无所事事，就看了朋友们的status，
哇，个个都变了，
而我却仿佛困在一个小筐筐里，走不出来。
我大部分时间都在考试读书，好像都跟外面的世界脱离了关系。
我在想，有必要吗？

时常让自己读读读，真的有用？
对自己要求那么高，是怕输？是怕达不到别人对我的期望？还是不能面对失败？

也许每个都有。。
可是我累了，真得好累了，
我只想放下身段，轻轻松松做我自己，
与我爱的家人朋友一起度过快乐时间。：）

Introduction of Botox

The medicine Botox® is actually botulinum toxin released by Clostridium botulinum. Clostridium botulinum produces seven serotypes of the toxin that is botulinum toxin A±G but the commonly used Botox in the treatment of wrinkle is botulinum toxin A.(BT-A). Besides, it is a neurotoxin that is made up of a light chain and heavy chain linked by a single disulphide bond.  (Image Adapted from Centerr for Cellular Molecular Biology in Hyderabad )                                                                                                    

The botulinum toxin initial uses were for strabismus(crossed eye), blepharospasm (uncontrollable blinking), and cervical dystonia (wry neck). (Tortora G.J, Derrickson.B. 2010.) In the year of 2002, it was approved to be used cosmetically to treat facial lines and wrinkles. Follow by then, in the year 2004, FDA approved Botox for treating excessive underarm sweating. 

The presence of high doses of botulinum toxin in food causes food poisoning and could be fatal. They can enter the body easily and interfere with the transmission of nerve impulses, causing disturbances in sensory and also paralysis of the respiratory muscles, leading to suffocation. However, the Botox used for injections is diluted with saline or other liquid. Thus, the dose given is so small that it does not cause significant harmful effect. (eMedicineHealth. 2010.) 

Figure 2: Botox Available in Market
 (Image Adapted from BotoxTreatment.com)

How Wrinkles Formed?

There are three types of wrinkles: dynamic wrinkles, static wrinkles, and wrinkle folds with each formed by different factors. The articles will be explaining more on dynamic wrinkles as botox works well in it.

Figure 1: Release of Acetylcholine into synaptic cleft
(Image adopted from Rugged Elegance)

The dynamic wrinkles are formed by repeated contraction of muscle through facial expression. When impulse arrives at axon terminal, neurotransmitter acetylcholine is exocytosised into the synaptic cleft to attach to the receptors on the postsynaptic membrane. This generate muscle action potential and trigger muscle contraction.(Tortora G.J, Derrickson.B. 2010.) The shortening of sarcomeres and fiber during muscle contraction will then causes the skin to becomes bunch together, forming lines between the muscles. 

 

Click on the video to show how muscle contract(Adopted from youtube.com)

 

Besides, frequent muscle contraction causes the skin elastic tissue network deteriorates by deformation of the dermis and the hypodermis layers. The skin will becomes looser, loses the ability to snap back to its original state after being deformed and thus wrinkles are formed. Furthermore, as skin cells regenerate themselves at slower rate and tend to favor a specific orientation with age, frequent facial expression with muscle contraction causes wrinkles to become permanent and more pronounced.In addition, the height of the bulging of the wrinkles depends on the amplitude of the muscle contraction.(Dr. Jonathan Hoenig. 2002-2004.)

The second type static wrinkles occur from the loss of elasticity of the skin due to lifestyle and age while wrinkle folds, is caused by the loss of subcutaneous facial fat and sagging of the underlying facial structures.Folds appear when skin is deformed but disappear after removal of the deformation. Repetition of skin folding on the same site would progressively give rise to permanent wrinkles.(Nadia M.T, Prem.K,Jean L. n.d.)

The Mechanism of Botox in Wrinkles Reduction

Generally, the Botox or BT-A works by weakens or paralyzes muscles by inhibiting the release of acetylcholine. Soon after the Botox is injected,

Figure 1:Binding of BT-A with receptors on plasma membrane

1.0 The heavy chain of the BT-A bind irreversible with specific receptors called sialoglycoproteins in the plasma membrane of motor nerve.

1.1 The binding  allows efficient uptake of Botox by the motor nerve and facilitates selective targeted treatment at the injection site.

