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BACKGROUND: Infantile café au lait spot is a brown macule with various sizes (diameter: 0.5 cm-30 cm). Infantile giant café au lait spot (IGCALS) is a huge (diameter >20cm) irregular-shaped benign hyperpigmented skin disorder that arises in infants. There has been no clearly established laser treatment consensus for the treatment of IGCALS because infants are too fragile to receive laser treatment with long hours and broad areas along with the possibility of undesirable cosmetic results. OBJECTIVES: This study investigated the safety and efficacy of Golden Parameter Therapy (GPT) using a high fluence 1064-nm Q-switched Nd:YAG laser (QSNL) for IGCALS treatment. METHODS: This study included 24 Korean patients with IGCALS. Twenty-one patients who were treated with a 1064-nm QSNL weekly for 30-50 treatment sessions with GPT. The parameters included a spot size of 7 mm, a fluence of 2.2 J/cm2 and a pulse rate of 10 Hz with one pass using a sliding-stacking technique over the IGCALS. In control group, three patients were treated with a 532-nm picosecond laser monthly for three treatment sessions with a spot size of 3 mm, a fluence of 1 J/cm2 and a pulse rate of 2 Hz. RESULTS: After the last treatment, 21 patients with IGCALS reached the complete removal of pigmented lesions, which can be considered optimal cosmetic results without any side effects such as purpura, crust, post-inflammatory hyperpigmentation, iatrogenic punctate leukoderma, and scarring. There are no recurrences in any patients after 6-21 months' follow-up, but treatment failure occurred in three patients who were treated with 532 nm picosecond laser. CONCLUSIONS: Convincingly, we argue that early intervention before 12 months of age with GPT using a high fluence 1064 nm QSNL is a safe, applicable and effective treatment for IGCALS, minimizing side effects without any recurrences.
Subject(s)
Cafe-au-Lait Spots , Lasers, Solid-State , Humans , Lasers, Solid-State/therapeutic use , Cafe-au-Lait Spots/radiotherapy , Female , Male , Infant , Treatment Outcome , Child, Preschool , Low-Level Light TherapyABSTRACT
The aim of the study was to measure the degree of dentine surface roughness caused by five distinct lasers used to treat dentine hypersensitivity, as well as to evaluate the subsequent bacterial colonization on these irradiated surfaces. Sixty human maxillary premolar teeth without caries or restoration which were extracted for periodontal reasons were used in this study. Five different types of lasers were applied to the root dentin surface. Tested samples were divided into six groups of 10 samples each; control, diode (810 nm), diode (980 nm), Nd: YAG, Er: YAG, and Er, Cr: YSGG laser groups. The arithmetic mean of the surface roughness values (Ra) and the average roughness over a measurement area (Sa) were measured pre- and post-application using any of the laser types. Swab samples were then collected from the dentin surface. Following a 24-hour incubation period at 37 °C, the colony forming units were counted using a stereoscope. The results demonstrated a statistically significant difference in the surface roughness values pre- and post-application (Ra and Sa, respectively) in the Er, Cr: YSGG laser group (p = 0.037,p = 0.007). No significant difference was observed in the other groups (p > 0.05). There was no statistically significant difference in the number of bacterial colonies observed between the test and control groups. Diode and Nd: YAG lasers showed either a decrease or no change in surface roughness; however, the hard tissue lasers (Er: YAG, Er, Cr: YSGG) showed an increase. The Er: YAG and Nd: YAG laser groups exhibited decreased bacterial adhesion compared to the other groups.
