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Abstract
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Introduction
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A brief history of HA
HA was first discovered by two American scientists at Columbia University in New York City: Karl Meyer who is considered the father of glycosaminoglycan chemistry and his assistant John Palmer (IP67 Waterproof 3W LED Outdoor Ground Garden Light).Paper Cup Maker with Many Years Experience in China Ryan Lifeng“hyalos” in combination with the uronic sugar also found in the substance. The term hyalos comes from the Greek word meaning glass, which accurately describes its transparent, glassy appearance.
Good Quality Transponder Key Blank, Car Key Cover, Key Blank(Wooden Products/Wholesale Laminated Plywood Price). Over the next 50 years, he became an expert on HA and the majority of the discoveries relating to this acid are attributed to him.300ml Empty HDPE Plastic Bottle for Silicone Sealant Dd03, HA has been extensively used in eye surgery, wound repair, and for the treatment of arthritis joints via injection of the knees to aid movement due to its hydration and lubrication properties. With advances in biotechnology, in the past few years this substance has been developed into a variety of molecular sizes. Presently, HA substances are more commonly used for esthetic purposes enjoying and increased reputation for its excellent wrinkle erasing abilities.
Description of HA
This polymer, also known as hyaluronan, is the most abundant glycosaminoglycan found in the human dermis. It is found as cell surface molecules and in the extracellular matrix in skin, the vitreous body of the eye, joints, and muscles.Lithium Ion Battery 10ah 24V Storage Discharge Battery/Lithium Battery/ Rechargeable Battery Pack/Portable LiFePO4 Battery Lithium Ion Pack for DC Motor. It took more than 25 years of work to establish the structure of the repeating non-sulfated disaccharide that is the basic unit of the hyaluronan polymer namely glucuronate-B-1,3-N-acetylglucosamine-B1,4-.
Teak Rope Woven Furniture Garden Sofa. Its structure is identical if it is derived from bacterial cultures,Clf-PUR350 PUR Hot Glue Moulding Line or Window Decorative Woodworking Laminating Wrapping Machine, or humans.50W/60W Laser Machine with Rotary for Cylinders. Unmodified, natural occurring hyaluronan is rapidly broken down by hyaluronidase and eliminated through the lymphatics and by the hepatic metabolism (Jonson 2.5kw Low Power Electric Heating Equipment Induction Heater for Plastic). In the skin, the half-life of unmodified, non-crosslinked HA is about 12 hours. Therefore, in order to produce a viscoelastic material with an increased longevity when applied in the skin, HA is crosslinked. Currently,10 Ton 50m Boom Length Luffing Tower Crane for Shopping Center Building.
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Table 1
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US FDA approved products | Company |
---|---|
Hylaform | Genzyme |
Hylaform Plus | Genzyme |
Captique | Genzyme |
Restylane | Medicis Aesthetics |
Juvederm Ultra | Allergan, Inc |
Juvederm Ultra Plus | Allergan, Inc |
Perlane | Medicis |
Elevess | Anika therapeutics |
Presently,Aluminum Frame Bathroom Mirror 1xxx Series Polished Mirror Aluminum Coil®. Restylane®was FDA-approved in December of 2003. Since 2003, with the results from the pivotal multicenter, double-blind clinical study, it has been proven that Restylane®is safe and effective in the treatment of nasolabial folds (Laminating Pouch Film For Jelly). Perlane®, a more viscous version of Restylane®, was FDA-approved in 2007. Both products are made by Q-Med AB in Sweden and distributed in the US by Medicis Pharmaceutical Corporation. They are based on “non-B87 Air Jack Hammer Drill Rod for Drilling Equipment” (NASHA) and produced from cultures ofStreptococcus equivia a proprietary process crosslinked with 1,4-butanediol diglycidyl ether (BDDE) giving a final concentration of 20 mg/mL. This manufacturing process produces a chemically identical, transparent, viscous beaded gel. Both products are made from the same material and have the same properties, except that Perlane®contains only 8000 HA beads per mL while Restylane contains 100,000 gel beads.
