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Lasers in Surgery and Medicine Jul 2023Postoperative bile leakage is a common complication of hepatobiliary surgery and frequently requires procedural intervention. Bile-label 760 (BL-760), a novel...
Assessment of a novel biliary-specific near-infrared fluorescent dye (BL-760) for intraoperative detection of bile ducts and biliary leaks during hepatectomy in a preclinical swine model.
OBJECTIVES
Postoperative bile leakage is a common complication of hepatobiliary surgery and frequently requires procedural intervention. Bile-label 760 (BL-760), a novel near-infrared dye, has emerged as a promising tool for identifying biliary structures and leakage, owing to its rapid excretion and strong bile specificity. This study aimed to assess the intraoperative detection of biliary leakage using intravenously administered BL-760 compared with intravenous (IV) and intraductal (ID) indocyanine green (ICG).
MATERIALS AND METHODS
Laparotomy and segmental hepatectomy with vascular control were performed on two 25-30 kg pigs. ID ICG, IV ICG, and IV BL-760 were administered separately, followed by an examination of the liver parenchyma, cut liver edge, and extrahepatic bile ducts for areas of leakage. The duration of intra- and extrahepatic fluorescence detection was assessed, and the target-to-background (TBR) of the bile ducts to the liver parenchyma was quantitatively measured.
RESULTS
In Animal 1, after intraoperative BL-760 injection, three areas of leaking bile were identified within 5 min on the cut liver edge with a TBR of 2.5-3.8 that was not apparent to the naked eye. In contrast, after IV ICG administration, the background parenchymal signal and bleeding obscured the areas of bile leakage. A second dose of BL-760 demonstrated the utility of repeated injections, confirming two of the three previously visualized areas of bile leakage and revealing one previously unseen leak. In Animal 2, neither ID ICG nor IV BL-760 injections showed obvious areas of bile leakage. However, fluorescence signals were observed within the superficial intrahepatic bile ducts after both injections.
CONCLUSIONS
BL-760 enables the rapid intraoperative visualization of small biliary structures and leaks, with the benefits of fast excretion, repeatable intravenous administration, and high-fluorescence TBR in the liver parenchyma. Potential applications include the identification of bile flow in the portal plate, biliary leak or duct injury, and postoperative monitoring of drain output. A thorough assessment of the intraoperative biliary anatomy could limit the need for postoperative drain placement, a possible contributor to severe complications and postoperative bile leak.
Topics: Swine; Animals; Fluorescent Dyes; Bile; Hepatectomy; Bile Ducts; Indocyanine Green
PubMed: 37003294
DOI: 10.1002/lsm.23661 -
Dermatologic Surgery : Official... Apr 2024Warts are one of the most common benign neoplasms caused by human papillomavirus infection and often pose a therapeutic challenge.
BACKGROUND
Warts are one of the most common benign neoplasms caused by human papillomavirus infection and often pose a therapeutic challenge.
OBJECTIVE
To summarize the current evidence on the safety and efficacy of laser and energy-based devices for the treatment of cutaneous verrucae.
METHODS
A comprehensive systematic review of the literature on laser and energy-based devices for the treatment of cutaneous verrucae was performed.
RESULTS
A total of 904 unique studies were identified, of which 109 were included in this review. The most commonly used lasers as a single treatment modality for verrucae included the long-pulsed Nd:Yag (n = 20) and pulsed dye (n = 18) lasers. Other modalities included the CO2 ablative laser (n = 10), photodynamic therapy (n = 11), local hyperthermia (n = 11), microwave therapy (n = 2), and nanopulse stimulation (n = 1). Other studies combined energy-based modalities with additional treatments, such as retinoids, imiquimod, and intralesional bleomycin. Overall, such devices were generally well-tolerated, with only a mild side effect profile.
CONCLUSION
Overall, the use of laser and energy-based devices is a safe and well-tolerated option for cutaneous verrucae that is relatively less invasive than surgical interventions. Future studies using more consistent outcome assessment tools will be valuable to help clinicians develop device-specific protocols and treatment regimens to ensure replicable and effective outcomes.
Topics: Humans; Treatment Outcome; Warts; Skin; Bleomycin; Hyperthermia, Induced; Lasers, Solid-State
PubMed: 38551277
DOI: 10.1097/DSS.0000000000004069 -
The Tokai Journal of Experimental and... Dec 2023Ecchymosis is a common side effect after injury and surgery. A pulsed dye laser (PDL) is the gold standard for vascular lesions and can minimize ecchymosis. Heating...