Subject(s)
Bacterial Adhesion , Dentin Sensitivity , Dentin , Lasers, Semiconductor , Lasers, Solid-State , Surface Properties , Humans , Lasers, Solid-State/therapeutic use , Dentin/microbiology , Dentin/radiation effects , Surface Properties/radiation effects , Dentin Sensitivity/radiotherapy , Dentin Sensitivity/microbiology , Dentin Sensitivity/therapy , Lasers, Semiconductor/therapeutic use , Bacterial Adhesion/radiation effects , Low-Level Light Therapy/methods , Low-Level Light Therapy/instrumentation , In Vitro Techniques , Bicuspid/microbiology , Bicuspid/radiation effects , Bicuspid/surgeryABSTRACT
Purpose: To explore the efficiency and safety of carbon dioxide (CO2) laser-assisted sclerectomy surgery (CLASS) in Chinese patients with glaucoma secondary to vitrectomy. Methods: This retrospective study consisted of 16 eyes from 16 patients with glaucoma secondary to vitrectomy who underwent CLASS and were followed up for 12 months. Main outcome measures included preoperative and postoperative intraocular pressure, best corrected visual acuity (BCVA), number of anti-glaucoma medications, and postoperative surgical success rate and complications. Results: The postoperative IOP and number of anti-glaucoma medications used at all follow-up time point were significantly lower than those preoperatively. The difference in BCVA was not significant before and after surgery. The main complicatios were peripheral anterior synechiae (PAS) and scleral reservoir reduction, which were controlled after neodymium-doped yttrium aluminum garnet (Nd:YAG) laser, 2 (12.50%) patients underwent re-operation. The complete and total success rates at 12 months were 68.75% and 87.50%, respectively. Conclusion: CLASS is a safe and effective procedure for Chinese patients with glaucoma secondary to vitrectomy. PAS and scleral reservoir reduction is a major contributor to postoperative IOP elevation, and trabecular minimally invasive perforation with the Nd:YAG laser is effective in lowering IOP and increasing scleral cistern volume.
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Laser hair removal (LHR) has been established as a safe and efficient method for eliminating unwanted hair. This study aimed to investigate the frequency of LHR complications and assess the contributing factors. During one year, 16,900 patients undergoing LHR therapy were evaluated for complications. For each case, two external controls were selected (matched based on age, sex, Fitzpatrick skin type (FST) III-IV, and the treated anatomical region). To assess the impact of anatomical region on complication occurrence, each patient was used as their internal control if another area was treated during the same session. GEE analysis was used for statistical analysis.The incidence of LHR complications was calculated to be 0.69%. The most common complications were petechia, purpura, and ecchymosis (31.66%) followed by pigmentation changes (20.0%). LHR complications were most commonly observed in the lower limbs (32.0%), face and neck (23.3%), and genitalia and thighs (22.3%), respectively. Possible risk factors were younger age (OR = 0.74, P-value ≤ 0.001), operating LHR in the head and neck (OR = 5.8, P-value = 0.022), utilization of the alexandrite laser (OR = 2.32, P-value = 0.011), and fluence in the Alexandrite laser (OR = 3.47, P-value = 0.003).Overall, the results of this study indicate that LHR is generally a safe method for removing unwanted hair. However, factors such as younger age, treatment of the facial area, and use of the alexandrite laser especially with higher fluence levels in patients with FST III-IV were identified as potential risk factors.
Subject(s)
Hair Removal , Lasers, Solid-State , Humans , Hair Removal/adverse effects , Hair Removal/methods , Female , Case-Control Studies , Male , Adult , Risk Factors , Middle Aged , Lasers, Solid-State/adverse effects , Lasers, Solid-State/therapeutic use , Young Adult , Ecchymosis/etiology , Ecchymosis/epidemiology , Tertiary Care Centers , Purpura/etiology , Postoperative Complications/etiology , Postoperative Complications/epidemiology , Adolescent , Laser Therapy/adverse effects , Laser Therapy/methodsABSTRACT
This case report describes the successful treatment of refractory vesicourethral anastomosis (VUA) pain in an 82-year-old man following radical prostatectomy using a combination of non-ablative erbium:YAG and neodymium:YAG laser therapy with Fotona SP Dynamis. Despite various conventional treatments, the patient's pain persisted, which significantly impaired his quality of life. The rationale for using laser therapy is based on its potential to promote tissue healing and nerve regeneration and reduce inflammation at the anastomosis site. The patient underwent monthly laser irradiation sessions, with the erbium:YAG laser targeting the area around the urethral anastomosis site via the anus and the neodymium:YAG laser irradiating the base of the penis and scrotum. Urethral pain gradually decreased from a visual analog scale score of 10 to 0 over the course of treatment. This highlights the importance of considering alternative approaches when conventional methods fail to provide relief. The targeted, minimally invasive nature of laser therapy may offer a safer and more effective alternative to systemic medications for managing chronic post-surgical pain. Although further research is needed to establish the generalizability and long-term effectiveness of this approach, this case provides a promising foundation for future investigations of the role of laser therapy in managing refractory VUA pain following radical prostatectomy.
