Hasan M. El-Fakahany

Efficacy of mesotherapy in facial rejuvenation: a histological and immunohistochemical evaluation

Background  Mesotherapy, commonly known as “biorejuvenation” or “biorevitalization”, is a technique used to rejuvenate the skin by means of a transdermal injection of a multivitamin solution and natural plant extracts that are thought to improve the signs of skin aging.

Deoxyribonucleic acid repair and apoptosis in testicular germ cells of aging fertile men: the role of the poly(adenosine diphosphate-ribosyl)ation pathway

OBJECTIVE To explore the relationship between mens age and DNA damage repair proteins related to apoptosis in human testicular germ cells. DESIGN Retrospective case-control study. SETTING Academic institutions. PATIENT(S) Testicular specimens were obtained from 22 fertile volunteers aged 20-82 years. INTERVENTION(S) Deoxyribonucleic acid repair markers were assessed using immunohistochemical staining for the cell proliferation marker [proliferating cell nuclear antigen (PCNA)]; DNA repair markers [poly(adenosine diphosphate-ribose) polymerase-1 (PARP-1), poly(adenosine diphosphate-ribose) (PAR), X-ray repair cross-complementing1(XRCC1), and apurinic/apyrimidinic endonuclease 1 (APE1)]; and apoptosis-associated markers (caspase 9, active caspase 3, and cleaved PARP-1). MAIN OUTCOME MEASURE(S) The prevalence and cellular localization of the above markers in testicular tissues of young, middle aged, and old men. RESULT(S) Statistically significant differences in DNA damage repair-associated proteins (PARP-1, PAR, XRCC1, and APE1), and apoptosis markers (caspase 9, active caspase 3, and cleaved PARP-1) were observed in testicular samples from older men. These differences were most marked in spermatocytes. CONCLUSION(S) The study demonstrates that there is an age-related increase in human testicular germ cell DNA break repair and apoptosis with age.

Fractional versus ablative erbium:yttrium-aluminum-garnet laser resurfacing for facial rejuvenation: An objective evaluation

BACKGROUND Laser is one of the main tools for skin resurfacing. Erbium:yttrium-aluminum-garnet (Er:YAG) was the second ablative laser, after carbon dioxide, emitting wavelength of 2940 nm. Fractional laser resurfacing has been developed to overcome the drawbacks of ablative lasers. OBJECTIVE We aimed to objectively evaluate the histopathological and immunohistochemical effects of Er:YAG 2940-nm laser for facial rejuvenation (multiple sessions of fractional vs single session of ablative Er:YAG laser). METHODS Facial resurfacing with single-session ablative Er:YAG laser was performed on 6 volunteers. Another 6 were resurfaced using fractional Er:YAG laser (4 sessions). Histopathological (hematoxylin-eosin, orcein, Masson trichrome, and picrosirius red stains) and immunohistochemical assessment for skin biopsy specimens were done before laser resurfacing and after 1 and 6 months. Histometry for epidermal thickness and quantitative assessment for neocollagen formation; collagen I, III, and VII; elastin; and tropoelastin were done for all skin biopsy specimens. RESULTS Both lasers resulted in increased epidermal thickness. Dermal collagen showed increased neocollagen formation with increased concentration of collagen types I, III, and VII. Dermal elastic tissue studies revealed decreased elastin whereas tropoelastin concentration increased after laser resurfacing. Neither laser showed significant difference between their effects clinically and on dermal collagen. Changes in epidermal thickness, elastin, and tropoelastin were significantly more marked after ablative laser. LIMITATIONS The small number of patients is a limitation, yet the results show significant improvement. CONCLUSION Multiple sessions of fractional laser have comparable effects to a single session of ablative Er:YAG laser on dermal collagen but ablative laser has more effect on elastic tissue and epidermis.

The expression and distribution of deoxyribonucleic acid repair and apoptosis markers in testicular germ cells of infertile varicocele patients resembles that of old fertile men

OBJECTIVE To explore the expression and distribution of DNA damage repair and apoptosis marker proteins in human testicular germ cells of infertile varicocele patients; and to compare the expression and distribution with that of young and old fertile men. DESIGN Retrospective case-control study. SETTING Academic institutions. PATIENT(S) Testicular specimens were obtained from 8 infertile varicocele patients aged 20-30 years and from 16 fertile volunteers aged 20-82 years. INTERVENTION(S) Testicular germ cell DNA repair markers were assessed using immunohistochemical staining for the cell proliferation marker (proliferating cell nuclear antigen), DNA repair markers [poly(ADP-ribose) polymerase-1 (PARP-1), poly(ADP-ribose), X-ray repair cross-complementing 1, and apurinic/apyrimidinic endonuclease 1], and apoptosis markers (caspase 9, active caspase 3, and cleaved PARP-1). MAIN OUTCOME MEASURE(S) The prevalence and cellular localization of the above markers in testicular tissues of varicocele patients and fertile men of varying ages. RESULT(S) Statistically significant differences in DNA damage repair-associated proteins and apoptosis markers were observed in infertile men with varicocele compared with fertile young men. Old fertile men showed similar expression of the same markers when compared with infertile varicocele patients. CONCLUSION(S) The study demonstrates that there is an increase in human testicular germ cell DNA repair and apoptosis in infertile varicocele patients and that their profile resembles that of premature aging.

