藥物與乾眼症 (DED) 和瞼板腺功能障礙 (MGD) Medications DED and MGD

與乾眼症 (DED) 和瞼板腺功能障礙 (MGD) 相關的藥物包括口服避孕藥,由於其含有雌激素和黃體素,可能導致與 MGD 相關的乾眼症。用於治療攝護腺問題的坦索羅辛和特拉唑嗪也與乾眼症有關。某些抗癌藥物,如甲胺蝶呤和西妥昔單抗,會影響淚腺,導致乾眼症。此外,常用於治療胃灼熱的質子幫浦抑制劑 (PPI) 也可能透過維生素 B12 缺乏或影響腸道菌叢而導致乾眼症。

局部用藥時,苯扎氯銨 (BAK) 是一種存在於許多眼藥水中的防腐劑,它與乾眼症和 MGD 密切相關,因為它會破壞淚膜。許多青光眼藥物也含有 BAK,長期使用會加重乾眼症。

其他可能導致乾眼症 (DED) 和瞼板腺分泌障礙 (MGD) 的因素包括配戴隱形眼鏡(這會加劇症狀)以及眼瞼衛生不良(會導致細菌積聚,從而對瞼板腺分泌產生負面影響)。蠕形蟎在這些疾病中的作用仍在研究中,但一些研究表明其與瞼板腺分泌障礙 (MGD) 有關,尤其是在乾眼症 (DED) 患者中。

治療方法包括透過熱敷、眼瞼按摩和眼瞼擦洗來保持眼瞼衛生,以改善瞼板腺分泌。脂質類人工淚液有助於穩定淚膜,而局部或全身性用藥則可根據 DED/MGD 的嚴重程度進行。診室內操作,例如瞼板腺擠壓術或 LipiFlow,可以幫助疏通阻塞的腺體。

Medications associated with Dry Eye Disease (DED) and Meibomian Gland Dysfunction (MGD) include oral contraceptives, which can lead to MGD-related dry eye due to their estrogen and progesterone content. Tamsulosin and terazosin, used for prostate issues, are also linked to DED. Certain anticancer drugs, such as methotrexate and cetuximab, can affect the lacrimal glands, contributing to dry eye. Additionally, proton pump inhibitors (PPIs), commonly used for heartburn, may cause DED through vitamin B12 deficiency or impacts on the gut microbiome.

Topically, benzalkonium chloride (BAK), a preservative found in many eye drops, is strongly associated with DED and MGD as it disrupts the tear film. Many glaucoma medications contain BAK as well and can worsen dry eye with prolonged use.

Other factors that can contribute to DED and MGD include contact lens wear, which can exacerbate symptoms, and poor eyelid hygiene that allows bacteria to accumulate, thereby negatively affecting meibomian gland secretion. The role of Demodex mites in these conditions is still under investigation, though some studies suggest a link with MGD, particularly in patients with DED.

Treatment options include maintaining eyelid hygiene through the use of warm compresses, eyelid massage, and lid scrubs to improve meibomian gland flow. Lipid-based artificial tears can help stabilise the tear film, while topical or systemic medications may be prescribed based on the severity of DED/MGD. In-office procedures, such as meibomian gland expression or LipiFlow, can help clear blocked glands.

及早察覺瞼板腺功能障礙 Early detection of Meibomian gland dysfunction

瞼板腺是人體中最辛勤工作的組織之一。它們晝夜不停地運作,製造足夠的油脂分泌出來,凝成及維持穩定的淚膜,減少淚液蒸發,潤滑和保護眼球表面,並確保清晰的視力。這些腺體位於眼瞼內,隨著年齡的增長,以及環境因素和其他影響的影響,它們的數量會逐漸減少。並失去油脂分泌功能,最終萎縮。

瞼板腺功能障礙的初期症狀通常很輕微,許多人可能只是偶爾使用潤滑眼藥水。因此,他們可能直到感到不適才意識到問題所在,而不適通常是在腺體功能嚴重喪失後出現的。當您開始感到嚴重的眼睛不適時,您的瞼板腺功能可能已經喪失了近一半。

雖然一般的居家照護措施(例如使用熱敷、保持眼瞼衛生、保持眼部衛生以及服用歐米伽-3等營養補充劑)可能有所幫助,但它們只是輔助性質。有效的治療需要在診所進行專業的治療。如果沒有及時適當的護理,可能會出現更嚴重的症狀,導致眼球表面損傷、視力模糊,並嚴重影響生活品質。

