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1.
Arch Esp Urol ; 74(3): 343-349, 2021 Apr.
Artículo en Inglés, Español | MEDLINE | ID: mdl-33818431

RESUMEN

OBJECTIVES: With the spread of more powerful lasers and the advent of new technologies, endoscopic interventions for urolithiasis are continuously evolving. The aim of this study is to present our experience and technique regarding Low Energy (LE)/High Frequency (HF) lithotripsy by using a 120-W Holmium laser (Lumenis®). METHODS: We retrospectively analysed our prospectively maintained Retrograde Intra Renal Surgery (RIRS) database. Lithotripsy was performed using LE/HF settings with a Long Pulse Width (LPW) and consisted of the following steps: 1) contact Laser lithotripsy (LE/HF/LPW dusting - 0,5 J/50 Hz or 02 J/70 Hz); 2) extraction ofmain fragments; 3) non-contact Laser lithotripsy (LE/HF/Short Pulse Width Pop Dusting - 0,5 J /80Hz). Pre-operativeand peri-operative outcomes were collected. Post-operative complications were recorded according to Clavien-Dindo Grading System. Finally, all patients under went a CT scan at three months after RIRS to assess the success of procedure, defined as stone-free or presence of ≤4 mm fragments (Clinical Insignificant Residual Fragments - CIRF). RESULTS: Overall, 104 LE/HF/LPW RIRS from December 2017 to January 2019 were performed. Mean operative time was 59 (SD ±23) minutes, median post-operative stay was two days (IQR 2-3). The post-operative complication rate was 4,8%: one patient had nausea and vomiting (Clavien-Dindo I) and four patients developed urosepsis (Clavien-Dindo II). The success rate was 88,5% (71,2% stone-free and 17,3% CIRF). CONCLUSIONS: LE/HF/LPW RIRS seems to be safe and effective in terms of positive success rate, safety and standard operative time. However, randomized clinical trials are needed to compare this technique to standard RIRS.


Asunto(s)
Cálculos Renales , Láseres de Estado Sólido , Litotripsia por Láser , Humanos , Cálculos Renales/cirugía , Láseres de Estado Sólido/uso terapéutico , Estudios Retrospectivos , Resultado del Tratamiento , Ureteroscopía
2.
Urologiia ; (1): 28-32, 2021 Mar.
Artículo en Ruso | MEDLINE | ID: mdl-33818931

RESUMEN

INTRODUCTION: surgical treatment of urinary stone disease plays an important role in urological practice. Stone fragmentation can be performed using various lithotripters, from which Holmium fiber laser (Ho: YAG) has currently taken the main place. According to the current literature, a superpulsed thulium fiber laser with a wavelength of 1.94 m and a maximum power output of 40 W showed in vitro higher efficiency compared to Ho: YAG, while having the same safety profile. The use of a thulium fiber laser with a pulse energy of 0.025-6 J and a high repetition rate (up to 1600 Hz) allows to most effectively perform stone dusting during retrograde intrarenal surgery (RIRS). AIM: to improve the performance of RIRS using the 1.94m superpulsed thulium fiber laser. MATERIALS AND METHODS: a total of 152 patients with renal stones who were treated during the period from February 2018 to July 2019 were included in the study. The analysis of the laser settings, their effect on retropulsion and visibility when performing RIRS using a superpulsed thulium fiber laser with a wavelength of 1.94 m and a maximum power output of 40 W, a peak power of 500 W, as well as an assessment of the stone-free rate the first postoperative day and 3 months after the procedure was done. RESULTS: The most frequently used settings were as following: 0.5 J, 30 Hz, 15 W (No. 1), 0.15 J, 200 Hz, 30 W (No. 2), 0.8 J, 31.25 Hz, 25 W (No. 3), 0.8 J, 37.5 Hz, 30 W (No. 4). The statistical analysis of the influence of the settings on the quality of endoscopic imaging and retropulsion was carried out. In addition, the features of each settings were analyzed. The stone-free rate on the first postoperative day was evaluated using low-dose CT. CONCLUSION: A superpulsed thulium fiber laser with a wavelength of 1.94 m and a maximum power of 500 W has shown high efficiency in clinical practice when performing RIRS, since it allows to have good endoscopic imaging, minimal retropulsion, and to perform stone dusting, which had a positive effect on the stone-free rate. Optimization of the settings of thulium fiber lithotripsy may improve the results of surgical treatment of urinary stone disease.