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A 71-year-old, one-eyed female patient presented with a loss of vision in the right eye due to trauma 20 years ago and a progressive diminution of vision in the left eye over the past six years. An ambiguous history of some surgery performed on the left eye was elicited, with no available records, adding an element of uncertainty to this case. Visual acuity (VA) was noted as no light perception (No PL) in the right eye and light perception with accurate projection of rays (PL+, PR accurate) in the left eye. Anterior segment slit-lamp evaluation of the right eye showed a shrunken globe with low intraocular pressure (IOP). The left eye exhibited signs of chronic uveitis with occlusio pupillae, non-visualization of the lens, and a doubtful conjunctival bleb with scleral thinning superior to the limbus. B-scan evaluation was suggestive of phthisis in the right eye and an equivocal lens shadow in the left eye. A yttrium aluminum garnet (YAG) pupillary membranotomy was planned for the left eye under steroid cover and was cautiously attempted, successfully detaching the occlusio membrane and revealing an underlying complicated cataract beneath it. Post-laser, medical management included topical anti-glaucoma and steroid medications, along with systemic steroids. The VA improved from PL+, PR accurate to 3/60 (improving to 6/60 with a Retinal Acuity Meter). After stabilization of the uveitis over the next few weeks and under a steroid cover, a temporal clear-corneal phacoemulsification was cautiously performed with intra-operative management of the small pupil, and a hydrophobic lens was implanted. At one month post-surgery, the patient's best-corrected visual acuity had improved to 6/12 for distance and N6 for near. This report highlights a compelling instance wherein the neodymium:Yttrium-aluminum-garnet (Nd:YAG) laser was efficaciously employed for a lesser-known application in resolving a diagnostic dilemma and for instituting an interim treatment strategy in a challenging case involving a one-eyed patient prior to planning a definitive surgery. This case emphasizes the importance of thinking out of the box, ensuring comprehensive preoperative and careful intra-operative precautions in the management of patients diagnosed with complex ocular inflammatory conditions, so as to optimize visual outcomes, eventually resulting in achieving a gratifying reduction of visual disability and improvement of quality of life.
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In the context of veterinary medicine, minimally invasive techniques for feline spinal surgery remain underexplored, particularly for percutaneous laser disc ablation (PLDA) when using the Holmium:YAG (Ho:YAG) laser. This study aimed to refine the application of the Ho:YAG laser in PLDA by determining the optimal laser intensity and safe insertion angles for the thoracic and lumbar intervertebral discs (IVDs) in cats. Through utilizing computed tomography (CT) for precise guidance, this research involved a cadaveric study of 10 cats to evaluate the spatial configurations that allow for safe needle insertions and effective laser ablation. Various energy settings of the Ho:YAG laser (20 J, 40 J, and 60 J) were tested to ascertain the balance between adequate disc vaporization and minimal adjacent tissue damage. The results demonstrate that a 40 J setting is the most effective in achieving significant disc decompression without compromising surrounding tissue integrity. Additionally, the CT scans proved crucial in confirming the accuracy of the needle placement and the safety of the laser application angles. This study established that the 40 J setting on the Ho:YAG laser, combined with CT-guided insertion techniques, offers a reliable method for PLDA, thus enhancing the safety and efficacy of feline spinal surgeries.
