首页期刊导航|Lasers in surgery and medicine.
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Lasers in surgery and medicine.
Wiley-Liss
Lasers in surgery and medicine.

Wiley-Liss

0196-8092

Lasers in surgery and medicine./Journal Lasers in surgery and medicine.
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    4页
      原文链接:
    • NSTL

    Passively scanned, single‐fiber optical coherence tomography probes for gastrointestinal devices

    David O. OtuyaNicholas M. DecheneDarina PoshtupakaSeth Judson...
    10页
    查看更多>>摘要：Abstract Background/Objectives Optical coherence tomography (OCT) uses low coherence interferometry to obtain depth‐resolved tissue reflectivity profiles (M‐mode) and transverse beam scanning to create images of two‐dimensional tissue morphology (B‐mode). Endoscopic OCT imaging probes typically employ proximal or distal mechanical beam scanning mechanisms that increase cost, complexity, and size. Here, we demonstrate in the gastrointestinal (GI) tracts of unsedated human patients, that a passive, single‐fiber probe can be used to guide device placement, conduct device?tissue physical contact sensing, and obtain two‐dimensional OCT images via M‐to‐B‐mode conversion. Materials and Methods We designed and developed ultrasmall, manually scannable, side‐?and forward‐viewing single fiber‐optic probes that can capture M‐mode OCT data. Side‐viewing M‐mode OCT probes were incorporated into brush biopsy devices designed to harvest the microbiome and forward‐viewing M‐mode OCT probes were integrated into devices that measure intestinal potential difference (IPD). The M‐mode OCT probe‐coupled devices were utilized in the GI?tract in six unsedated patients in vivo. M‐mode data were converted into B‐mode images using an M‐to‐B‐mode conversion algorithm. The effectiveness of physical contact sensing by the M‐mode OCT probes was assessed by comparing the variances of the IPD values when the probe was in physical contact with the tissue versus when it was not. The capacity of forward‐ and side‐viewing M‐mode OCT probes to produce high‐quality B‐mode images was compared by computing the percentages of the M‐to‐B‐mode images that showed close contact between the probe and the luminal surface. Passively scanned M‐to‐B‐mode images were qualitatively compared to B‐mode images obtained by mechanical scanning OCT tethered capsule endomicroscopy (TCE) imaging devices. Results The incorporation of M‐mode OCT probes in these nonendoscopic GI devices safely and effectively enabled M‐mode OCT imaging, facilitating real‐time device placement guidance and contact sensing in vivo. Results showed that M‐mode OCT contact sensing improved the variance of IPD measurements threefold and side‐viewing probes increased M‐to‐B‐mode image visibility by 10%. Images of the esophagus, stomach, and duodenum generated by the passively scanned probes and M‐to‐B‐mode conversion were qualitatively superior to B‐mode images obtained by mechanically scanning OCT TCE devices. Conclusion These results show that passive, single optical fiber OCT probes can be effectively utilized for nonendoscopic device placement guidance, device contact sensing, and two‐dimensional morphologic imaging in the human GI tract in vivo. Due to their small size, lower cost, and reduced complexity, these M‐mode OCT probes may provide an easier avenue for the incorporation of OCT functionality into endoscopic/nonendoscopic devices.
      原文链接:
    • NSTL
    • Wiley

    Fluorescence kinetics study of twice laser irradiation based HpD‐PDT for nonmelanoma skin cancer

