Calibration of an orientation sensor for freehand 3D ultrasound and its use in a hybrid acquisition system

Background and Objectives

Liposuction continues to be one of the most popular procedures performed in cosmetic surgery. As the public's demand for body contouring continues, laser lipolysis has been proposed to improve results, minimize risk, optimize patient comfort, and reduce the recovery period. Mathematical modeling of laser lipolysis could provide a better understanding of the laser lipolysis process and could determine the optimal dosage as a function of fat volume to be removed.

Study design/Materials and Methods

An Optical-Thermal-Damage Model was formulated using finite-element modeling software (Femlab 3.1, Comsol Inc). The general model simulated light distribution using the diffusion approximation of the transport theory, temperature rise using the bioheat equation and laser-induced injury using the Arrhenius damage model. Biological tissue was represented by two homogenous regions (dermis and fat layer) with a nonlinear air-tissue boundary condition including free convection. Video recordings were used to gain a better understanding of the back and forth movement of the cannula during laser lipolysis in order to consider them in our mathematical model. Infrared video recordings were also performed in order to compare the actual surface temperatures to our calculations. The reduction in fat volume was determined as a function of the total applied energy and subsequently compared to clinical data reported in the literature.

Results

In patients, when using cooled tumescent anesthesia, 1064 nm Nd:YAG laser or 980 nm diode laser: (6 W, back and forth motion: 100 mm/s) give similar skin surface temperature (max: 41°C). These measurements are in accordance with those obtained by mathematical modeling performed with a 1 mm cannula inserted inside the hypodermis layer at 0.8 cm below the surface. Similarly, the fat volume reduction observed in patients at 6-month follow up can be determined by mathematical modeling. This fat reduction depends on the applied energy, typically 5 cm³ for 3000 J. At last, skin retraction was observed in patients at 6-month follow up. This observation can be easily explained by mathematical modeling showing that the temperature increase inside the lower dermis is sufficient (48–50°C) to induce skin tightening

Discussion and Conclusion

Laser lipolysis can be described by a theoretical model. Fat volume reduction observed in patients is in accordance with model calculations. Due to heat diffusion, temperature elevation is also produced inside the lower reticular dermis. This interesting observation can explain remodeling of the collagenous tissue, with clinically evident skin tightening. In conclusion, while the heat generated by interstitial laser irradiation provides stimulate lipolysis of the fat cells, the collagen and elastin are also stimulated resulting in a tightening in the skin. This mathematical model should serve as a useful tool to simulate and better understand the mechanism of action of the laser lipolysis     

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.      

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。     

Capillary hemangioma (strawberry mark) of infancy: comparison of argon and Nd:YAG laser treatment

Capillary hemangioma of infancy (strawberry mark) is a self-limiting problem, and conservative treatment is recommended. These birthmarks can be associated with a great deal of morbidity. There is definitely a role for a palliative form of treatment without systemic complications or destruction of adjacent tissue. In a 6-year period, 55 patients received 57 Nd:YAG or argon laser treatments. Thirty patients received 31 argon treatments, and 25 patients received 26 Nd:YAG treatments; and 2 received first argon with subsequent Nd:YAG treatments. Although more dramatic successes were noted in the Nd:YAG laser, complications were more frequent and severe. Complications included delayed healing, postoperative bleeding, and some hypertrophic scarring. Complications were seen in 12 percent of all patients, 9 percent of these associated with the Nd:YAG laser.     

1064nm Nd：YAG激光对5种甲真菌病重要致病菌的作用

目的观察1064nmNd：YAG激光对5种甲真菌病重要致病菌（红色毛癣菌、须癣毛癣菌、白念珠菌、近平滑念珠菌、烟曲霉）生长的影响。方法将各菌的菌悬液均匀点种于培养基上,生长至形成一定大小的菌落,给予不同能量1064nmNd：YAG激光照射,皮肤癣菌类观察激光照射后第1、3、6天菌落生长受抑制的直径变化情况;念珠菌类观察其次代培养存活率的差异;烟曲霉菌悬液铺满整个平皿,观察经不同能量激光照射受抑制的菌落空白处直径大小差异。结果在体外,当激光能量累计达到3200J／cm^2时,可对培养基上生长的以上各菌产生生长抑制作用,且随着能量增大,抑制作用增强,甚至可发生杀灭作用。结论1064nmNd：YAG激光当能量累计达到一定量时可对甲真菌病致病菌产生明显的生长抑制或杀灭作用。     

Ureteral anastomosis by Nd:YAG laser light; experimental studies in dogs]

The results of experimental ureteral anastomoses with laser Nd:YAG are discussed. Cut ureters were anastomosed in all animals. Anastomosis consisted of the scar of the connective tissue covered with intermediate epithelium and scarring process was quicker, if modelling catheter was used.     

