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Effective treatment of corticosteroid-induced facial erythema using fractional radiofrequency microneedling 使用点阵射频微针有效治疗皮质类固醇引起的面部红斑
IF 2.4 3区 医学 Q2 DERMATOLOGY Pub Date : 2024-05-01 DOI: 10.1002/lsm.23787
Xiaowen Huang PhD, Siqi Zheng MBBS, Pingjiao Chen PhD, Menghua Zhu MD, Jia Guo MD, Qian Li PhD, Kang Zeng PhD, Sijin He MD

Objectives

To investigate the efficacy of Fractional Radiofrequency Microneedling (FRM) in treating corticosteroid-induced facial erythema.

Methods

A retrospective study was conducted involving eight patients diagnosed as corticosteroid-induced facial erythema. Each patient underwent a single session of FRM. Evaluative measures included Clinician's Erythema Assessment (CEA), Patient's Self-Assessment (PSA), assessment of telangiectasia severity, procedure-associated pain (10-point scale), patient satisfaction (3-point scale) and secondary outcomes.

Results

The study found a 75% success rate and 100% effectiveness rate in alleviating erythema symptoms. CEA and PSA scores decreased by 67.7% and 78.1%, respectively. No cases of erythema rebound were recorded during the 3-month follow-up period.

Conclusions

FRM demonstrated effectiveness and safety in treating facial erythema, offering promising advancement in dermatologic therapeutics.

目的 探讨点阵射频微针疗法(FRM)在治疗皮质类固醇引起的面部红斑方面的疗效。方法 对 8 名确诊为皮质类固醇引起的面部红斑患者进行回顾性研究。每位患者都接受了一次 FRM 治疗。评估指标包括临床医师红斑评估(CEA)、患者自我评估(PSA)、毛细血管扩张严重程度评估、手术相关疼痛(10 分制)、患者满意度(3 分制)和次要结果。CEA和PSA评分分别下降了67.7%和78.1%。结论FRM 在治疗面部红斑方面表现出了有效性和安全性,是皮肤病治疗领域的一大进步。
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引用次数: 0
Cover Image: Volume 56 Issue S36 封面图片:第 56 卷第 S36 期
IF 2.4 3区 医学 Q2 DERMATOLOGY Pub Date : 2024-04-30 DOI: 10.1002/lsm.23791

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引用次数: 0
In vivo assessment of bladder cancer with diffuse reflectance and fluorescence spectroscopy: A comparative study 利用漫反射和荧光光谱对膀胱癌进行活体评估:比较研究。
IF 2.4 3区 医学 Q2 DERMATOLOGY Pub Date : 2024-04-22 DOI: 10.1002/lsm.23788
Nadezhda V. Zlobina MSc, Gleb S. Budylin PhD, Polina S. Tseregorodtseva BSc, Viktoria A. Andreeva MSc, Nikolay I. Sorokin PhD, David M. Kamalov PhD, Andrey A. Strigunov MSc, Artashes G. Armaganov MSc, Armais A. Kamalov PhD, Evgeny A. Shirshin PhD

Objectives

The aim of this work is to assess the performance of multimodal spectroscopic approach combined with single core optical fiber for detection of bladder cancer during surgery in vivo.

Methods

Multimodal approach combines diffuse reflectance spectroscopy (DRS), fluorescence spectroscopy in the visible (405 nm excitation) and near-infrared (NIR) (690 nm excitation) ranges, and high-wavenumber Raman spectroscopy. All four spectroscopic methods were combined in a single setup. For 21 patients with suspected bladder cancer or during control cystoscopy optical spectra of bladder cancer, healthy bladder wall tissue and/or scars were measured. Classification of cancerous and healthy bladder tissue was performed using machine learning methods.

Results

Statistically significant differences in relative total haemoglobin content, oxygenation, scattering, and visible fluorescence intensity were found between tumor and normal tissues. The combination of DRS and visible fluorescence spectroscopy allowed detecting cancerous tissue with sensitivity and specificity of 78% and 91%, respectively. The addition of features extracted from NIR fluorescence and Raman spectra did not improve the quality of classification.

Conclusions

This study demonstrates that multimodal spectroscopic approach allows increasing sensitivity and specificity of bladder cancer detection in vivo. The developed approach does not require special probes and can be used with single-core optical fibers applied for laser surgery.