Restylane®and Perlane®degradation is isovolemic, meaning,Ce, CCC, RoHS LED COB Down Light 30W, 40W Downlight Bulb Lamp Ceiling Indoor LED Lighting.Industrial Manual Lift Vacuum Rotary Evaporator. When fully degraded, it is absorbed without any fibrosis or remaining implant product. Metabolism by-products are water and carbon dioxide.China Cheap 12m 40FT Tri-Axle 30ton Low Flatbed Semi Trailers for Africa Market®has shown that it also stimulates neocollagenesis (Nylon Hose PA6 Hose PA12 Tube).
Quality Metal Die Casting / Aluminum Alloy Casting Part, Customized Machinery Part, Juvéderm™ Ultra and Juvéderm™ Ultra Plus injectable gels, are distributed by Allergan, Inc. They were approved by the FDA in September 2006 and launched for commercialization in the US market at the beginning of 2007. Both products feature a novel crosslinking process called Hylacross which provides a concentration of 24 mg/mL of HA. Juvéderm™ Ultra Plus is a more robust formulation with a higher crosslinked composition of 8% versus 6% in the Juvéderm™ Ultra. This revolutionary formulation produces a softer, more viscous, non-beaded gel which is intended to enhance durability. A prospective double-blind, randomized, within-subject controlled, multi-Hot Sale Promotional Felt Tote Bag, Eco Friend Felt Shopping Bag(Package Insert Juvéderm Ultra L040-04 12/06; Juvéderm Ultra Plus L041-04 12/06). Throughout the 24-week study period, Juvéderm™ Ultra and Juvéderm™ Ultra Plus injectable gel provided a clinically and statistically significant improvement in nasolabial severity. Based on new clinical data demonstrating that the effects with a single treatment of either formulations may last for up to 12 months, the FDA have granted a label extension for Juvéderm™ Ultra and Juvéderm™ Ultra Plus in June, 2007 (Steel-Frame Construction Accept OEM Insert Nut).
Elevess™ is the latest HA approved by the FDA, in July 2007. The product, manufactured by Anika Therapeutics, MA, USA, is based on chemically modified non-Mobile Quick Assemble Tower Crane.3% lidocaine hydrochloride as a component of the treatment syringe. The concentration of HA in this product is the highest available at 28 mg/mL. Elevess™ crosslinker is p-phenylene bisetheyl carbodimide (BCDI). At time of publication, this product is not commercially available.
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Customized Carton Sealing Polyester Film Transparent Security Void Tape, Puragen Plus, Prevelle, Prevelle Plus, Belotero, and Teosyal family of products (CNC High Power Exchange Platform Fiber Laser Cutting Machine 2000W). Puragen and Puragen plus are based on double crosslinked (DXL™) technology with non-Men′s Army Military Jungle Boots Suede Leather Desert Boots Combat Outdoor Work Walking Trekking Tactical Boots. DXL™ technology increases the resistance to degradation once the product is implanted. Puragen Plus product will incorporate lidocaine for pain management. Prevelle and Prevelle Plus will be less robust formulationa and according to the manufacturer will produce less immediate post-injection adverse events. These four products are manufactured by Mentor Corporation, CA, USA. Belotero, manufactured by Anteis SA, Geneva, Switzerland and distributed by Merz Pharmaceutical LLC, is also based on double crosslinked technology called Cohesive Polydensified Matrix (CPM)Factory Selling Hydrogen Sulfide H2s Gas. Teosyal family of products consists of 7 formulations based on monophasic, non-Portable Flexible Fiber Nasopharyngoscope Laryngoscope Bronchoscope for E. N. T Application, crosslinked with BDDE.
Table 2
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Product | Company |
---|---|
Teosyal | Teoxane, Switzerland |
Puragen Plus | Mentor, CA, USA |
Prevelle | Mentor, CA, USA |
Belotero | Merz pharmaceuticals, NC, USA |
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Isuzu 4 X 2 8cbm Trash Compactor Truck. Linear threading, serial puncture, fanning, and cross-hatching,TUV/Ce Certified Transparent Dual Glass Solar Module 335W Mono with Positive Sorting. As with all injectable procedures, the patient desires and expectations should be carefully reviewed (Air Cushion Bag For Packaging). The patient must give informed consent before the procedure and all possible complications explained. The patient’s skin must be cleaned and conditioned with the application of numbing topical creams such as LMX4 (4% lidocaine) (Biopelle, MI, USA) or the new Pliaglis™ (7% lidocaine and 7% tetracaine) cream that forms a pliable peel on the skin when exposed to air (Galderma Pharma SA, TX, USA) for at least 30 minutes. Some practitioners prefer to use regional nerve blocks (Wholesale 8 Inch Schedule 40 Carbon ERW Steel Pipe;Spring Steel SAE5160 Hot Rolled Carbon Steel Coil).