Multiple microneedling sessions for minimally invasive facial rejuvenation: an objective assessment

Microneedling or percutaneous collagen induction is a new modality used for skin rejuvenation, tightening, and scar remodeling. It offers a simple and effective treatment for photoaged skin with minimal disruption of the epidermis, thus limiting adverse effects and minimizing downtime.

Abortive Apoptosis and Sperm Chromatin Damage

The term apoptosis refers to a morphologically distinct form of cell death that plays a major role during the normal development and homeostasis of multicellular organisms. This mode of cell death is a tightly regulated series of energy-dependent molecular and biochemical events orchestrated by a genetic program. Apoptosis is either developmentally regulated (launched in response to specific stimuli, such as deprivation of survival factors, exposure to ionizing radiation and chemotherapeutic drugs, or activation by various death factors and their ligands) or induced in response to cell injury or stress. Apoptosis is also being recognized in the pathogenesis of many diverse human diseases including cancer, acquired immune deficiency syndrome, neurodegenerative disorders, atherosclerosis, and cardiomyopathy. Maintaining the homeostatic relationship between apoptosis and cell proliferation is important for tissue development and degeneration. Decreased apoptosis may lead to neoplasia, whereas increased apoptosis may lead to a dystrophic condition.

Fractional Microneedling: A Novel Method for Enhancement of Topical Anesthesia Before Skin Aesthetic Procedures.

BACKGROUND Skin microneedling or fractional microneedle therapy is a recent approach used for skin rejuvenation or to enhance transdermal delivery of topical medications. OBJECTIVE The authors evaluated the efficacy of skin microneedling, using an automated device, to enhance the numbing effect of topical anesthesia, used before minimally invasive aesthetic approaches. METHODS Fifteen patients, looking for treatment of atrophic acne scars, were subjected to randomized split-face study comparing automated fractional skin microneedling (0.5 mm depth) followed by application of topical anesthetic cream (Lidocaine 2.5% + Prilocaine 2.5%) on one side of face, with topical anesthesia alone on the other side, followed by full face fractional microneedling treatment for postacne scars (2.5 mm depth). RESULTS The treated sides (fractional needling + topical anesthesia) had significantly lower pain scores when compared with the nontreated sides (topical anesthesia alone). The scores of pain sensation, during the whole procedure, were statistically significantly (p < .0001) less on the treated sides (3.10 ± 1.09) of the face when compared with the nontreated sides (5.37 ± 0.99). There was also a statistically significant (p < .0001) difference in pain sensation scores between the 2 sides of the face after horizontal passes, as the mean scores of the treated and nontreated sides were 3.93 ± 0.59 and 6.20 ± 0.41, respectively. LIMITATIONS The small number of patients, yet the results show a significant difference. CONCLUSION Application of topical anesthesia for minimally invasive aesthetic procedures can be enhanced with fractional microneedling pretreatment.

Apoptosis in Ejaculated Spermatozoa and in the Normal and Pathological Testes: Abortive Apoptosis and Sperm Chromatin Damage

Apoptosis refers to a morphologically distinct form of cell death that plays a major role during the normal development and homeostasis of multicellular organisms. This mode of cell death is a tightly regulated series of energy-dependent molecular and biochemical events orchestrated by a genetic program. Apoptosis is either developmentally regulated or induced in response to cell injury or stress. Maintaining the homeostatic relationship between apoptosis and cell proliferation is important for tissue development and degeneration. Decreased apoptosis may lead to neoplasia, whereas increased apoptosis may lead to a dystrophic condition. Apoptosis is however very different in the testis.

The Genetic and Epigenetic Contributions of Sperm to Early Embryogenesis

During fertilization, the sperm delivers a haploid set of chromosomes to the zygote. Genetic alterations, such as numerical or structural chromosome defects, can affect the ability of the embryo to undergo normal development. Similarly, epigenetic defects, such as abnormal methylation of gene promoters, may affect gene expression during embryogenesis and affect the viability or health of the developing embryo. This chapter explores the genetic and epigenetic contributions of sperm to normal embryogenesis.