    Chunxiao LiPeiru WangDixin WangLei Shi...
    10页
    查看更多>>摘要：Abstract Background Hematoporphyrine injection (HpD)‐based photodynamic therapy (HpD‐PDT) has emerged as a promising cancer therapy. However, its tumor‐targeting ability and metabolokinetics in nonmelanoma skin cancer (NMSC) have not been well explored. Importantly, photodynamic diagnosis is widely used for cancer lesion assessment and positioning to ensure effective therapy, while the photosensitizer metabolic kinetics study is utilized for biosafety assessment and light‐protection instruction. These are particularly important for the optimization of therapeutic parameters. Objectives In the present study, NMSC patients were subjected to twice laser irradiation‐based HpD‐PDT strategy. Broadly, the study aimed to assess long‐term variations in fluorescence (FL) intensity in vivo in NMSC patients after intravenous (i.v.) administration of HpD, and thus obtain information regarding metabolism, biosafety, and light‐protection instruction for HpD during the therapy. Methods In vitro experiments were used for the evaluation of absorption and fluorescent characterization of HpD in aqueous solution and cutaneous squamous cell carcinoma (SCC) cells. For in vivo assessment, 20 patients with NMSC, including SCC, basal cell carcinoma (BCC), Bowen disease (BD), extramammary Paget's disease (EMPD), and malignant proliferating tricholemmoma (APT), were recruited, and treated with HpD‐PDT. To evaluate the selectivity and pharmacokinetics of HpD in vivo, relative changes in FL intensity for lesional, perilesional, and nonlesional skin of nonmelanoma skin cancer patients, before and after HpD injection, were semiquantitatively analyzed for 1?month, using the FL detection system and Wood's lamp. Results The absorption and FL spectra were detected and semiquantitatively analyzed in HpD diluted solution and SCC cells after coincubation with HpD. After i.v. administration of HpD in EMPD patients, FL was detected in the skin lesions at 24 hours, and it was characterized by clear edges. Importantly, FL intensity in the skin lesions increased significantly at 48?and 72?hours?postinjection, which was suitable for HpD‐PDT. After 72?h, it decreased gradually and reached close to the baseline value at 4 weeks postinjection. No severe side effects were observed during HpD injection and the therapy. Urinary tract infection was recorded in one patient (with a previous history of recurrent urinary tract infections) after HpD‐PDT, and the patient was cured afterward. Transient light was observed in two patients after HpD‐PDT and they soon recovered after therapy. Conclusions The present study reported a significant increase in FL intensities at 48?and 72?hours?after i.v. administration of HpD in patients with nonmelanoma skin cancers, which indicated accumulation of HpD at the cancer site. Importantly, HpD was found to be safe for NMSC patients. After therapy, FL intensities decreased, which indicated expending and metabolization of HpD. Thus, the results of the present study highlighted the suitability of a twice red‐light laser irradiation strategy for the application of HpD‐PDT in nonmelanoma skin cancer treatment.
      原文链接:
    • NSTL
    • Wiley

    Cavitation and radiofrequency versus cryolipolysis on leptin regulation in central obese subjects: A randomized controlled study

    Nabil M. Abdel‐AalMohamed S. E.M. MostafaJoseph W. SaweresRamy S. Ghait...
    9页
    查看更多>>摘要：Abstract Background and Objective To investigate the efficacy of adding ultrasound cavitation and radiofrequency versus cryolipolysis to weight reduction program on leptin, insulin, waist circumference, skinfold, body weight in central obese subjects. Material and Methods Sixty centrally obese participants were randomly allocated into three equal groups. Subjects in the study group (I) received cavitation and radiofrequency plus dietary regimen, subjects in the second study group (II) received cryolipolysis in conjunction with the same diet program, and subjects in the control group (III) received the same dietary regimen only. Leptin, insulin level, waist circumference, skinfold, body weight, and body mass index were measured shortly before intervention techniques and 3 months afterward. Results There were no statistically significant differences between cavitation plus radiofrequency and cryolipolysis on leptin and insulin levels after 3 months of intervention. However, statistically significant differences were found in waist circumference, skinfold, weight reduction, and body mass index in favor of the cavitation group (p?<?0.05). In addition, both cavitation‐radiofrequency and cryolipolysis were statistically significantly different than the diet alone in favor of the study groups (p?<?0.05) in all the outcome measures. Furthermore, there were statistically significant differences in all outcome measures (p?<?0.05) when comparing the baseline and postintervention results in each group except for leptin level in the diet group (p?=?0.14). Conclusion Subjects who underwent cavitation plus radiofrequency had better improvement on waist circumference, skinfold, and body mass index than subjects who received cryolipolysis. However, no differences were found between cavitation plus radiofrequency and cryolipolysis on leptin and insulin levels.
      原文链接:
    • NSTL
    • Wiley