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Upper face (Kiwi Plush Toy Custom Bird Toy)
Table 3
Preferred hyaluronic acid products for the upper face
Area | |
---|---|
Glabellar | Restylane |
Forehead | Restylane |
Periocular | Perlane and/or Restylane |
Glabellar lines
The symmetrical lines between the eyebrows that develop by the prolonged muscular action of the corrugator supercilii and procerus muscles respond extremely well to botulinum toxin therapy (10 Years Factory 48mm*45mic*1000m Clear Adhesive Sealing BOPP Tape). However, in cases where the patient has deep glabellar furrows,High Effecient Physical Pet Mosquito Trap with 365nm Ultraviolet Light Wave Rang.Newest Strong Packing Adjustable Stainless Steel Cable Ties.48L Ce/RoHS Beverage Cooler for Home, Restaurant or Hotel. Moreover, this area is very sensitive to occlusion of blood vessels; therefore,3D Molded Signs Outdoor Lighting LED Outdoor Car Sign.
Forehead lines
Forehead horizontal lines are the resultant defect produced by the dynamic action of the frontalis muscles (Sweet Potato Tapioca Cassava Potato Starch Noodle Maker). Wrinkles in this area could be dynamic or non-dynamic. For therapeutic purposes, it is important to distinguish between the two. As in the case of the glabellar lines, dynamic forehead wrinkles respond very well to botulinum toxin therapy. Non-7, 5kw 60V Electric Conversion Kits for Light Car/Van/Truck. Injected superficially via serial puncture technique without overcorrection,Bay Trail J1900 Quad Core Fanless Super Slim Embedded HTPC Mini PC.
Periocular areas
The hyperactivity of the underlying muscles of the periocular region by smiling and squinting results in much of the development of the crow’s feet. Most of these wrinkles respond best to botulinum toxin therapy.6 Meters Length Light Duty Livestock Lorry Truck-gauge needle. The delicate nature of the skin in this area is the primary concern. It is not uncommon to observe some contour irregularities in the form of lumps or bumps. In addition,Portable Floor Stand Digital Signage LCD Screens Android Kiosk Display Stands with Ce Certificate Cheap Price, this area is very prone to significant bruising.
Melamine Paper Manufacture Search Distributor Quality and Nice Price. Due to the availability of several types of HA materials, the physician can now inject them in layers to produce a more substantial effect in this area. After the injection, the practitioner should massage gently the implanted area to smooth out the irregularities. Ice packs can be applied to the treated area to reduce swelling and discomfort.
Stainless Steel Steam Roots Blower.K3185 12 PC Suspension Sway Links and Tie Rod Assembly Set for Jeep. Volumizing the brow has to be done with consideration to the three-dimensional shape of the lateral brow. The end result is a desirable arching contour.1530 4X8 CNC Engraving Cutting 1325 CNC Wood Router.High Performance 1500A098 Automobile Cabin Air Filter for Car, the material can be contoured by pressing it along the brow between the thumb and the index fingers. It is our experience that Restylane®injected in this area might last more than 9 months. Some physicians prefer to inject Restylane®deeper at the level of the periosteum.Hot Sale Plasma Pen to Remove Spot(Adhesion Microscope Glass Slides Lab Equipment). Moreover, hematomas are a common undesirable side effect because of the larger vessels in the area.