Asunto(s)
Cálculos Renales , Láseres de Estado Sólido , Litotripsia por Láser , Cálculos Urinarios , Humanos , Tulio , Cálculos Urinarios/cirugía
3.
Artículo en Inglés | MEDLINE | ID: mdl-33819321

RESUMEN

This paper reports on a study undertaken to ascertain the efficacy of the erbium:YAG laser (EYL) for peri-implantitis treatment. A total of 12 patients with bone loss resulting from peri-implantitis were involved in this study. The treatment protocol consisted of using the EYL for implant surface debridement and deproteinized bovine bone mineral (DBBM) for bone grafting. The following parameters were analyzed: probing pocket depth (PPD), clinical attachment level (CAL), bleeding on probing (BOP), bone levels (BLs), and the lipopolysaccharide levels before and after debridement with the EYL. This study found a statistically significant improvement in PPD, CAL, BOP, and BL at 3 and 12 months postoperative. Furthermore, a statistically significant decrease in implant-surface LPS levels was observed following debridement with the EYL. These findings show that using the EYL for debridement in peri-implantitis cases is effective in decreasing LPS levels. Moreover, after partial reconstruction with DBBM grafting, BLs were restored for at least 12 months. It was shown in one case that BLs had remained stable over 6 years, which also attests to the efficacy of this treatment. The combined use of EYL and DBBM could be effective for regenerative surgical peri-implantitis treatment.


Asunto(s)
Implantes Dentales , Láseres de Estado Sólido , Periimplantitis , Animales , Biomarcadores , Bovinos , Erbio , Humanos , Láseres de Estado Sólido/uso terapéutico , Periimplantitis/cirugía
4.
J Appl Oral Sci ; 29: e20200736, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33825753

RESUMEN

OBJECTIVE: To evaluate the efficacy of Nd:YAG laser associated with calcium-phosphate desensitizing pastes on dentin permeability and tubule occlusion after erosive/abrasive challenges. METHODOLOGY: Dentin specimens were exposed to 17% ethylene diamine tetra-acetic acid (EDTA) solution for 5 min and randomly allocated into five groups: G1, control (no treatment); G2, Nd:YAG laser (1 W, 10 Hz, 100 mJ, 85 J/cm2); G3, Laser + TeethmateTM Desensitizer; G4, Laser + Desensibilize Nano P; and G5, Laser+Nupro®. Specimens underwent a 5-day erosion-abrasion cycling. Hydraulic conductance was measured post-EDTA, post-treatment, and post-cycling. Post-treatment and post-cycling permeability (%Lp) was calculated based on post-EDTA measurements, considered 100%. Open dentin tubules (ODT) were calculated at the abovementioned experimental moments using scanning electron microscopy and ImageJ software (n=10). Data were analyzed using two-way repeated measures ANOVA and Tukey's test (α=0.05). RESULTS: G1 presented the highest %Lp post-treatment of all groups (p<0.05), without significantly differences among them. At post-cycling, %Lp significantly decreased in G1, showed no significant differences from post-treatment in G3 and G4, and increased in G2 and G5, without significant differences from G1 (p>0.05). We found no significant differences in ODT among groups (p>0.05) post-EDTA. At post-treatment, treated groups did not differ from each other, but presented lower ODT than G1 (p<0.001). As for post-cycling, we verified no differences among groups (p>0.05), although ODT was significantly lower for all groups when compared to post-EDTA values (p<0.001). CONCLUSION: All treatments effectively reduced dentin permeability and promoted tubule occlusion after application. COMBINING ND: YAG laser with calcium-phosphate pastes did not improve the laser effect. After erosive-abrasive challenges, treatments presented no differences when compared to the control.


Asunto(s)
Desensibilizantes Dentinarios , Láseres de Estado Sólido , Calcio/farmacología , Dentina , Permeabilidad de la Dentina , Láseres de Estado Sólido/uso terapéutico , Microscopía Electrónica de Rastreo
5.
J Appl Oral Sci ; 29: e20200266, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33825761

