Lasers in Surgery and Medicine最新文献

Background: The efficacy and safety of microneedle radiofrequency (MRF) for antiaging skin treatment has already been demonstrated. This study aims to, for the first time, comprehensively interpret the short and long-term effects of MRF by combining histology, high-throughput molecular analysis, and clinical evaluation.

Methods: At 1, 3, and 6 months after MRF in different parameters, the skin samples were taken for HE staining, Masson staining, and Victoria blue staining to observe the overall histological changes. Real-time PCR and WB were used to evaluate the quantitative changes of collagen I and III, MMP-2 and TGF-β1 at the different time periods. After transcriptome sequencing, bioinformatics analysis was performed to identify important biological processes related to skin after MRF treatment. At the same time, patients who had undergone facial MRF treatment in our department between 2020 and 2023 were collected for clinical review within half a year after treatment. Patient satisfaction score and Global Aesthetic Improvement Scale (GAIS) were collected.

Results: The histological sections showed that collagen and elastic fibers regenerated and the density increased after MRF. The mRNA and protein levels of collagen in each treatment group also showed an upward trend after treatment, especially in Group A. However, there was no significant difference among the treatment groups and compared with the blank control group. Transcriptome analysis showed that the differentially expressed genes were significantly enriched in collagen regeneration-related pathways at 1 month after treatment, then gradually decreased at 6 months. The clinical data showed that after MRF treatment, patients mainly rated the effect of skin rejuvenation as "3 - satisfied." The GAIS score showed that the long-term effect after MRF was better than the short-term effect (p = 0.040).

Conclusions: MRF can stimulate collagen rearrangement and rejuvenation in facial rejuvenation. The long-term rejuvenation effect of MRF can last at least 6 months and is better than the short-term effect.

Objectives: Advances in improving existing noninvasive optical diagnostic methods and creating new criteria for assessing the effects of diabetes on tissues and the vascular system are highly demanded. One of the promising, noninvasive and contactless methods for visualizing the vascular system is laser speckle contrast imaging. This study studies the possibility of using magnetic resonance contrast agents in laser speckle contrast imaging and optical coherence tomography, for the first time, on rat ears, under conditions of alloxan-induced type 1 diabetes. By combining diagnostic techniques, the study investigated the ability to differentiate between healthy rat tissue and diabetic rat tissue based on dynamic and structural changes caused by local application of magnetic resonance agents.

Methods: This study explores the possibility of using magnetic resonance contrast agents for laser speckle-contrast imaging and optical coherence tomography of rat ears under conditions where alloxan-induced type 1 diabetes mellitus is developing was studied for the first time.

Results: Kinetics of scattering coefficient (µ_s) for healthy and diabetic rats during optical clearing were evaluated. The most significant reduction is seen with the Gadovist solution, showing decreases of 18.6% and 16.1% for healthy and diabetic rats, respectively. Magnevist induced a smaller reduction in the µ_s, with decreases of 12.6% and 6.8%, respectively. Data on the flow rate in the vessels of the ears of laboratory rats obtained in the diabetic group demonstrate reduced indicators, relative to the healthy group of animals.

Conclusions: These results confirm the effectiveness of magnetic resonance contrast agents as optical clearing agents for both optical coherence tomography and laser speckle contrast imaging. For the first time, the nature of the change in the contrast of the static part with a change in scattering was studied. This is an additional application for studying the efficiency of optical clearing, and contributes to the multimodal application of speckle imaging methods.

Background: Seborrheic keratosis (SK) is the most prevalent benign skin tumor associated with aging, posing esthetic concerns and potential discomfort. The rising demand for cosmetic interventions prompts the exploration of effective removal methods. This study compares three treatment modalities: curettage, 532 nm laser, and propane-butane cryotherapy.

Methods: A prospective interventional clinical study was conducted with 30 subjects, treating 123 SK using curettage, 532 nm laser, and propane-butane cryotherapy. Randomized allocation and evaluations at 0, 4, 8, and 12 weeks were employed. Objective measures included clearance rates (assessed by a dermatologist) and blinded cosmetic ratings by 125 observers. Subjective outcomes encompassed patient-reported pain (VAS), side effects, satisfaction, and preferences.

Results: Curettage achieved the highest clearance rate (87.5% vs. laser: 55%, cryotherapy: 50%; p < 0.01). However, patients perceived complete healing most frequently with laser (90% vs. curettage: 87%, cryotherapy: 53%). Despite lower efficacy, 67% favored laser for future treatments, valuing minimal bleeding and no dressings. Observers rated curettage's cosmetic outcomes superior (50% vs. laser: 22.5%). Laser caused the fewest side effects (mean 0.93/lesion) but highest pain (VAS: 4.62 vs. cryotherapy: 3.85). Cryotherapy showed efficacy comparable to laser (50% vs. 55%) but more adverse events.