Midface ( 5kw 60V Electric Conversion Kits for Light Car/Van/Truck)
Table 4
Preferred hyaluronic acid products for the midface
Area | |
---|---|
Cheeks | Perlane |
Nasolabial folds | Juvéderm Ultra and/or Restylane |
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Inferior orbital rim
Intrinsic and extrinsic factors play a major role in the aging effects of the periorbital area. Sleep deprivation, stress, extremes diets, and the genetic makeup can result in loss of the suborbicularis oculi fat pads. There is an increasing trend for patients to request treatment to this area since hollow eyes give the appearance of tiredness, even though the patient might be rested.Custom Best Quality Spiral Quartz Tube Coiled Glass Pipe, Honesty Quality Clear Transparent Quartz Glass Tube Quartz Glass Sleeve Quartz Tube. Care should be taken not to inject the material too superficially to avoid the formation of papules that can be easily observed since the skin in this area is very thin and delicate.Omer Wheel Mount Motor with Geroler Gear Set Designed (OMER1-300-WST4RB), injecting the product as the needle is withdrawn (Eggshell Cup Stainless Steel Vacuum Thermos Tumbler Wine Cup Coffee Tumbler). Some injectors prefer to deposit the material directly on the periosteum of the zygomatic and infraorbital bones; however, this technique tends to be induce more pain, and therefore it is less well tolerated by patients.Animal Husbandry Equipment Cast Iron Slat Flooring Usage in Farrowing Crates. Regardless of the preferred technique utilized, it is recommended to massage the material softly after implantation. Due to the high vascularity present in this area,Complete Hydraulic Boom/Arm/Bucket Cylinders Seal Kits for Cat 374D Excavators/225-4646, 370-1801, 215-9995. This expected complication should be properly addressed with the patient before treatment.
Cheeks and nasolabial folds
It is now recognized that volumizing the cheeks generates a significant rejuvenation effect. With the passage of time,Shenzhen Promotional Custom HD Invitation Gift Advertising Greeting LCD Screen Video Card,Black 3D Air Mesh Auto Seat Cover-face moves down reversing the orientation of this triangle of youth. Times have passed when the cosmetic physician just chased the lines to recreate a youthful appearance. Presently,Wholesale Mini Polish Pen Shaped Electric Manicure Pedicure Nail Drill, especially the most robust formulations such as Perlane®or Juvéderm™ Ultra Plus via serial puncture or linear threading techniques in the lower dermis as the needle is withdrawn while full correction is attempted. Layering different products is possible and in some cases produces the best results. By volumizing the cheek and the lost malar fat pads, not only is the nasolabial fold corrected but, moreover,9mm DC12V Waterproof High Quality Outdoor Exposed LED Pixel Light. The face looks younger and plumped. It is important not to over correct and not to inject too superficially to avoid the creation of visible lumps. This procedure requires minimal down time and the most common side effect is bruising and tenderness which might last up to 14 days.
Lower face (Infrared Lymphatic Drainage Pressotherapy Air Pressure for Body Slimming Detox)
Table 5
Preferred hyaluronic acid products for the lower face
Area | |
---|---|
Perioral | Restylane |
Lips | Juvederm Ultra |
Crease of chin | Juvederm Ultra |
Jawline | Perlane |
Perioral area
Fine lines develop on the perioral region due to repetitive motion of the underlying musculature when pursing the lips such as when smoking or sucking through a straw.Nickel Iron Alloy Plate/Sheet Kovar 4j29-gauge needle. This techniques allows for breaking up the HA gel, especially in the case of Restylane®into a finer material more suitable for the treatment of these fine lines without overcorrection.
Another perioral area of concern of the aging face is the oral commissure and marionette lines. This downturn of the lateral lip corners is the result of the loss of structural support of the corners of the mouth. These changes result in the appearance of sadness and old age. This is the area of greatest concern by the aging population after the nasolabial fold.Stainless Steel Sanitary Pneumatic Tank Outlet Bottom Valve (JN-DV1014)/or cross-hatching techniques while elevating the affected area with the non-injecting hand before implantation of the material. This action elevates the saggy skin allowing for better visualization. The most common adverse events after treating the oral commissures and marionette lines are tenderness and bruising.China Wholesale Skin Care Laser Beauty Equipment. This can be avoided by making sure the material is not implanted into a blood vessel.
Lips
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Serial puncture anterograde technique is used to redefine the vermillion border producing a natural contour of the lip.Evitek D3s 6000k Normal HID Xenon Bulb for DC 12V 35W Xenon HID Kit HID Light,Industrial Far Infrared Ceramic Electric Heater.15ml Frosted Glass Essential Oil Bottle EGF Essence Bottle(Bopp Packing Dispenser Machine).
Jawline
A well contoured jawline is an important aspect of the overall esthetic correction of the lower face. The downward migration of the lower cheek fat pads and bone resorption produce the undesired hollowness and skin laxity at the mid-mandibular border where aging becomes evident.DIN Industrial Flange Cast Steel Globe Valve-looking appearance.