RESUMEN

OBJECTIVES: We analyzed the effects of the Er:YAG laser used with different parameters on dentinal tubule (DT) occlusion, intrapulpal temperature and pulp tissue morphology in order to determine the optimal parameters for treating dentin hypersensitivity. METHODOLOGY: Dentin specimens prepared from 36 extracted human third molars were randomized into six groups according to the treatment method (n=6 each): control (A); Gluma desensitizer (B); and Er:YAG laser treatment at 0.5 W , 167 J/cm2 (50 mJ, 10 Hz) (C), 1 W , 334 J/cm2 (50 mJ, 20 Hz) (D), 2 W , 668 J/cm2 (100 mJ, 20 Hz) (E), and 4 W and 1336 J/cm2 (200 mJ, 20 Hz) (F). Treatment-induced morphological changes of the dentin surfaces were assessed using scanning electron microscopy (SEM) to find parameters showing optimal dentin tubule occluding efficacy. To further verify the safety of these parameters (0.5 W, 167 J/cm2), intrapulpal temperature changes were recorded during laser irradiation, and morphological alterations of the dental pulp tissue were observed with an upright microscope. RESULTS: Er:YAG laser irradiation at 0.5 W (167 J/cm2) were found to be superior in DT occlusion, with an exposure rate significantly lower than those in the other groups (P<0.05). Intrapulpal temperature changes induced by Er:YAG laser irradiation at 0.5 W (167 J/cm2) with (G) and without (H) water and air cooling were demonstrated to be below the threshold. Also, no significant morphological alterations of the pulp and odontoblasts were observed after irradiation. CONCLUSION: Therefore, 0.5 W (167 J/cm2) is a suitable parameter for Er:YAG laser to occlude DTs, and it is safe to the pulp tissue.


Asunto(s)
Láseres de Estado Sólido , Oclusión Dental , Dentina , Humanos , Láseres de Estado Sólido/uso terapéutico , Microscopía Electrónica de Rastreo
6.
Eur J Paediatr Dent ; 22(1): 47-54, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33719483

RESUMEN

AIM: The aim of this study was to review the craniofacial growth impairment and different malfunctions associated with short lingual frenum and to assess the validity of lingual frenum surgery based on minimally invasive laser release with a myofunctional approach. MATERIALS AND METHODS: Thirty patients, children and adolescents whose ages ranged from 8 years to 18 years, diagnosed with a short lingual frenum and concomitant orthodontic problems and/or presence of associated muscular or postural problems, were treated in this study. Pre-operative tongue assessment was performed following morphological and functional criteria, consisting of measurement of the free tongue, and of visual assessment of tongue protrusion out of the mouth and elevation to the incisive palatal papilla. Postural evaluation was assessed in frontal and lateral view. Laser surgery was completed with local anaesthesia, using Erbium YAG laser (2940 nm, LightWalker, AT-Fotona, Ljubljana, Slovenia) equipped with sapphire conical tip (600 micron), with energy ranging from 120 to 160 mJ, at 15 Hz frequency, and varying the adjustable pulse duration from 300 µs to 600 µs. RESULTS: Significant improvement was noted in 29 of 30 patients comparing preoperative scores to both three-week and two-month post-op scores. Postural improvement was found in 18 of 30 patients, indicating the multifactorial involvement of different causes for correct body posture. CONCLUSION: This study confirmed the validity of Erbium:YAG laser surgery as an effective technique in children and adolescents to release a short lingual frenum. The functional approach of the procedure performed with the Erbium:YAG laser, and the concomitant myofunctional therapy demonstrated to be simple and safe in children, and adolescents. Because of the multifactorial causes involved in correct body posture, an adequate osteopathic therapy is important to successfully complete the full body rehabilitation.


Asunto(s)
Terapia por Láser , Láseres de Estado Sólido , Enfermedades de la Lengua , Adolescente , Niño , Humanos , Lactante , Frenillo Lingual/cirugía , Lengua , Enfermedades de la Lengua/cirugía
7.
Stomatologiia (Mosk) ; 100(1): 34-43, 2021.
Artículo en Ruso | MEDLINE | ID: mdl-33528954

RESUMEN

THE AIM: Of the work is to develop and substantiate the method of minimally invasive complex orthodontic treatment of patients with constriction and deformation of the upper jaw in the period of permanent bite with the combined use of a bracket system, orthodontic devices for the expansion of the upper jaw and fractional photothermolysis to improve the effectiveness of complex treatment. MATERIALS AND METHODS: The results of complex treatment of patients with the deficiency of the upper jaw in the period of permanent bite are presented. Complex treatment consisted of orthodontic treatment using a bracket system, laser corticotomy, orthodontic devices for the expansion of the upper jaw. Ultrasound examination before and after the procedure was performed to obtain reliable results of laser impact on bone tissue. RESULTS: After conducting a clinical and radiological examination (using cone-beam computed tomography) of all patients and analyzing the data obtained, we have developed algorithms for therapeutic measures. As a result of orthodontic treatment aimed at the expansion of the upper jaw patients who underwent fractional photothermolysis procedure achieved the expansion of the upper jaw at both the dentoalveolar and skeletal levels. CONCLUSION: It was found that a comprehensive approach with minimally invasive effects can improve the effectiveness of treatment of patients with constriction and deformation of the upper jaw during the period of permanent bite and achieve stable treatment results.


