Developing a Hetero-Trinuclear Erbium(III)-Copper(II) Complex Based on Apoferritin: Targeted Photoacoustic Imaging and Multimodality Therapy of Tumor.

For the integration of targeted diagnosis and treatment of tumor, we innovatively designed and synthesized a single-molecule hetero-multinuclear Er(III)-Cu(II) complex (ErCu2) and then constructed an ErCu2@apoferritin (AFt) nanoparticle (NP) delivery system. ErCu2 and ErCu2@AFt NPs not only provided an evident photoacoustic imaging (PAI) signal of the tumor but also effectively inhibited tumor growth by integrating photothermal therapy, chemotherapy, and immunotherapy. ErCu2@AFt NPs improved the targeting ability and decreased the systemic toxicity of ErCu2 in vivo. Furthermore, we confirmed that ErCu2 and ErCu2@AFt NPs inhibited tumor growth by inducing apoptosis and autophagy of tumor cells and activating the immune system. The study not only provides a novel strategy to develop therapeutic metal agents but also reveals their potential for targeted accurate diagnosis and multimodality therapy of cancer.

Efficacy of Er,Cr:YSGG Laser Application in Nonsurgical Treatment of Peri-implantitis: A Human Randomized Controlled Trial.

This investigation was designed to evaluate the efficacy of an erbium, chromium-doped yttrium, scandium, gallium and garnet (Er,Cr:YSGG) laser (laser group) compared to conventional mechanical debridement (control group) in the treatment of peri-implantitis. In a double-blinded, randomized, controlled clinical trial, 32 patients with 88 implants with peri-implantitis were randomly assigned to either group. Statistical analyses were performed at 9 months for both groups. The laser-treated group showed a statistically significant reduction in probing depth (PD) compared to the control group (P = .04), but no statistically significant differences were observed for clinical attachment level gain (P = .29) or reduction of bleeding on probing (P = .09). In the subgroup analysis, mandibular single implants with screw-retained restorations treated with Er,Cr:YSGG demonstrated a statistically significant decrease in PD (P < .05) compared to all other groups. A complete resolution of peri-implantitis was achieved in 21% of implants in the test group and 5% of implants in the control group. Er,Cr:YSGG laser is an efficacious therapeutic tool to treat peri-implantitis, achieving greater PD reduction than conventional mechanical debridement alone. Er,Cr:YSGG laser also showed increased benefits in the treatment of mandibular, screw-retained, and single-unit implants compared to the sole use of conventional mechanical debridement.

Comparative study between topical steroid alone versus combined fractional Erbium:YAG laser with topical steroid in treatment of alopecia areata.

AA is a common autoimmune skin disease that causes hair loss on the scalp and sometimes other areas of the body. New therapy approaches for alopecia areata are emerging, with the goal of improving clinical outcomes. In this study, the effects of topical steroids against fractional Er:YAG laser followed by topical steroids in the treatment of alopecia areata will be compared. A total of 30 participants with alopecia areata were included in the study. Each patient's lesions were treated with one of two methods: topical clobetasol propionate or fractional Er:YAG laser followed by topical clobetasol propionate. SALT score, patient satisfaction, and dermoscopic imaging were used to evaluate therapeutic response. Both treatment modalities showed a significant clinical improvement in alopecia areata with a statistically significant reduction in the SALT score. The SALT score was more evident in the laser-steroid group. On comparing the dermoscopy findings in both treated areas before and after treatment, a significant reduction was found regarding all dermoscopic findings of alopecia areata in both modalities. Combining fractional Er:YAG laser with topical steroids is found to be a safe treatment modality and more effective than topical steroids in alopecia areata.

Comparative evaluation of combined efficacy of methylene blue mediated antimicrobial photodynamic therapy (a-PDT) using 660 nm diode laser versus Erbium-chromium-yttrium-scandium-gallium-garnet (Er, Cr: YSGG) laser as an adjunct to scaling and root planing on clinical parameters in supportive periodontal therapy: A randomized split-mouth trial.