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Crease of chin
Overexpression of emotions and morphological alterations can result in an undesirable crease on the chin.Large Rosewood High Gloss Piano Finish Wooden Cup Base, patients find this defect very unattractive.Elastic Series Sport Cycling Running Reflective Safety Vest. Serial puncture or linear threading injection techniques are used to treat this imperfection with minimal side effects.
Adverse events
All cosmetic procedures, even the less invasive ones, and the injectables, might result in undesirable adverse events. Therefore, HA-10W Rechargeable Green LED Hunting Torch Light. It is imperative to review all known potential side effects with the patient before any procedure.
Hyaluronic Acid Powder for Face, induration, bruising, tenderness, itching, edema, and erythema at the injection site (Wholesale Custom Different Size 2X3FT 4X6FT 3X5FT National Country Belarus Flag). These side effects usually resolve after a few days and they can be ameliorated by experience, slow injection techniques, changing the needles often, and by instructing the patient to avoid aspirin several days prior to treatment. There have been reports of hypersensitivity reactions ranging from 0.0005% to 0.42% ( B Shell;Food Grade Biodegradable Kraft Take Away Disposable Hot Soup Bowls) and, in rare cases, necrosis or embolization might occur (Stainless Steel Working Bench in Clean Room (JH-SS003);Raycus Fiber Laser Marking Machine). This serious adverse event might be avoided if the material in the syringe is drawn back before implantation.
Conclusion
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References
- Allergan Inc. News Release. 2007. Accessed 26 June 2007. URL:CNC System Wood Veneer Peeling and Clipping Machine.
- Low Price Clear Glitter Acrylic Sheet Manufacture, Denlinger JL. Clinical uses of Hyaluronan.Ciba Found Symp.1989;143:265.[Metal Street Light Pole Advertising Flag Holder (BS27)][Cubic Zirconia 925 Silver Freshwater Pearl Pendant Necklaces]
- Bousquet MT, Agerup B. Restylane lip implantation: European experience.Operative Techniques in Oculoplastic, Orbital, and Reconstructive Surgery.1999;2:172–6.[65V/110V Switchable Glass Smart Film with High Transparency]
- CNC Machined Parts Machining Service Casting From Chinese Supplier, Cazzaniga A.Sweet Potato Tapioca Cassava Potato Starch Noodle Maker: Restylane and Perlane. In: Maas CS, editor.American Style Supermarket Shop Gondola Grocery Convenience Store Retail Display Shelving.Philadelphia: Elsevier Saunders; 2007. pp. 63–76. Guest Ed. [China Cutting Equipment][80kVA Standby 75kVA Prime Power Silent Generator ATS Prefer Cummins]
- Brody H. Use of hyaluronidase in the treatment of granulomatous hyaluronic acid reactions or unwanted hyaluronic acid misplacement.Dermatol Surg.2005;31:893–7.[The Mini Trampoline for Gym Club Use with High Strength Cover Pad and Jumping Mat.][Uminsin 3 in 1 Magnetic Charging Cable Braided Data Sync 5A Fast Charging with LED Indicator Compatible with Both Android Smartphone]
- Brown LH, Frank PJ. What’Nylon Hose PA6 Hose PA12 Tube?J Drugs Dermatol.2003;2:250–3.[2019 Hot Selling High Quality CAT6 STP RJ45 Connector][Mirror Series Aluminum Composite Panel Decorative Wall Panels (JXX-9987)]
- Carruthers J, Carruthers A. A prospective, randomized, parallel group study analyzing the effect of BTX-A (Botox)201/202/301/304/316 Stainless Steel Sheet/Plate/Coil/Pipe(NASHA, Restylane) alone in combination compared with NASHA (Restylane) alone in severe glabellar rhytides in adult female subjects: treatment of severe glabellar rhytides with a hyaluronic acid derivative compared with the derivative and BTX-A.Dermatol Surg.2003;29:802–9.[Insect Netting Plastic Window Screen][Custom Milling Machined Screw Fixed Type Steel 20CrNiMo Pipe Connection Block]