Ecchymosis is a common side effect after injury and surgery. A pulsed dye laser (PDL) is the gold standard for vascular lesions and can minimize ecchymosis. Heating induces hemoglobin modification due to oxidative and heat reactions with the formation of bilirubin and methemoglobin, resulting in color changes to brown-yellow. Therefore, downtime following cosmetic procedures can be shortened.
Topics: Humans; Ecchymosis; Lasers, Dye; Hot Temperature
PubMed: 37981852
DOI: No ID Found -
Skin Research and Technology : Official... Oct 2023Studies on pulsed dye laser (PDL) have shown the best efficacy and safety data for treating vascular anomalies among the various lasers used and the 595-nm PDL has been...
BACKGROUND
Studies on pulsed dye laser (PDL) have shown the best efficacy and safety data for treating vascular anomalies among the various lasers used and the 595-nm PDL has been used to treat cutaneous vascular anomalies for about 30 years. The purpose of this study was to assess the efficacy of 595 nm Pulsed Dye Laser in the management of facial flat angiomas present in the form of Port-Wine Stain.
MATERIALS AND METHODS
Seven cases of PWS in Fitzpatrick skin type ranged from I to III and colour ranging from pink to purple, were treated with 595 nm pulse Dye Laser. Patients underwent to 6-8 laser sessions at 20-30 days intervals. Results obtained were judged by dermatologist, by comparing pre-treatment and post-treatment photographs, 6 months after the last session and a quartile scale of lesion clearance (4-point Investigator Global Assessment scale): 1 = no or low results (0%-25% of the lesion area improved), 2 = slight improvement (25%-50% of the lesion area cleared), 3 = moderate-good improvement (50%-75%), and 4 = excellent improvement (75%-100%) was used. Possible side effects such as blisters, hyper/hypopigmentation, and scarring were monitored.
RESULTS
All patients observed global improvements. 71% of patients achieved excellent clearance and 29% patients achieved good-moderate clearance of their angioma. Patients were asked for a subjective evaluation of the results: 57% of patients were very satisfied, 29% were satisfied, and 14% patients were not very satisfied with the results. No patients were dissatisfied. No significant side effects were noted.
CONCLUSION
This research confirms the efficacy of the 595 nm PDL for flat angioma management, without considerable side effects.
Topics: Humans; Treatment Outcome; Lasers, Dye; Port-Wine Stain; Cicatrix; Hemangioma
PubMed: 37881052
DOI: 10.1111/srt.13494 -
Polymers Jul 2023Due to the increased application of lasers in different fields (industry, medicine, etc.), there is a growing need for new laser sources with good beam quality and...
Due to the increased application of lasers in different fields (industry, medicine, etc.), there is a growing need for new laser sources with good beam quality and variable emission wavelength. At the same time, for environmental reasons, the obtaining of novel eco-friendly active optical materials, such as those based on the deoxyribonucleic acid (DNA) biopolymer, with optimal light emission properties, is of high interest. The results obtained in this study of the temporal dependence of the transmittance and of the light emission in thin films of DNA-CTMA-Rhodamine 610 (at different Rhodamine concentrations) (DNA-CTMA-Rh610), when they are illuminated with continuous wave laser light at 532 nm (frequently used in the optical pumping of dye lasers), are presented and discussed. The transmittance results obtained for thin film samples are compared to those obtained for the DNA-CTMA-Rh610 solutions in butanol, from which the films have been made, and also with those obtained for Rh610 solutions in butanol with the same concentrations. The investigation was performed in order to assess the influence of the DNA-CTMA and of the green laser light at 532 nm wavelength on relevant chromophore properties such as light transmission and fluorescence emission. The results obtained revealed that the DNA-CTMA matrix has an active influence on the Rhodamine 610 emission, in the whole range of concentrations of the investigated samples.
PubMed: 37514494
DOI: 10.3390/polym15143105 -
Clinical and Experimental Dental... Dec 2023Different surface preparation and treatment methods may have dissimilar effects on the microleakage of composite resin. This study was conducted to determine the...
OBJECTVES
Different surface preparation and treatment methods may have dissimilar effects on the microleakage of composite resin. This study was conducted to determine the deproteinizing effect of 10% bromelain enzyme, 10% papain enzyme, CO , and erbium-YAG laser in regard to decrease in the microleakage of composite restorations.