AIM: The aim of this study was to evaluate combined efficacy of methylene blue mediated antimicrobial photodynamic therapy (a-PDT) using 660 nm diode laser versus Er, Cr: YSGG laser as an adjunct to scaling and root planing on improving the Probing depth (PD), Clinical attachment level (CAL), Plaque Index (PI) and Gingival Index (GI).clinical parameters in Supportive periodontal therapy. MATERIALS AND METHOD: In this split-mouth, double-blind, randomized controlled trial, we compared a-PDT versus Er,Cr:YSGG as an adjunct to scaling and root planning (SRP) with SRP alone in Supportive periodontal therapy. A total of 36 subjected were enrolled. In each patient, two quadrants constituted the control group (Group I - Scaling and root planing SRP alone), one site in other quadrant constituted the test group 1 (Group II - SRP followed by application of Er, Cr: YSGG laser), and another site in different quadrant constituted the test group 2 (Group III - SRP followed by antimicrobial Photodynamic therapy using diode laser). The diode laser was operated at a peak power of 70 mW using a 0.6 mm diameter fiber-optic tip. Each site was irradiated with a power density of 28 mW/cm2, for 10 s, thus delivering a total energy of 16.72 J/cm2 per tooth. Whereas, the Er,Cr:YSGG laser's parameters were set to 1 W of power, 10% air, and 15% water. The same procedure was repeated at 1st, 2nd and 3rd week for both the laser therapies. Plaque index (PI), Gingival index (GI), Probing depth (PD,) and Clinical attachment level (CAL) were measured by a single examiner at baseline and 3 months follow up. Inter group analysis of the parameters were done using One-way ANOVA and pairwise comparison was carried out by Tukey's post hoc test. Intra group analysis was performed using Students's paired t test. Statistical significance was set to p < 0.05. RESULTS: There were no significant differences between participants for clinical parameters at baseline. PI, GI PD, and CAL significantly improved at 3 months follow up compared to baseline in both the study groups (Group II - SRP + Er,Cr:YSGG, Group III - SRP + a-PDT) with P < 0.05. Adjunctive use of Er,Cr:YSGG laser with SRP showed better clinical outcomes than a-PDT with SRP. CONCLUSION: Nonsurgical periodontal therapy of chronic periodontitis using Er, Cr: YSGG, and a-PDT as an adjunct to SRP was significantly more effective than SRP alone in reducing PD, CAL, GI, and PI at 3 months follow up. Adjunctive use of Er,Cr:YSGG laser with SRP showed better clinical outcomes than a-PDT with SRP. However, the long-term positive benefits of the laser therapies are yet unknown and more research with longer follow-ups are required.

Fractional erbium:YAG laser (2940 nm) plus topical hydroquinone compared to intradermal tranexamic acid plus topical hydroquinone for the treatment of refractory melasma: a randomized controlled trial.

OBJECTIVES: Melasma is a chronic acquired condition characterized by grayish-brown macules and patches with a distinct border on the face. Although various treatments methods have been suggested for treating melasma, none has been completely successful. The aim of the study was to compare the efficiency of erbium: yttrium-aluminum-garnet (Er:YAG) laser and 4% hydroquinone (HQ) with the effects of intradermal tranexamic acid (TA) and 4% HQ for the treatment of refractory melasma. METHODS: The study included 31 female patients with refractory melasma. The left or right side of the patient's face was chosen randomly to receive laser therapy with topical HQ on the one side (i.e. the laser side) and intradermal injection of TA plus topical HQ on the other side (i.e. the mesotherapy side). Digital photography was performed at baseline, at the end of the treatment, and three months after the treatment as follow-up. Two independent dermatologists evaluated the modified Melasma Area and Severity Index (mMASI) score according to the pictures. Overall, 27 patients completed the study and went through the clinical evaluation. RESULTS: Treatment using HQ in combination with either Er:YAG laser therapy or intradermal injection of TA significantly improved the hemi-mMASI and resulted in higher patient satisfaction. While the improvement was not significantly different between the two regiments after the treatment and upon follow up and both were equally efficient in the treatment of refractory melasma (p = 1.308), recurrence rate was higher after treatment with Er:YAG laser than TA (12% vs 34%). CONCLUSION: This study confirmed the comparable efficacy of TA plus topical HQ versus Er:YAG laser plus topical HQ for the treatment of refractory melasma. Both groups improved significantly and no subject left the treatment because of adverse effects. TRIAL REGISTRATION NUMBER: IRCT20191011045057N1.

