doubled Q-switched Nd:YAG (10 ns, Ø = 3 mm, 2.0 to 3.0 J/cm2). Biopsy specimens of the CALMs were obtained before treatment in 11 patients to achieve the diagnosis of CALMs. Treatment of CALMs usually requires several laser sessions, so the treatment was carried out at 2-month intervals. Clinical follow-up was done 3 and 12 months after the final treatment to observe results and recurrences. RESULTS: The analysis shows that the only statistically significant criteria was the jagged aspects of the edges of the CALMs. Consequently, this criteria should be evaluated in further studies in relation with the laser treatment of CALMs.

Adolescent↗
PubMed1999

A preliminary clinical and histopathological study of laser skin resurfacing using a frequency-doubled Nd:YAG laser after application of Chromofilm.

BACKGROUND AND OBJECTIVES: Carbon dioxide (CO2) and Er:YAG lasers are commonly used for laser skin resurfacing. In demonstrating their efficacy, intra- and interoperator variability may be important. In attempting to solve this problem, a new concept was developed which combines a previous application of an exogenous chromophore onto the skin in a standardized way (Chromofilm) and irradiation with a millisecond, low-power pulsed laser. MATERIALS AND METHODS: This study aimed to evaluate this new concept in vivo in human skin using a 532-nm Nd:YAG laser connected to a scanner using the following parameters: 532 nm, 2W, 1-mm spot size, 30-mm2 hexagonal surface irradiation and 50-120-ms pulse duration. The laser irradiation was performed both 15 h and 1 h prior to the facelift procedure. Tissue samples were examined histologically to determine the injury depth using nitroblue-tetrazolium chloride (NBTC) staining, haematoxylin-eosin staining and Masson's staining. RESULTS: Morphometric analysis of histological preparations showed that the depth of injury was dose-dependent: 50-ms pulse duration induced total epidermis ablation and fine dermal coagulation; 120-ms pulse duration induced dermal coagulation down to 120 microns. No residual carbon film was observed on histologic sections. CONCLUSION: Laser skin resurfacing using a 532-nm laser irradiation after application of a carbon film transfer is an effective method for skin resurfacing. With this new galenic approach (Chromofilm), the control of all parameters (thickness, chromophore concentration and distribution) can be achieved to predict the thermal injury obtained after laser irradiation.

Burns↗
PubMed1999

[Facial aging. Analysis of esthetic semiology and proposal for systematic treatments].

Surgical literature is severely lacking in anatomo-clinical descriptions of facial aging. Only a few authors provide minor reports on the pathophysiology of aging in order to propose methods of correction. It therefore appears important to start with a diagnosis of the lesions as precise as possible in order to be able to perform the most appropriate treatment. We propose a semeiological analysis of the face, not only stage by stage but layer by layer, starting with the skin, then the fat, muscle and bone. We will then consider the methods which appear to be the most suitable for correction of the various structures concerned by aging within the framework of a total facial reorganisation. We will conclude with a presentation of surgical cases describing the surgical techniques used, with respect to a semiological analysis from each case.

Esthetics↗
PubMed1989

Simulation analysis of an outpatient services facility.

Anderson Memorial Hospital in Anderson, South Carolina is in the process of constructing a new Outpatient Services Center. The Outpatient Services Center will combine existing outpatient services within the hospital and offsite services at the Outpatient Diagnostic Center. A simulation model of the proposed facility has been developed based on historical data. The information obtained from the simulation model includes the analysis of outpatient services utilization, patient waiting and flow times, and service area queue sizes. This information has been used to determine minimum facility design requirements, such as waiting room size, based on the expected demands.

Ambulatory Care↗
PubMed1983

Granulomatous prostatitis. Special reference to radiologic findings.

Cystourethrography was performed in 2 patients with nonspecific, noneosinophilic granulomatous prostatitis. Lengthening of the prostatic urethra was noted essentially in the inframontane portion, thus differentiating it from benign prostatic hypertrophy. The widening in the prostatic urethra differentiates it from carcinoma of the prostate.

Biopsy↗
PubMed1982

Paraganglioma complicating pregnancy and the puerperium.

A rare case of a paraganglioma (extraadrenal pheochromocytoma) that complicated both pregnancy and the puerperium is described. The patient presented a confusing clinical picture simulating pregnancy-induced hypertension, which, after delivery, masqueraded as intractable fever of unknown origin. Computed tomography precisely identified the presence and location of the mass, which had eluded detection despite exhaustive testing. Pheochromocytoma should be considered in the differential diagnosis of postpartum fever of unknown origin, especially if associated with paroxysmal hypertension.

Adult↗