光敏剂特性影响光动力治疗鲜红斑痣的数学仿真研究

目的：通过建立光动力治疗鲜红斑痣中激光、光敏剂、氧的分布及其相互作用关系的数学模型,对表皮、真皮、血管中单线态氧的产生过程进行仿真,了解光敏剂的药代动力学和扩散特性对单线态氧产生的影响,进而了解光敏剂特性在光动力治疗鲜红斑痣中的作用和意义。方法：用’Monte Carlo方法描述光在组织中的分布;用药代动力学描述光敏剂在血管中的变化规律;用Fick定律描述光敏剂和氧在组织中的扩散和分布;用与氧含量有关的二级动力学描述光敏剂的漂白;用Lambert—Beer定律和单线态氧的量子产率来计算各层组织中单线态氧的产生。结果：光敏剂药代动力学的变化,使注射光敏剂后开始照光的时间对各层组织中单线态氧产量有明显的影响。光敏剂扩散特性的改变,对真皮和表皮中单线态氧的产生有较大影响,对血管中单线态氧的产生没有影响。结论：光敏剂的特性对光动力治疗鲜红斑痣有明显的影响,数学仿真能较全面地反应这种作用的特点和意义。     

基于病灶图像特征提取的光动力治疗方案

识别和分析病灶区域是光动力治疗的一个重要环节。以鲜红斑痣疾病为例,光动力治疗是利用光、光敏剂和分子氧对病变细胞进行强烈的光动力作用,让活性氧杀死病变细胞,最终达到治疗疾病的目的。传统的治疗方案存在病灶区域无法精确诊断、无法精准治疗和总体治疗成本较高等问题。本研究方案设计了一款用于照射治疗鲜红斑痣的窄光谱LED光源,根据病灶特征计算病灶区域分布与病灶程度,最后根据计算结果制作非均匀透射密度的胶片,用于精准调控治疗光源强度。试验结果显示,图像特征提取技术、设计的光源和胶片能够解决光动力治疗中无法精确诊断、无法精准治疗和治疗光源均匀性等问题,在试验描述的鲜红斑痣治疗方面具有广阔的应用前景。     

评估光动力血管损伤的光学监测技术

血管靶向光动力疗法(Vascular targeted photodynamic therapy,V-PDT)已成为临床治疗鲜红斑痣和老年黄斑变性等血管性疾病的重要方法。V-PDT通过主动或被动血管靶向的作用机制诱发系列生物响应以封闭病变血管。本文评述了V-PDT的作用机制和血管生物学响应,重点讨论了用于评估V-PDT中血管损伤的光谱与成像技术,并分析了这些技术的优点和局限性。最后展望了用于评估V-PDT血管损伤的光学技术发展及其应用前景。     

PhotoDerm治疗鲜红斑痣的临床疗效分析

目的：探讨PhotoDerm治疗鲜红斑痣的疗效。方法：成人鲜红斑痣108例,选用PhotoDerm能量密度38J/cm^2-42J/cm^2,滤光片570mm-590mm,儿童鲜红斑痣160例,photoDerm能量密度28J/cm^2-38J/cm^2,滤光片570mm,回顾分析影响疗效因素,并探讨预防副作用的措施。结果：年龄小、粉红型、面积小,发生于颈部疗效显著。结论：PhotoDerm治疗鲜红斑痣,疗效可靠,并发症少,是一种鲜红斑痣最佳治疗办法。     

强脉冲光光子美容技术的回顾与进展

强脉冲光(intense pulsed light,WL)是一种高强度的,多光谱的,非相干的光源,它的波长范围在500nm～1200nm,这些特性使强脉冲光在以皮肤组织对不同波长的光具有选择性吸收并产生光热解效应的原理为基础的无损伤性皮肤美容治疗中具有较广泛的应用。同时,与传统的治疗皮肤光损伤与光老化的方法比较,强脉冲光光子美容技术具有治疗效果好以及病人恢复时问较快等优点。文中回顾了强光光子嫩肤技术的产生及近年来的研究进展,说明强脉冲光光子美容技术是一种新颖的、有效的、非损伤性的治疗皮肤光损伤、光老化的方法,具有良好的美容医疗应用前景。     