Dual-Responsive and ROS-Augmented Nanoplatform for Chemo/Photodynamic/Chemodynamic Combination Therapy of Triple Negative Breast Cancer.

Integrating chemodynamic therapy (CDT) and photodynamic therapy (PDT) into one nanoplatform can produce much more reactive oxygen species (ROS) for tumor therapy. Nevertheless, it is still a great challenge to selectively generate sufficient ROS in tumor regions. Meanwhile, CDT and PDT are restricted by insufficient H2O2 content in the tumor as well as by the limited tumor tissue penetration of the light source. In this study, a smart pH/ROS-responsive nanoplatform, Fe2+@UCM-BBD, is rationally designed for tumor combination therapy. The acidic microenvironment can induce the pH-responsive release of doxorubicin (DOX), which can induce tumor apoptosis through DNA damage. Beyond that, DOX can promote the production of H2O2, providing sufficient materials for CDT. Of note, upconversion nanoparticles at the core can convert the 980 nm light to red and green light, which are used to activate Ce6 to produce singlet oxygen (1O2) and achieve upconversion luminescence imaging, respectively. Then, the ROS-responsive linker bis-(alkylthio)alkene is cleaved by 1O2, resulting in the release of Fenton reagent (Fe2+) to realize CDT. Taken together, Fe2+@UCM-BBD exhibits on-demand therapeutic reagent release capability, excellent biocompatibility, and remarkable tumor inhibition ability via synergistic chemo/photodynamic/chemodynamic combination therapy.

Yb3+, Er3+ Codoped Cerium Oxide Upconversion Nanoparticles Enhanced the Enzymelike Catalytic Activity and Antioxidative Activity for Parkinson's Disease Treatment.

Oxidative stress plays an important role in Parkinson's disease (PD) and is considered a therapeutic target for PD. However, most therapeutic antioxidants show limitations due to their low reactive oxygen species (ROS) catalytic properties and low crossing of blood-brain barrier. Herein, the antioxidative activity of Yb3+ and Er3+ double-doped CeO2-x (Yb/Er/CeO2-x) upconversion nanoparticles (UCNPs) is obtained for PD treatment. Doping of Yb3+ and Er3+ ions increases oxygen vacancies, which leads to higher enzymelike catalytic activities compared to CeO2-x nanoparticles alone. Tyrosine hydroxylase protein and glial fibrillary acidic protein expression in substantia nigra and striatum as well as the open-field activity test indicates that Yb/Er/CeO2-x is effective for treatment of PD. The activities of glutathione peroxidase and total antioxidant capacity increase and the production of ROS decreases with Yb/Er/CeO2-x UCNP treatment compared with MPTP-induced injury. This indicates that the mechanism of PD treatment is to catalyze ROS products. There have been no reports to date on the usage of Yb/Er/CeO2-x as an antioxidant for PD treatment. Yb/Er/CeO2-x UCNPs cross the blood-brain barrier and exhibit biocompatibility and antioxidant catalytic properties, which decrease the ROS and effectively help in treating PD.

Nonablative transurethral Erbium:YAG laser treatment for chronic prostatitis/chronic pelvic pain syndrome: A prospective comparative study.

AIMS: This prospective study aimed to compare the clinical outcomes between the use of Erbium:YAG (Er:YAG) laser in a nonablative mode, to the use of the pharmacological treatment of oral tadalafil for the treatment of chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS). METHODS: The laser group received two sessions of Erbium:YAG laser, administered intraurethrally in a long, nonablative train of long pulses (SMOOTH™ mode), applied at the level of the male prostatic urethra. Tadalafil group received oral tadalafil at a dose of 5 mg/day, consecutively for 2 months. Effectiveness was assessed using the International Prostate Symptom Score (IPSS) questionnaire, VAS (visual analogue scale) pain score, and maximum urethral flow at follow-up visits up to 12 months after initiating treatment. Adverse effects were recorded after each treatment and follow-up sessions. RESULTS: The results show a significant decrease in the IPSS score in both groups up to the 12-month follow-up. The increase in Q-max was evident up to 3-months follow-up in the tadalafil group and up to 6 months in the laser group. The decrease in the VAS pain score was also significant in both treatment groups, lasting up to 3 months in the tadalafil group and up to 6 months in the laser group. CONCLUSIONS: The nonablative Er:YAG SMOOTH™ laser seems to be a promising treatment for this widely occurring condition. More studies are needed to confirm its safety and efficacy.