In vitro laser ablation of natural marine biofilms

We studied the efficiency of pulsed low-power laser irradiation of 532 nm from an Nd:YAG (neodymium-doped yttrium-aluminum-garnet) laser to remove marine biofilm developed on titanium and glass coupons. Natural biofilms with thicknesses of 79.4 +/- 27.8 microm (titanium) and 107.4 +/- 28.5 microm (glass) were completely disrupted by 30 s of laser irradiation (fluence, 0.1 J/cm2). Laser irradiation significantly reduced the number of diatoms and bacteria in the biofilm (paired t test; P < 0.05). The removal was better on titanium than on glass coupons.     

基于OCT技术的鼠皮肤激光热损伤修复过程的监测

采用Er:YAG激光(波长为2 940 nm,能量密度为:2.5 J/cm2单光斑,扫描次数为4)照射活体小白鼠皮肤,利用光学相干层析成像(optical coherence tomography,OCT)技术在活体小鼠上观察其皮肤组织在激光作用之前及作用之后光热损伤修复的整个过程,得到了激光光热作用下引起损伤的皮肤组织在此过程中皮肤光学特性参数的变化情况,发现皮肤修复过程中光学参数有显著差异,并分析了这些差异引起的原因,以揭示激光美容中并发症主要因素。     

Differential effects of Nd-YAG laser on collagen and elastin production by chick embryo aortae in vitro. Relevance to laser angioplasty for removal of atherosclerotic plaques

Aortae from 17-day old chick embryos were subjected to irradiation with a Nd:YAG laser at energy densities varying from 1.2 - 4.7 X 10(3) J/cm2. The aortae were pulse-labeled in vitro with [3H]proline or [14C]valine, and the synthesis of collagenous polypeptides and soluble elastin was examined by SDS-polyacrylamide gel electrophoresis, followed by fluorography and quantitative scanning densitometry. Irradiation of the aortae with Nd:YAG laser resulted in inhibition of the synthesis of the extracellular matrix proteins. The production of collagen was inhibited to a considerably larger degree than the production of elastin. Thus, the biosynthetic pathway for collagen production appears to be more susceptible to laser inhibition than the corresponding pathway for elastin production. These observations may have relevance to laser angioplasty which has been proposed to be applicable for removal of atherosclerotic plaques in human vessels. Specifically, the results suggest that inhibition of the extracellular matrix production may result in weakening of the vessel wall with subsequent aneurysm formation and rupture.     

Q开关Nd:YAG 1064nm和532nm激光对犬心肌切割作用的研究

目的 :研究 10 64nm和 53 2nm波长激光在激光能量为 14 0mJ/pulse(脉冲 )时对犬心肌切割效率。方法 :用Q开关Nd :YAG 10 64和 53 2nm波长脉冲激光分别照射犬离体和在体心肌组织 ,光学显微镜和偏振光学显微镜行组织学分析 ,观察不同条件下激光切割组织的深度和光热对组织的损伤。结果 :离体和在体实验 ,10 64nm波长激光的切割效率高于 53 2nm(p <0 .0 1)。在体和离体实验显示 10 64nm激光能量和重复率相同时 ,所致的切割效率无明显差异 (p >0 .0 5) ,血液对 10 64nm激光的切割效率影响较小。相反 ,在 53 2nm时血液对其影响较大 ,相同的激光能量和重复率 ,离体实验切割效率高于在体 (p <0 .0 1)。 10 64nm激光所致的光热和机械损伤均轻于 53 2nm激光。结论 :在切割效率方面 ,10 64nm激光比 53 2nm更适用于TMLR。 10 64nmQ开关Nd :YAG激光可通过光导纤维传输 ,是TMLR的一个有潜力的激光源     

The response of Na+/K+ -ATPase of human erythrocytes to green laser light treatment

The objective of this study was to investigate the response of Na(+)/K(+)-ATPase of human erythrocytes to green laser irradiation. Effects of green laser light of fluences 9.5-63.3 J.cm(-2) and merocyanine 540-mediated laser light treatment were studied. Isolated erythrocyte membranes (protein concentration of 1 mg/ml) were irradiated by Nd:YAG laser (532 nm, 30 mW) and then incubated in a medium with 2 mM ATP for 30 min. Activity of ATPase was determined colorimetrically by measuring the colored reaction product of liberated inorganic phosphate and malachite green at 640 nm. Contribution of Na(+)/K(+)-ATPase to overall phosphate production was determined using ouabain. A positive effect of green laser light on Na(+)/K(+)-ATPase activity was observed. The dependence of enzymatically liberated inorganic phosphate on light fluence showed a linear correlation (R(2)=0.96, P=0.0005) for all fluences applied (9.5-63.3 J.cm(-2)). On the other hand, MC 540-mediated phototreatment caused a suppression of enzyme activity.     

Characterization of 1064 nm Nd:YAG laser-produced cu plasma

The plasma was produced by focusing Nd:YAG laser pulses of 1064 nm wavelength on to a copper target at laser fluences of 5.35, 6.95, and 9.33 J/cm². An ion collector placed along the target surface normal was used to record the time-of-flight (TOF) ion signal during plasma expansion in vacuum. The TOF ion pulses were deconvoluted using the Coulomb-Boltzmann-shifted function to estimate the available Cu ion charge states, equivalent plasma ion temperature, and accelerating potential in the nonequilibrium plasma. The maximum available ion charge state, equivalent plasma ion temperature, and accelerating potential are found to increase with laser fluence. In the local thermal equilibrium conditions, the accelerating potential can be supposed to apply across a distance of the order of the Debye length. The Debye length and, hence, the electric field in the laser produced plasma at three laser fluences values were estimated. The electric field was in the range of 1 MV/cm and increased with laser fluence. In the laser fluence range used in this work, the sum of thermal and adiabatic energy of the ion was slightly higher than its Coulomb energy.     