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The oral cavity's soft and hard tissues create a conducive environment for microbial proliferation and biofilm development, facilitating the colonization of prosthodontic and implant materials such as titanium (Ti) and zirconia (Zr). This study aimed to compare the efficacy of conventional decontamination methodologies (i.e., chemical and mechanical, using 0.12% digluconate chlorhexidine (CHX) solution-treatment and airflow) to adjunctive laser-based interventions on Ti and Zr substrates inoculated with Staphylococcus (S.) aureus ATCC 25923. Additionally, this investigation sought to elucidate the impact of these treatments on temperature variations and surface integrity, analyzing the laser irradiation effects on these prevalent dental materials. Experimental configurations were delineated for both Ti and Zr samples across four groups: (1) a conventional treatment group (CV); (2) a photodynamic therapy group (PDT); (3) an Er:YAG laser treatment group (Er); (4) a combined PDT and Er:YAG treatment group (PDTEr). Also, a negative control group (C) that received no treatment was considered. The decontamination of the inoculated disc samples was evaluated by quantifying the microbial colonies in colony-forming units per milliliter (CFU/mL). Temperature variations on the surface of the samples were determined during laser treatments. Surface modifications were investigated using scanning electron microscopy (SEM) and optical coherence tomography (OCT). For statistical analysis, Fisher 95% confidence intervals, Hsu's MCB method, and the Kruskal-Wallis test were applied. With regard to the 105 CFU/mL of the negative control group, results indicated average values equal for each study group to (1) 2.66 CFU/mL for Ti and 2 CFU/mL for Zr for the CV group; (2) 0.33 CFU/mL for Ti and 1 CFU/mL for Zr for the PDT group; (3) 1.25 CFU/mL for Ti and 0 CFU/mL for Zr for the Er group; (4), and 0 CFU/mL for both Ti and Zr for the PDTEr group. Therefore, the combined PDT and Er:YAG treatment (PDTEr) and the singular PDT modality outperformed conventional decontamination methods in eradicating S. aureus biofilms from both Ti and Zr surfaces. Notably, the PDTEr regime achieved a comprehensive elimination of microbial colonies on treated substrates. Surface examination employing OCT demonstrated discernible alterations in the surface morphology of samples subjected to Er:YAG and combined PDT and Er:YAG treatments. Temperature checks during treatments showed no major changes, suggesting the applied laser methods are safe. In conclusion, PDTEr and PDT eliminated bacteria more effectively, but Zr surfaces were more resilient, making them better for microbe-controlling applications. Also, the study demonstrated that the (less costly but lower resolution) OCT method can replace SEM for such investigations.
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OBJECTIVES: To assess laser-tissue interactions through ablation, coagulation, and carbonisation characteristics in a non-perfused porcine kidney model between three pulsed lasers: holmium (Ho): yttrium-aluminium-garnet (YAG), thulium fiber laser (TFL), and pulsed thulium (p-Tm):YAG. MATERIALS AND METHODS: A 150-W Ho:YAG, a 60-W TFL, and a 100-W p-Tm:YAG lasers were compared. The laser settings that can be set identically between the three lasers and be clinically relevant for prostate laser enucleation were identified and used on fresh, unfrozen porcine kidneys. Laser incisions were performed using stripped laser fibers of 365 and 550 µm, set at distances of 0 and 1 mm from the tissue surface at a constant speed of 2 mm/s. Histological analysis evaluated shape, depth, width of the incision, axial coagulation depth, and presence of carbonisation. RESULTS: Incision depths, widths, and coagulation zones were greater with Ho:YAG and p-Tm:YAG lasers than TFL. Although no carbonisation was found with the Ho:YAG and p-Tm:YAG lasers, it was common with TFL, especially at high frequencies. The shapes of the incisions and coagulation zones were more regular and homogeneous with the p-Tm:YAG laser and TFL than with Ho:YAG laser. Regardless of the laser used, short pulse durations resulted in deeper incisions than long pulse durations. Concerning the distance, we found that to be effective, TFL had to be used in contact with the tissue. Finally, 365-µm fibers resulted in deeper incisions, while 550-µm fibers led to wider incisions and larger coagulation zones. CONCLUSION: Histological analysis revealed greater tissue penetration with the p-Tm:YAG laser compared to the TFL, while remaining less than with Ho:YAG. Its coagulation properties seem interesting insofar as it provides homogeneous coagulation without carbonisation, while incisions remained uniform without tissue laceration. Thus, the p-Tm:YAG laser appears to be an effective alternative to Ho:YAG and TFL lasers in prostate surgery.
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A male patient in his early 20s presented to our outpatient clinic, having previously been misdiagnosed and unsuccessfully treated as a case of viral warts. Dermoscopic and histopathological evaluations revealed characteristic features of the nevus sebaceous. The lesion was eventually treated with an erbium-doped yttrium aluminum garnet (Er:YAG) laser after the patient declined surgical excision. Nevus sebaceous often presents with verrucous surfaces that make misdiagnosis common. A correct diagnosis is crucial due to potential neoplastic transformations. Histopathological analysis is essential for both the confirmation of disease and the exclusion of malignancy. Full-thickness surgical excision remains the preferred treatment.