 

Figure 2:Endocytosis of BT-A into motor nerve cytoplasm

2.0 The binding induces receptor-mediated endocytosis of the toxin where the Botox molecule passes through the cell membrane of the motor nerve and into its cytoplasm.

2.1 The light chain of BT-A that is responsible for the toxicity is activated and split off in the cell.
(This is due to the fact that the subunit of BT-A are linked together by only single disulphide bond, the BT-A is therefore unstable and can break down into inactive subunits as a result of minimal mechanical and thermal stresses. )

Figure3: Inactivation of SNAP 25

3.0 Light chain of Botox cleaves apart a synapse-specific protein,  synaptosomal-associated protein of 25kDa( SNAP25) that enable neurotransmitter acetylcholine storing vesicles to attach to cell membrane. 

3.1 SNAP-25 is inactivated from a fusion complex of three proteins.

All the images above adopted from:

Allergan Incorporation. 2010. Mechanism of Action.

4. Cleaving SNAP25 prevents acetylcholine storing vesicles from fusing with the membrane and prevents the release of acetylcholine into the neuromuscular junction (the space between the motor nerve and the muscle).

As Acetylcholine act as chemical trigger of ion channel, inhibiting the release of acetylcholine causes blockage in transmission of the nerve impulses to neuromuscularjunction and myoneural (muscle-nerve) junctions. Thus, muscle cannot contract and the muscle activity decreases.  (P. Becker-Wegerich, L. Rauch and T. Ruzicka. 2001.)

Figure 4: Difference in the neuromuscular junction after botox injection. Notice that the acetylcholine is no longer released into end plate region after injection. (Image adopted from emedicine.com)

Click on the video below to view how botox inhibit muscle contraction.


 (Video adopted from youtube.com)

The Effectiveness of Botox in Wrinkle Reduction

It is well known that the Botox can treat the dynamic wrinkles that normally appear on forehead. The picture below shows  forehead of  patients before and after injected with botox.

Figure 1: Picture of patient before and after treatment of Botox

                                                        (Image adopted from: Billinkoff Aesthetic Incorporation)

There are also others area injected with Botox. The others commonly area injected with botox are shown in the picture below:

Figure 2: Others commonly injected area

                                                                                            (Image adopted from: Hana Dental Center)

However, the effect of Botox is just temporaly and normally can last for few to several months depending on area of muscle injected and individual patient. The functional recovery is due to the formation of new neural sprouts and this process takes at least 2-3 months in striated muscles but probably takes much longer in smooth muscles. This is because longer clinical effects have been described when injections of Botox are given in a smooth muscle such as the detrusor.(Allergan Incorporation. 2010) The diagram below showing the recovery of muscle contraction.

A)Figure 1:  Nerve Sprouting: 

1. New nerve endings sprout and connect to the muscle after the original nerve ending is blocked.


2. The ability of the nerve to cause muscle contractions is renew . 






Figure 2:  Reestablishment of Nerve Connection:

1. Eventually, the new nerve sprouts retract.

2. The original nerve ending regains its function,acetylcholine released. 

Figure 1&2 adopted from: Allergan Incorporation. 2010. Mechanism of Action


Click on the video below to view how Botox is injected and it's effectiveness. (Adopted from Youtube.com)

  Adverse Effect of Botox

1. Droopy eye lid:

Any Botox administered around the eye has the potential to affect the muscle that opens then upper eyelid. As Botox can spread from an injection site approximately 1 inch or 2.5cm and is a paralyzing toxin, the muscle that opens then lid is technically also paralyzed, which may make it difficult to open then eyelid carefully. Poor location of the injection and excessive doses of Botox are the culprits of eyelid drooping.  (R.W. Westreich, 2008)

2. More wrinkles:

This happens because the paralyzed facial muscles force other muscles to move in an effort to recreate the facial expressions that Botox has blocked.

For example, when injected, Botox temporarily paralyzes the muscles there and its freezing effects prevent people from frowning. Since there is no muscle contraction, no wrinkles are formed. However, muscles in the upper nose, middle eyebrow and eyelid may try to recreate the expression of a scowl. Repetitions of this cause new wrinkles. (Sharon Bell, 2007)

3 Limit emotion experience:

Due to the paralysis of muscles causes by the injection of botox, facial muscles that have been injected will have less movement therefore less feedback to the brain on facial expressivity.