蒙特卡罗模拟多束光辐照下生物组织中的光吸收分布

用蒙特卡罗方法模拟了均匀分布光和高斯分布光在生物组织内的传播。通过比较单束以及多束均匀分布光和高斯分布光照射下组织内的光子能量分布规律,分析了不同光源和光斑大小对光吸收分布的影响。结果表明:与均匀光束比较,高斯光束辐照时,激光能量较为集中,但侧向传播范围较窄。在总功率相同的情况下,使用单束大功率宽光源与多束功率较小的小光斑光源均能明显地增大光的侧向传播距离,但使用多束功率较小的小光斑光辐照时生物组织中的最大光吸收率增大。多束组合光源光束间距对光吸收分布影响很大。     

新型强脉冲光治疗雀斑临床疗效观察

目的:观察新型强脉冲光治疗雀斑的疗效。方法:采用飞顿辉煌激光360嫩肤系统(以色列飞顿公司),波长570～950nm,光斑面积10mm×30mm,脉宽10、12、15ms,能量14～19J/cm~2。治疗40例雀斑患者,每三周一次,共治疗5次,末次治疗后评价患者雀斑的疗效。结查:40例患者经过治疗后,18例(45%)基本完全消退,14例(35%)明显消退,8例(20%)好转,总有效率为100%。所有患者面部治疗区域皮肤质地较以前更光滑、细腻,无严重不良反应出现。结论:采用新型强脉冲光治疗雀斑疗效显著、安全,副作用少。     

水稻群体冠层光分布及光合作用模型

作物冠层光分布及光合作用模型,是作物栽培学、作物育种学研究的共同基础,对优化设计和评价作物株型、模拟作物生长发育与对环境变化的响应研究都有十分重要的价值.本文根据水稻群体冠层结构的特点,在虚拟切层法的基础上,建立了水稻群体冠层光分布及光合速率模型,模型包括冠层形态子模型、冠层光分布子模型和冠层光合速率子模型等.利用本模型,对设定的15625种水稻株型的光合速率进行了模拟计算,获得水稻最佳株型模型.结果表明,水稻群体光合速率与叶片数、叶含氮量、叶长、叶宽和叶倾角等5因素密切相关;最佳株型的上述5因素在冠层上部取值大,向下逐渐变小.     

肿瘤血管新生的数值模拟

利用Overture开发肿瘤血管新生模型的计算程序,使用有限差分法模拟肿瘤血管新生过程中,血管内皮细胞在细胞间基质中的增生和迁徙,阐明了血管内皮生长因子和血管新生因子的调节机制.针对三种调节因子的不同组合下的模型进行数值模拟,对比说明三种因子在肿瘤血管新生中的不同作用.模型计算结果与病理学现象实验一致.     

基于光谱编码的血管内光声组分成像

光声成像突破了传统的光学成像和超声成像在生物组织成像领域的困境,该技术基于光声(Photoacoustic,PA)效应,脉冲激光激励下的生物组织产生超声信号,超声信号被接收后,通过反投影算法将其携带的时间信息和强度信息转化为能够反映生物组织吸收结构和分布的可视化图像。基于不同生物组织的光吸收差异,当激发光强度均匀且稳定时,光声成像反映的就是该物质对于该波长光的吸收特性。本文中,我们基于导管式的血管内光声断层扫描平台结合多波长激发的光声成像算法开发了基于光谱编码的血管内光声组分成像系统,实现了在离体血管斑块中脂质组分的定量成像,高分辨获得了脂质核心的大小形态和边界信息,表征了斑块内的脂质相对含量。     

Thermography as a predictive tool for laser treatment of port-wine stains

The argon laser, which has been proven both useful and safe for port-wine stain therapy, interacts with the hemoglobin of the vessels. In a percentage of cases, this treatment is still inefficient, and there is a lack of correlation between these bad results and clinical or histologic criteria. Thermography, which explores the vascularization of the port-wine stain, leads us to consider port-wine stains from a physical point of view. This very simple test shows no correlation with the clinical parameters of port-wine stain but is closely related to the results obtained with laser therapy. It seems to be a good criterion to estimate the argon laser treatment prognosis.     

