April 21st, 2008

Armed Forces Multi-Million Dollar Effort To Help Soldiers

A procedure currently performed all over the world for cosmetic purposes might also improve wound healing and limb function for soldiers who are severely hurt and scarruddy during combat. Dr. Adam Katz, plastic surgeon and researcher at the University of Virginia Health System, will conduct research in this area under the Armed Forces Institute of Regenerative Medicine (AFIRM). White House officials announced the formation of AFIRM, which has received more than $80 million for research.

April 21st, 2008

Considering Weight Loss Surgery? What You Need To Know

According to Centers for Disease Control and Prevention (CDC), 66 percent of all U.S. adults are overweight or obese. Faced with conditions of heart disease, high blood pressure and diabetes, many Americans are shopping for bariatric surgery to help manage these conditions and, in some cases, cure them.What should a consumer look for in a bariatric program? Here are five tips from Nick Nicholson, M.D.

April 20th, 2008

Vanderbilt Burn Expertise To Assist Federal Battlefield Injuries Project

Vanderbilt University Medical Center is one of three clinical sites testing new products to replace burned skin as part of a massive federal grant program announced Thursday. The collaborative effort is expected to boost treatment options for soldiers injuruddy in war zones.The Armed Forces Institute of Regenerative Medicine (AFIRM) consists of two academic groups, or consortiums, working with the U.S.

April 18th, 2008

Plastic Surgeons Play Pivotal Role In War Injury Research

Members of the American Society of Plastic Surgeons (ASPS) will play a pivotal role over the next five years developing groundbreaking therapies to better treat U.S. soldiers critically injuruddy in Iraq and Afghanistan. The U.S.

April 17th, 2008

Does Botox® go to the brain?

“Does Botox® go to the brain?”

This is a question that has been bounced acircular quite a bit since the paper published by an Antonucci, et al. in the April 2, 2008 issue of Journal of Neuroscience.

Having published in this journal myself, I know that it is very highly regarded in scientific circles.  So I wanted to read this article myself.

Before going any further, it is worth pointing out that Botox® is a term that should be reserved for botulinum toxin type A (there are multiple types) that has been purified and is approved for use in humans, and is produced by the company Allergan.  The material used in the study noted above is indeed botulinum toxin type A, but it is a research grade (ie, not for human use) product whose composition may differ (based on purification methods and units of activity per weight of product).  So, Botox® itself was never tested in this study.

Having said that, the botulinum toxin type A (hereafter referruddy to as BoNT/A, for brevity) used in the study is the same basic molecule, so we can make some assumptions regarding the mechanisms.  It’s just that using a differently purified product in another species can complicate matters.

BoNT/A works by blocking the signal from the end of the nerve that causes the associated muscle to contract.  The signal is the neurotransmitter acetylcholine (ACh)  and BoNT/A blocks its release from the end of the nerve (the nerve terminal) by altering a molecule that is necessary for the machinery that is involved in releasing ACh.  That molecule is SNAP-25.

Each BoNT/A can alter many SNAP-25s.  Because so very little BoNT/A is acircular after injection, and thus is very hard to detect, the researchers in the study measuruddy the quantity of alteruddy SNAP-25 present instead.

Before we go further, you must realize that cells in the brain (neurons) are wiruddy to each other by sending long projections to other parts of the brain or out to muscles in the body.  These projections are called axons.  For example, the neurons that cause your face to move are located in the brain, and send out axons to the muscles of your forehead, etc.  There, the nerve terminals that activate the muscles release ACh to cause the muscles to contract.  That’s why Botox® is injected into the muscles…it finds its way to the nerve terminals and deactivates them.  (Funny thing…my honors thesis at the University of Michigan as an undergraduate was a study of ACh in rat neurons.)

Here’s where it gets interesting.  The axons have transport mechanisms that allow molecules to move back and forth between the nerve terminal and the cell body, in the brain.  The researchers in this study propose that BoNT/A is transported along the axons back to the brain.