近年在乾眼症及治療瞼板腺功能障礙的技術上,也突破性的發展。現在更了解清楚乾眼症的成因及病理,可以針對性,精準地,同時處理多方面的病因。更有效,快速及安全地治療,在短時間內改善乾眼徵狀、且效果更可維持半年或以上。

Meibomian glands are among the hardest-working tissues in the body. They work around the clock to produce enough oily secretion to form and maintain a stable tear film, reduce tear evaporation, lubricate and protect the surface of the eyeball, and ensure clear vision. These glands are located in the eyelids, and as we age, along with exposure to environmental factors and other influences, their number gradually decreases. They also tend to lose their oil-secreting function and can eventually atrophy.

The initial symptoms of meibomian gland dysfunction are often subtle, and many people may only occasionally use lubricating eye drops. As a result, they may not recognise the problem until they experience discomfort, which can occur after a significant loss of gland function. By the time you start experiencing substantial eye discomfort, you may have already lost nearly half of your meibomian gland function.

While general home care practices—such as using warm compresses,
Lipid-based artificial tears, maintaining lid hygiene, practicing eye hygiene, and taking nutritional supplements like omega-3—can be helpful, they are only supplementary. Effective treatment requires professional intervention at an ophthalmology clinic. Without timely and appropriate care, more serious symptoms can develop, leading to damage to the eyeball’s surface, blurred vision, and a significant impact on one’s quality of life.

In recent years, there have been breakthroughs in the technology of dry eye and treatment of meibomian gland dysfunction. Now we have a better understanding of the causes and pathology of dry eye, and we can treat multiple causes in a targeted, precise and simultaneous manner. More effective, fast and safe treatment can improve dry eye symptoms in a short period of time, and the effect can last for half a year or more.

抗衰老食疗20 – NMN膳食補充劑

解釋什麼是NMN之前,先要知道什麼是NAD+?
NAD+的全名是 Nicotinamide Adenine Dinucleotide, 它是所有生物與生俱來的天然生成體內物質。
NAD+擔當身體不可或缺的角色, 作為所有細胞的燃料、負責生產能量、激活長壽基因 Sirtuins 修復細胞基因損傷、協調多個與抗衰老有關的表觀遺傳訊息傳遞渠道、
減少炎症及維持體內所有機制的平衡…等等。


資料參考 Cell Metabolism 27, March 6, 2018

研究表明,小朋友和年青時期體內NAD+維持在非常高的水平, NAD+水準會隨著年齡增長,呈斷崖式減少,引發人體機能衰老質變。恢復體內的NAD+水準可以延長健康壽命,這使得它成為抗衰老研究的焦點。

體內NAD+水平,可以透過口服NAD+的前導體 Nicotinamide Mononucleotide ( NMN ) 來補充。在人體內的NAD+是由 NMN 衍生出來, 服用 NMN 膳食補充劑,是最安全、直接、有效提高體內 NAD+水平的方法。


資料參考 Cell Metabolism 27, March 6, 2018

有臨床報告,應用 NMN 在 COVID-19 新冠肺炎的病患者,對控制病情有正療效。
Robert Huizenga, MD. Dramatic Cytokine Storm Reversal with an Over the Counter NMN Cocktail. COVID-19 Case Report. April 20, 2020.
NMN直接補充體內NAD+水平, 對於減緩衰老相關的組織/器官機能衰退、增強免疫力, 調節免疫細胞過度反應之危險 Cytokine storm, 促進血液循環, 保護腎臟、肝臟、腦部受疾病的影響, NMN表現顯著及正面的臨床療效。

提升身體營養,增強抵抗力,預防疾病,是抗衰老中不可或缺的一環。
NMN 膳食補充劑已發展至第四代技術。

上天給我的獎勵

七月八日的早上,今天的精神特別好,可能是昨晚睡飽了。在醫院個多月的自己,從虛弱的身體,經過長時間的調理修養,體力慢慢地恢復起來,胃口也正常了。雖然還未百分百康復,但距離這天應該不會太久了。