方法多模态方法结合了漫反射光谱(DRS)、可见光(405 nm 激发)和近红外(NIR)(690 nm 激发)范围内的荧光光谱以及高波长拉曼光谱。所有四种光谱方法都结合在一个装置中。对 21 名疑似膀胱癌患者或在对照膀胱镜检查期间的膀胱癌、健康膀胱壁组织和/或疤痕的光学光谱进行了测量。结果发现肿瘤组织和正常组织之间在相对总血红蛋白含量、氧饱和度、散射和可见荧光强度方面存在显著统计学差异。结合 DRS 和可见荧光光谱检测癌症组织的灵敏度和特异度分别为 78% 和 91%。本研究表明,多模态光谱方法可以提高体内膀胱癌检测的灵敏度和特异性。所开发的方法不需要特殊探针,可与用于激光手术的单芯光纤一起使用。
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引用次数: 0
Influence of vitamins and food on the fluorescence spectrum of human urine 维生素和食物对人体尿液荧光光谱的影响
IF 2.4 3区 医学 Q2 DERMATOLOGY Pub Date : 2024-04-11 DOI: 10.1002/lsm.23785
Praveen Chalissery, Christian Homann PhD, Herbert Stepp PhD, Maximilian Eisel PhD, Maximilian Aumiller PhD, Adrian Rühm PhD, Alexander Buchner MD, Ronald Sroka PhD

Objectives

Fluorescence spectroscopy of human urine is a method with the potential to gain importance as a diagnostic tool in the medical field, e.g., for measuring Coproporphyrin III (CPIII) as an indicator of cancer and acute types of porphyria. Food can change human urine's color, which could influence the urine fluorescence spectrum and the detection of CPIII in urine. To determine if there is a noticeable influence on the urine fluorescence spectrum or on the detection of CPIII in urine, 16 vitamin supplements, and three food items were tested. Such investigation may also prevent false interpretation of measured data.

Methods

Urine samples were collected before and after (overnight, ca. 8 h) intake of each test substance. Samples were investigated by fluorescence spectrum analysis. At excitation wavelengths from 300 to 500 nm and emission wavelengths from 400 to 700 nm excitation-emission-matrices were measured. Data obtained from urine before intake were compared to the data from overnight urine. Furthermore, the investigation of any interference with the CPIII concentration was performed at an excitation wavelength of 407 ± 3 nm and emission wavelengths of 490−800 nm.

Results

Only vitamin B2, but none of the other tested substances, showed noticeable influence on the urine fluorescence spectrum. None of the tested substances showed noticeable interference with the recovery rate of CPIII.

Conclusions

The correct interpretation of measured data by fluorescence spectroscopy is possible with the exception if vitamin B2 supplementation was performed; thus, the consumption of vitamin B2 supplements before fluorescence testing of the patient's urine should be avoided and/or must be requested. CPIII concentrations could reliably be measured in all cases.

目的人体尿液荧光光谱法是一种有可能在医学领域作为重要诊断工具的方法,例如用于测量作为癌症和急性卟啉症指标的铜卟啉 III(CPIII)。食物会改变人体尿液的颜色,从而影响尿液荧光光谱和尿液中 CPIII 的检测。为了确定对尿液荧光光谱或尿液中 CPIII 的检测是否有明显影响,我们对 16 种维生素补充剂和 3 种食物进行了检测。方法在摄入每种测试物质前后(过夜,约 8 小时)收集尿液样本。通过荧光光谱分析对样本进行调查。激发波长为 300 至 500 nm,发射波长为 400 至 700 nm。将摄入前尿液的数据与隔夜尿液的数据进行比较。此外,在激发波长为 407 ± 3 nm 和发射波长为 490-800 nm 时,对 CPIII 浓度的干扰进行了调查。结论通过荧光光谱法可以正确解释所测得的数据,但补充维生素 B2 的情况除外;因此,在对患者的尿液进行荧光检测之前,应避免服用维生素 B2 补充剂,并且/或者必须要求服用维生素 B2 补充剂。在所有情况下都能可靠地测量出 CPIII 的浓度。
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引用次数: 0
Percutaneous delivery of liquid tetracycline using a thermal resurfacing drug delivery system for the treatment of festoons 利用热重塑给药系统经皮给药液态四环素以治疗静脉曲张
IF 2.4 3区 医学 Q2 DERMATOLOGY Pub Date : 2024-04-11 DOI: 10.1002/lsm.23786
Margarita Safir MD, Inbar Waizer MD, Ari Safir MD, Morris E. Hartstein MD, Ofir Artzi MD

Objectives

To examine the effects of percutaneous tetracycline delivery to the malar area using a thermomechanical device (Tixel) in patients suffering from festoons.