For example, reading negative emotional words causes contraction of the corrugator supercilii, which pulls the eyebrows down towards the centre of the face to produce vertical frown lines at the top of the nose, whereas reading positive emotional words activates the zygomaticus, which raises the corners of the mouth to produce a smile. These findings provide evidence that involuntary facial expressions can evoke emotions, and suggest that the brain mechanisms involved in experiencing emotions are also used in understanding the emotional content of language. (Mo, 2010)

4 Botox may leak into brain:

Botox might migrate from its injection site into other parts of the nervous system. In the current study, researchers injected botulinum toxin into one side of the hippocampus into the brains of rats and observed it to migrate to the other side of the brain. When the toxin was injected into the brain’s superior colliculus, which is involved in vision, it migrated into the animals’ eyes. (David Gutierrez, 2009)

5. Botox induced muscle paralysis rapidly degrades bone:

A study conducted by Department of Orthopaedics and Sports Medicine, University of Washington show that Botox can actually degrades some of the bones in body. (Sarah E.W,a David A.S, Blair A. B, Steven D, Sundar S and Ted S. G. 2006.)For more information, click here.

                 Others Uses of Botox

1. Cure migraines :

Patients suffering from migraines and severe tension headaches are now turning to Botox for treatment. Botox injections block brain receptors from registering Migraine pain. Muscles begin to relax, reducing tension. (Jeffrey Raval, 2010)

 2. Cure excessive underarm sweating :

Those with a condition known as hyperhidrosis or excessive perspiration is also finding some relief with Botox. Hyperhidrosis is the result of overactive sweat glands. Botox injection can inhibit nerves in body that control the sweat glands. (Keion Moradi, 2007)

3. Cure overactive bladder :

Symptoms of overactive bladder include urinary frequency, urgency or urge incontinence. Botox toxin paralyzes the nerves that release chemicals that cause the muscle to become stimulated. Without the stimulation, the muscle weakens and reduces the spasticity that patients have. The toxin is delivered through a cytoscope, a small telescope that is inserted through the urethra and into the bladder. This means no incisions have to be made in the skin. ( John Tyler, 2003)

4. Enlarged prostate:

Botox causes the muscles around the prostate relax, alleviating pressure on the urethra. Botox treatment for an enlarged prostate report less pain during urination. (Keion Moradi, 2007)

Alternatives Other Than Botox

1. Hexapeptide:

Hexapeptide is said to be alternative to Botox as it is less risky compared to Botox. It works by blocking the Specific Site Kinase, thus preventing the clustering of acetylcholine which is neccessary to activate action potential. (Inyline. N.d) For more information about hexapeptide and related product, click here.

2. Collagen:

Collagen is another well known anti-wrinkle product and it can be injected into muscle as well. It helps to regenerate cell and thus preventing the deformation of dermis due to muscle contraction.( OxynergyParis. N.d.)

3. Hyaluronic Acid:

It support structural protein collagen and elastin, and give the skin elasticity and softness. This is due to its capability to bind large amount of water, which plumpness up the skin. It also helps in building up the cell framework and cell differentiation. ( OxynergyParis. N.d.)

References:

Allergan Incorporation. 2010. Mechanism of Action. Available from:< http://www.allergan.com/assets/pdf/botox_mechanism_of_action.pdf> [ Accessed on 5th July 2010]

David Gutierrez. 2009. Botox injection can leak Botulism into the brain, warn scientists. Available from: <http://www.naturalnews.com/025278.html>[Accessed on 15th June 2010]

Dr. Jonathan Hoenig. 2002-2004. Facial Wrinkles:Turn Back Time On Your Skin. Available from: <;http://www.la-plastic-surgery.com/wrinkles.html> [Accessed on 5th July 2010]

Dr. Larry A. Johnson, D.C. Nov 2005. Headaches and Botox Injections. Available from: <http://ezinearticles.com/?Headaches-and-Botox-Injections&id=97662>[Accessed on 15th June 2010]

eMedicineHealth. 2010. Botox Injection. Available from:< http://www.emedicinehealth.com/botox_injections/page2_em.htm> [ Accessed on 5th July 2010]

Inyline. N.d. A new strategy to escape from expression line. Available from: <http://www.lipotec.com/archivos/Inyline_E.pdf>[Accessed on 10th July 2010]