Asunto(s)
Láseres de Estado Sólido , Adulto , Tomografía Computarizada de Haz Cónico , Oclusión Dental , Humanos , Maxilar , Resultado del Tratamiento
8.
Braz Oral Res ; 35: e29, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33605359

RESUMEN

This study evaluated how Er,Cr:YSGG laser, associated or not with 5% fluoride varnish, influences the surface roughness and volume loss of bovine root dentin submitted to erosive and/or abrasive wear. One hundred and twenty dentin specimens were divided into the groups: without preventive treatment (WPT), 5% fluoride varnish (FV); Er,Cr:YSGG laser irradiation (L), and varnish combined with laser (FV + L). The specimens (n = 10) were subdivided into: 1 = erosion (E); 2 = abrasion (A); and 3 = erosion followed by abrasion (E + A). The erosive solution used was a soft-drink (pH = 2.42 at 4ºC) applied in 5-min cycles twice a day for 10d. Abrasive wear involved brushing for 60s with an electric brush (1,600-oscillations/s) at a load of 2.0N. Surface roughness and volume loss were evaluated using a laser scanning confocal microscope. Roughness data were submitted to one-way ANOVA and Tukey post-hoc test. For volume loss, the Kruskal-Wallis and Dunn's post-hoc tests were used (α = 5%). The lowest values of roughness were found in the control areas of all subgroups (p > 0.05). In the experimental area, the [(WPT) + (E+A)] subgroup had a significantly higher roughness (5.712 ± 0.163 µm 2 ) than the other subgroups (p < 0.05). The L and (FV + L) groups had statistically similar roughness, regardless of the type of wear. The (FV + L) group had the lowest volume loss, regardless of the type of wear performed: [(FV + L) + (E)] = 7.5%, [(FV + L) + (A) = 7.3%, and [(FV + L) + (E + A)] = 8.1%. The subgroup [(WPT) + (E + A)] had the highest volume loss (52.3%). The proposed treatments were effective in controlling dentin roughness. Laser irradiation can be an effective method to increase root dentin resistance after challenges and limit problems related to non-carious lesions.


Asunto(s)
Láseres de Estado Sólido , Erosión de los Dientes , Animales , Bovinos , Dentina , Fluoruros , Láseres de Estado Sólido/uso terapéutico , Erosión de los Dientes/etiología , Raíz del Diente , Cepillado Dental
9.
Niger J Clin Pract ; 24(2): 282-291, 2021 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-33605921

RESUMEN

Aims: To evaluate the effect of various aging periods and different surface preparation methods on microtensile bond strength (µTBS) for composite repair. Materials and Methods: One hundred twelve composite resin blocks were formed using a nanohybrid composite resin. The samples were distributed into four groups according to surface preparation methods (n = 28): control (sound composite blocks); Er, Cr: YSGG laser; air abrasion; silicone carbide. All samples were then divided into four subgroups according to various aging periods: (i) No aging, (ii) 10,000 thermocycling, (iii) 30,000 thermocycling, and (iv) 50,000 thermocycling. Following surface preparation and aging procedures, surface topography of one sample from each group was evaluated under scanning electron microscope (SEM). The repair composites were bonded to the sample surfaces, using a three-step etch&rinse adhesive. Finally, thirty beams of size 1 × 1 × 8 mm from each group were subjected to µTBS test and failure modes were determined. The data were analyzed using two-way ANOVA, Post-hoc Bonferroni, and Chi-square tests (P = 0.05). Results: When different surface preparation methods were evaluated together, no aging and 10,000 thermocycling groups displayed higher µTBS values (P < 0.05). When all aging periods were evaluated together, the surface preparation with air abrasion provided higher µTBS (P < 0.05). The interactions of various aging periods with different surface preparation methods revealed significant variations in repair µTBS (P < 0.05). There were statistically significant differences on failure mode distributions among surface preparation methods (P < 0.001). SEM evaluations provided valuable outcomes that help to comment on the µTBS findings. Conclusions: Different surface preparation methods, various aging periods, and the interaction of both affected the repair µTBS of the tested nanohybrid composite resin.