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In this study, we propose a method for navigating the choice of treatment for stress urinary incontinence (SUI) and urgency urinary incontinence (UUI) using graph theory in discrete mathematics. Our previous study accumulated data from 150 patients who underwent tension-free vaginal tape (TVT), transobturator tape (TOT), and vaginal non-ablation Erbium YAG laser (VEL) surgeries between 2014 and 2016. Network diagrams were created using this data. The treatments TVT, TOT, and VEL, along with patient characteristics (1-hour pad test: 1-hrPadTest, Overactive Bladder Symptom Score: OABSS), were represented as nodes and edges in the network diagram. We then employed a heuristic function to select the optimal treatment method for the patients with SUI and UUI. This process enables medical professionals to easily navigate the data for patients with both SUI and UUI concerns by calculating the shortest path connecting the 1-hrPadTest and OABSS. These results, which are consistent with those of previous studies, suggest that VEL is the optimal treatment. Unlike previous studies that employed statistical knowledge that is challenging for patients to understand, our study aids patients in visually comprehending and developing a customized treatment plan. This approach introduces a novel perspective for clinical decision-making in the treatment of urinary incontinence. To the best of our knowledge, this is the first study to apply discrete mathematics to patient decision-making for urinary incontinence treatment.
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Background/purpose: Establishing effective irrigation methods is warranted to ensure the predictability of minimally invasive root canal instrumentation. This study aimed to compare the smear layer removal efficacy of different irrigation techniques in root canals instrumented with TruNatomy nickel-titanium rotary instruments. Materials and methods: Experiment 1: Extracted human mandibular incisors were instrumented using TruNatomy Shaping Files up to Small (#20/0.04), Prime (#26/0.04), or Medium (#36/0.03) (n = 17, each) and irrigated with EDTA, NaOCl, and again with EDTA using syringe irrigation (SI). Experiment 2: Extracted mandibular incisors were instrumented using TruNatomy Small and irrigated with EDTA and NaOCl as in Experiment 1, using (1) conventional laser-activated irrigation (LAI) with an erbium-doped yttrium aluminum garnet laser unit at 30 mJ/10 Hz (LAI 30/10) or 70 mJ/20 Hz (LAI 70/20), (2) photon-induced photoacoustic streaming (PIPS) (20 mJ/15 Hz), (3) ultrasonic-activated irrigation, or (4) SI (n = 13 each). Five additional canals served as negative controls (no irrigation). The smear layer on the canal wall was scored under scanning electron microscopy. Results: In Experiment 1, the TruNatomy Small group exhibited significantly higher smear layer scores compared to the other groups in the apical and middle thirds. In Experiment 2, the LAI 70/20 and PIPS groups demonstrated significantly lower smear layer scores compared to the LAI 30/10 and SI groups in the apical third. Conclusion: Conservative instrumentation using the TruNatomy Small reduced the cleaning efficacy of irrigation. However, PIPS performed satisfactory for smear layer removal without injury to the root canal wall.
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Nowadays, lasers are used in various medical fields. Ophthalmology was the first medical specialty to utilize lasers in patient treatment and still remains the leading medical field that uses laser energy for both therapeutic and diagnostic purposes. The neodymium: yttrium-aluminum-garnet (Nd: YAG) laser is one of the most common lasers used in ophthalmology. It is a solid-state laser with a wavelength of 1064 nm that works on the principle of photodisruption. Since its introduction in ophthalmology over 40 years ago, it has found various applications, mainly for procedures where cutting or disruption of ocular tissue is required. Compared to surgical alternatives, the use of Nd: YAG lasers on ocular tissue is minimally invasive. In this review, we focus on the two most common ophthalmic applications of Nd: YAG laser - laser peripheral iridotomy and posterior capsulotomy. The history of the techniques, current trends, potential complications, and the prognosis for future use is discussed.