Methods

This retrospective study included patients who underwent combination treatment with a thermomechanical device (Tixel) followed by application of topical tetracycline 1% at two private clinics between 2019 and 2023. Demographic and medical data, treatment parameters along with before and after treatment photographs were retrieved retrospectively. All patients were asked to answer a questionnaire, assessing self-reported pre and posttreatment disturbance, patient global impression of change (PGIC) score, overall satisfaction with treatment, and the onset and duration of treatment effect. Finally, three masked reviewers evaluated and graded the severity of before and after treatment photographs.

Results

Twenty healthy patients received the combination treatment. The mean age was 59.4 ± 8.2 years (range: 45–72 years), and 90.0% (n = 18) were female. The number of treatment sessions per patient ranged from 2 to 8, mean of 5.0 ± 1.9, performed at 5.4 ± 1.2-week intervals. The masked reviewers' grading scores demonstrated a significant improvement (2.81 ± 1.3 before vs. 1.6 ± 1.1 after, p < 0.001). The self-reported disturbance caused by the festoons improved significantly as well (4.7 ± 0.98 vs. 1.7 ± 1.1, p < 0.001). On the PGIC score, 85% (17/20) reported moderate (grade 5) to significant (grade 7) improvement of symptoms and life quality after treatment. Improvement onset was reported to occur 11.2 ± 6.6 days after the first treatment (range 2−30 days), and 90% (18/20) of the patients reported improvement lasting at least 4 months after completion of the second treatment.

Conclusions

Topical tetracycline application following Tixel treatment induced significant improvement in patient with festoons.