Asunto(s)
Recubrimiento Dental Adhesivo , Láseres de Estado Sólido , Adhesivos , Resinas Compuestas , Análisis del Estrés Dental , Humanos , Ensayo de Materiales , Cementos de Resina , Propiedades de Superficie , Resistencia a la Tracción
10.
Am J Dent ; 34(1): 31-38, 2021 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-33544986

RESUMEN

PURPOSE: To examine the marginal adaptation in enamel and dentin of mixed Class V saucer shaped restorations where cavities were prepared by two different lasers. METHODS: A handpiece-integrated Er:YAG laser @ 4.5 W, 300 mJ, 15 Hz (LiteTouch III) and a novel CO2 laser @ 12.95 W, 19.3 mJ, 671 Hz (Solea 9.3 µm). Diamond bur preparation with a 25 µm diamond bur (Intensiv) in a red contra angle at high speed under water spray cooling served as the control. Eight cavities per group were readied and restored under simulation of dentin fluid with a one bottle universal adhesive (One Coat 7 Universal) and a nanohybrid resin composite (Everglow), applied in two layers. For every preparation technique, the adhesive system was applied in the selective-etch and the self-etch mode, resulting in six experimental groups. Marginal analysis was performed immediately after polishing and after simultaneous thermal (5-50°C, 2 minutes each) and mechanical (max. 49 N; 200,000 cycles) loading by using a SEM (x200 magnification). RESULTS: Significant differences were found for all groups - except groups 2 and 5 - between initial and terminal results and between the groups as well (P< 0.05, 2-way ANOVA with Fisher's post-hoc test). The bur prepared group with selective-etch technique showed the best overall results after loading, followed by Er:YAG prepared self-etch group and CO2-prepared selective-etch group. CLINICAL SIGNIFICANCE: By using a universal one-component adhesive system, marginal adaptation in enamel and in dentin depended on the preparation method and on the adhesive's application technique as well. When using lasers, Er:YAG in self-etch mode and CO2 9.3 µm in selective-etch mode total marginal adaptation showed results which were comparable to conventional bur preparation with selective-etch technique.


Asunto(s)
Recubrimiento Dental Adhesivo , Láseres de Estado Sólido , Dióxido de Carbono , Resinas Compuestas , Preparación de la Cavidad Dental , Cementos Dentales , Dentina , Recubrimientos Dentinarios , Cementos de Resina
11.
Adv Clin Exp Med ; 30(1): 7-15, 2021 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-33529502

RESUMEN

BACKGROUND: Reduced tooth structure in the pediatric and adolescent population is frequently restored with prefabricated zirconia crowns. On permanent teeth, these restorations may need to be removed and replaced with permanent restorations. OBJECTIVES: To explore and compare the use of 2 high-powered erbium lasers for removing prefabricated zirconia crowns from molar teeth as a non-invasive alternative to rotary instruments. MATERIAL AND METHODS: Twenty-five permanent molars were prepared to dentin and prefabricated all-ceramic zirconia crowns were fitted and cemented with resin modified glass ionomer (RMGI) cement. The teeth were randomly assigned into one of the 2 retrieval treatment groups: the erbium-doped yttrium, aluminum and garnet (Er:YAG) laser group (G1; n = 12) or the erbium, chromium-doped yttrium, scandium, gallium and garnet laser (Er,Cr:YSGG) laser group (G2; n = 13). The laser operating parameters for the Er:YAG laser were 300 mJ, 15 Hz, 4.5 W, and 50-microsecond pulse duration (SSP mode); for the Er,Cr:YSGG laser, they were 4.5 W, 15 Hz, 20 water/20 air, and 5 W, 15 Hz, 50 water/50 air, and 60-microsecond pulse duration (H mode). The experiment was repeated twice. The surface area and the volume of teeth and crowns were measured and the cement space was calculated. The retrieval time and temperature changes were tested and recorded. The data were analyzed with the t-test. The surfaces of the dentin and the crown from each group were further examined using scanning electron microscopy (SEM). RESULTS: The average time for crown removal using the Er:YAG laser was 1 min 32.7 s; for the Er,Cr:YSGG laser it was 3 min 13.9 s (p < 0.0001). The mean temperature changes were 1.41 ±1.36°C for the Er:YAG laser and 2.2 ±0.99°C for the Er,Cr:YSGG laser (p = 0.0321). The SEM examination showed no damage or major structural changes caused by treatment with either erbium-family laser. CONCLUSIONS: Both lasers are effective, non-invasive tools to remove prefabricated zirconia crowns cemented with resin cement and should be considered as viable alternatives to rotary instrumentation.


