Side effects and complications of variable-pulsed erbium:yttrium-aluminum-garnet laser skin resurfacing: extended experience with 50 patients

Recent advances in technology have provided laser surgeons with new options for cutaneous laser resurfacing. Despite its popularity, there is limited information on the short-term and long-term side effects and complications of variable-pulsed erbium:yttrium-aluminum-garnet (erbium:YAG) laser skin resurfacing. The purpose of this study was to prospectively evaluate postoperative wound healing, side effects, and complications of multiple-pass, variable-pulsed erbium:YAG laser skin resurfacing for facial photodamage, rhytides, and atrophic scarring. Fifty consecutive patients with facial photodamage, rhytides, or atrophic scarring were treated with a variable-pulsed erbium:YAG laser. Side effects and complications relating to postoperative healing, erythema, and pigmentary changes were tabulated. Patients were evaluated at postoperative days 3 through 7 and at 1, 3, 6, and 12 months after laser skin resurfacing. The average time for reepithelialization was 5.1 days. Prolonged erythema (>1 month) was observed in three patients (6 percent). Transient hyperpigmentation occurred in 20 patients (40 percent), with an average duration of 10.4 weeks. No cases of hypopigmentation or scarring were seen. In summary, a variable-pulsed erbium:YAG laser can safely be used for the treatment of facial photodamage, rhytides, and atrophic scarring. Although more postoperative erythema is seen after variable-pulsed erbium:YAG laser treatment than is usually produced with a short-pulsed erbium:YAG system, the side-effect profile and recovery period after variable-pulsed erbium:YAG laser skin resurfacing still are more favorable than after multiple-pass carbon dioxide laser skin resurfacing.     

Nd:YAG激光治疗人工晶体植入术后后囊膜混浊的临床应用

目的：总结Nd：YAG激光治疗人工晶体(intraocular lens,IOL)植入术后后囊膜混浊(posterioc rcapsular opacification,PCO)的疗效和并发症,探讨此类手术临床应用的技巧与适用范围。方法：在不散瞳的条件下,应用Nd：YAG激光切开瞳孔区后囊膜混浊。结果：患者术后视力改善显著,术后并发症有眼压升高、AI晶体损伤、出血及玻璃体疝形成。结论：Nd：YAG激光治疗人工晶体植入术后晶体后囊膜混浊效果显著,严格掌握适应症以及熟练的手术技巧是获得最佳疗效的关键。     

Intraductal laser photocoagulation of the bilateral parotid ducts for reduction of drooling in patients with cerebral palsy

Patients with cerebral palsy who experience drooling are often isolated from social interaction. Surgical treatment is effective in reducing abnormal, profuse drooling in patients who have low cognitive function, but it has a risk of complications. In this study, a new, simple procedure using laser intervention that minimizes surgical complications is described. Forty-eight patients with cerebral palsy and persistent drooling after more than 6 months of conservative treatment were enrolled in this study. An Nd:YAG laser (1064 nm) was used for intraductal laser photocoagulation of the bilateral parotid ducts at 7 to 10 W for 10 seconds. The outcome was evaluated by questionnaire-based, semiquantitative assessments of drooling severity and frequency, collection and measurement of stimulated saliva, and salivary amylase measurement. The entire procedure was completed in 25 to 65 minutes, with a mean duration of 38.4 minutes. Early complications included transient facial swelling in all patients. Swelling persisted for 6 to 37 days (mean, 11 days). One hematoma (2.1 percent of patients), two infections (4.2 percent of patients), and two cystic formations (4.2 percent of patients) also occurred. No obvious xerostomia or visible scar was noted after the procedure. In the final assessment, a significant improvement in drooling severity (p < 0.05) and frequency (p < 0.05) was noted in the majority of cases. Forty patients (83.3 percent) demonstrated remarkable improvement in drooling severity, seven patients (14.6 percent) showed significant improvement, and one patient (2.1 percent), who was also autistic, continued to experience severe drooling after the laser procedure. The decrease in the amount of saliva produced ranged from 20 to 60 percent at 12 weeks after surgery. The decrease in the amount of salivary amylase measured ranged from 4 to 97 percent at 12 weeks after surgery (p < 0.05). In conclusion, the intraductal laser photocoagulation of bilateral parotid ducts is a simple, effective procedure for reducing drooling in patients who have cerebral palsy. This procedure minimizes risks and complications, compared with those associated with conventional surgery.     