MATERIALS AND METHODS
Thirty teeth were selected and 60 class V cavities were prepared on the lingual and buccal sides. They were divided into six groups (n = 10): Group 1, phosphoric acid gel; Group 2, bromelain enzyme 10%; Group 3, papain enzyme 10%; Group 4, mixed papain and bromelain enzymes 10%; Group 5, CO laser; and Group 6, erbium-YAG laser. They were stored in basic fuchsine and dye penetration was evaluated. Kruskal-Wallis and Mann-Whitney tests were used for statistical analysis, p < 0.05 RESULTS: In both occlusal and gingival margins, comparison of microleakage between groups 1, 2, 3, 4, and 5 showed no significant differences (p = 1) and group 6 had a significant difference with other groups (p ˂ 0.001).
CONCLUSIONS
Microleakage of composite resin in the dentin surface was not affected significantly using either bromelain or papain 10% enzymes or erbium laser. However, CO laser had a negative effect on the enamel and dentin margins and increased the microleakage. Erbium laser showed a better effect than enzymes on microleakage.
Topics: Humans; Erbium; Carbon Dioxide; Papain; Bromelains; Dental Cavity Preparation; Composite Resins; Lasers, Solid-State; Dental Caries
PubMed: 38037462
DOI: 10.1002/cre2.822 -
Photodermatology, Photoimmunology &... Jan 2024Rosacea is a chronic skin disorder characterised by abnormal neurovasculature and inflammation in the central region of the face. The efficacy of pulsed-dye laser and... (Clinical Trial)
Clinical Trial
The effects of long-pulsed alexandrite laser therapy on facial redness and skin microbiota compositions in rosacea: A prospective, multicentre, single-arm clinical trial.
BACKGROUND
Rosacea is a chronic skin disorder characterised by abnormal neurovasculature and inflammation in the central region of the face. The efficacy of pulsed-dye laser and intense pulsed light treatments for rosacea have been demonstrated in several clinical trials. However, there is currently no research on the efficacy of long-pulsed alexandrite laser (LPAL) therapy alone for rosacea-related facial redness and its effect on skin microbiota.
AIM
To evaluate the efficacy of LPAL therapy on facial redness in rosacea and assess changes in skin microbiota composition.
METHODS
Subjects with rosacea (n = 21, mean age: 39.2 ± 11.3 years) were recruited from two medical institutions and received monthly LPAL treatments (Clarity II™, Lutronic Corp.) for 3 months. At each visit, clinical photographs were taken, and erythema was measured using a spectrometer. At the initial and final visits, the Dermatology Life Quality Index (DLQI) and Skin Sensitivity Questionnaire (SSQ) were evaluated. Skin swabs were obtained at the initial and final visit, and facial microbiome composition was analysed using 16S rRNA amplicon sequencing.
RESULTS
After three LPAL treatment sessions, the average facial erythema index, measured using Mexameter® decreased significantly from 360.0 ± 96.7 at baseline to 312.0 ± 94.5 at the final visit (p < .05). The DLQI and SSQ showed significant improvement of symptoms. Skin microbiome diversity and relative abundance were altered significantly, particularly in the genera Clostridium, Lawsonella, Bacteroides, and Lactobacillus.
CONCLUSIONS
LPAL therapy alone showed favourable efficacy for the treatment of facial redness in rosacea, with some impacts on the skin microbiota composition.
Topics: Humans; Adult; Middle Aged; Prospective Studies; Lasers, Solid-State; RNA, Ribosomal, 16S; Rosacea; Erythema; Treatment Outcome
PubMed: 37890996
DOI: 10.1111/phpp.12921 -
Lasers in Medical Science Sep 2023Applications of lasers in phototherapy have been the trend for the last few decades. The photodynamic therapy process normally depends on photosensitizers and laser...
Applications of lasers in phototherapy have been the trend for the last few decades. The photodynamic therapy process normally depends on photosensitizers and laser beams. Through this study, indocyanine green has been used as a photosensitizer, which is normally activated using laser lines between 750 and 805 nm. The activity of the indocyanine green to do fluorescence by other pulsed laser sources has been tested by fluorescence technique, and it has been proven that the laser lines at 810, 940, and 980nm are able to excite the indocyanine green with different extents. The indocyanine green activation has been tested by several laser lines (810, 940, and 980 nm) commonly used as surgical lasers. The generated oxygen has been measured after irradiating the indocyanine green with the different laser lines. A comparison has been made between laser irradiation as a pinpoint and a broad beam. It is found that the wide beam is more effective in activating oxygen production. In the end, it is concluded that lines 810 and 940nm were effective in activating the used dye, while the 980nm activity did not show enough efficiency.