Conclusion: Curettage remains optimal for thick, hyperkeratotic SKs, enabling histopathological confirmation. The 532 nm laser, preferred subjectively for convenience, may suit small, non-hyperkeratotic lesions but warrants further validation. Propane-butane cryotherapy offers a cost-effective alternative. The discordance between patient preferences (prioritizing convenience) and clinical efficacy underscores the need for personalized treatment strategies balancing outcomes, tolerability, and cosmetic expectations.

Background: Fractional Photothermolysis (FP) relies on precise laser focus to create microscopic treatment zones (MTZs). Focal plane deviations, caused by handpiece pressure and movement, shift the treated tissue out of focus, increasing spot size and reducing lesion depth, compromising treatment efficacy. This study investigates an optimized spacer to mitigate load-induced deviations and improve clinical outcomes.

Methods: A difference frequency generation (DFG) laser system (IPG Medical) with 3050/3200 nm wavelength treated ex vivo human abdominoplasty skin, mounted on a load-adjustable platform (0-1000 g, ±0.1 g). Tissue was treated at 5 mJ/pulse with a nominal spot size of 40 µm using spacers ranging from 2 × 2 mm² to 8 × 8 mm² and an optimized 2 × 2 mm² grid spacer. Optical coherence tomography measured skin bulging and focal plane deviations, while histological analysis validated lesion depth and diameter. Knife-edge technique projections were used to assess theoretical beam behavior.

Results: Applied load caused skin bulging, resulting in a linear increase in lesion diameter and a linear decrease in depth. Smaller spacers (2 × 2 mm²) reduced focal deviations and maintained MTZ precision within the Rayleigh range. 2 × 2 mm² grid spacers further reduced bulging by redistributing the load and ensuring more uniform MTZ formation.

Conclusion: Load-induced focal shifts significantly impact FP efficiency, particularly on nonuniform skin surfaces. An optimized spacer enhanced precision by minimizing bulging, allowing treatments to remain within one Rayleigh length. These findings highlight the clinical importance of spacer selection in achieving consistent FP outcomes, particularly for small-spot laser applications. Clinicians should integrate smaller or grid-patterned spacers to enhance procedural accuracy.

Objectives: To synthesize current evidence and trends supporting the dual 1550-nm erbium glass fiber and 1927-nm thulium fiber non-ablative fractional laser system's mechanism of action and proven efficacy and safety profile in addressing aging skin concerns.

Methods: A review of current evidence and expert consensus was conducted to evaluate the 1550/1927-nm dual laser system. The analysis focused on the 1550 and 1927-nm lasers' specific mechanisms of action and their applications in treating various skin conditions.

Results: The 1550-nm laser effectively targets dyschromia, fine lines, and various types of scars, while the 1927-nm laser specifically addresses actinic keratoses, dyschromia, and pigmented lesions. Expert consensus has established standardized protocols while emphasizing personalized treatment approaches on the basis of factors including treatment area and Fitzpatrick skin type.

Conclusion: The 1550/1927-nm dual laser system's ability to offer customizable settings positions it as a versatile tool in the growing field of esthetic medicine, particularly for addressing the multiple components of skin aging.

Background: Androgenetic alopecia (AGA) affects at least 80% of men and 50% of women by age 70. This study aimed to assess the efficacy of a non-ablative fractional laser (NAFL) in treating AGA and enhancing hair appearance on the scalp in male and female patients.

Methods: This was a single-center, retrospective, observational study. Case files of all subjects, who were treated for improvement of scalp hair appearance using a 1565-nm NAFL at LaserMed Clinic (Lublin, Poland) between February 24, 2020, and January 31, 2023, were reviewed for study inclusion. The authors were not involved in the administration of treatments but reviewed the data that were obtained for the study. Digital images taken before and following laser treatment were gathered and blindly evaluated by non-treating physicians for quality of results. The study's primary efficacy endpoint was the proportion of image sets correctly classified as before and after treatment. Success was defined as correct identification of the posttreatment image as the image demonstrating scalp hair growth and clinical improvement by at least two out of three blinded reviewers. Safety was evaluated based on the incidence of adverse events or safety issues.

Results: A total of 132 patients were included in the study, of whom 98 patients had photos of adequate quality for assessing device efficacy. The overall success rate of correct identification of before and after images among the 98a evaluable patients was 96.9% (95% confidence interval: 91.4%-98.5%) and remained consistently high (> 95%) across the evaluated subgroups (patients with AGA, patients with unknown type of alopecia, males and females). No adverse events were documented in the clinic records for the 132 subjects included.

Conclusions: NAFL is a safe and effective method for promoting visible hair growth and improving the appearance of scalp hair.