Nd：YAG1064nm激光、伊曲康唑治疗轻中度甲真菌病近期疗效分析

目的 观察Nd：YAG1064nm激光治疗机、伊曲康唑治疗甲真菌病的有效性及安全性.方法 选取符合入组条件的患者60例,病甲共125个.将60例患者随机分为A、B两组,A组予以Nd：YAG1064nm激光治疗;B组予以伊曲康唑口服治疗.每组均于第8周、第16周、第24周时随访,随访时予以真菌学评价及临床疗效评价.结果 A组第8周、16周、24周有效率分别为78.9％、52.6％、52.6％,B组第8周、16周、24周有效率分别为80.9％、66.2％、67.6％.A、B两组临床疗效差异无统计学意义（P＞0.05）.结论 激光治疗甲真菌病疗效肯定,且元不良反应.在轻中度甲真菌病患者中,激光治疗和药物治疗有效率差异不大.     

国产Nd:YAP激光组织热损伤效应的比较研究

目的:通过比较1 341 nm Nd:YAP与临床常用激光器脉冲Nd:YAG和连续Nd:YAG对皮肤、肌肉、静脉和肝脏组织的热损伤效应,了解Nd:YAP激光的作用特点,为其临床应用提供实验依据。方法:以大鼠作为实验对象,分为皮肤、肌肉组和静脉、肝脏组。皮肤、肌肉组:Nd:YAP激光、连续和脉冲Nd:YAG选择能量密度1000 J/cm2、2 000 J/cm2,静脉、肝脏组采用Nd:YAP激光和连续Nd:YAG两种激光器,能量密度选择500 J/cm2和1 000 J/cm2,对组织进行非接触式点状照射。照射过程中观察组织变化和损伤直径大小,并于照射后即刻、3天取材做病理切片,光镜下观察病理变化,比较相同能量密度下三种激光器对组织的热损伤和损伤修复情况。结果:皮肤、肌肉组:Nd:YAP激光在1 000 J/cm2条件下对组织的损伤以热凝固效应为主,2 000 J/cm2条件下组织发生明显气化、有一定的切割作用。相同能量密度下,脉冲Nd:YAP激光气化作用较两种Nd:YAG激光显著,而凝固损伤范围较连续Nd:YAG浅,较脉冲Nd:YAG深。肝脏、静脉组:Nd:YAP激光对肝脏的热凝固效应与Nd:YAG激光近似,气化作用明显;Nd:YAP激光对血管及其周围组织的凝固及气化作用均较连续Nd:YAG激光明显。结论:Nd:YAP激光具有良好的凝固与气化作用。     

Combined erbium:YAG laser resurfacing and face lifting

Facial aging occurs secondary to gravity-induced tissue ptosis and photoaging. Combined face lifting and carbon dioxide laser resurfacing provides a comprehensive one-stage approach to facial rejuvenation but is condemned by many plastic surgeons due to the nonspecific thermal effects of the laser and risk of skin necrosis. Newer high-energy erbium:YAG lasers allow precise tissue ablation with minimal thermal effect. In this study, various facial rejuvenation techniques were combined with simultaneous erbium:YAG laser resurfacing to assess results and complications. A total of 257 patients from Florida, Melbourne, Australia, and Tel Aviv, Israel, underwent combined erbium:YAG laser resurfacing and surgical facial rejuvenation. Various face-lift methods were used, including endoscopic, deep plane, and subcutaneous. Simultaneous, full-facial laser resurfacing was performed using a variety of erbium:YAG lasers. It was found that combined laser resurfacing and face lifting was successful in greater than 95 percent of patients with minimal morbidity. Two patients (1 percent) (both heavy smokers) developed small areas of skin necrosis that healed with minor pigment changes. Five patients (2 percent) developed synechia that was treated with no residual effect. Two additional patients (1 percent) developed temporary ectropion. There were no other cases of scarring, infection, or cosmetically obvious hypopigmentation. Although larger studies are necessary, it seems that the lack of thermal injury from the erbium:YAG laser makes it possible to safely perform laser resurfacing with surgical facial rejuvenation in nonsmokers. However, the authors caution that familiarity with the nuances of erbium:YAG laser resurfacing be obtained before performing combined laser resurfacing and face lifting.     

