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Background and Objective: Radiofrequency currents are commonly used in dermatology to treat cutaneous and subcutaneous tissues by heating. The subcutaneous morphology of tissue consists of a fine, collagenous and fibrous septa network enveloping clusters of adipocyte cells. The architecture of this network, namely density and orientation of septa, varies among patients and, furthermore, it correlates with cellulite grading. In this work we study the effect of two clinically relevant fibrous septa architectures on the thermal and elastic response of subcutaneous tissue to the same RF treatment; in particular, we evaluate the thermal damage and thermal stress induced to an intermediate- and a high-density fibrous septa network architecture that correspond to clinical morphologies of 2.5 and 0 cellulite grading, respectively., Study Design/materials and Methods: We used the finite element method to assess the electric, thermal and elastic response of a two-dimensional model of skin, subcutaneous tissue and muscle subjected to a relatively long, constant, low-power RF treatment. The subcutaneous tissue is constituted by an interconnected architecture of fibrous septa and fat lobules obtained by processing micro-MRI sagittal images of hypodermis. As comparison criteria for the RF treatment of the two septa architectures, we calculated the accumulated thermal damage that corresponds to 63% loss in cell viability., Results: Electric currents preferentially circulated through the fibrous septa in the subcutaneous tissue. However, the intensity of the electric field was higher within the fat because it is a poor electric conductor. The power absorption in the fibrous septa relative to that in the fat varied with septum orientation: it was higher in septa with vertical orientation and lower in septa with horizontal orientation. Overall, maximum values of electric field intensity, power absorption and temperature were similar for both fibrous septa architectures. However, the high-density septa architecture (cellulite grade 0) had a more uniform and broader spatial distribution of power absorption, resulting in a larger cross-sectional area of thermal damage (≈1.5 times more). Volumetric strains (expansion and contraction) were small and similar for both network architectures. During the first seconds of RF exposure, the fibrous septa were subjected to thermal expansion regardless of orientation. In the long term, the fibrous septa contracted due to the thermal expansion of fat. Skin and muscle were subjected to significantly higher Von Mises stresses (measure of yield) or distortion energy than the subcutaneous tissue., Conclusion: The distribution of electric currents within subcutaneous tissues depends on tissue morphology. The electric field is more intense in septum oriented along the skin to muscle (top to bottom) direction, creating lines or planes of preferential heating. It follows that the more septum available for preferential heating, the larger the extent of volumetric RF-heating and thermal damage to the subcutaneous tissue. Thermal load alone, imposed by long-exposure to heating up to 50 °C, results in small volumetric expansion and contraction in the subcutaneous tissue. The subcutaneous tissue is significantly less prone to non-reversible deformation by a thermal load than the skin and muscle., (© 2015 Wiley Periodicals, Inc.)

Background and Objectives: Radiofrequency (RF) energy exposure is a popular non-invasive method for generating heat within cutaneous and subcutaneous tissues. Subcutaneous fat consists of fine collagen fibrous septa meshed with clusters of adipocytes having distinct structural, electrical and thermal properties that affect the distribution and deposition of RF energy. The objectives of this work are to (i) determine the electric and thermal effects of the fibrous septa in the RF heating; (ii) investigate the RF heating of individual fat lobules enclosed by fibrous septa; and, (iii) discuss the clinical implications., Methods and Results: We used the finite element method to model the two-dimensional, time-dependent, electro-thermal response of a three-layer tissue (skin, subcutaneous fat, and muscle). We considered two different configurations of subcutaneous fat tissue: a homogenous layer of fat only and a honeycomb-like layer of fat with septa. Architecture of the fibrous septa was anatomically accurate, constructed from sagittal images from human micro-MRI. For a large electrode applied to the skin surface, results show that the absorbed electric power density is greater in some septa than in the surrounding fat lobules, favoring the flux of electric current density. Fibers aligned parallel to the electric field have higher electric flux and, consequently, absorb more power. Heat transfer from the septa occurs over time during and after RF energy delivery. There is a greater temperature rise in fat with fibrous septa., Conclusions: The presence of septa affects the local distribution of the static electric field, facilitates the flux of electric current and enhances the bulk electric power absorption of the subcutaneous fat layer. Fibrous septa aligned with the local electric field have higher absorbed power density than septa oriented perpendicular to the electric field. Individual fat lobules gain heat instantly by local power absorption and, eventually, by diffusion from the surrounding septa., (Copyright © 2013 Wiley Periodicals, Inc.)

