Treatment of Raynaud's phenomenon with ketanserin in patients with connective tissue disorders.

The serotonin receptor blocker ketanserin was given orally in a double blind crossover study to 10 patients with connective tissue disorders and Raynaud''s phenomenon. Eight of the 10 patients improved clinically on ketanserin and none on placebo. Digital blood flow was assessed with laser Doppler flowmetry (LDF), photoplethysmography, and skin temperature measurements. Laser Doppler flowmetry was the most useful method, showing a significant reduction in recovery time after a standard cold provocation. Although the resting flow was not significantly improved, digital ulcers healed in four out of five patients, providing evidence of increased nutritive flow. The results of this study suggest that orally administered ketanserin may be an effective and well tolerated treatment for Raynaud''s phenomenon associated with connective tissue disorders, especially scleroderma.     

Capillary blood perfusion during postischemic reperfusion in striated muscle.

Monitoring of nutritive blood flow in muscle is of particular importance to reconstructive surgeons, since ischemia/reperfusion in striated muscle is known to result in postischemic microvascular perfusion failure. Laser Doppler flowmetry has recently been introduced as an easy-to-use, noninvasive technique for continuous monitoring of microvascular tissue perfusion. Despite its popularity, there exists a great deal of controversy as to what actually generates the laser Doppler signal recorded from a given tissue. Intravital microscopy is a technique for direct visualization of the nutritional circulation in tissue. By using intravital microscopy, direct measurements of blood perfusion in individual segments of the nutritional microcirculation can be made. In 22 Syrian golden hamsters we performed laser Doppler flowmetry and intravital microscopy measurements in muscle tissue prior to and during reperfusion after 4 hours of tourniquet ischemia using the dorsal skinfold chamber model. Intravital microscopy (n = 10) revealed a heterogeneous capillary perfusion during the early reperfusion phase with a decrease (p less than 0.01) in functional capillary density to 49.4 +/- 17.0 percent of control. No recovery was observed after 24 hours of reperfusion. Laser Doppler flowmetry (n = 12) showed a parallel reduction of capillary red blood cell flux during the early perfusion phase to 43.9 +/- 22.6 percent of control values (p less than 0.01), and no recovery was observed after 24 hours of reperfusion. However, the laser Doppler flowmetry technique was not able to detect the capillary perfusion inhomogeneities shown by intravital microscopy. Postischemic reperfusion in striated muscle is characterized by a decrease in functional capillary density and a heterogeneous capillary perfusion. Laser Doppler flowmetry is a useful tool for monitoring microvascular tissue perfusion, although in striated muscle of the hamster it must be considered that accurate nutritional "capillary" flow readings can be grossly overestimated if larger vessels, such as arterioles and collecting venules, are contained in the measuring field of the laser Doppler probe.     

Measurement of mucosal blood flow in the canine intestine with laser doppler velocimetry

Laser Doppler velocimetry is a technique for continuous estimation of changing blood flow in the surface of a tissue and does not require invasion of the circulation. This technique is based upon the Doppler principle that a shift in the frequency of an electromagnetic wave emitted or reflected from a moving object is proportional to the velocity of the object. The capacity of Laser Doppler velocimetry to estimate changes in intestinal mucosal blood flow was tested in a canine free flow preparation. In anesthetized dogs in which a segment of ileum was isolated, simultaneous measurements of instantaneous changes in total blood flow (measured with the electromagnetic blood flow meter) and instantaneous changes in presumed mucosal blood flow (using laser Doppler velocimetry) were obtained. Determinations were made during conditions of rest, prostacyclin induced vasodilation and norepinephrine induced vasoconstriction. Changes in laser Doppler velocimeter readings were qualitatively similar to and temporally related to changes in total blood flow to the gut segment during administration of the vasoactive drugs. The magnitude and direction of changes with the two measurements were significantly correlated. Stabilizing the laser probe on the mucosal surface to ensure reproducible readings proved technically difficult. Pharmacologically induced changes in laser Doppler velocimeter estimated changes in flow were more readily correlated with changes in electromagnetic flow meter readings than were control values obtained with the two methods.     

Reaction of the skin microvessels to a change in blood flow to the extremities based on data from photoplethysmography and laser Doppler fluxmetry

A comparative study of the non-invasive methods of photoplethysmography and laser Doppler fluxmetry in the assessment of dermal vascular responses of the forearm has been made. Vasoconstrictive and vasodilatation responses on intracutaneous introduction of noradrenaline in a dose of 10(-6) g have been quantitatively assessed. Correlation volumes of vascular responses in the use of these methods have been obtained.     