脉冲Nd∶YAG激光在根管预备中的临床应用——与超声根管预备、传统手动根管预备比较

为了观察脉冲Ｎｄ∶ＹＡＧ激光在根管预备（以下简称根备）中的作用,我们用Ｎｄ∶ＹＡＧ激光辅助,对３０颗患牙进行根备,根备后即时根充。并与超声根备后即时根充、传统根备后即时根充比较,结果表明：激光组的术后疼痛反应少于超声组与传统组,远期疗效与超声组相仿,而优于传统组。     

Efficacy and safety of long pulse 1064 and 2940 nm lasers in noninvasive lipolysis and skin tightening

Noninvasive body shaping is becoming a growing demand. The aim of this study was to investigate the efficacy and safety of the combined treatments of 1064 nm Nd:YAG and 2940 nm Er:YAG in noninvasive lipolysis and skin tightening. Ten females were enrolled, and all women's side of the waist or the lower part of the abdomen were treated. In the first step, the 1064 nm Nd:YAG was used. As a second step, the 2940 nm Er:YAG laser was applied. Each woman was treated four times, once every 2 weeks. The effects were determined by comparative photo documentation, waist circumference measurement, two‐dimensional B‐mode ultrasonography and low‐dose native computer tomography (CT), whereas body fat was monitored with bioelectric impedance. The tissue firmness was measured by ultrasound shear wave elastography. Combined laser treatment significantly reduced waist circumference and total body fat. Ultrasonography has revealed that the treatment considerably decreased fat thickness and improved skin stiffness in the treated region. Subcutaneous fat volume, measured by low‐dose CT, displayed a moderate decrease in the waist region. The combined 1064 nm Nd:YAG and 2940 nm Er:YAG laser treatment results in the reduction of fat tissue and tightens the skin as confirmed by objective measurements.      

Nd:YAG激光治疗特殊部位尖锐湿疣的疗效观察

目的：观察Nd：YAG激光治疗位于尿道口、阴道口、肛门及肛周的难治性尖锐湿疣的疗效。方法：将61例特殊部位的尖锐湿疣的患者随机分为实验组（31例）和对照组（30例）,实验组采用Nd：YAG激光机治疗,对照组采用普通CO2激光治疗机,随访半年观察两组的创面愈合情况、治愈率及复发率。结果：采用Nd：YAG激光治疗的实验组一次治愈率为80．64％,高于对照组的一次治愈率56．67％（x^2=4．087,P〈0．05）,但两组的总治愈率无显著性差异（x^2=1．198,P〉0．05）。实验组复发率为22．58％,低于对照组的复发率46．67％。两者有显著性差异（x^2=3．918,P〈0．05）。激光术后第5天实验组的愈合率45．16％高于对照组的愈合率20．00％,两者有显著性差异（x^2=4．380,P〈0．05）;第7天实验组的愈合率为87．09％高于对照组的愈合率60．00％,两者有显著性差别（x^2=4．469,P〈0．05）;第10天实验组的患者全部愈合,愈合率为100％,高于对照组的愈合率83．33％（P=0．024〈0．05）。结论：Nd：YAG激光治疗特殊部位尖锐湿疣效果好,创面愈合快,复发率低。     

Microbiological study and scanning electron microscopic analysis of root canal wall dentin following pumped Diodium Nd:YAG laser irradiation

The capability of Nd:YAG laser in sterilizing root canals and the alterations of dentinal walls induced by laser treatment were investigated. Thirty root canals were infected by P. aeruginosa ATCC 27853 and thirty canals by A. naeslundii CH-12. Within each infection, 4 groups were selected on the basis of the treatment. Among them, 2 test groups (TGs) were treated by Nd:YAG laser at 15 Hz for 15 s, using 2 different settings: 1 Watt/70 Joule and 1.5 Watt/100 Joule, respectively (n = 10 each). The other 2 groups, used as controls (CGs), were: untreated (positive control, n = 5) and sterilized by 5.25% NaClO group (negative control, n = 5). Observations under scanning electron microscope (SEM) and quantitative bacterial counts were performed. These analyses were performed once per group after infections and treatments. Laser treatments significantly reduced the number of both bacteria. SEM investigation showed melting and crystallization of canal dentin over 1.5 W/100 J. Laser irradiation has a bactericidal effect but it does not completely sterilize the root canal as NaClO 5.25% solution does if the goal of treatment is also to avoid alterations of dentinal walls.     