Study Design: Measurement of sympathetic effector organ responses to selective activation of muscle and skin nociceptors below lesion in spinal cord-injured (SCI) subjects., Objectives: To test whether selective noxious stimulation below lesion causes exaggerated sympathetic responses in human SCI., Setting: Prince of Wales Medical Research Institute, Australia., Methods: Twelve subjects (C5-T10, ASIA A-C), none of whom had sensation below the lesion, were included in the study. Selective stimulation of muscle or cutaneous nociceptors was produced by bolus injection of hypertonic (5%) saline into the tibialis anterior muscle or overlying skin and compared with non-noxious electrical stimulation of the abdominal wall. Cutaneous vasoconstrictor (photoelectric plethysmography) and sudomotor (skin conductance) responses, in addition to respiration, heart rate and continuous arterial pressure were monitored., Results: Electrical stimulation of the abdominal wall caused a significant increase in arterial pressure (31.8+/-6.1%). Conversely, intramuscular or subcutaneous injection of hypertonic saline caused no significant changes in blood pressure (-3.0+/-2.4%; -1.4+/-3.4%) heart rate, skin blood flow or sweat release., Conclusions: While hypertonic saline injected into muscle or skin induces strong pain, cutaneous vasoconstriction and sweat release in able-bodied subjects, we saw no evidence of exaggerated sympathoexcitation when these same noxious stimuli were delivered below lesion in subjects with SCI. This suggests that certain types of somatic noxious input may not trigger autonomic dysreflexia, and questions the concept that any painful stimuli originating below lesion can reliably trigger dysreflexia.

Many types of invisible electromagnetic waves are produced in our atmosphere. When these radiations penetrate our body, electric fields are induced inside the body, resulting in the absorption of power, which is different for different body parts and also depends on the frequency of radiations. Higher power absorption may result into health problems. In this communication, effects of electromagnetic waves (EMW) of 41 and 202 MHz frequencies transmitted by the TV tower have been studied on skin, muscles, bone and fat of human. Using international standards for safe exposure limits of specific absorption rate (SAR), we have found the safe distance from TV transmission towers for two frequencies. It is suggested that transmission towers should be located away from the thickly populated areas and people should keep away from the transmission towers, as they radiate electromagnetic radiations that are harmful to some parts/tissues of body.

Radiation-induced skin injury has been reported for multiple fluoroscopic procedures. Previous studies have indicated that prolonged fluoroscopic exposure during even a single percutaneous coronary intervention (PCI) may lead to cutaneous radiation injury. We document a novel case of deep muscle damage requiring wide local debridement and muscle flap reconstruction in a 59-year-old man with a large radiation-induced wound to the lower thoracic region following 1 prolonged PCI procedure. The deep muscular iatrogenic injury described in this report may be the source of significant morbidity. Recommendations to reduce radiation-induced damage include careful examination of the skin site before each procedure, minimized fluoroscopy time, utilization of pulse fluoroscopy, employment of radiation filters, and collimator s and rotation of the location of the image intensifier.

Fibrosis is characterized by proliferation of fibroblasts and deposition of extracellular matrix (ECM). As alterations in the composition of ECM may account for its chronic extension, we studied the expression of the tenascin-C (TN-C) and tenascin-X (TN-X) ECM glycoproteins in our pig model of the effects of accidental exposures to radiation, in which cutaneous and muscle fibrosis developed after the induction of necrosis after a high single dose (160 Gy at the skin surface) of gamma rays. We found that, in the healed fibrotic dermis and underlying muscle fibrosis, the amount of TN-C mRNA was increased up to 18- and 39-fold, respectively, compared to normal dermis, whereas the level of TN-X mRNA remained almost unchanged. In analyses by Western blotting, the two main TN-C isoforms of 235-240 and 190-200 kDa increased up to 45- and 105-fold in fibrotic tissues, respectively. The large isoform was expressed more strongly than the smaller, although in healed fibrotic scar tissues their ratio was lower in protein than in RNA. Compared to unirradiated skin, an immunohistological study revealed stronger TN-C staining at the dermo-epidermal junction and in areas of remodeling in healed skin. An intense extracellular staining was observed around myofibroblasts in muscle fibrosis. Therefore, the gene encoding TN-C is highly up-regulated in fibrotic tissues, and mechanisms regulating the levels of TN-C variants occur at both the RNA and protein levels. Each isoform might play a distinct role in the chronic activation of fibrosis by differentially regulating mechanisms like cell adhesion, migration or proliferation.

Background/objective: A new pulsed near-infrared laser was developed for incision of soft tissues. This article presents a preliminary investigation of the 1.44-micron laser., Methods: A prototype laser was used with a cleaved 600-micron quartz fiber (1.44 microns, 5-30 Hz, 30 W max.). Standardized 5-cm incisions were made on skin, striated muscle, and liver in anesthetized New Zealand White rabbits. The animals were euthanized and the tissues were immediately harvested, and histologic examination completed after hematoxylin and eosin (HE) staining. The acute zone of coagulation was measured. A wound healing study was conducted on anesthetized NZW rabbits. The hind leg muscle was exposed and four, 5-cm incisions were made using the laser (0.5 J, 25 Hz) and four incisions were made with an electrosurgical unit on coagulating current (25 W). The incisions were marked and the overlying skin reapproximated. One rabbit was euthanized on day 11 and one on day 21. The wounds were exposed and excised for histology., Results: The acute zone of injury was 1160 +/- 120 microns to 1250 +/- 110 microns for skin; 70 +/- 20 microns to 400 +/- 280 microns for muscle, and 660 +/- 120 microns to 1930 +/- 300 microns for liver. The chronic study demonstrated less inflammation in the laser wounds on day 11 and a chronic inflammatory response on day 21. No gross differences in healing were noted., Discussion/conclusion: The 1.44 microns laser wavelength interacts with tissues in a manner that is substantially equivalent to the holmium laser (2.1 microns). Further studies of the 1.44 microns laser and delivery system development are warranted.