    The effect of a restricted diet on the results of fractional microneedle radiofrequency therapy: A comparison of vegan and omnivorous participants in terms of the antiaging effect of radiofrequency therapy

    Nebahat Demet AkpolatSezin Unlu
    6页
    查看更多>>摘要：Abstract Objectives The aim of the present study was to compare the results of fractional microneedle radiofrequency (FMR) therapy in vegan and omnivorous participants. Methods A total of 30 vegan and 30 omnivorous women who were treated with FMR therapy for combating aging were included in the study. The clinical results were examined in Months 3 and 6 based on the Fitzpatrick Wrinkle Scale (FWS). Individual satisfaction was investigated in Month 6 using the Patient's Global Impression of Change (PGIC). Results At the onset of the treatment, there was no significant difference with regard to the FWS scores in both groups. The decrease in the FWS score was significantly lower in vegans after 3 months (p?=?0.01). Vegans had worsened clinical outcomes by Month 6 (p?=?0.01). The PGIC scores were significantly lower in vegans (p?=?0.01). Conclusion A vegan diet adversely affects the outcome of FMR?therapy.
      原文链接:
    • NSTL
    • Wiley

    Clinical and dermoscopic evaluation of melanocytic nevi changes during diode laser hair removal: A prospective study

    Renata AcleMaría José Zambrano‐MericqCristian Navarrete‐DechentPablo Uribe...
    8页
    查看更多>>摘要：Abstract Background Laser hair removal (LHR) is a common practice with increasing use worldwide. Clinical and dermoscopic changes in melanocytic nevi after LHR have been reported but prospective studies are lacking. Objective To describe dermoscopic changes of melanocytic nevi at different time points after LHR. Methods Prospective study in a cohort of female patients undergoing diode LHR. Dermoscopic follow‐up of at least three nevi on the legs that underwent hair removal. We included three?nonexposed nevi on the arms as controls. Two blinded investigators analyzed dermoscopic images, according to variables selected based on the available literature. Results Thirty‐four patients were included with a total of 148 nevi on the legs and 112 nevi on the arms (controls). 47.9% (71/148) of the nevi on the legs had evidence of dermoscopic changes at the sixth hair removal session, compared to 9.8% (11/112) on controls (p?<?0.001). The most frequent change was “bleaching” (41.9%, 62/148). Also, we observed “irregular hyperpigmented areas,” and “regression structures” in 5.4% (8/148) and 4.7% (7/148) of the cases at the sixth session, respectively.?Neither of these structures were observed in the controls (p?<?0.05). Limitations Only females were included; we did not perform histopathological evaluation nor reflectance confocal microscopy of changing nevi. Conclusion Melanocytic nevi frequently change after diode LHR. The changes cannot always distinguish between LHR induced and melanoma, so we advise avoiding nevi during laser therapies with melanin targets.
      原文链接:
    • NSTL
    • Wiley

    Low‐intensity cold atmospheric plasma reduces wrinkles on photoaged skin through hormetic induction of extracellular matrix protein expression in dermal fibroblasts