Effect of hyperbaric oxygen and medicinal leeching on survival of axial skin flaps subjected to total venous occlusion

This study evaluates the effect of hyperbaric oxygen and medicinal leeching on axial skin flaps subjected to total venous occlusion. Axial epigastric skin flaps (3 x 6 cm) were elevated on their vascular pedicles in 40 male Wistar rats. Total venous occlusion was achieved by division of all veins draining the skin flap. Arterial inflow was left intact. Animals were randomly assigned to one of five groups: sham (n = 8); control, total venous occlusion only (n = 8); occlusion with hyperbaric oxygen (n = 8); occlusion with leeching (n = 8); occlusion with leeching and hyperbaric oxygen (n = 8). The hyperbaric oxygen protocol consisted of 90-minute treatments, twice daily, with 100% O2 at 2.5 atmospheres absolute for 4 days. The leeching protocol consisted of placing medicinal leeches on the congested flaps for 15 minutes, once daily, for 4 days. Laser Doppler measurements of flap perfusion were recorded preoperatively, postoperatively, and on postoperative days 1 and 3. The percentage of flap necrosis was evaluated on postoperative day 3. Mean percentage necrosis and mean laser Doppler readings were compared between both groups. The flaps in the sham group demonstrated 99 percent survival, whereas the flaps in the occlusion-only group demonstrated 100 percent necrosis. The flaps in the occlusion with oxygen, the occlusion with leeching, and the occlusion with oxygen and leeching groups demonstrated 1, 25, and 67 percent survival, respectively. Sham laser Doppler readings remained within normal limits. Laser Doppler readings in the occlusion-only and the occlusion with oxygen groups decreased to negligible levels on postoperative day 1, and on postoperative day 3 no perfusion was demonstrated. In both the occlusion with leeching and the occlusion with leeching and oxygen groups, there was also a significant decrease in laser Doppler measurements after surgery, but perfusion remained stable throughout the remainder of the study. This study demonstrates that hyperbaric oxygen alone is not an effective treatment for skin flaps compromised by total venous occlusion. The combination of leeching and hyperbaric oxygen treatment of total venous occlusion results in a significant increase in flap survival above that found with leeching alone. It appears that hyperbaric oxygen is effective because of the venous outflow provided by leeching as demonstrated by laser Doppler flow readings.     

Decreased cutaneous sensory axon-reflex vasodilatation below the lesion in patients with complete spinal cord injury

The histamine-induced skin flare response has been considered of practical value in determining the level of a spinal cord lesion, but clinical observations have varied widely with regard to the nature and degree of change below the lesion. We have quantified cutaneous sensory axon-reflex vasodilatation in patients with complete spinal cord injury (SCI) above and below the lesion, and compared the findings with normal subjects. Axon-reflex vasodilatation was induced by intradermal histamine injection, and measured by (a) laser Doppler fluxmetry and (b) tracing the surface area of the flare. Axon-reflex vasodilatation was present in all SCI patients above and below the lesion, but was significantly diminished below the lesion by both measures (pflux rise = 0.0008; pflare = 0.023), and in comparison with controls (by 39%). The flux increase was significantly correlated with the area of flare (r = 0.82; p = 0.02). Axon-reflex vasodilatation and visual analogue scale (VAS) pain scores on histamine injection were not significantly different above the lesion in SCI patients from controls. Baseline laser Doppler flux was not different at any test site in SCI and normal subjects. The cutaneous sensory axon-reflex is thus significantly diminished in SCI patients below the level of the lesion, but the underlying mechanism is unclear. A possible explanation under investigation is that increased basal or reflex sympathetic vasoconstriction mediated via the isolated spinal cord may counteract the vasodilatation produced by the cutaneous sensory terminals.     

激光联合氨甲环酸、谷胱甘肽及维生素C 治疗黄褐斑的临床观察

目的：探讨黄褐斑应用激光联合氨甲环酸、谷胱甘肽及维生素C 治疗的临床效果。方法：选择2012 年6 月~2014 年6 月期 间我院皮肤科门诊收治的黄褐斑女性患者117 例,根据随机数字表将其平均分为三组,即激光组、药物组、联合治疗组各39 例。 激光组单纯应用激光治疗,药物组应用氨甲环酸、谷胱甘肽及维生素C治疗,联合治疗组应用激光联合氨甲环酸、谷胱甘肽及维 生素C 治疗。对比三组治疗前后黄褐斑面积及黄褐斑颜色评分、临床疗效及治疗后不良反应。结果：联合组治疗后黄褐斑面积及 黄褐斑颜色评分显著低于激光组、药物组及治疗前（P<0.05）。联合组治疗的总有效率显著高于激光组及药物组（P<0.05）。药物组 不良反应发生率为2.56%,其他两组未见明显不良反应。结论：激光联合氨甲环酸、谷胱甘肽及维生素C 治疗黄褐斑的疗效确切, 可以有效改善黄褐斑面积及颜色,安全性佳,适于临床应用。     