「人誰無過 ,善莫大焉」這兩句話不停在我腦海裡重複。人來到這世界,就是來學習,來貢獻。不是每天只幹著乏味的工作,二十四小時的玩電動或漫無目的不停地互聯網搜尋。

活著還有很多有趣,有意義的事情等著大家品嚐回味。
在學習的過程中,總有些冒險,不確定,迷失,犯錯,失敗。接著修正,改過,磨練到成功。
學懂了新的智慧,思想或生活的態度,模式和方向。

因為這是上天給我的獎勵,福分和責任。要把愛伸延開去,要讓活著的人得到安慰和力量。

我學懂了這個,得到上天賞賜的貴寶,也在靚博客跟親愛的你分享。

Keynote on multi-technology platforms by VIORA

I was grateful to be invited to participate in the annual company training of VIORA machine manufacturer from Israel. The meeting was held at lovely ‘Movenpick Resort’ in Phuket, Thailand on May 26 ~ 28, 2016.

This was my first business trip traveling with colleagues of Good Union Company

Stunning scenery from my room

This was an old slide about development of a fractional radio frequency machine. I presented it once in 2012 and used this slide again as the first of my keynote presentation.

 

It was my first time to join VIORA company event and I had prepared a 30 minutes keynote presentation to share with colleagues about design concept, applications and unique features of the latest innovations of multi-technology platform series, e.g. V10 V20 and V30 with interchangeable hand pieces for skin tightening, fractional RF resurfacing with SVC (Switching-Vacuum-Cooling), long pulse 1064nm Nd:YAG laser with PCR (PulseConfiguRythm™ Control), Intense Pulse lights with PCR (PulseConfiguRythm™ Control), e.g. V-ST, V-FR, V-Nd:YAG, V-IPL and the latest developed and my new favorite for non-invasive body contouring (BC) and skin tightening V-FORM hand pieces (HP) with Multi-CORE and ABS (Anti-burn system).


V-FORM BC HP can be connected to large and small size of tips for treatment. Apart from a very unique appearance of hard ware design, the large size V-FORM BC HP has very large area coverage 97×83 mm2. The new Multi-CORE system and Anti-burn system allow RF energy to penetrate deeply and produce large volume of homogeneous warming inside subcutaneous fat layer at 3 cm from skin surface without causing epidermal injury and patient’s discomfort. Total treatment time of whole abdomen of average size Chinese can be as short as 20 minutes. It is very suitable as lunch time procedure.

One of most difficult presentation I have ever made 2 years ago. I wanted to ease our life, limited the scope of aesthetic medicine and suggested an approach on practice of aesthetic medicine.

 

A simplified idea of polymodal balanced approach in combination of aesthetic procedures.

 

I first presented the concept of application of ‘a poly-modal balanced approach’ on aesthetic medicine in 2009. At that time, most of aesthetic treatments are based on a single modality. For example, IPL or 800nm Diode laser for hair removal, fractional non-ablative laser resurfacing for skin rejuvenation. A stand alone machine can provide treatment for a few indications. Combination of different machine treatments or modalities was not common.

There were another type of machines called all-in-one machines. A machine with a few applicators or modules combining together as a unit. More treatment can be provided. However, mostly the size of all-in- one machine was big and its hard ware was not up-gradable. If there was malfunctioning of a module, the whole machine should be sent for repair.

Therefore I purposed a new concept of machine design, multi-technology platforms based on ‘the concept of poly-modal balanced approach’ It was my dream for many years. All applicators can be plugged in and interchangeable for usage.

It is difficult to rely on a single treatment modality to treat a diseased or ageing skin condition in all patients with all skin color types.

As a result, a well designed complete aesthetic platform should consist of multiple modalities to successfully manage any skin conditions within an individual and patients with different skin color I to VI. Therefore, patients can be treated in a rational, ethical and cost-effective way and not subjected to unnecessary side effects of treatments or prolonged treatment duration.

An aesthetic multi-technology platform works as a central unit of energy supply.
For example, it should provide various kinds of energies such as radio frequency energy, lasers and light energy.

All radio frequency energy dependent (RF-dependent) hand pieces (HPs) or applicators are connected to the universal RF connector of the platform. Same as lasers and IPL HPs which are plugged into Laser energy universal connector or IPL connector, respectively.

Newly developed application HPs can be easily add-on to the platform via same universal connectors.

Therefore, multi-technology platform is up-gradable in both hard wares and softwares, functionally expandable and more economical in space and money.