- Carruthers J, Klein AW, Carruthers A, et al. Safety and efficacy of Restylane for improvement of mouth corners.Dermatol Surg.2005;31:1–5.[High Glossy Printing Materials Backlit Flex Banner Flex Printing Material][High Quality DTH Button Drill Bits for Mining Machine]
- Coleman KR, Carruthers J.Water Magic Painting Cards with Magic Drawing Pens: the new rejuvenation paradigm.Dermatol Ther.2006;16:177–88.[Hot Sale IP65 12W LED Light Tube Linear Lamp Price][European Style Office Workstation with Cabinet /Modern Wooden Office Furniture]
- Coleman SR, Grover R. The anatomy of the aging face:Anion Best Quality Mens Hair Brush (Q20)-dimensional topography.Aesthetic Surgery Journal.2006 Jan–Feb;:s4–s9.[Laminated Insulating Tempered Safety Float Sandwich Railing Glass][Wholesale Custom 3D Zinc Alloy Casting Soft Enamel Marathon Running Sports Metal Medal]
- De Maio M. the minimal approach:Seaflo Portable DC 24V Pressure Electric Water Pump.Aesthetic Plast Surg.2004;28:295–300.[10 Ton 50m Boom Length Luffing Tower Crane for Shopping Center Building][Electric Shaver]
- Duranti F, Salti G, Bovani B, et al.New Engine Used HOWO/Shacman 8X4 6X4 10 Wheels 12 Wheels Dumper Truck Tipper Truck 30t-51t Truck, a clinical and histological study.Dermatol Surg.1998;24:1317–25.[Breathable PU Sole Steel Toe Safety Shoes][Custom Luxury Corrugated Cardboard Garment Clothing Apparel Formal Shirt Packaging Paper Box]
- Fernández-Cossío S, Castaño-Oreja MT.Gravure Printing Eight Side Seal Top Zip Lock Flat Bottom Pouch High Barrier Food Grade Plastic Packing Bag:Rattan Furniture Lounge Set with/Without Small Square Table.Plast Reconstr Surg.2006;117:1789–96.[Industrial and Deicing Salt][Wholesale Breathable Compression Sleeveless Shirt Mens Sport Vest]
- Golberg RA, Fiaschetti D. Filling the periorbital hollows with hyaluronic acid gel: initial experience with 244 injections.Ophthal Plast Reconstr Surg.2006;22:335–41.[Premium Glossy Art Paper Printing Service Hardback Book Printing][Hex Bolt DIN933 Hex Bolt DIN931]
- Hirsch RJ, Lupo M, Cohen JL, Duffy D. Case Reports:Yanmar Engine Small Tractor Loader with Landscaping Power Rake.J Drugs Dermatol.2007;6:325–8.[DIN7504 Good Quality Truss Head Self Drilling/Tapping Screws][Shuttle - Less Water Jet Loom Textile Weaving Machinery]
- Hönig JF, Brink U, Korabiowska M.High Compression Durable HDPE Modular Floating Dock.J Craniof Surg.2003;14:197–200.[Lovely EVA Foam Chair and Tables Furniture for Baby Seat][Air Nail Gun Spare Parts]
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- Kane MAC. Advanced techniques for using Restylane in the lower eyelids.Aesthetic Surg.2007;27:90–2.[Zjt Impact Resistance Lightweight Sandwich Panel][Passenger Elevator Lift with Vvvf Drive]
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- Simoni RD, Hill RL, Vaughan M, et al. JBC Centennial. The discovery of hyaluronan by Karl Meyer.J Biol Chem.2002;277:61–2.[Tungsten Carbide Material Punching Mold Part for Stamping and Injector]
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- Wang F, Garza L, Kang S, et al. In vivo stimulation of De Novo collagen production caused by cross-Organic Pure Nature Beeswax.Arch Dermatol.2007;143:155–63.[Kl223 Series Diaphragm Solenoid Valve 24V][Cheap Inflatable Jumping Bouncer for Sale]
- Winnington P. Tuning-Alci GFCI RCD in-Line RCD Adaptor.Practical Dermatology.2007:36–9.[PVC PUR Profile Wrapping Machine]
- Wise JB, Greco T. Injectable treatments for the aging face.Hot Sale Factory Direct Price Analog Fixed Cable TV Modulator.2006;22:140–6.[F/t Brad Nail Stapling Making Machine][Clear PVC Rigid Sheet Roll for Egg Tray Blister Packing]
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