健康体检人群甲状腺结节多普勒超声检查结果及影响因素分析

目的:研究健康体检人群甲状腺结节多普勒超声检查结果及影响因素。方法:将从2018年1月~2019年12月,于医院接受体检的健康体检人员5270例纳入研究,对所有受试者均进行多普勒超声检查,分析超声检查结果和体检人群基线资料的关系,分析甲状腺结节多普勒超声特征。采用单因素以及多因素Logistic回归分析健康体检人群甲状腺结节的影响因素。结果:在5270例健康体检人群中,甲状腺结节检出率为51.86%(2733/5270),女性甲状腺结节检出率为52.83%(2355/4458),高于男性的46.55%(378/812),且随着年龄的不断增长,健康体检人群甲状腺结节检出率呈逐渐升高趋势(均P<0.05)。甲状腺结节患者的多普勒超声检查特征以低回声以及结节直径<2 cm为主(均P<0.05),但是结节数目以及病变部位比较无明显差异(均P>0.05)。经单因素分析发现:吸烟、甲状腺疾病家族史、高血压及糖尿病的健康体检人员甲状腺结节检出率高于不吸烟、无甲状腺疾病家族史、无高血压及无糖尿病的健康体检人员(均P<0.05),而不同民族、受教育年限、体质量指数(BMI)、是否饮酒的健康体检人员甲状腺结节检出率比较无统计学差异(均P>0.05)。经多因素Logistic回归分析发现:女性、年龄、吸烟、甲状腺疾病家族史、高血压及糖尿病均是健康体检人群甲状腺结节发生的独立危险因素(均OR>1,P<0.05)。结论:甲状腺结节多普勒超声检查特征以低回声以及结节直径≤2 cm为主,其影响因素包括年龄、性别、吸烟、甲状腺疾病家族史、高血压及糖尿病,值得临床重点关注。     

Laser blepharoplasty for making double eyelids in Asians

The double-eyelid operation is a cosmetic procedure performed primarily on Asians who have no supratarsal folds. The goal in Oriental blepharoplasty is to ensure a stable double-eyelid fold with predictable and long-lasting results. Candidates for this procedure desire attractive eyelids with a natural-looking fold. Today, the CO2 laser is used as a surgical tool by plastic surgeons, and its use in cosmetic surgery has recently been expanded to blepharoplasties.We used the high-power CO2 laser (UltraPulse; Coherent, Santa Clara, Calif.) in the double-eyelid operation. Between September of 1995 and September of 1999, a total of 241 patients underwent laser double-eyelid operations at Korea University Medical Center and Dr. Choi's Aesthetic Clinic, with an average follow-up of 18 months.By using the CO2 laser, we could create a stable double-eyelid fold with long-lasting results. The rate of fold release was 2 percent, which was less than the rate using the conventional scalpel incision method. The CO2 laser contributed to a reduction in pain or discomfort after the operation; therefore, patient comfort and early recovery could be enhanced after double-eyelid surgery. In the healing of the incision line, it showed mild redness for 3 weeks, but long-term follow-up showed the scar produced by the laser appeared to be equal in quality compared with the conventional method. Laser blepharoplasty is a useful and effective method to create a stable and attractive double eyelid for Asian patients.     

Optical incoherent technique for noninvasive assessment of blood flow in tissues: Theoretical model and experimental study

Laser noninvasive methods for assessment of a tissue blood flow (BF), for example, the Laser Doppler Flowmetry (LDF), are well-known today. However, in such methods, low-frequency fluctuations (LFFs) in the registered optical signal caused by blood volume changes inside a tissue have not been studied in details until now. The aim of this study is to investigate the LFFs formation and to justify the LFFs-based diagnostic technique for cutaneous BF assessment. LFFs are theoretically described and experimentally shown in the input LDF signal inside the frequency range 0 to 10 Hz. They are substantiated as the basis of the new diagnostic method, in which BF is defined as the magnitude of blood volume changes in a tissue per unit time. The hand-made prototype of the promising diagnostic tool with light emitted diodes is used to validate the technique in experiments in vivo on 16 healthy volunteers in comparison with the LDF method. Experimental results show a good similarity of the recorded BF for both coherent and incoherent method. The proposed technique makes it possible the creation of inexpensive diagnostic equipment for assessment of cutaneous BF without using lasers and coherent light, completely and functionally comparable to LDF devices.     