Subject(s)
Lasers, Solid-State , Humans , Lasers, Solid-State/therapeutic use , Laser Therapy/methods , Laser Therapy/instrumentation , Posterior Capsulotomy/methods , Iridectomy/methods , Ophthalmology , Iris/surgeryABSTRACT
OBJECTIVE: This retrospective cohort study with propensity score (PS) matching aimed to evaluate the efficacy and safety of a combination therapy with vaginal and urethral erbium:yttrium aluminum garnet laser (VEL+UEL) (SP Dynamis; Fotona d.o.o., Ljubljana, Slovenia) in the treatment of overactive bladder with urinary incontinence (OAB-wet). METHODS: The study included female OAB-wet patients aged 65 and above who were already taking OAB medication. Data obtained from electronic medical records were subjected to propensity score matching. All patients received instructions on pelvic floor exercises and were prescribed an appropriate dose of OAB medication. The VEL+UEL group (n=30) underwent three monthly laser sessions, while the control group (n=30) did not receive the treatment. Clinical outcomes were evaluated using the Overactive Bladder Symptom Score (OABSS), International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF), three-day urination diary, and Vaginal Health Index Score (VHIS). Medication usage and adverse events were also assessed. Statistical analysis and R code were performed using the AI chatbot GPT-4.0. RESULTS: The VEL+UEL group showed significant improvements in OABSS score, ICIQ-SF score, voided volume, daytime frequency, nocturia, and VHIS after 12 months of treatment (p<0.001). Notably, 13.3% of patients transitioned from OAB-wet to OAB-dry. In contrast, the control group did not exhibit significant changes. Medication use was significantly reduced in the VEL+UEL group compared to the control group (p<0.001). No long-term side effects were reported. CONCLUSION: Combination therapy with VEL+UEL demonstrated efficacy and safety in the treatment of OAB-wet. Improvements in OAB symptoms, voided volume, frequency, nocturia, and vaginal health were observed, with a subset of patients transitioning to OAB-dry. VEL+UEL therapy offers a potential treatment option for OAB-wet, reducing medication use and improving patient outcomes. Further research is warranted to investigate the mechanism, long-term effects, safety, and cost-effectiveness of VEL+UEL therapy.
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BACKGROUND AND OBJECTIVES: Considering the pulse widths of picosecond and nanosecond lasers used in cutaneous laser surgery differ by approximately one order of magnitude, can nanosecond lasers produce the optical effect in human skin similar to laser-induced optical breakdown (LIOB) caused by picosecond lasers? METHODS: Cutaneous changes induced by a focused fractional nanosecond 1064-nm Nd:YAG laser were evaluated by VISIA-CR imaging, histological examination, and harmonic generation microscopy (HGM). RESULTS: A focused fractional nanosecond 1064-nm Nd:YAG laser can generate epidermal vacuoles or dermal cavities similar to the phenomenon of LIOB produced by picosecond lasers. The location and extent of photodisruption can be controlled by the laser fluence and focus depth. Moreover, laser-induced shock wave propagation and thermal degeneration of papillary collagen can be observed by HGM imaging. CONCLUSION: Focused fractional nanosecond lasers can produce an optical effect on human skin similar to LIOB caused by picosecond lasers. With techniques of application, the treatment can induce epidermal and dermal repair mechanisms in a tunable fashion to improve skin texture, wrinkles, scars, and dyspigmentation, without disrupting the epidermal surface.
Subject(s)
Lasers, Solid-State , Skin , Humans , Lasers, Solid-State/therapeutic use , Skin/radiation effects , Laser Therapy/methods , Laser Therapy/instrumentationABSTRACT
Nail psoriasis is a chronic, inflammatory condition which is difficult to treat, linked with greater psoriasis severity, and may be associated with anxiety and significant functional impairment of the quality of life. The 1064 nm Nd: YAG laser was reported to yield satisfactory results in the treatment of nail psoriasis.The aim of the study was to assess the clinical and ultrasonographic efficacy of long-pulsed 1064 nm Nd: YAG laser in the treatment of fingernail psoriasis and compare its effect to control fingernails.This intra-patient randomized controlled trial analyzed 86 fingernails collected from 13 patients suffering from cutaneous and nail psoriasis. The nails were randomized into two groups. Group A was treated with Nd: YAG laser once monthly for three sessions while group B served as control. Assessment took place at baseline, 1 and 3 months after the last treatment session. For scoring, the 32-points target NAPSI scoring systems was used. Additionally, two blinded dermatologists' score of improvement, patients' pain assessment by visual analogue score and ultrasonographic assessment were all performed.At the end of follow up, the medians of tNAPSI score, plate definition, matrix thickness, bed thickness and bed vascularity decreased significantly in the Nd: YAG laser treated group in comparison to baseline (p = 0.001, 0.006, 0.039, < 0.001 and 0.010, respectively). While, there was a non-significant reduction in median tNAPSI score in the control group at last follow up, however, ultrasonography recorded a significant reduction in the medians of plate definition, bed thickness and vascularity (p = 0.002, 0.011 and 0.033, respectively) from the baseline. Comparison of the Nd: YAG laser and the control groups showed no significant difference from baseline regarding the medians of tNAPSI, tNAPSI percentile improvement, pits count, blinded evaluation of photographs and ultrasonographic assessments.In conclusion, Nd: YAG laser showed clinical and ultrasonographic improvement in fingernail psoriasis. Ultrasonography is a useful noninvasive tool in diagnosing and monitoring the clinical and even the subclinical changes in nail psoriasis. Nail psoriasis although difficult to treat, may show spontaneous improvement.