A Janus upconverting nanoplatform with biodegradability for glutathione depletion, near-infrared light induced photodynamic therapy and accelerated excretion.

The major limitations of photodynamic therapy (PDT) are the poor tissue penetration of excitation light and the neutralization of reactive oxygen species (ROS) generated by overexpressed glutathione (GSH) in cancer cells. Despite tremendous efforts to design nanoplatforms, PDT still suffers from unsatisfactory effects. Furthermore, the residual of nanomaterials in the body has restricted their clinical application. To address these issues, Janus nanocomposites containing an Yb/Er codoped NaYF4 upconverting nanocrystal head and a disulfide-bridged mesoporous organosilicon body (UCN/MON) with loaded chlorin e6 (Ce6) were designed. On one hand, the upconverting nanocrystal head can convert near-infrared (NIR) light into visible light to activate Ce6 to release ROS. On the other hand, the silica body can be degraded though a redox reaction with GSH, to not only improve the tumor selectivity of the photosensitizer by redox- and pH-triggered Ce6 release, but also diminish the concentration of GSH in cancer cells to reduce the depletion of ROS. Thereby, an enhanced PDT triggered by NIR irradiation was achieved. Furthermore, UCN/MONs showed a higher clearance rate after therapeutic actions than nonbiodegradable UCN/MSNs due to their biocompatibility. Taken together, this work revealed the potential of UCN/MONs for highly efficient and NIR-induced PDT, highlighting the prospects of UCN/MONs in the clinic.

High catalytic efficiency from Er3+-doped CeO2-x nanoprobes for in vivo acute oxidative damage and inflammation therapy.

Cerium oxide nanoparticles (NPs) due to their advanced catalytic performance have been widely used to treat oxidative damage. However, Ce2O3 NPs have not been further investigated in the treatment of acute oxidative injury in vivo. It is meaningful to improve the efficiency for treatment of acute oxidative injury with NPs in vivo. In this report, we designed Er3+-doped Ce2O3 (Er/Ce2O3) NPs with a size of 7.9 nm, which were used to treat acute liver injury. Er/Ce2O3 NPs realized high-efficiency catalysis of hydrogen peroxide (H2O2) at room temperature. An acute liver damage model was established through intraperitoneal injection of lipopolysaccharide (LPS) in C57 mice. By analyzing histopathological and biochemical indexes, Er/Ce2O3 NPs showed a significant improvement in LPS-induced acute liver injury. Acute liver oxidative damage can be treated within 24 hours, which proved the high catalytic efficiency of Er/Ce2O3 NPs in vivo. The activities of SOD, GPx and CTA increased and production of ROS decreased with Er/Ce2O3 NP treatment in comparison with LPS-induced injury, indicating that the mechanism of Er/Ce2O3 NPs in the treatment of acute oxidative damage of liver was mainly via catalysis of ROS products. Moreover, the protein expression levels of TNF-α, CD45 and IL-1ß in liver decreased in the Er/Ce2O3 NPs-treated group, which indicated that Er/Ce2O3 NPs have the function of anti-inflammation property. Therefore, Er/Ce2O3 NPs can be applied to treat and prevent diseases caused by acute oxidative damage.

Preliminary outcome of non-ablative vaginal Erbium laser treatment for female stress and mixed urinary incontinence.