Jeffrey Raval. 2010. Botox – Not just for wrinkles anymore. Available from: <http://www.cosmeticsurgery.com/articles/archive/an~95>[Accessed on 15th June 2010]

John Tyler. 2003. Botox for your bladder. Available from:<http://www.wchstv.com/newsroom/healthyforlife/2114.shtml> [Accessed on 15th June 2010]

Keion Moradi. 2007. Other uses of Botox besides stopping wrinkles. Available from: <http://www.articlesbase.com/health-articles/other-uses-of-botox-besides-stopping-wrinkles-257494.html>[Accessed on 15th June 2010]

Mo. April 2010. Botox may diminish the experience of emotion. Available from: <http://scienceblogs.com/neurophilosophy/2010/04/botox_may_diminish_the_experience_of_emotions.php>[Accessed on: 15th June 2010]

Nadia M.T, Prem.K,Jean L. n.d. A Computational Skin Model: Fold and Wrinkle Formation. Available from:<http://www.miralab.ch/repository/papers/159.pdf>[Accessed on: 15th June 2010]


OxynergyParis. N.d. Collagen Mask. Available from: <http://www.oxynergy.com/export/downloadenglish/oxygenskincare/collagenmasks.pdf> [Accessed on 10th July 2010]

P. Becker-Wegerich, L. Rauch and T. Ruzicka. 2001. Botulinum toxin A in the therapy of mimic facial lines. Blackwell Science Ltd X Clinical and Experimental Dermatology, Review Article, 26, 619-630

R.W. Westreich, 2008. What causing eyelid drooping after Botox? Available from: <http://www.ehow.com/about_5453390_causes-eyelid-drooping-after-botox.html>[Accessed on 15th June 2010]

Sarah E.W,a David A.S, Blair A. B, Steven D, Sundar S and Ted S. G. 2006. Botox induced muscle paralysis rapidly degrades bone.Available from:< http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1435733> [ Accessed on 5th July 2010]

Tortora G.J, Derrickson.B. 2010. Essential of Anatomy and Physiology. Eighth edition. John Wiley&Sons. Pg 290.

有些人，值得我们去尊敬，甚至崇拜，
我们应当接近他们， 并好好学习
可是有些人，狡猾无比，钩心挖角，善于掩饰
我们称之为小人， 应离他远远。
这是其中一位Malaysia International 小姐教的。


人之初，性本善，
请问小人们也是这样吗？
如果是，
他们的改变是为了保护自己，
还是伤害别人？

曾几何时，
你说了谎，伤害人
而你以为大家不以为然，
而我却看得清清楚楚

我不必要把它解开，
因为也许你是为了保护自己
可是实情是这样吗？

我错了，
很后悔我会交到你们这群人，
真是第一次会觉得交错朋友，
不， 你不配做我的朋友，
我所认识的朋友，全是真心真意，
即使有利益纠纷， 也不至于把我推进县崖。

对不起，我真的不能接受有你们酱的朋友在我身边，
像个计时炸弹，
随时把我丢入你们的陷阱，
把我弄得很惊慌。

这样把别人弄不开心，
真的能建筑你的快乐吗？

请你离我远远，
我不想我的生活那么的宫心计，
还有，
请不要再交垃圾作业给我，
对，对于已不再是我朋友的人，我是很计较的，
当你认为你的东西是不必要改，
而我却认为很大问题的时候，
这还是集体合作吗？

当你认为我应把所有责任扛起，
而你是不必要多管，
我可以叫你一声寄生虫吗？

是时候扛我的责任了，
过完这个学期请不要再攀附在我身上了，
因我已有一群真正将心比心的朋友了。

Another video created for assignment purpose as well...
Ever try spaghetti with Mango Sauce??
The innovative creation, tata.....
Mango Salsa: Tingling while apetizing!
No preservatives& Chemicals..

Say Cheers...Special thanks to my groupmates,
such a memorable time to develop this new product with u all!!
though so many times trial..
lol

Annie Bibliography:

Parents: Tracy+ Sin Yen+ Celest 

Birthday: 3rd July 2010 (0800-00.30)

BirthPlace: Starbucks JJ Wangsa Maju -> Sakai House

Every1 viewing this, pls, support Annie thinking: Be Vegan, Go Green oh!!