Although radiation-induced fibrosis has long been characterized by excess fibroblast proliferation and extracellular matrix deposition, the origin of cell activation in these complications of radiotherapy or radiation accidents is still controversial. The present work was designed to test the hypothesis that the abnormal production of TGF-beta 1 in irradiated tissues results in continuous signals for tissue repair and long-term cell activation. We examined gene expression of this growth factor in a well-characterized pig model of radiation-induced fibrosis, using Northern-blot and slot-blot hybridizations and indirect immunofluorescence. We found that the TGF-beta 1 mRNA level was increased 19-fold in the irradiated skin during the early erythematous phase, which started 3 weeks after irradiation. During the later phases of fibrosis, from 6 to 12 months after irradiation, the TGF-beta 1 gene was highly expressed in the repaired skin and the underlying muscular fibrotic tissue, with 10- and 8-fold maximal increases, respectively. In addition, we found that the beta-actin mRNA level was increased in the fibrotic tissue. Immunostaining for TGF-beta 1 revealed the presence of the protein in endothelial cells of capillaries, in myofibroblasts, and in the collagenous matrix of the fibrotic tissue. These results suggest that TGF-beta 1 may be one of the key cytokines involved in the cascade of events that leads to radiation-induced fibrosis, at both early and late stages.

The method is proposed for primary evaluation of the ability of drugs of various genesis to affect the accumulation of radionuclides in cells. Extracts of mycelium of wood-rotting Basidiomycetes were shown to prevent 137Cs accumulation in cultures of human embryo fibroblast.

Leg contracture, defined as the difference in extensibility of the control and irradiated hind legs of mice, was found to correlate with single doses of radiation from about 20 to 80 Gy. The time of development of the early phase of the response coincided with that reported for the appearance of the acute skin response, and in some cases, partially reversed as this reaction healed. The contracture then progressed again at a moderate rate through 90 days, and then more slowly through one year. Skin contraction, measured by decrease in intertattoo distance, was assayed in the same mice. It followed the same time course as leg contracture, but had a different dose-response relationship. Maximal contraction occurred following doses of 30 Gy or more, reaching this level sooner following higher doses. The early reactions in individual mice were not reliable in predicting late response for either assay. To determine the contribution of skin contraction to the overall leg contracture response, mice were sacrificed and the leg contracture measured before and after the removal of the skin of the leg. After doses of up to 30 Gy, little contracture remained from skinning the leg, indicating that skin contraction was largely responsible for leg contracture in this dose range. After doses of about 45 Gy and above, some contracture remained in the skinned legs, although less than in intact legs. This indicated that injury to the deeper tissues of the leg as well as to the skin was responsible for contracture at these higher doses. There was little or no enhancement of either skin contraction or leg contracture by the hypoxic cell sensitizers metronidazole or misonidazole.

The dielectric properties of a rat tumour (rhabdomyosarcoma R1H), skin and muscle were measured in vivo with an open-ended coaxial line and a computer-controlled system based on a network analyser. The permittivity of the tumour R1H and of the normal tissues in anaesthetised rats was determined at frequencies between 0.2 and 2.4 GHz. No significant differences were observed either between rat tumour and muscle or between normal and 15 Gy irradiated rat tumour and skin. However, after a hyperthermia treatment at 43 degrees C for 60 min the dielectric properties, especially of the rat skin, changed due to the hyperthermic induced oedema which is related to an increase in tissue water content. The process of the oedema modifies the dielectric properties of the skin to a higher degree than those of the tumour.

Our present results were obtained in a histological and histoenzymological study done with an experimental porcine model of high dose local irradiation. This model was chosen to simulate accidents which occurred among humans. It enabled the determination of several post-irradiation phases. After an initial phase, with superficial lesions, ischemic necrosis occurred three weeks after irradiation. After two months, expanding necrosis became obvious in the muscular region preceded by an initial spread of vascular lesions. Histo-enzymological studies of the muscular tissue show metabolic alterations which precede histological modifications. Finally, sclerosis observed was characterized by its mutilating pseudo-sarcomatous aspect.

Prompted by an alleged case of child abuse resulting from microwave oven burns and the discovery of one other case, an animal model was chosen to explore microwave burn characteristics upon living, perfusing tissue. Anesthetized piglets were exposed to radiation from a standard household microwave oven for varying lengths of time, sufficient to result in full-thickness skin and visceral burns. Characteristic burn patterns were grossly identified. Biopsies studied with both light and electron microscopy demonstrated a pattern of relative layered tissue sparing. Layered tissue sparing is characterized by burned skin and muscle, with relatively unburned subcutaneous fat between these two layers. These findings have important forensic and patient care implications.