Lasers in Surgery and Medicine最新文献

Objectives: Cutaneous collagenous vasculopathy (CCV) is a rare, idiopathic microangiopathy marked by widespread telangiectasias and histologic vessel wall thickening. Due to its rarity and clinical overlap with other vascular conditions, CCV poses diagnostic and therapeutic challenges. This report highlights the successful use of pulsed dye laser (PDL) therapy in treating a case of extensive CCV.

Methods: A 40-year-old woman with a decade-long history of progressive telangiectasias involving the extremities, trunk, and forearms underwent treatment with a 595-nm PDL. Six treatment sessions were conducted over 14 months.

Results: The patient experienced significant improvement in erythema, telangiectasias, and associated discomfort, with sustained clinical response and substantial cosmetic benefit observed across all treated areas.

Conclusion: PDL is a safe and effective treatment for CCV, offering both symptomatic relief and cosmetic improvement. This case adds to limited existing literature supporting its use and highlights the importance of individualized laser parameters for optimal outcomes.

Background: Hemoporfin-mediated photodynamic therapy (PDT) is a high efficacy treatment alternative for port-wine stains (PWS) patients, and PDT also induced eczematous dermatitis in treated areas. However, the effect of PDT treatment on the prevalence and risk of dermatitis in patients with PWS have not been reported.

Purpose: To assess the association between PDT and dermatitis incidence and to investigate the mechanism of PDT-triggered dermatitis in PWS patients.

Patients and methods: A total of 512 PWS patients who received hemoporfin-mediated PDT treatment between June 2020 and September 2022 at the dermatology department of Wuhan No.1 Hospital were recruited in this study. Clinical images were used to calculate the percentage of dermatitis in treated areas. The arithmetic mean roughness (Ra), the average depth of roughness (Rz) and the mean square roughness (Rq) were used to assess the change of surface roughness. Transepidermal water loss (TEWL), stratum corneum hydration (SCH) and total lipid content (TLC) were used to analyze the skin barrier function.

Results: After treatment, we found that 27.15% (139/512) of PWS patients developed dermatitis on the treated areas, and the percentage of dermatitis was closely related to the treatment times and age of the patient. Moreover, these treated areas also exhibited markedly increased skin roughness (Ra, Rz, Rq; p < 0.05) and impaired barrier function, evidenced by significantly elevated TEWL and TLC (p < 0.05) and reduced SCH (p < 0.05).

Conclusion: PDT caused skin barrier dysfunction in PWS patients, which may lead to increased permeability of the epidermis and contribute to the dermatitis development.

Objectives: The movement of cilia in the fallopian tubes (FTs) facilitates important processes involved in fertility, and abnormalities in cilia function are linked with diseases including endometriosis and pelvic inflammatory disease. For the first time, we demonstrate the use of optical coherence tomography (OCT) to create depth-resolved mapping of motile cilia locations and quantify cilia beat frequency (CBF) in human FT samples ex vivo.

Methods: Segments of the FT ampulla were acquired from five patients following salpingectomy under an IRB approved protocol. The samples were longitudinally opened to expose the luminal surface for imaging. A sequence of at least 500 OCT images were acquired at 5-10 locations on each sample. To define the location of the motile cilia in the images, pixel-wise Fast Fourier Transform (FFT) analysis of intensity fluctuations with a sliding temporal window was performed on each image sequence. The frequencies corresponding to the physiological range of CBF (2-10 Hz) were selected for mapping, while the part of the FFT spectrum at higher frequencies (> 23 Hz) was used to define the noise threshold. The frequency with the highest FFT amplitude for each supra-threshold pixel was considered the CBF for this pixel and used to create a color-coded CBF map. The CBF map was overlaid with the OCT intensity image sequences to reveal cilia locations. Frequency histograms from the sliding window were examined to assess temporal consistency of the mapping and evaluate movement artifacts.

Results: OCT image sequences clearly showed the structure of FT plicae. The ciliated epithelium was obvious as a "shimmering" (rapidly changing intensity) layer atop plicae. Colored pixels on CBF maps visually aligned to these shimmering regions. Frequency histograms revealed that the image sequence peak CBF could be robustly determined, even in the presence of outliers attributable to table vibrations or bulk sample movement.

Conclusions: OCT can provide depth-resolved maps of CBF in human ex vivo FT tissue. Potentially, this technique can aid in understanding cilia dynamics in the normal human FT over the menstrual cycle and across age, as well as in diseases that affect the FTs. Future work will be directed toward in vivo implementation including miniaturization and robust motion compensation.