V-series (V10, V20 & V30) Platforms by VIORA are examples of multi-technology platforms.

For example: Unwanted hair removal
Both Nd:YAG 1064nm lasers and IPL with 570nm and 630nm filter are applied
Hand pieces: V-Nd:YAG laser HP and V-IPL HP. Both of them have PulseConfigRythm system which can make the light or laser pulse as single pulse, a train of multiple sub-pulses or rapid pulses of low fluence. More time for heat dispersion is suitable to darker skin type. In addition to very effective water cooling system to keep the glass tip of both V-IPL and V-Nd:YAG HP at 5C, pain, risk of epidermal thermal injury and post-inflammation hyper-pigmentation are minimized.
V-IPL 570nm for average hair on lighter skin
V-IPL 630nm for hair on darker skin type
V-Nd:YAG 1064nm laser for dark hair with hair follicles inside deep dermal region
Modalities are enough to remove unwanted hair thin to thick, sparse to dense, and different skin color type I to VI.

By means of a Multi-technology Platform V30 by VIORA, multiple skin conditions can be managed.

I received a gift from Dr. Inna who is the clinical director of VIORA

 

An official photo from VIORA. I was very grateful to participate in this annual event and made friends with colleagues all over the world. Thank you very much for all arrangement of this wonderful gathering.

 

Uncle Koala said 'Yeah, well done'

 


8th Anniversary is coming.

台北新藝術博覽會 2012

最喜愛左邊這一幅

Michael 喜歡這一幅 Fake & Fear

與 Michael 合照

剛剛參觀了 台北新藝術博覽會 2012
好友年青畫家 Michael Lam
以創新突破概念,全新 ‘Mirror’ 對照系列 參展
自己對那些畫得很「真」的畫,沒什麼興趣!真也真不過高清照片吧。
還是喜愛 Michael 那種 介乎於 抽象和現實,充滿想像空間的作品。

Rebirth & Freedom

很多觀眾問的 Lost 迷失

很有 Givenchy 的感覺。嘻嘻!

Looking for Love

同場還可欣賞 中國,台灣,及世界各地的藝術作品。

Art Revolution Taipei 2012
二0一二年三月廿一至廿五 台北展演二館 Booth C34

我选择护肤洁肤产品的原则

最近有读者问我,为何不在自己的网站或blog介绍护肤洁肤产品,想一想:有以下原因。

1. 护肤产品的种类繁多,成份各有好处和缺点。

2.每天都有新的产品推出,要等医学研究报告,可能要花上好几年,那时候又有新的产品推出。

3.在未有正式报告前下定论产品是好还不好,又是不公平。

4.影响产品的效果因素很多,皮肤的质素、天气的转变、阳光紫外线的强弱、抽烟、饮酒、环境污染、个人健康、过敏症、睡眠质素、精神压力、女性週期等等......
5.产品的使用:主要成份的含量、使用次数份量、使用的时间(早/晚)、足够的时间效果,有没有因长期使用而减低等等.......

6.对副作用的反应(包括主要成份及其他成份:颜料、防腐剂、稳定剂、香料等等...)

7.溷合使用不同牌子,不同种类成份的护肤洁肤用品。因为溷合使用可使产品之间有物理或化学作用,例如:PH值的改变形成化合物等,影响产品的吸收。当溷合使用会令皮肤接触不同的成份,引起过敏的机会当然更高。

所以推介产品倒不如 大家分享,我选择护肤洁肤产品的原则:
A.跟处理其他疾病一样要对症下药,根据不同的目的和肤质,选择合适的成份,要纯保湿,是处理豆豆粉刺,还是美白或紧肤。
B.减少溷合使用不同牌子种类的护肤品,因为这样可减少皮肤接触不同产品的成份,如香料、防腐剂引致过敏,溷合亦会引起不配合化学或物理作用,影响产品的功用,有可能产生有害物质和刺激皮肤。例如果酸类要PH值3.5-4.5,若超出这个范围就会失效或引致刺激。建议:使用同一产品系列,因为在优良产品面世前,厂商应做足不同形式的测试可合併使用,确保成份稳定。
C.试用,一定要试用,不要浪费金钱和时间,不要只相信广告或专柜小姐的推介,不论多好多名贵的产品,亦要讲配合,亦可能有机会过敏。当然真正的疗效,可能要多点时间,但起码减少短期的副作用。
D.医学的建议:医生相信証据,EVIDENCE BASED MEDICINE相信医生会根据已証实的医学知识,按照客人的肤质状况给予建议。
E.皮肤是有生命的,不是不会改变的,所以要应不同状态给予配合的产品。