脉冲Nd:YAG激光照射氟斑牙后充填微渗漏的实验研究

目的:观察氟斑牙经脉冲Nd-YAG激光照射后充填微渗漏的发生情况,为相关研究提供参考。方法:选取人体因各种原因而拔除的氟斑牙(重度)30颗,分成A、B两组。A组为Nd:YAG激光消除龋坏组织作为实验组,B组用传统涡轮钻去龋作为对照组。所有牙齿用树脂充填,经冷热循环处理后,再进行微渗漏观察。结果:实验组充填体边缘微渗漏比对照组明显低(P0.01)。结论:脉冲Nd:YAG激光去除氟斑牙坏死组织有助于增强充填物与釉质连接,不增加微渗漏,有助于充填成功。     

Nd:YAG laser radiation alters the proteolytic resistance of the liver tissue proteins in rats]

Small tissue strips were excised from rat liver and exposed to extensive irradiation with Nd:YAG laser followed by homogenization and spectrophotometric detection of 5% TCA-soluble protein fractions (oligopeptides) in both supernatants and 5NKOH-soluble sediments of the irradiated specimens. Trypsin along, or with chemotrypsin was added to the specimens to evaluate their proteolytic resistance during and after incubation for 24 h in the proteinase(s). The results showed that Nd:YAG laser irradiation resulted in significantly more oligopeptides following either schedule of the proteolysis employed in both supernatants and sediments as compared to the unaffected proteolytically tested specimens. At the same time a proteolytically resistant 5% TCA-insoluble fraction was elicited which belonged to proteins and, judging by the parallel ultrastructural data, was located in the cellular membranes. The probable mechanisms of the observed protein modifications, along with some pertinent clinical implications of Nd:YAG laser surgery, are considered.     

MLB-200型Q-开关Nd:YAG激光治疗雀斑67例疗效观察

本文报道使用MLB－200型Q－开关Nd:YAG激光治疗67例雀斑的疗效。选用532nm波长,光斑直径2－3mm,能量密度6－10J/cm^2,脉冲频率2－5次／秒,光斑重叠不超过10％。术后8周进行第二次治疗,第二次治疗后三个月评定疗效。结果,两次治疗后总痊愈率为92．545,无严重副作用产生。     

可调脉宽倍频Nd:YAG激光干预兔耳增生性瘢痕的实验研究

目的:探讨可调脉宽倍频Nd:YAG激光对兔耳增生性瘢痕的治疗作用.方法:制作兔耳增生性瘢痕模型,术后30天对兔耳增生性瘢痕进行可调脉宽倍频Nd:YAG激光干预,观察兔耳瘢痕大体形态和组织病理改变,并采用免疫组化的方法检测兔耳瘢痕治疗前后血管内皮生长因子(vascular endothelial growth factor,VEGF)的表达情况.结果:可调脉宽倍频Nd:YAG激光干预后,兔耳增生性瘢痕出现明显的萎缩,免疫组化检查VEGF表达减弱.结论:可调脉宽倍频Nd:YAG激光可能通过损伤瘢痕组织内的微血管促进兔耳增生性瘢痕萎缩,对早期增生性瘢痕具有治疗作用.     

Comprehensive histologic analysis of interstitial lipolysis with the 1444 nm wavelength during a 3-month follow-up

A number of near-infrared wavelengths have been proposed and studied for laser lipolysis, but the histologic evaluation of tissue response to laser lipolysis during long-term follow-up has been lacking. A 1444 nm Nd:YAG laser with better absorption in both fat and water has recently attracted attention. The present study was designed to investigate the comprehensive histopathology of 1444 nm Nd:YAG laser-assisted lipolysis at different energy levels during a 3-month follow-up. Laser lipolysis was performed on porcine fat tissue in vivo using a 1444 nm Nd:YAG laser (AccuSculpt?, Lutronic Corporation, Ilsan, Republic of Korea) and the total energies delivered interstitially to 10x10 cm2 areas were 750 J, 1500 J, 2250 J, 3000 J, 3750 J, 4500 J, and 5250 J. Biopsy samples were taken and histologically analyzed immediately after biopsy and at 1, 2, 4, and 12 weeks postoperatively. With a fluence setting above 3000J/100 cm2, inflammation was severe and remained by the 3-month follow-up, resulting in severe scarring of the fat tissue. Below this energy level, mild lobular inflammation in the early phase biopsy had resolved with no scarring by the 3-month follow-up. No histologic changes in the epidermis or dermal connective tissue were present. This study suggested that controlling the energy level is important for clinical applications of laser lipolysis with no significant complications.     