Hahaha, poor Annie, has weird sound...

Cannot study…listening to songs, music, everything…phone is offline…msn is in “Do not disturb” status…everything is calm & peace for a good study environment…the colour of package of biscuit I’m eating is blue…just like my mood…


Hate myself somehow for giving myself stress mode with just a small small matter. Have i really changed better already? Why izzit I was being so sure and told everyone that I finally did? Too desperate can cause self-misunderstood! It’s very guilty myself get “merajuk” easily after thinking back. Again, I chose to run away, to avoid. I know he’ll get mad at me this time for doing this again, as I promised him I won’t give him silent treatment without letting him know. I really wanna concentrate in studies, don’t want any hassle, not even wanna contact with him for the time being. I’m sorry again The thing is it’s not working. My mind is messed as usual when anything happen between us.

I’m stressed and couldn’t think of what to do again. Sorry~

(p/s: I hope I won’t fail my tests)

Many people will be passing through our lives, no matter we are happy with them or hate them..we still need to live everyday… have one more friend is better than having one more enemy… sometimes..even a friend whom u know for sometime can bluff u or cheat on u… But.. do not b angry.. forgive them… just stay calm n solve problems rationally… don’t fight… also, don’t keep it in the heart or take revenge..
Do you know what is one cross + three nails = forgiven ? if u don’t..find out then!
well…the world will be more harmony n peaceful

Just now i read a really meaningful mail, made me thinking deeply on the meaning, and cant deny this as i thought. “When a person is in a mad/angry mood, his/her EQ is like a 5-year-old kid”. Thinking back the scenario when u are in mad mood, u would realise this statement is true

Teachings for myself after incident that day:

-DON’T do something which would make u regret, coz the feeling of regret is much worse than feeling of ad,

  upset, sad n anything else

-DON’T make ANY decision, say ANYMORE word, do ANYTHING to that person when u are mad at

  him/her, cuz u would REGRET after all

-Appreciate him~ Really appreciate him~

wow..today had IT presentation..was like slept on wednesday evening at 5pm…tried to do power point but slept till 1am thursday morning..then rush for the power point and speech..Tik Tok, Tik Tok, time passing quickly...prepare go to school, have to be tidy shirt..wear shoes..I am so nervous, standing in front of class and present my title: How web publishing impact on traditional publishing. The process didn't go through smoothly as i thought..i failed to fix the lap top screen showing the slide show and end up refer to the projector image..after mumbling mumbling about ten minutes, my speech end..hoo, what a relief..From now on, i can focus on my quizs next week without forgetting that the bloger assignment deadline is on monday too...it is a great ann bz day…then after bz chatting with ppl..can rest here n write about MY today…hehe

MIAO~

It's my starting of blue mood again,
Since today is Monday..
Wohh..really tired and bored..
Laziness fill up my mind,
So I looked for an video..


^.^ Finally I found some1 same as me,
Lazy and tired..



I hope I won't fall asleep as her so soon..
lol

What a busy but bored Sunday.
Facing computer all day long rushing assignments...
 

Then figure out how to apply slide show on this blog,
how to add page elements,
how to add videos and audio.
only I realize the effort of those blogger in maintaining their blog...

It's the starting of a week again &

Tomorrow have the blue Monday again :(

Good Luck for this week~

Wondering my trip last week,

with a group of UTAR student

that just finish final exam,

=o='' Am i celebrating my starting of stressful sem 

with those release from "jail"?

Anyway, It was a fantastic trip

although not really far..

I get chance to scared by different reptiles at same day,

Met a nice clown,

Play cute games...
Like going back to childhood ^-^












They are so cute and nice!!

The parrot holding by Fang Fang seems like so excited

Haha..Pretending very scare( Childish??)

Lulu made lollipop for us + cheers!! Yeah...

At first,
I thought I don't know what to write here,
for the sake of handle assignment,
but then after 2 days time,
I remind what my friend wrote to me on her blog,
few years time ago~


So, I viewed her blog once again,
 http://www.wretch.cc/blog/vicky6810/5870772


Refering the blog,
My tears drop at the same time,




Thanks god for giving me such a valuable friend,
My life was wonderful,
My family and my Best frens,
U all are my precious treasures~