Asunto(s)
Láseres de Estado Sólido , Coronas , Humanos , Itrio , Circonio
13.
Curr Opin Ophthalmol ; 32(2): 141-147, 2021 Mar 01.
Artículo en Inglés | MEDLINE | ID: mdl-33470670

RESUMEN

PURPOSE OF REVIEW: For decades, laser trabeculoplasty has been a well-proven therapeutic option in glaucoma management, and more recently, it has only gained in popularity. One reason for such popularity is that selective laser trabeculoplasty (SLT) is a therapy independent of patient adherence, which is typically low among glaucoma patients. Consequently, the number of studies on SLT has multiplied throughout the past years. This review provides an overview of studies on SLT from the last 12 months. RECENT FINDINGS: The studies on treatment outcome show a wide range of success rates of SLT reaching between 18 and 88%; however, study designs differ and many studies are not directly comparable. The prospective laser trabeculoplasty for open-angle glaucoma and ocular hypertension (LiGHT) trial has demonstrated good efficacy of SLT - 75% of the eyes achieved their target pressure without drops and 58% after a single SLT. SUMMARY: SLT has proven to be effective in lowering IOP with satisfactory success rates even after single SLT. SLT is repeatable independent of patient's adherence.


Asunto(s)
Glaucoma de Ángulo Abierto/cirugía , Terapia por Láser/métodos , Láseres de Estado Sólido/uso terapéutico , Malla Trabecular/cirugía , Trabeculectomía/métodos , Glaucoma de Ángulo Abierto/fisiopatología , Humanos , Presión Intraocular/fisiología , Hipertensión Ocular/fisiopatología , Hipertensión Ocular/cirugía
14.
BMJ Case Rep ; 14(1)2021 Jan 29.
Artículo en Inglés | MEDLINE | ID: mdl-33514620

RESUMEN

Complications after renal allograft transplantation are not so uncommon. Most complications are related to graft rejection, immune-suppressive drug toxicity and the operative procedure. Stents are placed after a transplant to prevent urine leak at the site of ureteric reimplantation, to facilitate an early healing in immune-suppressed individuals and to prevent obstruction at the site of ureteral anastomosis. We report a case of a renal allograft recipient with a forgotten ureteral double J stent. where the stent remained in situ for more than 4 years and further complicated by encrustation and stone formation at both the bladder and renal pelvic ends. The stone over the bladder coil was removed by holmium laser cystolithotripsy while the encrusted renal pelvic coil was removed by percutaneous approach. This case is presented for its rarity and also to emphasise on the need for maintenance of a stent register in order to ensure avoidance of such preventable complications.


Asunto(s)
Remoción de Dispositivos/métodos , Trasplante de Riñón/efectos adversos , Nefrolitotomía Percutánea/métodos , Stents/efectos adversos , Adulto , Aloinjertos , Humanos , Trasplante de Riñón/métodos , Láseres de Estado Sólido , Masculino , Receptores de Trasplantes , Resultado del Tratamiento , Cálculos de la Vejiga Urinaria/diagnóstico por imagen , Cálculos de la Vejiga Urinaria/etiología , Cálculos de la Vejiga Urinaria/cirugía , Cálculos Urinarios/diagnóstico por imagen , Cálculos Urinarios/etiología , Cálculos Urinarios/cirugía
15.
Int J Pharm ; 595: 120242, 2021 Feb 15.
Artículo en Inglés | MEDLINE | ID: mdl-33484919

RESUMEN

Platelet-rich plasma (PRP) is rich in cytokines and growth factors and is a novel approach for tissue regeneration. It can be used for skin rejuvenation but the large molecular size of the actives limits its topical application. In this study, low-fluence laser-facilitated PRP was delivered to evaluate its effect on absorption through the skin, infection-induced wound, and photoaging. The PRP permeation enhancement was compared for two ablative lasers: fractional (CO2) laser and fully-ablative (Er:YAG) laser. In the Franz cell experiment, pig skin was treated with lasers with superficial ablation followed by the application of recombinant cytokines, growth factors, or PRP. The transport of interferon (IFN)-γ and tumor necrosis factor (TNF)-α was negligible in intact skin and stratum corneum (SC)-stripped skin. Both lasers significantly elevated skin deposition of IFN-γ and TNF-α from PRP, and fully-ablative laser showed a higher penetration enhancement. A similar tendency was found for vascular endothelial growth factor and epidermal growth factor. Er:YAG laser-exposed skin displayed 1.8- and 3.9-fold higher skin deposition of platelet-derived growth factor (PDGF)-BB and transforming growth factor (TGF)-ß1 from PRP, respectively. According to the confocal images, both laser interventions led to an extensive and deep distribution of IFN-γ and PDGF-BB in the skin. In the in vivo methicillin-resistant Staphylococcus aureus (MRSA) infection model, CO2 laser- and Er:YAG laser-assisted PRP delivery reduced bacterial load from 1.8 × 106 to 5.9 × 105 and 1.4 × 104 colony-forming units, respectively. The open wound induced by MRSA was closed by the laser-assisted PRP penetration. In the mouse photoaging model, elastin and collagen deposition were fully restored by combined PRP and full-ablative laser but not by PRP alone and PRP combined with fractional laser. Laser-facilitated PRP delivery even with a low fluence setting can be considered a promising strategy for treating some dermatological disorders.