Bactericidal action of high-power Nd:YAG laser light on Escherichia coli in saline suspension

Infra-red light (1064 nm) from a high-power Nd:YAG laser caused more than 90% loss of viability of Escherichia coli during exposures that raised the temperature of PBS suspensions of the bacteria to 50 C in a thermocouple-equipped cuvette. In contrast, there was minimal loss of viability after heating the same suspensions to 50 degrees C in a water-bath, or in a PCR thermal cycler. The mechanism of laser killing at 50 degrees C was explored by differential scanning calorimetry, by laser treatment of transparent and turbid bacterial suspensions, and by optical absorbency studies of E. coli suspensions at 1064 nm. Taken together, the data suggested that the bactericidal action of Nd:YAG laser light at 50 degrees C was due partly to thermal heating and partly to an additional, as yet undefined, mechanism. Scanning electron microscopy revealed localized areas of surface damage on laser-exposed E. coli cells.     

Vitreous Humor Rheology After Nd:YAG Laser Photo Disruption

This work aimed to consider the hazardous side effect of eye floaters treatment with Q-switched Nd:YAG laser on the protein and viscoelastic properties of the vitreous humor, and evaluate the protective role of vitamin C against laser photo disruption. Five groups of New Zealand rabbits were divided as follows: control group for (n = 3) without any treatment, the second group (n = 9) treated with Q-switched Nd:YAG laser energy of 5 mJ × 100 pulse delivered to the anterior, middle, and posterior vitreous, respectively (n = 3 for each). The third group (n = 9) received a daily dose of 25 mg/kg body weight vitamin C for 2 weeks, and then treated with laser as the previous group. The fourth group (n = 9) treated with 10 mJ × 50 pulse delivered to the anterior, middle, and posterior vitreous, respectively (n = 3 rabbits each). The fifth group (n = 9) received a daily dose of 25 mg/kg body weight vitamin C for 2 weeks, and then treated with laser as the previous group. After 2 weeks of laser treatment, the protein content, refractive index (RI), and the rheological properties of vitreous humor, such as consistency, shear stress, and viscosity, were determined. The results showed that, the anterior vitreous group exposed to of 5 mJ × 100 pulse and/or supplemented with vitamin C, showed no obvious change. Furthermore, all other treated groups especially for mid-vitreous and posterior vitreous humor showed increase in the protein content, RI and the viscosity of vitreous humor. The flow index remained below unity indicating the non-Newtonian behavior of the vitreous humor. Application of Q-switched Nd:YAG laser should be restricted to the anterior vitreous humor to prevent the deleterious effect of laser on the gel state of the vitreous humor.     

Pulmonary Complications of Drug Abuse

Complications resulting from drug abuse more frequently affect the lung than any other organ. The spectrum of pulmonary complications associated with drug abuse is wide. The current practice of using mixtures of drugs is mainly responsible for the increase in pulmonary complications. The chief complications observed in a series of 241 drug abuse patients were aspiration pneumonitis (12.9 percent), pulmonary edema (10.0 percent), and pneumonia (7.5 percent).     

脱落酸高产菌的激光诱变效应研究

本实验对比紫外、 Ｈｅ Ｎｅ 激光、 Ｎｄ： Ｙ Ａ Ｇ 倍频脉冲激光对脱落酸产生菌的诱变效果。紫外诱变正变率为 ３８４％ ,负变率 ７６９％ ; Ｈｅ Ｎｅ 激光诱变正变率为 ５６％ ; Ｎｄ： Ｙ Ａ Ｇ 倍频脉冲激光诱变正变率为１９６％ 。 Ｎｄ： Ｙ Ａ Ｇ 倍频脉冲激光诱变辐照次数在 ４００ 次时效果较好,所得高产株效价提高率可达 ６０％ 以上     

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.