OBJECTIVE: This prospective study presents a preliminary result to compare the clinical efficacy of patients with stress urinary incontinence and mixed urinary incontinence using minimal invasive Er:YAG vaginal laser. MATERIALS AND METHODS: A total of 20 patients were included, in which were 10 patients with SUI and 10 patients with MUI (stress and urge incontinence), and underwent a 2940 nm Er:YAG laser with a special SMOOTH mode in an outpatient office without anesthesia or postoperative medications. All patients completed two sessions of treatment with an interval time of 28 days. At three months after treatment, all patients were asked to a clinical visit for evaluate the clinical outcome by pre-treatment and post-treatment ICIQ-SF questionnaire. At pretreatment and 3 months after the completion of two therapy sessions, patients were asked to answer the ICIQ-SF questionnaire. The questionnaire consists of three scales for assessment of the treatment outcome of urinary incontinence as: no change (no change score), improvement (decrease score 1-5), and strong improvement (decrease score >5) for two groups of patients with SUI and MUI. All the results were compared by Student's t test with two way analysis of variance between the two groups. RESULTS: A total of 20 patients presented with SUI symptom relief and improvement with treatment satisfaction. All 10 patients with SUI reported improvement after vaginal laser treatment, 70% with marked improvement and 30% with improvement. All 10 patients with MUI also had improvement, 40% with marked improvement and 60% with improvement. There was no statistically significant difference in the treatment outcome between the two groups. CONCLUSIONS: Vaginal Erbium laser produce provides vaginal collagen remodeling and synthesis that may repair and restore the pelvic floor function. Despite of sample limitation and short follow up, this treating procedure presented a good and a safe clinical outcome in patients with SUI and with MUI by assessment of ICIQ-SF questionnaire.

Post-radiosynovectomy imaging utilizing Erbium-169 citrate.

Currently, there is no imaging procedure for radionuclide therapy utilizing Erbium-169 (Er-169). We have recently published the first post-radiosynovectomy imaging of Er-169 citrate in a case report (Farahati et al., 2017). In this study, we performed in-vitro and in-vivo studies to evaluate the feasibility to assess the distribution of Er-169 citrate after radiosynovectomy in fourteen patients with seventeen affected joints treated for refractory chronic synovitis. Post-radiosynovectomy imaging revealed the feasibility of post-radiosynovectomy detection and distribution utilizing Er-169 citrate in all cases. However, additional in-vitro studies including in-vitro imaging, gamma spectrometry and analysis of half-life indicated that emitted gamma-rays of the Ytterbium-169 in the radiopharmaceutical together with bremsstrahlung induced by Er-169 are the imaging source of emitted counts. Post-radiosynovectomy imaging utilizing Er-169 citrate is feasible and should be implemented in the guidelines for theranostics for quality control, patient safety and therapy monitoring.

Efficacy of using erbium, chromium-doped: Yttrium scandium gallium garnet laser-treated dentine in a dentine barrier test device.

OBJECTIVES: The aim of this study was to evaluate the efficacy of using erbium, chromium-doped:yttrium scandium gallium garnet (Er,Cr:YSGG) laser-treated dentine in a dentine barrier test device. MATERIALS AND METHODS: The test materials (G-Bond™ and Vitrebond™) were applied onto laser-treated or laser-untreated dentine discs. After 24 h of exposure with perfusion of the test chamber, cell survival was evaluated based on enzyme activity and compared to a nontoxic control material. The mean of the control was set to 100% viability. Data were analyzed using the one-way analysis of variance and the Tukey's honest significant difference tests. RESULTS: The responses of bovine pulp-derived cells after exposure to G-Bond and Vitrebond on Er,Cr:YSGG laser-treated and laser-untreated dentin were statistically different from negative control group (P < 0.05). CONCLUSION: Er,Cr:YSGG laser treatment was not successful enough in decreasing the cytotoxic effects of the dental materials. Different parameters of Er,Cr:YSGG laser or different laser types could be investigated as an alternative to minimizing the cytotoxic effects of dental materials.

O Laser e o tratamento da flacidez e atrofia vulvo-vaginal: uma revisão integrativa da literatura / Laser and the treatment of vulvo-vaginal laxity and atrophy: an integrative review of literature

A atrofia vulvo-vaginal (VVA) é uma condição progressiva e crônica que se manifesta como involução das mucosas vulvo-vaginais e tecidosdevido à diminuição dos níveis de estrogênio. O uso do laser com papel terapêutico ganhou interesse como um tratamento não hormonal para a VVA. Esse estudo objetivou avaliar os efeitos dos lasers de CO2 e Erbium: YAG na flacideze atrofia vulvo-vaginal em mulheres menopausadas. Trata-se de uma revisão integrativa, realizada na base de dados PubMed, utilizando os descritores: vagina, postmenopause, vulvovaginal atrophy, vulvovaginal laxity e laser. Ambos os tipos de lasers aumentam a espessura do epitélio pavimentoso estratificado, estimulam a produção de fibras colágenas, elásticas e outros componentes da matriz extracelular, melhoram a irrigação vascular da vagina e aliviam os sintomas de secura, ardor e dispareunia. No entanto, a duração dos efeitos terapêuticos e a segurança de aplicações repetidas ainda precisam ser mais bem estudados.(AU)