Topics: Reactive Oxygen Species; Indocyanine Green; Photochemotherapy; Photosensitizing Agents; Oxygen; Lasers
PubMed: 37704871
DOI: 10.1007/s10103-023-03876-1 -
Lasers in Surgery and Medicine Apr 2024Port wine birthmark (PWB) is a congenital vascular malformation of the skin. Pulsed dye laser (PDL) is the "gold standard" for the treatment of PWB globally.... (Review)
Review
BACKGROUND
Port wine birthmark (PWB) is a congenital vascular malformation of the skin. Pulsed dye laser (PDL) is the "gold standard" for the treatment of PWB globally. Hematoporphyrin monomethyl ether (HMME or hemoporfin)-mediated photodynamic therapy (HMME-PDT) has emerged as the first choice for PWB treatment, particularly for young children, in many major hospitals in China during the past several decades.
AIM
To evaluate whether HMME-PDT is superior to PDL by comparing the clinical efficacies of both modalities.
METHOD
PubMed records were searched for all relevant studies of PWB treatment using PDL (1988-2023) or HMME-PDT (2007-2023). Patient characteristics and clinical efficacies were extracted. Studies with a quartile percentage clearance or similar scale were included. A mean color clearance index (CI) per study was calculated and compared among groups. An overall CI (C), with data weighted by cohort size, was used to evaluate the final efficacy for each modality.
RESULT
A total of 18 HMME-PDT studies with 3910 patients in China were eligible for inclusion in this analysis. Similarly, 40 PDL studies with 5094 patients from nine different countries were eligible for inclusion in this analysis. Over 58% of patients in the HMME-PDT studies were minors (<18 years old). A significant portion (21.3%) were young children (<3 years old). Similarly, 33.2% of patients in the PDL studies were minors. A small proportion (9.3%) was young children. The overall clearance rates for PDL were slightly, but not significantly, higher than those for HMME-PDT in cohorts with patients of all ages (C, 0.54 vs. 0.48, p = 0.733), subpopulations with only minors (C, 0.54 vs. 0.46, p = 0.714), and young children (C, 0.67 vs. 0.50, p = 0.081). Regrettably, there was a lack of long-term data on follow-up evaluations for efficacy and impact of HMME-PDT on young children in general, and central nervous system development in particular, because their blood-brain barriers have a greater permeability as compared to adults.
CONCLUSION
PDL shows overall albeit insignificantly higher clearance rates than HMME-PDT in patients of all ages; particularly statistical significance is nearly achieved in young children. Collectively, current evidence is insufficient to support HMME-PDT as the first choice of treatment of PWBs in young children given: (1) overall inferior efficacy as compared to PDL; (2) risk of off-target exposure to meningeal vasculature during the procedure; (3) administration of steriods for mitigation of side effects; -and (4) lack of long-term data on the potential impact of HMME on central nervous system development in young children.
Topics: Child; Adult; Humans; Child, Preschool; Adolescent; Photochemotherapy; Hematoporphyrins; Treatment Outcome; Port-Wine Stain; Lasers, Dye; China; Photosensitizing Agents
PubMed: 38506454
DOI: 10.1002/lsm.23779 -
Ophthalmic Surgery, Lasers & Imaging... Nov 2023This study characterizes trends in ophthalmic imaging volume and utilization in the United States among and assesses the potential impact of the COVID-19 pandemic using...
This study characterizes trends in ophthalmic imaging volume and utilization in the United States among and assesses the potential impact of the COVID-19 pandemic using data from the Centers for Medicare and Medicaid Services. Utilization of macular optical coherence tomography (OCT), optic nerve OCT, and fundus photography steadily increased from 2013 to 2020 and was not impacted by the COVID-19 pandemic. At the same time, there was minimal adoption of anterior segment OCT and a decline in the utilization of dye-based angiography. Utilization patterns may be impacted by the advent of new technologies, role of the clinician, and alignment with treatment paradigms. .
Topics: Aged; Humans; United States; Pandemics; Medicare; COVID-19; Tomography, Optical Coherence; Diagnostic Techniques, Ophthalmological
PubMed: 37855832
DOI: 10.3928/23258160-20231011-01