Asunto(s)
Terapia por Luz de Baja Intensidad/métodos , Staphylococcus aureus Resistente a Meticilina/efectos de la radiación , Plasma Rico en Plaquetas/metabolismo , Envejecimiento de la Piel/efectos de la radiación , Enfermedades de la Piel/terapia , Piel/efectos de la radiación , Infecciones Cutáneas Estafilocócicas/terapia , Administración Cutánea , Animales , Terapia Combinada , Citocinas/farmacocinética , Humanos , Péptidos y Proteínas de Señalización Intercelular/farmacocinética , Láseres de Gas/uso terapéutico , Láseres de Estado Sólido/uso terapéutico , Staphylococcus aureus Resistente a Meticilina/efectos de los fármacos , Ratones , Ratones Endogámicos BALB C , Ratones Desnudos , Piel/diagnóstico por imagen , Piel/efectos de los fármacos , Piel/metabolismo , Absorción Cutánea/efectos de la radiación , Envejecimiento de la Piel/efectos de los fármacos , Porcinos , Cicatrización de Heridas/efectos de los fármacos , Cicatrización de Heridas/efectos de la radiación
16.
J Formos Med Assoc ; 120(1 Pt 2): 388-394, 2021 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-32540310

RESUMEN

BACKGROUND/PURPOSE: Among various dental lasers, the erbium-doped yttrium-aluminum-garnet (Er:YAG) laser has great potential for periodontal treatment including soft and hard tissue ablation with minimal thermal side effects under suitable energy densities and it has multiple effects on tissues for wound-healing benefits. In the present study, we sought to reveal the molecular mechanism underlying the impact of Er:YAG laser on PDL fibroblasts. METHODS: Cells were irradiated by a Er:YAG laser with various energy densities (3.6-6.3 J/cm2). MTT assay was used for cell proliferation, and the transwell system was employed for migration and invasion abilities. The wound healing capacity was evaluated by a scratch assay. After confirming these effects, qRT-PCR and western blotting analysis was applied to identify the differentially galectin-7 expression in the irradiated cells. Knockdown experiments were conducted to reveal the functional role of galectin-7 in the modulation of Er:YAG laser-mediated effects. RESULTS: 4.2 J/cm2 was the lowest energy density to induce the optimal cell proliferation, migration and invasion abilities. In the group of upregulated genes, galectin-7 was selected for further examination and its elevation after Er:YAG laser treatment was validated by RT-PCR and Western blot. We demonstrated that silence of galectin-7 abrogated the effects of Er:YAG laser on cell proliferation, migration ad invasion, suggesting the Er:YAG laser promoted these effects through induction of galectin-7. CONCLUSION: These findings indicated that Er:YAG laser may accelerate the regeneration process in periodontal tissues through enhancement of their proliferative and mobile activities. Additionally, the significance of galectin-7 in the Er:YAG laser-elicited benefits was demonstrated.


Asunto(s)
Terapia por Láser , Láseres de Estado Sólido , Proliferación Celular , Fibroblastos , Galectinas/genética , Humanos , Ligamento Periodontal , Cicatrización de Heridas
17.
Urologe A ; 60(1): 19-26, 2021 Jan.
Artículo en Alemán | MEDLINE | ID: mdl-33315134

RESUMEN

Management of urolithiasis has undergone fundamental changes with the introduction of extracorporeal shock wave lithotripsy (ESWL) and percutaneous and ureterorenoscopic techniques in the 1980s. Since then, these minimally invasive techniques have been continuously optimized and specific laser techniques for stone disintegration have emerged. Besides the established holmium laser, other types of lasers are also emerging. Especially the thulium fiber laser is the subject of promising research due to its variable adjustment options. In terms of patient safety, both holmium and thulium techniques seem to be similar . While serious direct physical lesions are rare, there is increasing evidence of clinically relevant secondary thermal injury due to increased temperatures in the upper urinary tract during treatment. Our research group has recently demonstrated in both in vitro and in vivo (porcine animal model) experiments that monitoring the fluorescence spectra of calculi allows precise target differentiation between stone, tissue, and endoscope components. Consequently, pulse emissions were only emitted when stone material was detected. We believe that target monitoring will minimize the risk of laser-induced urothelial damage and decrease energy release into the upper urinary tract allowing adequate temperature management.