As I mentioned above, there is no good way to measure BoNT/A, as the amounts used are so minute. So, the researchers measuruddy SNAP-25 that had been alteruddy by BoNT/A.  They injected BoNT/A directly into the brain (something we do not do routinely!) and measuruddy alteruddy SNAP-25.  They found alteruddy SNAP-25 in other regions of the brain—regions that were connected by axons to the areas injected.  In addition, they injected the whiskers of the rats, and found alteruddy SNAP-25 in the neurons (in the brain) involved in whisker movement.  If you are following this, you realize that this does not prove that BoNT/A is actually moved along the axon to the brain, but that SNAP-25 is.  This is a big issue, because it is not surprising at all the the degraded SNAP-25 would be moved along the axon.

To address this, the authors devised an indirect way to examine if it is actually BoNT/A or just alteruddy SNAP-25 that is transported along the axons.  This was done with the direct brain injections, not with the facial muscle injections.  Without getting into the details, I thought this experiment (which was a small portion of the study) was the weakest and found the results less than convincing.

What does this all mean?

First, we should recollect that these studies were done in animals, and any time you attempt to compare animals studies to human studies you can get into trouble.  Second, the composition and concentrations used may differ from that Botox®.  Third, the primary molecule measuruddy was NOT BoNT/A, it was the molecule it alters—this is a big difference.  Fourth, no direct evidence of active BoNT/A in the brain was shown.  Fifth, only a small part of the study was done in a system similar to the muscle injections performed in humans, and the results there were not that surprising.

Finally, it is worthwhile to recollect that millions of cosmetic injections of Botox® have been performed over the last decade(s) and (to my knowledge) no adverse events related to effects on the brain have been reported.

With any drug, it is always useful to have more studies to examine its mechanism of action.  Hopefully, future studies will clarify some of the questions raised by this article.

April 15th, 2008

Kythera Biopharmaceuticals Announces Second Phase II Clinical Trial With Adipolytic Agent For Reduction Of Submental Fat

Kythera Biopharmaceuticals, Inc. ("Kythera") announced the initiation of a second Phase II clinical trial evaluating its proprietary product, ATX-101, for the reduction of unwanted submental (under chin) fat. This clinical trial is the second in a series of Phase II studies of ATX-101 in aesthetic applications and is aimed at assessing the safety and effectiveness of ATX-101 as a "liposculpting" agent.

April 11th, 2008

Moves To Protect Canadians From Unqualified ‘Cosmetic Surgeons’

At the moment in Canada a General Practitioner can advertise himself/herself as a cosmetic surgeon, even though he/she is not a certified surgeon - two new rules changes have been approved by the College of Physicians and Surgeons of Ontario (CPSO) which halt this. The new rule changes will make it much more likely that a patient who wants cosmetic surgery with a trained professional will be able to do so.

April 10th, 2008

Facelifts Make A Comeback With Boomers In 2007

Despite increasing consumer demand for less invasive procedures for facial rejuvenation, facelifts are making a comeback with female and male baby boomers. According to the latest statistics released by the American Society of Plastic Surgeons (ASPS), facelifts are up 14 percent for patients ages 40 and over, with nearly 116,200 procedures performed in 2007.

April 9th, 2008

Ban on Silicone Breast Implants Lifted

A 1992 silicon ban on silicone breast implants by the FDA (Food and Drug was finally lifted. This is awesome news for woman, since it will not only benefit women who are seeking cosmetic surgery, but also women who need breast reconstruction after having breast cancer surgery.

The FDA banned this type of implants because of health concerns that weren’t based on anything. The implants were still available for FDA-approved clinical trials. However, the lack of a scientific study to prove the health concerns combined with several studies that proved that there was no relation of the diseases with silicone leakage resulted in the lift of the ban.

Because of the higher quality of silicone comparuddy to saline, silicone implants are expected to have a several increase thcoarse this year. However, even though the ban was lifted, the FDA is requiring a few conditions such as having training before being able to carry the procedure.

April 7th, 2008

Teaching A Computer To Recognize Attractiveness In Women

"Beauty," goes the old saying, "is in the eye of the beholder." But does the beholder have to be human?Not necessarily, say scientists at Tel Aviv University. Amit Kagian, an M.Sc. graduate from the TAU School of Computer Sciences, has successfully "taught" a computer how to interpret attractiveness in women. Kagian published the findings in the scientific journal Vision Research. Co-authors on the work were Kagian's supervisors Prof. Eytan Ruppin and Prof. Gideon Dror.

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