Biophysical mechanisms of transient optical stimulation of peripheral nerve

A new method for in vivo neural activation using low-intensity, pulsed infrared light exhibits advantages over standard electrical means by providing contact-free, spatially selective, artifact-free stimulation. Here we investigate the biophysical mechanism underlying this phenomenon by careful examination of possible photobiological effects after absorption-driven light-tissue interaction. The rat sciatic nerve preparation was stimulated in vivo with a Holmium:yttrium aluminum garnet laser (2.12 microm), free electron laser (2.1 microm), alexandrite laser (750 nm), and prototype solid-state laser nerve stimulator (1.87 microm). We systematically determined relative contributions from a list of plausible interaction types resulting in optical stimulation, including thermal, pressure, electric field, and photochemical effects. Collectively, the results support our hypothesis that direct neural activation with pulsed laser light is induced by a thermal transient. We then present data that characterize and quantify the spatial and temporal nature of this required temperature rise, including a measured surface temperature change required for stimulation of the peripheral nerve (6 degrees C-10 degrees C). This interaction is a photothermal effect from moderate, transient tissue heating, a temporally and spatially mediated temperature gradient at the axon level (3.8 degrees C-6.4 degrees C), resulting in direct or indirect activation of transmembrane ion channels causing action potential generation.     

Potentialities of spiral computed tomography in the diagnosis and treatment of traumatic injuries of the midface

The paper summarizes the results of examination of 169 patients referred to the surgeon in the period from 1 till 47 days after medial facial (MF) trauma by using spiral computed tomography (SCT) and the method of laser stereolitography (LSLG). The actual aspects of diagnosis and treatment are marked; the methods for the analysis of injuries of soft tissue structures and adjacent areas while orbit trauma are developed together with the methods for determination of degree of enophthalmos. Also discussed are the possibilities of SCT and LSLG in visualization of MF injuries and planning patient treatment.     

Latex immunoagglutination assay for a vasculitis marker in a microfluidic device using static light scattering detection

We have developed a microfluidic immunoassay device using fiber optics to detect static light scattering (SLS) of latex microsphere agglutination. A 400-mum silica fiber was used to deliver blue light emitting diode (LED) or red laser light sources. A miniature, portable spectrometer was used to measure forward light scattering intensity collected by the same type of multi-mode fiber. To first show feasibility, anti-mouse IgG were used as target biomolecules and highly carboxylated polystyrene latex microspheres (510 nm) coated with mouse IgG were used as probes. Next, we tested for the vasculitis marker, anti-PR3, using the same type of microspheres coated with PR3 proteins. No false negatives or positives were observed. A limit of detection (LOD) of 50 ng mL(-1) was demonstrated for the vasculitis marker, anti-PR3. (Plasma samples from patients with vasculitis exhibited anti-PR3 at a median level of 380 ng mL(-1).) The optical detection system works without any fluorescence or chemiluminescence markers. The entire system proposed here is cost effective, small in size, and re-usable with simple rinsing. This may eventually lead to a portable, low-cost, re-useable, microfluidic, point of care immunoassay device.     

手外伤激光照射康复护理观察研究

目的：探讨激光照射对手外伤患者的康复效果。方法：随机选取87例手外伤患者为观察组,采用激光照射与作业疗法,支具、心理疗法相结合;对照组63例,只采用作业疗法、支具及心理疗法。观测伤部疼痛减轻及消退情况,肿胀消退时间,康复治疗2月进行手功能评定。结果：观察组疼痛消失时间,肿胀消退时间,手功能康复均优于对照组,两组比较,差异均具有显著意义。结论：手外伤术后患者激光照射治疗能明显缩短手康复时间,提高康复质量。     

Laser tissue welding in ophthalmic surgery

Laser welding of ocular tissues is an alternative technique or adjunct to conventional suturing in ophthalmic surgery. It is based on the photothermal interaction of laser light with the main components of the extracellular matrix of connective tissues. The advantages of the welding procedure with respect to standard suturing and stapling are reduced operation times, lesser inflammation, faster healing and increased ability to induce tissue regeneration. The procedure we set up is based on the use of an infrared diode laser in association with the topical application of the chromophore Indocyanine Green. Laser light may be delivered either continuously or in pulses, thus identifying two different techniques that have been applied clinically in various types of transplants of the cornea. (© 2008 WILEY‐VCH Verlag GmbH & Co. KGaA, Weinheim)     