Vulvo-vaginal atrophy (VVA) is a progressive and chronic condition that manifests as involution of the vulvovaginal mucosa and tissues due to decreased levels of estrogen. The use of laser with therapeutic paper gained interest as a non-hormonal treatment for VVA. This study aimed to evaluate the effects of CO2 and Erbium: YAG lasers on vulvovaginal laxity and atrophy in menopausal women. It is an integrative review, carried out in the PubMed database, using the descriptors: vagina, postmenopause, vulvovaginal atrophy, vulvovaginal laxity and laser. Both types of lasers increase the thickness of the stratified squamous epithelium, stimulate the production of collagen, elastic fibers, and other components of the extracellular matrix, improve vascular irrigation of the vagina, and relieve symptoms of dryness, burning, and dyspareunia. However, the duration of therapeutic effects and the safety of repeated applications still need to be better studied.(AU)

Clinical and biochemical effects of erbium, chromium: yttrium, scandium, gallium, garnet laser treatment as a complement to periodontal treatment.

OBJECTIVE: The purpose of this study was to investigate the clinical effects of erbium, chromium: yttrium, scandium, gallium, garnet (Er, Cr: YSGG) laser treatment as a complementary to scaling and root planning (SRP) during the treatment of chronic periodontitis and gingival crevicular fluid (GCF) interleukin-1 beta (IL-1ß), interleukin-6 (IL-6), and interleukin-35 (IL-35) levels. MATERIALS AND METHODS: Forty patients with chronic periodontitis were divided into two equal groups at random to receive SRP alone and SRP followed by Er, Cr: YSGG laser treatment, which are control and test groups, respectively. Clinical attachment level (CAL), probing depth (PD), bleeding on probing (BOP), gingival index (GI), and plaque index (PI) were measured for all patients in both groups at baseline and again at the end of the 1st, 3rd, and 6th months following the treatment. Levels of GCF IL-1ß, IL-6, and IL-35 were analyzed by enzyme-linked immunosorbent assay. RESULTS: After periodontal treatment, CAL, PD, BOP, GI, and PI, which are clinical parameters analyzed, decreased significantly (P < 0.05) in both test and control groups. GCF volume, IL-1 ß, IL-6, and IL-35, levels in both groups proved statistically significant reductions compared to the baseline (P < 0.05), but no substantial variations were detected among both groups. CONCLUSION: According to these results, we can suggest that IL-35 may be related to the pathogenesis of periodontitis and that Er, Cr: YSGG laser can be used as an adjunct to SRP in periodontal treatment.

Radiosynoviorthesis of acromioclavicular joint using 169Er-citrate: prospective evaluation of efficacy.

BACKGROUND: There is a clinical need for therapeutic alternative in patients with persisting painful arthritis of AC-joint and failure of previous treatments. However, no radiopharmaceutical is currently explicitly approved for radiosynoviorthesis of acromioclavicular joint. The aim of our study was to prospectively assess the efficacy and safety of radiosynoviorthesis of acromioclavicular joint using erbium-169 citrate. MATERIAL AND METHODS: Radiosynoviorthesis of acromioclavicular joint was performed in 51 consecutive patients (18 males, 33 females) mean age 64.3 (range 43.8-82.6, median 63.6) years with clinically confirmed arthritis of 85 acromioclavicular joints. The efficacy of RSO was reported by patients according to 10-step visual analogue scale of pain (VAS) (0 = no pain, 10 = most severe pain) at 6 months after radiosynoviorthesis and by ranking the global therapeutic effect of RSO in 4 categories (1 = the best effect, 4 = no change). To assess the variation of blood perfusion in treated joints, the efficacy of RSO was also evaluated by variation of target (acromioclavicular joint)/non-target (soft tissue) uptake ratio (T/NTR) of metylendiphosphonate (99mTc) measured as number of counts over region of interest on blood pool phase of two-phase bone scintigraphy performed before and 6 months after RSO. RESULTS: Radiosynoviorthesis was followed by significant decrease in VAS, mean - 3.1 (-47%). Excellent, good, moderate and bad response was observed in 57 (67%), 25 (29%), 1 (1%) and in 2 (2%) of acromioclavicular joints respectively. A significant correlation between decrease of T/NTR and variation of VAS in % (ρ = 0.532, p < 0.0001) and between T/NTR and subjective evaluation of therapeutic effect in scale 1-4 (ρ = 0.388, p = 0.0002) was observed. However, it was not possible to identify the cut-off value of relative decrease in T/NTR showing sufficient sensitivity and specificity to detect the therapeutic response. CONCLUSION: Results of this prospective study permit to conclude a good efficacy and safety of radiosynoviorthesis using erbium-169 citrate in a series of patients with arthritis of acromioclavicular joint in whom previous line(s) of treatment did not lead to satisfactory pain relief.