方法这项回顾性研究纳入了2019年至2023年期间在两家私人诊所接受热机械装置(Tixel)联合治疗,然后外敷1%四环素的患者。研究人员回顾性地检索了患者的人口统计学数据、医疗数据、治疗参数以及治疗前后的照片。所有患者都被要求回答一份问卷,评估自我报告的治疗前和治疗后干扰、患者总体变化印象(PGIC)评分、对治疗的总体满意度以及治疗效果的开始和持续时间。最后,三名蒙面评审员对治疗前后照片的严重程度进行了评估和分级。平均年龄为 59.4 ± 8.2 岁(范围:45-72 岁),90.0%(n = 18)为女性。每位患者的治疗次数为 2 至 8 次不等,平均为 5.0 ± 1.9 次,治疗间隔为 5.4 ± 1.2 周。蒙面评审员的评分结果显示,患者的病情有了明显改善(治疗前为 2.81 ± 1.3,治疗后为 1.6 ± 1.1,p <0.001)。患者自我报告的褶皱造成的干扰也有明显改善(4.7 ± 0.98 vs. 1.7 ± 1.1,p < 0.001)。在 PGIC 评分中,85%(17/20)的患者表示治疗后症状和生活质量得到了中度(5 级)到明显(7 级)的改善。据报告,第一次治疗后 11.2 ± 6.6 天(2-30 天不等)病情开始好转,90%(18/20)的患者报告在第二次治疗后病情好转持续了至少 4 个月。
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引用次数: 0
Modeling pulsed dye laser treatment of psoriatic plaques by combining numerical methods and image-derived lesion morphologies 结合数值方法和图像衍生皮损形态,建立脉冲染料激光治疗银屑病斑块的模型
IF 2.4 3区 医学 Q2 DERMATOLOGY Pub Date : 2024-04-05 DOI: 10.1002/lsm.23781
Leah S. Wilk PhD, Meagan Doppegieter MSc, Nick van der Beek MSc, Ton G. van Leeuwen PhD, Maurice C. G. Aalders PhD
<div> <section> <h3> Objectives</h3> <p>Knowledge of the physical effects of pulsed dye laser (PDL) treatment of psoriatic lesions is essential in unraveling the remedial mechanisms of this treatment and hence also in maximizing in its disease-modifying potential. Therefore, the main objective of this study was to provide estimates of these physical effects (for laser wavelengths of 585 and 595 nm), with the aim of identifying pathogenic processes that may be affected by these conditions.</p> </section> <section> <h3> Methods</h3> <p>We modeled the laser light propagation and subsequent photothermal heating by numerically solving the transient diffusion and heat equations simultaneously. To this end, we used the finite element method in conjunction with an image-derived psoriatic lesion morphology (which was defined by segmenting blood vessels from a confocal microscopy image of a fluorescently labeled section of a 3 mm punch biopsy of a psoriatic lesion). The resulting predictions of the generated temperature field within the lesion were then used to assess the possibility of stalling or arresting some suspected pathogenic processes.</p> </section> <section> <h3> Results</h3> <p>According to our results, it is conceivable that perivascular nerves are thermally denatured, as almost all locations that reach 60°C were found to be within 18 µm (at 585 nm) and 11 µm (at 595 nm) of a blood vessel wall. Furthermore, activation of TRPV1 and TRPV2 channels in perivascular neuronal and immune cells is highly likely, since a critical temperature of 43°C is generated at locations within up to 350 µm of a vessel wall (at both wavelengths) and sustained for up to 700 ms (at 585 nm) and 40 ms (at 595 nm), while a critical temperature of 52°C is reached by locations within 80 µm (at 585 nm) and 30 µm (at 595 nm) of a vessel wall and sustained for up to 100  ms (at 585 nm) and 30 ms (at 595 nm). Finally, we found that the blood vessel coagulation-inducing temperature of 70°C is sustained in the vascular epithelium for up to 19 and 5 ms at 585 and 595 nm, respectively, rendering partial or total loss of vascular functionality a distinct possibility.</p> </section> <section> <h3> Conclusions</h3> <p>The presented approach constitutes a useful tool to provide realistic estimates of the photothermal effects of PDL treatment of psoriatic plaques (as well as other selective photothermolysis-based treatments), yielding information that is essential in guiding future experimental studies toward unraveling the remedial mechanisms of these treatments.</p> </s
目的了解脉冲染料激光(PDL)治疗银屑病皮损的物理效应,对于揭示这种治疗方法的补救机制,从而最大限度地发挥其改变疾病的潜力至关重要。因此,本研究的主要目的是对这些物理效应(波长为 585 和 595 nm 的激光)进行估算,以确定可能受这些条件影响的致病过程。为此,我们将有限元法与图像衍生的银屑病皮损形态(通过共聚焦显微镜对银屑病皮损 3 毫米冲孔活检荧光标记切片的图像进行血管分割来定义)结合使用。结果根据我们的研究结果,血管周围神经可能发生热变性,因为几乎所有达到 60°C 的位置都在血管壁 18 微米(585 纳米)和 11 微米(595 纳米)范围内。此外,血管周围神经细胞和免疫细胞中的 TRPV1 和 TRPV2 通道极有可能被激活,因为在距离血管壁 350 微米以内的位置(在两种波长下)会产生 43°C 的临界温度,并可维持长达 700 毫秒(在 585 纳米波长下)和 40 毫秒(在 595 纳米波长下)、而血管壁 80 微米(585 纳米波长)和 30 微米(595 纳米波长)范围内的位置会达到 52°C 的临界温度,并持续 100 毫秒(585 纳米波长)和 30 毫秒(595 纳米波长)。最后,我们发现,在 585 纳米和 595 纳米波长下,血管上皮细胞内 70°C 的血管凝固诱导温度可分别持续长达 19 毫秒和 5 毫秒,从而使血管功能部分或完全丧失成为可能。结论所介绍的方法是一种有用的工具,可用于对银屑病斑块的 PDL 治疗(以及其他基于选择性光热解的治疗)的光热效应进行切合实际的估计,所产生的信息对于指导未来的实验研究以揭示这些治疗的补救机制至关重要。
{"title":"Modeling pulsed dye laser treatment of psoriatic plaques by combining numerical methods and image-derived lesion morphologies","authors":"Leah S. Wilk PhD,&nbsp;Meagan Doppegieter MSc,&nbsp;Nick van der Beek MSc,&nbsp;Ton G. van Leeuwen PhD,&nbsp;Maurice C. G. Aalders PhD","doi":"10.1002/lsm.23781","DOIUrl":"10.1002/lsm.23781","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Objectives&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Knowledge of the physical effects of pulsed dye laser (PDL) treatment of psoriatic lesions is essential in unraveling the remedial mechanisms of this treatment and hence also in maximizing in its disease-modifying potential. Therefore, the main objective of this study was to provide estimates of these physical effects (for laser wavelengths of 585 and 595 nm), with the aim of identifying pathogenic processes that may be affected by these conditions.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Methods&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;We modeled the laser light propagation and subsequent photothermal heating by numerically solving the transient diffusion and heat equations simultaneously. To this end, we used the finite element method in conjunction with an image-derived psoriatic lesion morphology (which was defined by segmenting blood vessels from a confocal microscopy image of a fluorescently labeled section of a 3 mm punch biopsy of a psoriatic lesion). The resulting predictions of the generated temperature field within the lesion were then used to assess the possibility of stalling or arresting some suspected pathogenic processes.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Results&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;According to our results, it is conceivable that perivascular nerves are thermally denatured, as almost all locations that reach 60°C were found to be within 18 µm (at 585 nm) and 11 µm (at 595 nm) of a blood vessel wall. Furthermore, activation of TRPV1 and TRPV2 channels in perivascular neuronal and immune cells is highly likely, since a critical temperature of 43°C is generated at locations within up to 350 µm of a vessel wall (at both wavelengths) and sustained for up to 700 ms (at 585 nm) and 40 ms (at 595 nm), while a critical temperature of 52°C is reached by locations within 80 µm (at 585 nm) and 30 µm (at 595 nm) of a vessel wall and sustained for up to 100  ms (at 585 nm) and 30 ms (at 595 nm). Finally, we found that the blood vessel coagulation-inducing temperature of 70°C is sustained in the vascular epithelium for up to 19 and 5 ms at 585 and 595 nm, respectively, rendering partial or total loss of vascular functionality a distinct possibility.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Conclusions&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;The presented approach constitutes a useful tool to provide realistic estimates of the photothermal effects of PDL treatment of psoriatic plaques (as well as other selective photothermolysis-based treatments), yielding information that is essential in guiding future experimental studies toward unraveling the remedial mechanisms of these treatments.&lt;/p&gt;\u0000 &lt;/s","PeriodicalId":17961,"journal":{"name":"Lasers in Surgery and Medicine","volume":"56 5","pages":"508-522"},"PeriodicalIF":2.4,"publicationDate":"2024-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/lsm.23781","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140568672","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Evaluating the effect of pulse energy on femtosecond laser trabeculotomy (FLT) outflow channels for glaucoma treatment in human cadaver eyes 评估脉冲能量对飞秒激光小梁切开术(FLT)流出通道的影响,在人体尸体眼睛中治疗青光眼
IF 2.4 3区 医学 Q2 DERMATOLOGY Pub Date : 2024-04-03 DOI: 10.1002/lsm.23783
Shangbang Luo PhD, Eric R. Mikula PhD, Reza Khazaeinezhad PhD, Samantha M. Bradford PhD, Fengyi Zhang MSc, James V. Jester PhD, Tibor Juhasz PhD