Asunto(s)
Láseres de Estado Sólido , Litotripsia por Láser , Litotricia , Urolitiasis , Animales , Humanos , Láseres de Estado Sólido/uso terapéutico , Seguridad del Paciente , Porcinos , Ureteroscopía/efectos adversos , Urolitiasis/terapia
19.
Int J Urol ; 28(3): 333-338, 2021 03.
Artículo en Inglés | MEDLINE | ID: mdl-33327043

RESUMEN

OBJECTIVE: To evaluate the safety, efficacy and cost-effectiveness of holmium enucleation of the prostate and bipolar transurethral enucleation of the prostate. METHODS: In our randomized controlled trial, 120 patients were allocated into two equal groups representing holmium enucleation of the prostate and bipolar enucleation of the prostate. Operative parameters were recorded according to operative, enucleation and resection time in addition to the intraoperative complications. Patients were followed up at 1, 3 and 12 months postoperative to assess the prostate size, post-voiding residual urine, International Prostate Symptom Score, peak urine flow rate and quality of life, and compared with the preoperative parameters. Cost analysis was evaluated for both procedures. RESULTS: We evaluated 107 patients who finished our follow up and their data were analyzed. The prostate size was 135.2 ± 34.8 mL and 125 ± 26.9 mL for holmium enucleation of the prostate and bipolar enucleation of the prostate, respectively. Holmium enucleation of the prostate was associated with a shorter operative time of 83.43 ± 6.92 min compared with 94.7 ± 12.2 min in bipolar enucleation of the prostate groups. Holmium enucleation of the prostate was associated with an earlier catheter removal time and shorter hospital stay compared with bipolar enucleation of the prostate. Postoperative International Prostate Symptom Score, quality of life, post-voiding residual urine, peak urine flow rate, prostate-specific antigen and prostate volume reduction were comparable between both groups, and they both showed statistically significant improvement compared with their preoperative parameters. In the cost analysis, holmium enucleation of the prostate was more cost-effective than bipolar enucleation of the prostate. CONCLUSION: Both holmium enucleation of the prostate and bipolar enucleation of the prostate are safe and effective in the surgical management of large prostatic adenomas. Holmium enucleation of the prostate has a shorter operative time and hospital stay with earlier catheter removal time, and is more cost-effective than bipolar enucleation of the prostate.


Asunto(s)
Terapia por Láser , Láseres de Estado Sólido , Hiperplasia Prostática , Resección Transuretral de la Próstata , Humanos , Láseres de Estado Sólido/uso terapéutico , Masculino , Hiperplasia Prostática/cirugía , Calidad de Vida , Resección Transuretral de la Próstata/efectos adversos
20.
Zhonghua Nan Ke Xue ; 26(8): 731-735, 2020 Aug.
Artículo en Chino | MEDLINE | ID: mdl-33377736

RESUMEN

Objective: To investigate the clinical effect and safety of transurethral decompression and drainage with holmium laser in the treatment of prostatic abscess. METHODS: We retrospectively analyzed the clinical data on 13 cases of prostatic abscess treated in our hospital from January 2015 to May 2019. One of the patients was cured by drug therapy while the other 12 underwent transurethral decompression and drainage with holmium laser after failure in medication. We recorded such postoperative symptoms as fever, frequent urination, urgent urination, painful urination, tenteria, dysuria and abdominal distension, obtained the dynamical indices of blood and urine routine and culture after surgery, and performed MRI during the follow-up for possible recurrence and complications. Those with disappearance of the clinical symptoms, negative results of urine leukocyte and pathogen examinations, and no recurrence revealed by MRI were considered to be cured. RESULTS: After operation, the clinical symptoms were improved significantly and the urinary catheters removed within 5-10 days in all the cases. At 3-5 days after removal of the catheters, all the patients experienced smooth urination, with no urinary retention or urethral stricture. The patients were followed up for 3-16 months, during which no recurrence was observed. CONCLUSIONS: Transurethral decompression and drainage with holmium laser can achieve a definite clinical effect in the treatment of prostatic abscess and therefore deserves to be promoted in clinical practice.


Asunto(s)
Absceso/cirugía , Descompresión Quirúrgica , Drenaje , Terapia por Láser , Láseres de Estado Sólido , Hiperplasia Prostática , Holmio , Humanos , Láseres de Estado Sólido/uso terapéutico , Masculino , Hiperplasia Prostática/cirugía , Estudios Retrospectivos , Resultado del Tratamiento
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