    Ga Ram AhnHyung Joon ParkYoung Gue KohSun Hye Shin...
    16页
    查看更多>>摘要：Abstract Background Recent evidence indicates that cold atmospheric plasma (CAP) can upregulate the production of extracellular matrix (ECM) proteins in dermal fibroblasts and enhance transdermal drug delivery when applied at a low intensity. Objectives The aim of this study was to evaluate the effect of low‐intensity CAP (LICAP) on photoaging‐induced wrinkles in an animal model and the expression profiles of ECM proteins in human dermal fibroblasts. Methods Each group was subjected to photoaging induction and allocated to therapy (LICAP, topical polylactic acid (PLA), or both). The wrinkles were evaluated via visual inspection, quantitative analysis, and histology. The expression of collagen I/III and fibronectin was assessed using reverse transcription‐quantitative polymerase chain reaction, western blot analysis, and immunofluorescence. The amount of aqueous reactive species produced by LICAP using helium and argon gas was also measured. Results Wrinkles significantly decreased in all treatment groups compared to those in the untreated control. The differences remained significant for at least 4 weeks. Dermal collagen density increased following LICAP and PLA application. LICAP demonstrated a hormetic effect on ECM protein expression in human dermal fibroblasts. The production of reactive species increased, showing a biphasic pattern, with an initial linear phase and a slow saturation phase. The initial linearity was sustained for a longer time in the helium plasma (~60?s) than in the argon plasma (~15?s). Conclusion LICAP appears to be a novel treatment option for wrinkles on the photodamaged skin. This treatment effect seems to be related to its hormetic effect on dermal ECM production.
      原文链接:
    • NSTL
    • Wiley

    Real‐time tissue perfusion assessment using fluorescence imaging topography scanning system: A preclinical investigation

    Francis A. PapayYang LiuTri T. QuangChen F. Wei...
    8页
    查看更多>>摘要：Abstract Background and Objectives We previously developed a real‐time fluorescence imaging topography scanning (RFITS) system for intraoperative multimodal imaging, image‐guided surgery, and dynamic surgical navigation. The RFITS can capture intraoperative fluorescence, color reflectance, and surface topography concurrently and offers accurate registration of multimodal images. The RFITS prototype is a promising system for multimodal image guidance and intuitive 3D visualization. In the current study, we investigated the capability of the RFITS system in intraoperative fluorescence vascular angiography for real‐time assessment of tissue perfusion. Study Design/Materials and Methods We conducted ex vivo imaging of fluorescence perfusion in a soft casting life‐sized human brain phantom. Indocyanine green?(ICG) solutions diluted in dimethyl sulfoxide (DMSO) and human serum were injected into the brain phantom through the vessel simulating tube (2?±?0.2?mm inner diameter) by an adjustable flow peristaltic pump. To demonstrate the translational potential of the system, an ICG/DMSO solution was perfused into blood vessels of freshly harvested porcine ears (n?=?9, inner diameter from 0.56?to 1.27?mm). We subsequently performed in vivo imaging of fluorescence‐perfused vascular structures in rodent models (n?=?10). 5?mg/ml ICG solutions prepared in sterile water were injected via the lateral tail vein. All targets were imaged by the RFITS prototype at a working distance of 350?400?mm. Results 3D visualization of 10?μg/ml ICG‐labeled continuous moving serum in the brain phantom was obtained at an average signal‐to‐background ratio (SBR) of 1.74?±?0.03. The system was able to detect intravenously diffused fluorescence in porcine tissues with an average SBR of 2.23?±?0.22. The RFITS prototype provided real‐time monitoring of tissue perfusion in rats after intravenous (IV) administration of ICG. The maximum fluorescence intensity (average SBR?=?1.94?±?0.16, p?<?0.001) was observed at Tpeak of ~30?seconds?after the ICG signal was first detected (average SBR?=?1.19?±?0.13, p?<?0.01). Conclusions We have conducted preclinical studies to demonstrate the feasibility of applying the RFITS system in real‐time fluorescence angiography and tissue perfusion assessment. Our system provides fluorescence/color composite images for intuitive visualization of tissue perfusion with 3D perception. The findings pave the way for future clinical translation.
      原文链接:
    • NSTL
    • Wiley

    High‐power 450?nm blue diode laser for endoscopic mucosal resection/endoscopic submucosal dissection in the stomach: Preliminary results on a porcine model with a modified flexible endoscope