Subject(s)
Lasers, Solid-State , Nail Diseases , Psoriasis , Ultrasonography , Humans , Psoriasis/diagnostic imaging , Male , Female , Adult , Lasers, Solid-State/therapeutic use , Ultrasonography/methods , Nail Diseases/diagnostic imaging , Nail Diseases/surgery , Nail Diseases/diagnosis , Middle Aged , Treatment Outcome , Severity of Illness Index , Nails/diagnostic imaging , Nails/surgery , Quality of Life , Pain Measurement , Young Adult , Low-Level Light Therapy/methodsABSTRACT
BACKGROUND: To evaluate the efficacy and safety of stromal vascular fraction (SVF), platelet rich plasma (PRP), and 1064-nm Q-switched Nd:YAG laser in reducing nanofat treated dark circles and wrinkles under the eyes. METHOD: This study was a single-blinded randomized clinical trial conducted on patients with suborbital darkening under the eyes that randomly divided into control and case groups. In the control group, 15 patients were treated with one session of nanofat injection only, and five patients of each intervention groups received one session of nanofat+SVF injection, nanofat+PRP injection, and nanofat injection+Nd:YAG laser, respectively. Assessments methods were (1) evaluation of the degree of darkness and repair under the eyes by a blinded dermatologist based on clinical photographs, (2) investigating patient satisfaction, (3) using biometric variables for color, thickness, and density of the skin (only 3 months after the treatment), and (4) recording the possible adverse effects. CONCLUSION: In terms of the extent of reduction in the intensity of darkness under the eyes, the combined treatment of nanofat injection together with SVF, PRP, and Nd:YAG laser had a much greater therapeutic effect than nanofat injection alone. In all three groups of combined treatments, patients were 100% satisfied. In terms of biometric variables, amount of changes in colorimeter, complete and dermal thickness, complete and dermal density, between the different groups was statistically significant. The use of combined treatments including nanofat with SVF injection, PRP, and 1064 Q-switched Nd:YAG laser may be more effective than nanofat alone, in reducing infraorbital dark circles and wrinkles.
Subject(s)
Cosmetic Techniques , Lasers, Solid-State , Platelet-Rich Plasma , Skin Aging , Humans , Female , Lasers, Solid-State/therapeutic use , Middle Aged , Single-Blind Method , Adult , Cosmetic Techniques/instrumentation , Treatment Outcome , Male , Patient SatisfactionABSTRACT
Objective: To assess the correlation of attenuation value measured as HU in Non-contrast computed tomography, stone size, location, fibre size and stone composition with Holmium: yttrium-aluminium garnet (Ho: YAG) laser parameters including, cumulative laser energy and final laser time. Materials and Methods: We prospectively analyzed 118 patients undergoing flexible/semirigid ureteroscopy and Holmium: YAG laser lithotripsy from October 2022 to October 2023 at Mogadishu Urological Centre. Our study parameters encompass preoperative stone characteristics determined in NCCT (stone size, attenuation value, and stone location), fibre size, cumulative laser energy and time, overall operative time, and postoperative stone composition analysis. Results: There were 118 patients eligible for our prospective study. In the logistic regression model for retrograde intrarenal surgery with a fibre size of 272 µm, cumulative laser energy showed a significant difference among stone size, location, fibre size, and calcium oxalate stones (P > 0.05). However, no significant difference was noticed in the attenuation value (P = 0.078) (R2 = 0.053). Our analysis showed a positive significance among all the parameters (P < 0.05) for laser time. In logistic regression for a rigid ureteroscope with a fibre size of 365 µm, cumulative laser energy showed a significant difference between the location stone and fibre size (P < 0.05) (R2 = 0.09). However, no significant difference was seen among stone size, attenuation value, and calcium oxalate stones (P > 0.05). For laser time, our analysis showed a positive significance among all parameters except the calcium oxalate stones, which showed no significant difference (P > 0.05). Conclusion: Our study showed that stone location, hardness, and fibre size are the most critical factors influencing the outcome of Ho: YAG laser parameters. The study revealed that CaOMH stones require more time to disintegrate into smaller ones, while PH-dependent stones such as carbonate apatite may require less time to fragment.