Evaluation of argon laser surgery in children under 13 years of age

Argon laser surgery is an effective treatment for ectasias and congenital port-wine stains; however, its use in children under the age of 13 is controversial. This paper reviews 202 children under the age of 13 who underwent argon laser treatments for congenital port-wine stains, spider angiomas, epidermal nevi, and lentigines. The clinical characteristics of port-wine stains in 170 children are discussed. Good to excellent results (moderate to complete clearing) in port-wine stains were obtained in 60 percent of patients and seemed to correlate best with lack of blanchability on pressure. Hypertrophic scarring was seen in only 7 children, all of whom had undressed wounds; no significant scarring has been seen in any subsequent child who had maintained a dressed wound postoperatively.     

Objective evaluation of treatment effects on port-wine stains using L*a*b* color coordinates

Wide variations in port-wine stains and their responses to various therapies pose a need for the development of an objective method to evaluate the effects of treatment. Several techniques such as laser Doppler, reflectance spectrometry, and tristimulus colorimetry have been used to evaluate the color of port-wine stains, but these techniques are limited by cost, small test size area, and other factors. Therefore, we developed a simple and cost-effective method of evaluating treatment results on port-wine stains using the L*a*b* color coordinate system in combination with a personal computer. For 22 patients with port-wine stains, the slide photographs were digitized using a slide scanner. L*a*b* color differences of the normal control and port-wine stain sites were obtained before and after treatment, and treatment effect (percent) was calculated. By calculating each color difference between the lesion and normal skin both before and after treatment, problems arising from different illuminating conditions during photography were minimized. The results were compared with the visual evaluation conducted by three experienced plastic surgeons. The treatment effects analyzed by L*a*b* color coordinate ranged from 4 to 95 percent, with a mean of 48.1 percent, whereas treatment effects evaluated by the plastic surgeons ranged from 15 to 92 percent, with a mean of 51.1 percent. The subjective clinical grades correlated well with the treatment effects obtained by the proposed color analysis system (correlation coefficient, 0.89). The maximum difference in the effect of treatment for a patient evaluated by the three clinicians was up to 60 percent, which means that visual judgment is very subjective and variable. The color analysis system proposed as a result of this study is very easy, objective, quantitative, cost-effective, and can be useful for the evaluation of treatment effects on colored skin lesions such as port-wine stains.     

585 nm for the treatment of port-wine stains

Although the flashlamp-pulsed-dye laser has been successfully used for the treatment of port-wine stains (PWS) at 577 nm, a number of adult patients had incomplete clearance of their birthmarks with this treatment modality because of residual vessels lying beyond the 0.75-mm penetration depth of 577-nm irradiation. Fifteen adult patients, of whom nine were previously treated with limited success at 577 nm (group A), and six untreated patients (group B) were included in the study. For the group A patients, treatment with 585 nm produced successful clearance of the birthmark. For the six patients in group B, parallel treatment of different sites of the same lesion coupled with skin biopsies and histologic examination revealed that a change in the wavelength from 577 to 585 nm allowed the laser light to penetrate from the midreticular dermis into the subcutaneous fat. This explained the clearance achieved at 585 nm and not at 577 nm.     