A systematic review of comparative studies of CO2 and erbium:YAG lasers in resurfacing facial rhytides (wrinkles).

BACKGROUND: Laser resurfacing is used to minimize wrinkles, solar scars and sequelae of acne. OBJECTIVE: Purpose of the systematic review was to compare resurfacing outcomes of CO2 laser and erbium: yttrium aluminium garnet (erb:YAG) laser therapies. MATERIALS AND METHODS: Medline, Cochrane Library, EMBASE and Google Scholar databases were searched until 9 April 2015 using the following terms: laser, carbon dioxide/CO2, facial wrinkles, rhytides and erbium-doped yttrium aluminium garnet/erbium:YAG/Er:YAG. Two-armed controlled split faced studies that compared CO2 laser and erbium:YAG laser in patients with mild-to-moderate facial wrinkles or rhytides were included. RESULTS: The pooled data in this study and findings of other studies support the greater efficacy with the CO2 laser in improving facial wrinkles, but the erb:YAG laser was associated with a better complication profile compared with the CO2 laser. Except one case of hypopigmentation, other complications (i.e., erythema, hyperpigmentation and crusting) and their rates were reported by studies examining both lasers. CONCLUSION: In general, the CO2 laser appeared to be more efficacious then the erb:YAG laser in treating facial wrinkles. Both lasers treatments were well tolerated.

αvß3-Isoform specific erbium complexes highly specific for bladder cancer imaging and photodynamic therapy.

We have synthesized a bifunctional erbium-porphyrin tumor imaging and PDT agent (Er-R3) that is capable of killing bladder cancer cells via its selective binding to the integrin αvß3 isoform overexpressed on the cell membrane.

Er,Cr:YSGG Laser Application for the Treatment of Periodontal Furcation Involvements.

OBJECTIVE: The purpose of this study was to evaluate the clinical use of an erbium, chromium: yttrium-scandium-gallium-garnet (Er,Cr:YSGG) laser in the management of root furcation involvements. BACKGROUND DATA: It has been suggested that the use of laser radiation within the periodontal pocket may be effective in periodontal treatment. However, very limited data from clinical trials exist directly comparing the use of the Er,Cr:YSGG laser to conventional root planing. MATERIALS AND METHODS: Thirty patients with chronic periodontitis were recruited. A total of 128 teeth with degree II or III furcation involvement were included in a split-mouth design such that the teeth on one side of the mouth were established as Group A and treated with the Er,Cr:YSGG laser and the teeth on the other side were established as Group B and treated with manual subgingival debridement. Changes in probing depth (PD), bleeding on probing (BOP), clinical attachment loss (CAL), and visual analogue scale (VAS) pain scores were compared between Groups A and B and within individuals over time at 6 and 12 weeks after treatment, testing the null hypothesis that there would be no clinical difference between treatment modalities. RESULTS: Both treatments significantly reduced the PD, CAL, and BOP in the diseased teeth with degree II or III furcation involvement. The reduction of PD and BOP at weeks 6 and 12 was significantly higher in Group A (laser treated) than in Group B. The VAS pain score was significantly lower in Group A than in Group B (p < 0.01). CONCLUSIONS: Pocket debridement with Er,Cr:YSGG laser is a safe, comfortable, and clinically effective means of subgingival debridement in periodontal therapy.