Weak biophoton emission after laser surgery application in soft tissues: Analysis of the optical features

Nowadays, laser scalpels are commonly used in surgery, replacing the traditional surgical scalpels for several applications involving cutting or ablating living biological tissue. Laser scalpels are generally used to concentrate light energy in a very small‐sized area; light energy is then converted in heat by the tissues. In other cases, the fiber glass tip of the laser scalpel is heated to high temperature and used to cut the tissues. Depending on the temperature reached in the irradiated area, different effects are visible in the tissues. In this study, we report the discovery and characterization of the light emitted by soft mammalian biological tissues from seconds to hours after laser surgery application. A laser diode (with hot fiber glass tip) working at 808 nm and commercially available for medical and dentistry applications was used. The irradiated tissues (red meat, chicken breast and fat) showed light emission in the visible range, well detectable with a commercial charge coupled device (CCD) camera. The time decay of the light emission, the laser power effects and the spectral features in the range 500 to 840 nm in the different tissues are here reported.      

Laser Doppler spectroscopy of biological objects

Laser Doppler spectroscopy permits to investigate the velocity distribution of the biological objects either single cells or ensembles. The main principles of laser Doppler spectroscopy and its practical application connected with the spectral correlation dependence of biological objects have been studied.     

Laser Doppler imaging and cryoglobulinemia]

Continuous microcirculation monitoring of the right foot was carried out for the first time in a 62-year-old patient with cryoglobulinaemia prior to, during and after manual needle insertion at Jie Xi(St.41) acupuncture point using a new method of laser Doppler perfusion imaging (PIMII, Lisca AB, Link?ping, Sweden). In addition to visual inspection, changes in mean perfusion were also used as evaluation parameters. Our results suggest that the new biomedical technique of laser Doppler imaging is a useful method for monitoring the effects of acupuncture on the peripheral microcirculation.     

CO2激光、LD激光联合治疗牙龈瘤46例疗效观察

目的：研究CO2激光、LD激光联合治疗牙龈瘤及保存牙体组织的临床疗效。方法：对46例口腔牙龈瘤患者发病的年龄,性别,好发部位进行分析,采用CO2激光、LD激光联合治疗机,先用CO2激光束切割肿瘤,而后CO2激光气化肿瘤波及牙齿的牙周膜,术后第二天用LD激光,每日一次,每次15分钟,连续5天照射手术创面。结果：46列牙龈瘤患者,42例一次治疗痊愈,4例复发,二次手术后无复发,手术疗效、治愈率100％。结论：CO2激光、LD激光联合切除牙龈瘤与传统的手术方法,治疗疗效机理进行了对照,其特点是保存了肿瘤波及的牙齿,不造成组织缺损,还具有手术时间短,出血少,愈合快等优点。     

The role of oxidative stress after retinal laser photocoagulation in nonproliferative diabetic retinopathy

Diabetic retinopathy (DR) represents the most common chronic complication of diabetes, and it is the leading cause of new cases of blindness in patients between 20-74 years old in developed countries. Laser photocoagulation (LF) represents an efficacious approach to the treatment of DR. Oxidative factors, such as free radicals (FR), are continuously generated in aerobic organisms as a result of different metabolic processes. It is well known that oxidative stress plays a role in the development of DR. The aim of this study was to evaluate the thermal effects of the scatter retinal laser photocoagulation technique on the production of FR. A total of 90 patients were enrolled in this study. They were divided in 3 groups: 30 diabetic patients with DR, 30 diabetic patients without DR, and 30 control individuals without diabetes mellitus (DM). Full scatter retinal LF was performed in all patients with DR. We measured the concentrations of superoxide dismutase (SOD), glutathione peroxidase (GPOD), catalase, and total antioxidative status (TAS). Of the 30 DR patients, 13 showed the appearance or worsening of macular edema after LEF, whereas the other 17 patients showed no change. Thirty days after LF, improvement in visual acuity was observed, but this change was not statistically significant. The mean plasma or erythrocyte lysate concentrations of various antioxidants were significantly lower in the diabetic patients without DR compared to the individuals without DM and in the diabetic patients with DR compared to the individuals without DM; the diabetic patients with DR did not show lower concentrations of the antioxidants compared to the diabetic patients without DR. The concentrations of SOD, GPOD, catalase, and TAS were significantly lower in the diabetic patients with DR after retinal scatter LF, which could be the consequence of retinal oxidative stress caused by the LF thermal effect.