Background and Objectives

Femtosecond laser trabeculotomy (FLT) creates aqueous humor outflow channels through the trabecular meshwork (TM) and is an emerging noninvasive treatment for open-angle glaucoma. The purpose of this study is to investigate the effect of pulse energy on outflow channel creation during FLT.

Materials and Methods

An FLT laser (ViaLase Inc.) was used to create outflow channels through the TM (500 μm wide by 200 μm high) in human cadaver eyes using pulse energies of 10, 15, and 20 μJ. Following treatment, tissues were fixed in 4% paraformaldehyde. The channels were imaged using optical coherence tomography (OCT) and assessed as full thickness, partial thickness, or not observable.

Results

Pulse energies of 15 and 20 μJ had a 100% success rate in creating full-thickness FLT channels as imaged by OCT. A pulse energy of 10 μJ resulted in no channels (n = 6), a partial-thickness channel (n = 2), and a full-thickness FLT channel (n = 2). There was a statistically significant difference in cutting widths between the 10 and 15 μJ groups (p < 0.0001), as well as between the 10 and 20 μJ groups (p < 0.0001). However, there was no statistically significant difference between the 15 and 20 μJ groups (p = 0.416).

Conclusions

Fifteen microjoules is an adequate pulse energy to reliably create aqueous humor outflow channels during FLT in human cadaver eyes. OCT is a valuable tool when evaluating FLT.