Preliminary study of the vascular dynamics of port-wine hemangioma with therapeutic implications for argon laser treatment

The vascular dynamics of port-wine hemangioma have been studied in several ways in order to better understand blood flow factors. Utilizing a laser Doppler velocimeter, differential perfusion/blood flow was studied and contrasted to normal skin, compared to heat and cold challenges, and finally measured in relationship to argon laser treatment. Results indicate that port-wine hemangiomas do not necessarily have different perfusion than normal skin but respond less vigorously to heat challenges. Cooling showed no uniform response by port-wine hemangioma vessels, while injection with Xylocaine plus epinephrine resulted in a markedly decreased perfusion and vasoconstriction contrary to previously held theories. Argon laser treatment did not uniformly alter laser Doppler perfusion to a predictable degree. Laser Doppler velocimeter flow studies were not able to predict future good versus bad results of laser treatment.     

Treatment of poikiloderma of Civatte on the neck with an intense pulsed light source

Effective treatment of poikiloderma of Civatte is difficult. The ideal treatment combines elimination of both the vascular and pigmented components simultaneously. Treatment with a broad-spectrum noncoherent intense pulsed light source delivers multiple wavelengths with software-controlled pulse durations and sequencing that permit treatment of both vascular and pigmented lesions simultaneously. The objective of this study was to determine the response and side effects of treating this condition with intense pulsed light. In the study, 66 patients with typical changes of poikiloderma of Civatte on the neck were treated with intense pulsed light at various settings every 4 weeks until the desired improvement occurred. A 50 to 75 percent improvement in the extent of telangiectasias and hyperpigmentation was observed after an average of 2.8 treatments. The incidence of hypopigmentation was 5 percent. It was concluded that intense pulsed light is an effective mode of therapy for poikiloderma of Civatte. It seems to offer a reduction in both pigmentation and telangiectasia-associated erythema, with minimal side effects.     

Argon laser therapy of port-wine stains: effects and limitations

One hundred and one patients (112 parts) with port-wine stains were treated by argon laser therapy. We strictly evaluated all patients according to color shift, scar formation, and pigmentation. We observed good to excellent results in 44 percent of patients, and less satisfactory results in 56 percent. The relationship between the effects of treatment and several factors, such as patients' age, anatomic site, and histologic type of the lesions, were investigated. More satisfactory results tended to be obtained in patients with neck lesions and with histologic type III lesions (dilated type). To date we have not discerned any definite criteria for precisely predicting the response of port-wine stains to argon laser therapy. Consequently, the performance of a test seems to us to be the best way of discovering the response and course of healing of an individual port-wine stain after laser therapy. Thirty-six consecutive patients were studied to determine whether compression and cooling would improve the outcome of argon laser therapy. The use of this method did not produce any noticeable effects.     

Argon laser treatment of port-wine stains: the patients' evaluations of the result.

The argon laser is now a well-established method of treating port-wine stains (PWS) in the face and neck areas. Satisfactory results are reported in 44 to 75 percent of cases, but criteria for that classification and the patients' perceptions of the result are seldom given. In the present paper, a sample of 58 patients was used to assess the patients' own perceptions of the degree of lightening and scarring. Three felt the results were excellent, 23 good, 18 fair, and 14 poor. The treatment was considered as unpleasant by 76 percent, and 55 percent of the patients asked for a new consultation. Scarring was noticed by 50 percent. The patients' perceptions of the results and physicians' rating were the same in 69 percent. The best results were obtained in older patients with small port-wine stains. Such lesions also can be treated surgically with good results.     

Demonstration of the Microvasculature of the Spinal Cord by Intravenous Injection of the Fluorescent Dye, Thioflavine S

In the past, thioflavine S has been used for visualizing blood vessels and patterns of blood flow (Schlegel 1949; Schlegel and Moses 1950; Oliver et al. 1951). Methods employed have involved an intravenous injection of the dye, immersion of hand-cut sections in glycerol and examination of sections under incident Wood's light. With improved techniques it is possible to obtain microtome-cut sections and to use a more intense light source for enhancing fluorescence and resulting visualization of small vessels. Occlusion of arterioles by undissolved dye particles is prevented by ultracentrifugation of the solution to be injected.