我不信『一瓶保养品可以用到老』

種族膚色 植髮醫學美容技術 二

不同種族,不同膚色,膚色跟頭髮顏色的差別,也會影響植髮的效果。

我們黃種人 Asian Chinese 的頭髮,有以下特點:
頭皮的毛囊 Follicular Unit 數目跟其他種族差不多,每根毛囊,約可長出一至二根頭髮。跟白種人 Caucasians 比較,每根毛囊,可長出三至四根頭髮

放大三十倍的頭皮髮根

黃種人的頭髮一般比白種人的頭髮直和粗壯
頭髮生長角度較大,接近垂直生長,頭髮不像白種人那樣貼服
頭髮跟頭皮顏色差別較大
頭髮顏色較深,黑髮看起來較濃密
可是掉髮時露出頭皮也較多,視覺上有較稀疏的感覺
所以整體結果是,需要移植一定數目的頭髮毛囊,才可達到一定濃密和自然的視覺效果
植髮前必須計算好植髮的數目
植髮時要特別注意頭髮植入的角度,要接近原有頭髮生長的方向

這是量度頭皮面積的工具,可先估計出需植髮的面積,才決定取出 多少個 在 Permanent Zone 可移植的毛囊 ,確保不浪費每根珍貴的毛囊。

利用 Follicular unit extraction FUE 技術,從Permanent Zone 取出頭髮毛囊,作移植之用。

下回跟大家討論,那些人士可接受植髮療程?
不死的頭髮 植髮醫學美容技術 一
種族膚色 植髮醫學美容技術 二
完美就是不自然 植髮醫學美容技術 三

減肥塑身技術一覽

相信發明家的路一定不好走,那種不怕辛苦,冒險創新的精神,經過漫長的時間,才發明出新產品來。起初可能受到不少的批評,懷疑產品技術的真確和成效。從懷疑到接受,不是一朝一夕的事情。醫學美容技術,也有不少這樣成功的例子,如:彩光/脈衝光嫩膚回春技術,低能量激光(LLLT)生髮技術。
那麼塑身減肥的技術,有沒有新的技術,新的突破?傳統的減重塑身,當然是飲食控制,適量運動,通淋巴,消脂針,服用減肥藥…等等。可是很多人還未可以擁有滿意的身材!於是我們便配合推脂技術,用儀器如超聲波,射頻或紅外線能量,把脂肪層溫度提升,增加新陳代謝。這樣的處理,可使脂肪細胞變少,達到塑身效果。
有些人會選擇外科整型手術,如傳統抽脂,鐳射溶脂等,把脂肪細胞破壞和抽離身體。選擇這類型療程的人,除了獲得塑身效果,當然還要承受手術的風險,手術後的不舒服和康復期。
以下是自己節目,跟大家分享一系列減肥塑身的技術
溶脂針
傳統抽脂
镭射溶脂
射頻紅外線塑身
綜合射頻塑身技術

炎炎夏日,大家都穿薄薄的,有沒有想把那些討厭的肥肉趕走呢?
自己會建議客人以綜合療法,從多方面入手。飲食控制,運動,健康食品,配合不同的塑身儀器療程,使效果更顯著。

減肥瘦身的健康餐單 上 TVB J2 姊妹淘 2012年2月4日
減肥瘦身的健康餐單-下 TVB J2 姊妹淘 2012年2月4日
TVB J2 姊妹淘一 第13集 – 健康減肥法 2011年7月
塑身的元素 Components of Body Contouring
減肥塑身技術一覽
減肥塑身 一 (橙皮脂肪的影響)
創新減肥塑身技術
華娛衛視 「教主來了」 醫學美容篇 自體脂肪移植手術 (豐胸) 之二
華娛衛視 「教主來了」 醫學美容篇 之 自體脂肪移植手術 (傳統抽脂) 之一
華娛衛視 「教主來了」醫學美容篇 之 雷射溶脂 (二)
華娛衛視 「教主來了」醫學美容篇 之 雷射溶脂 (一)
「橙皮脂肪」的影響
「脂肪」不是好的東西?
「抽脂減肥」辯論賽


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