背景和目的 飞秒激光小梁切开术(FLT)可通过小梁网(TM)形成房水外流通道,是治疗开角型青光眼的一种新兴无创疗法。本研究的目的是探讨 FLT 过程中脉冲能量对流出通道形成的影响。 材料和方法 使用 FLT 激光器(ViaLase 公司)在人体尸体眼球中创建流出通道(宽 500 μm,高 200 μm),脉冲能量分别为 10、15 和 20 μJ。处理后,将组织固定在 4% 多聚甲醛中。使用光学相干断层扫描(OCT)对通道进行成像,并评估为全厚度、部分厚度或不可观察。 结果 15 和 20 μJ 的脉冲能量在通过 OCT 成像创建全厚 FLT 通道方面的成功率为 100%。10 μJ 脉冲能量导致无通道(n = 6)、部分厚度通道(n = 2)和全厚度 FLT 通道(n = 2)。10 μJ 组和 15 μJ 组之间以及 10 μJ 组和 20 μJ 组之间的切割宽度差异有统计学意义(p < 0.0001)。然而,15 和 20 μJ 组之间的差异没有统计学意义(p = 0.416)。 结论 15 微焦耳的脉冲能量足以在人体尸体眼睛的 FLT 过程中可靠地创建房水流出通道。OCT 是评估 FLT 的重要工具。
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引用次数: 0
Optical penetration models for practical prediction of femtosecond laser ablation of dental hard tissue 用于实际预测飞秒激光烧蚀牙科硬组织的光学穿透模型。
IF 2.4 3区 医学 Q2 DERMATOLOGY Pub Date : 2024-04-02 DOI: 10.1002/lsm.23784
Peter L. Woodfield PhD, Andrei V. Rode PhD, Dzung Dao PhD, Van Thanh Dau PhD, Steve Madden PhD, Laurence J. Walsh PhD, Heiko Spallek PhD, Lee Walsh PhD, Andrew J. Sutton PhD, Omar Zuaiter MPP, Alaa Habeb MCyberSec, Timothy R. Hirst PhD, Ludovic Rapp PhD

Objectives

To develop and practically test high-precision femtosecond laser ablation models for dental hard tissue that are useful for detailed planning of automated laser dental restorative treatment.

Methods

Analytical models are proposed, derived, and demonstrated for practical calculation of ablation rates, ablation efficiency and ablated morphology of human dental enamel and dentin using femtosecond lasers. The models assume an effective optical attenuation coefficient for the irradiated material. To achieve ablation, it is necessary for the local energy density of the attenuated pulse in the hard tissue to surpass a predefined threshold that signifies the minimum energy density required for material ionization. A 1029 nm, 40 W carbide 275 fs laser was used to ablate sliced adult human teeth and generate the data necessary for testing the models. The volume of material removed, and the shape of the ablated channel were measured using optical profilometry.

Results

The models fit with the measured ablation efficiency curve against laser fluence for both enamel and dentin, correctly capturing the fluence for optimum ablation and the volume of ablated material per pulse. The detailed shapes of a 400-micrometer wide channel and a single-pulse width channel are accurately predicted using the superposition of the analytical result for a single pulse.

Conclusions

The findings have value for planning automated dental restorative treatment using femtosecond lasers. The measurements and analysis give estimates of the optical properties of enamel and dentin irradiated with an infrared femtosecond laser at above-threshold fluence and the proposed models give insight into the physics of femtosecond laser processing of dental hard tissue.