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Objective: To evaluate effects of dentin collagen versus Er:YAG laser application through enhancing human periodontal ligament fibroblast (PDLF) cells to attach to intact root surfaces imitating delayed replanted roots. Background Data: Accidental traumatic injuries with teeth avulsion are managed by replantation. Root resorption, poor conditioning, and non-viable fibroblasts are factors responsible for failure. Methods: Thirty six human healthy single-rooted premolars were collected. Six teeth were used for PDLF, six teeth used for dentin collagen, whereas the remaining 24 teeth (48 root slices) were used for PDLF cell density and morphology. Each root was soaked in 5.25% NaOCl. Three groups (n = 16 slices/each) were planned as follows: I: Control (untreated); II: dentin collagen application; III: Er:YAG laser irradiation (4 mm distance, 40 mJ/pulse, under coolant). Following incubation, cell density and morphology of PDLF were investigated under SEM. Statistical analysis was performed using analysis of variance with Scheffé's test, and p < 0.05 was considered significant. Results: All groups showed increased cultured PDLF following incubation. Regarding cell density, attached PDLFs were significantly lower in untreated controls (36.5 ± 6.36) (p < 0.00001 i.e., <0.05) in negative empty and/or light cellular areas, compared with dentin collagen (65 ± 6) and laser-irradiated (66.75 ± 5.77) groups that did not show significant differences (p = 0.940 i.e., >0.05) and showed intermediate and/or heavy cellular areas. Regarding cell morphology, controls showed round and/or oval appearance with less lamellipodia, whereas dentin collagen and laser groups showed flat morphology with cytoplasmic processes. Conclusions: Both dentin collagen and Er:YAG laser showed comparable effectiveness as biomodification tools with good biocompatibility for human PDLF cell attachment on intact root slices imitating delayed replantation. Dentin collagen as a natural bioactive material is considered an alternative to Er:YAG laser to enhance the regenerative effects.
ABSTRACT
This systematic review assesses the evidence concerning laser treatments for nail psoriasis (NP), a prevalent condition among individuals with cutaneous psoriasis that notably affects their quality of life. Traditional treatments have limitations in terms of drug delivery and poor patient adherence, leading to interest in laser therapies for their targeted approach, extended treatment intervals, and the potential to enhance topical medication effectiveness. The MEDLINE, Embase, Web of Science, and Cochrane Library databases were searched. English-language randomized and non-randomized controlled trials with full-text availability were included. Data on the laser type, treatment protocol, Nail Psoriasis Severity Index (NAPSI) outcomes, and adverse events were extracted, and nail bed and matrix features and patient satisfaction were assessed. The primary effect measure was a percentage reduction in NAPSI scores from baseline. Nineteen studies involving the pulse dye laser (PDL), long-pulsed neodymium:yttrium aluminum garnet (Nd:YAG) laser and fractional carbon dioxide laser (FCL) were identified. Lasers, particularly those used in conjunction with topical agents, have shown favorable results. PDL effectively lowered NAPSI scores, and the Nd:YAG laser had comparable effectiveness but more discomfort. FCL also shows promise, particularly for topical drug delivery. PDL and Nd:YAG laser treatment were more effective at reducing nail bed features, whereas FCL was effective at reducing both nail bed and matrix features. Overall, lasers are promising treatment alternatives for NP, with similar NAPSI outcomes to topical therapies and intralesional injections.