    Guoxiong LiuDali JiangMudan RenXinlan Lu...
    8页
    查看更多>>摘要：Abstract Background Due to the precise vaporization of the novel 450?nm blue diode laser in soft tissues (i.e., bladder and colon) in our previous studies, porcine stomach tissues were applied here to certify its efficacy in endoscopic mucosal resection (ESR)/endoscopic submucosal dissection (ESD) for hypothetical lesions ex vivo and in vivo. Materials and Methods In an ex vivo study of ESR, 20 pieces of tissues (8?cm?×?6?cm) from 7 fresh stomachs?after spraying saline were vaporized with a three‐dimensional scanning system using the blue diode laser at a maximum of 30?W, a different treatment speed and working distance (WD). In ex vivo ESD, 18 pieces of tissues from 6 fresh stomachs were used and the same laser parameters were used to perform the procedure. The depth, width, and coagulation of the laser vaporization were measured. Furthermore, the large scales (2.0?cm?×?1.5?cm) for 18 hypothetical lesions of the gastric mucosa and submucosa of the 6 fresh stomachs were also resected with a modified flexible endoscope. In vivo, six hypothetical lesions of six porcine were vaporized by the novel blue laser, and the resultant lesions at the acute and chronic stages were assessed by the naked eye and hematoxylin and eosin staining. Results In the contact mode, more tissue was vaporized, and the thickness of the coagulation was stable when the WD was 0?2?mm, whose?value varied from 0.33 to 1.73?mm. In the gastroscopy model, the mean thickness of coagulation from the mucosa was 0.67?mm, and a significant carbonization zone was not observed. In vivo, the laser beam could accurately act on the hypothetical target. No bleeding and clear vision were present in the procedure. After 3 weeks, tissue healing was well recovered after laser coagulation, resection, and submucosal dissection. Conclusions In the present study, the novel 450?nm blue diode laser exhibited ideal vaporization and thinner coagulation thickness in the porcine stomach, which indicated that it could be alternately used as a new device for stomach lesions.
      原文链接:
    • NSTL
    • Wiley

    Development of a microstructured tissue phantom with adaptable optical properties for use with microscopes and fluorescence lifetime imaging systems

    Ronald SrokaAdrian RühmChristian FreymüllerStephan Str?bl...
    17页
    查看更多>>摘要：Abstract Objectives For the development and validation of diagnostic procedures based on microscopic methods, knowledge about the imaging depth and achievable resolution in tissue is crucial. This poses the challenge to develop a microscopic artificial phantom focused on the microscopic instead of the macroscopic optical tissue characteristics. Methods As existing artificial tissue phantoms designed for image forming systems are primarily targeted at wide field applications, they are unsuited for reaching the formulated objective. Therefore, a microscopy‐ and microendoscopy‐suited artificial tissue phantom was developed and characterized. It is based on a microstructured glass surface coated with fluorescent beads at known depths covered by a scattering agent with modifiable optical properties. The phantom was examined with different kinds of microscopy systems in order to characterize its quality and stability and to demonstrate its usefulness for instrument comparison, for example, regarding structural as well as fluorescence lifetime analysis. Results The analysis of the manufactured microstructured glass surfaces showed high regularity in their physical dimensions in accordance with the specifications. Measurements of the optical parameters of the scattering medium were consistent with simulations. The fluorescent beads coating proved to be stable for a respectable period of time (about a week). The developed artificial tissue phantom was successfully used to detect differences in image quality between a research microscope and an endoscopy based system. Plausible causes for the observed differences could be derived based on the well known microstructure of the phantom. Conclusions The artificial tissue phantom is well suited for the intended use with microscopic and microendoscopic systems. Due to its configurable design, it can be adapted to a wide range of applications. It is especially targeted at the characterization and calibration of clinical imaging systems that often lack extensive positioning capabilities such as an intrinsic z‐stage.
      原文链接:
    • NSTL
    • Wiley