目的开发并实际测试用于牙科硬组织的高精度飞秒激光烧蚀模型,该模型有助于详细规划自动激光牙科修复治疗:提出、推导并演示分析模型,用于实际计算使用飞秒激光的人类牙釉质和牙本质的烧蚀率、烧蚀效率和烧蚀形态。这些模型假定了照射材料的有效光学衰减系数。要实现烧蚀,硬组织中衰减脉冲的局部能量密度必须超过预定的阈值,该阈值表示材料电离所需的最小能量密度。使用波长为 1029 nm、功率为 40 W 的碳化物 275 fs 激光器烧蚀成人牙齿切片,并生成测试模型所需的数据。结果:结果:模型与测量到的珐琅质和牙本质消融效率与激光能量曲线相吻合,正确捕捉到了最佳消融能量和每个脉冲消融材料的体积。利用单脉冲分析结果的叠加,可以准确预测 400 微米宽通道和单脉冲宽度通道的详细形状:结论:研究结果对规划使用飞秒激光的自动牙科修复治疗很有价值。通过测量和分析,可以估算出红外飞秒激光以高于阈值的通量照射牙釉质和牙本质时的光学特性,而所提出的模型则有助于深入了解飞秒激光处理牙科硬组织的物理学原理。
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引用次数: 0
Current clinical evidence is insufficient to support HMME–PDT as the first choice of treatment for young children with port wine birthmarks 目前的临床证据不足以支持将 HMME-PDT 作为治疗患有葡萄酒胎记的幼儿的首选方法。
IF 2.4 3区 医学 Q2 DERMATOLOGY Pub Date : 2024-03-20 DOI: 10.1002/lsm.23779
Chao Gao MSc, Vi Nguyen BA, Marcelo L. Hochman MD, Lin Gao MD, Elliott H. Chen MD, Harold I. Friedman MD, PhD, John Stuart Nelson MD, PhD, Wenbin Tan PhD
<div> <section> <h3> Background</h3> <p>Port wine birthmark (PWB) is a congenital vascular malformation of the skin. Pulsed dye laser (PDL) is the “gold standard” for the treatment of PWB globally. Hematoporphyrin monomethyl ether (HMME or hemoporfin)-mediated photodynamic therapy (HMME–PDT) has emerged as the first choice for PWB treatment, particularly for young children, in many major hospitals in China during the past several decades.</p> </section> <section> <h3> Aim</h3> <p>To evaluate whether HMME–PDT is superior to PDL by comparing the clinical efficacies of both modalities.</p> </section> <section> <h3> Method</h3> <p>PubMed records were searched for all relevant studies of PWB treatment using PDL (1988−2023) or HMME–PDT (2007−2023). Patient characteristics and clinical efficacies were extracted. Studies with a quartile percentage clearance or similar scale were included. A mean color clearance index (CI) per study was calculated and compared among groups. An overall CI (C<sub>0</sub>), with data weighted by cohort size, was used to evaluate the final efficacy for each modality.</p> </section> <section> <h3> Result</h3> <p>A total of 18 HMME–PDT studies with 3910 patients in China were eligible for inclusion in this analysis. Similarly, 40 PDL studies with 5094 patients from nine different countries were eligible for inclusion in this analysis. Over 58% of patients in the HMME-PDT studies were minors (<18 years old). A significant portion (21.3%) were young children (<3 years old). Similarly, 33.2% of patients in the PDL studies were minors. A small proportion (9.3%) was young children. The overall clearance rates for PDL were slightly, but not significantly, higher than those for HMME–PDT in cohorts with patients of all ages (C<sub>0</sub>, 0.54 vs. 0.48, <i>p</i> = 0.733), subpopulations with only minors (C<sub>0</sub>, 0.54 vs. 0.46, <i>p</i> = 0.714), and young children (C<sub>0</sub>, 0.67 vs. 0.50, <i>p</i> = 0.081). Regrettably, there was a lack of long-term data on follow-up evaluations for efficacy and impact of HMME-PDT on young children in general, and central nervous system development in particular, because their blood-brain barriers have a greater permeability as compared to adults.</p> </section> <section> <h3> Conclusion</h3> <p>PDL shows overall albeit insignificantly higher clearance rates than HMME-PDT in patients of all ages; particularly statistical significance is nearly achieved in young children. Collectively,
背景:葡萄酒港胎记(PWB)是一种先天性皮肤血管畸形。脉冲染料激光(PDL)是全球治疗葡萄酒胎记的 "金标准"。目的:通过比较HMME-PDT和PDL的临床疗效,评估HMME-PDT是否优于PDL:方法:在PubMed上检索所有使用PDL(1988-2023年)或HMME-PDT(2007-2023年)治疗PWB的相关研究。提取患者特征和临床疗效。纳入了具有四分位数百分比清除率或类似比例的研究。计算每项研究的平均颜色清除指数(CI),并在各组间进行比较。根据组群规模对数据进行加权后得出的总CI(C0)用于评估每种方法的最终疗效:结果:中国共有 18 项 HMME-PDT 研究、3910 名患者符合纳入分析的条件。同样,来自 9 个不同国家的 40 项 PDL 研究(5094 名患者)也符合纳入本分析的条件。HMME-PDT研究中超过58%的患者为未成年人(0 ,0.54 vs. 0.48,p = 0.733)、仅有未成年人的亚人群(C0 ,0.54 vs. 0.46,p = 0.714)和幼儿(C0 ,0.67 vs. 0.50,p = 0.081)。遗憾的是,由于幼儿的血脑屏障与成人相比具有更大的通透性,因此缺乏关于 HMME-PDT 对幼儿,尤其是中枢神经系统发育的疗效和影响的长期跟踪评估数据:结论:在所有年龄段的患者中,PDL 的清除率总体上高于 HMME-PDT,尽管微不足道;尤其是在幼儿中,几乎达到了统计学意义。总之,目前的证据不足以支持将 HMME-PDT 作为治疗幼儿血管内皮瘤的首选方法,因为:(1)总体疗效不如 PDL;(2)治疗过程中存在脑膜血管脱靶的风险;(3)需要使用类固醇来减轻副作用;以及(4)缺乏有关 HMME 对幼儿中枢神经系统发育潜在影响的长期数据。
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引用次数: 0
Erbium: YAG laser treatment efficacy and association with histologic features for giant congenital melanocytic nevi management 铒:YAG 激光治疗巨型先天性黑素细胞痣的疗效及其与组织学特征的关系。
IF 2.4 3区 医学 Q2 DERMATOLOGY Pub Date : 2024-03-20 DOI: 10.1002/lsm.23776
Yifei Zhao MD, Yun Zou MD, Hui Chen MD, PhD, Yamin Rao MD, Xiaoxi Lin MD, PhD

Background

Limited research exists on laser treatment of giant congenital melanocytic nevus (GCMN).

Objective

We sought to elucidate the efficacy of the Erbium: YAG laser on GCMN and the histologic factors associated with a positive clinical response.

Methods and Materials

Between 2019 and 2022, we enrolled 30 medium-to-giant CMN patients who underwent Er: YAG laser treatment. All patients received biopsies before and after laser treatments. Clinical efficacy outcomes were evaluated by the investigator's global assessment (IGA), 5-point scale of depigmentation, and Vancouver Scar Scale (VSS) scores at least 6 months after treatment.

Results

Of the 30 cases, 18 (60.0%) showed improvement (IGA score ≥3). Eight (26.7%) patients showed repigmentation. Eight (26.7%) patients developed hypertrophic scars. The average IGA, depigmentation, and VSS scores were 2.93, 3.57, and 3.20. The IGA score was higher (3.24 ± 1.18 vs. 2.22 ± 0.97, p = 0.031) and a lower repigmentation rate (14.3% vs. 55.6%, p = 0.032) was observed in the cases with Grenz zone. The IGA score was higher (3.33 ± 1.24 vs. 2.13 ± 0.89, p = 0.023) and the repigmentation rate was lower (11.1% vs. 50.0%, p = 0.034) also in the cases with the melanocytes nests with aggregation of melanin. Lesions with superficial ablation resulted in less hypertrophic scar formation than those with deep ablation (5.9% vs. 53.8%, p < 0.05).

Conclusion

The Er: YAG laser demonstrated effective clinical results for GCMNs. The grenz zone and the melanocytes nests with aggregation of melanin are promising predictors of laser efficacy.

背景:关于激光治疗巨大先天性黑素细胞痣(GCMN)的研究有限:关于激光治疗巨大先天性黑素细胞痣(GCMN)的研究有限:目的:我们试图阐明铒:YAG激光对GCMN的疗效,以及与阳性临床反应相关的组织学因素:2019年至2022年间,我们招募了30名接受Er:YAG激光治疗的中型至大型CMN患者。所有患者在激光治疗前后都接受了活检。在治疗后至少 6 个月,通过研究者的总体评估(IGA)、色素沉着 5 点量表和温哥华疤痕量表(VSS)评分来评估临床疗效:在 30 例患者中,18 例(60.0%)病情有所改善(IGA 评分≥3)。8例(26.7%)患者出现色素沉着。8例(26.7%)患者出现增生性疤痕。IGA、色素沉着和 VSS 平均得分分别为 2.93、3.57 和 3.20。格伦茨区病例的 IGA 评分较高(3.24 ± 1.18 vs. 2.22 ± 0.97,p = 0.031),色素沉着率较低(14.3% vs. 55.6%,p = 0.032)。在有黑色素细胞巢和黑色素聚集的病例中,IGA评分更高(3.33 ± 1.24 vs. 2.13 ± 0.89,p = 0.023),再色素沉着率更低(11.1% vs. 50.0%,p = 0.034)。浅层消融的病变比深层消融的病变更少形成增生性疤痕(5.9% 对 53.8%,P 结论:浅层消融的病变比深层消融的病变更少形成增生性疤痕:Er: YAG 激光对 GCMNs 的临床疗效显著。格伦茨区和黑色素细胞巢与黑色素聚集是预测激光疗效的可靠指标。
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引用次数: 0
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Lasers in Surgery and Medicine
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