Photoradiation therapy of cutaneous angiosarcomas in mice

Cutaneous angiosarcoma is a relatively rare but devastating malignant vascular tumor. It has a high incidence of recurrence following conventional therapeutic modalities applied either singly or in combination. The increased vascularity of cutaneous angiosarcomas, facilitating selective uptake and retention of a photosensitizing agent, such as hematoporphyrin derivative (HPD), suggests that these tumors would respond well to photoradiation therapy. To study the feasibility of this treatment modality, transplantable hemangiosarcomas were implanted in B6C3F1 female mice. Within 2.5 to 3.5 hours after intraperitoneal administration of HPD, fluorescence was recorded in the tumor as compared with surrounding normal skin. When these photosensitized tumors were exposed to 70 J/cm2 of laser energy from an argon-pumped dye laser at 630 nm, the tumors showed marked necrosis within 24 hours. In another series, the tumors were initially photosensitized with HPD for 3 hours and then treated with laser energy ranging from 0 to 96 J/cm2. A dual labeling procedure demonstrated a dose-related decrease in DNA synthesis rate in tumors that were exposed to 0 to 30 J/cm2 at 24 hours after treatment. Furthermore, tumor tissue exposed to laser energy in excess of 30 J/cm2 showed no significant cellular DNA synthesis. These data, supported by histologic evidence of tissue destruction, suggest that photoradiation therapy has a great potential as a therapeutic modality for cutaneous angiosarcomas.     

脉冲Nd:YAG激光对单层KB细胞损伤效应的研究

目的：观察脉冲Nd：YAG激光照射体外单层培养KB细胞后的形态改变及损伤后HSP70,c-Fos的表达情况,初步探讨较强脉冲激光对细胞的损伤效应及损伤修复机制。方法：建立单层培养细胞的脉冲Nd：YAG激光损伤模型,每个脉冲能量密度为160J／cm^2～186J／cm^2或220J／cm^2～257J／cm^2,分别于照后即刻、2h和6h,用台盼蓝染色、TUNEL检测分析该激光对KB细胞的损伤特点,免疫组化法检测HSP70,c-Fos的表达水平。结果：当照射剂量为220J／ecm^2～257J／cm^2时,照后即刻,光斑中央细胞形态严重破坏,直接坏死;周围细胞形态未发生明显改变。2h后周围细胞TUNEL。着色也增强,呈强阳性。照后6h光斑中央及周围细胞着色均减弱。TUNEL着色区直径随时间先扩大后缩小。当照射剂量为160J／cm^2～186J／cm^2时,细胞内HSP70、c-Fos表达随时问先显著增强,而后减弱至正常。结论：脉冲Nd：YAG激光在所选剂量下,可以引起单层KB细胞的损伤,包括即刻坏死、延迟性死亡及可逆性损伤。HSP70、c-Fos的高表达说明它们在保护受损细胞、修复激光所致损伤中发挥重要作用。     

Fat liquefaction: effect of low-level laser energy on adipose tissue

Low-level laser energy has been increasingly used in the treatment of a broad range of conditions and has improved wound healing, reduced edema, and relieved pain of various etiologies. This study examined whether 635-nm low-level lasers had an effect on adipose tissue in vivo and the procedural implementation of lipoplasty/liposuction techniques. The experiment investigated the effect of 635-nm, 10-mW diode laser radiation with exclusive energy dispersing optics. Total energy values of 1.2 J/cm(2), 2.4 J/cm(2), and 3.6 J/cm(2) were applied on human adipose tissue taken from lipectomy samples of 12 healthy women. The tissue samples were irradiated for 0, 2, 4, and 6 minutes with and without tumescent solution and were studied using the protocols of transmission electron microscopy and scanning electron microscopy. Nonirradiated tissue samples were taken for reference. More than 180 images were recorded and professionally evaluated. All microscopic results showed that without laser exposure the normal adipose tissue appeared as a grape-shaped node. After 4 minutes of laser exposure, 80 percent of the fat was released from the adipose cells; at 6 minutes of laser exposure, 99 percent of the fat was released from the adipocyte. The released fat was collected in the interstitial space. Transmission electron microscopic images of the adipose tissue taken at x60,000 showed a transitory pore and complete deflation of the adipocytes. The low-level laser energy affected the adipose cell by causing a transitory pore in the cell membrane to open, which permitted the fat content to go from inside to outside the cell. The cells in the interstitial space and the capillaries remained intact. Low-level laser-assisted lipoplasty has a significant impact on the procedural implementation of lipoplasty techniques.     

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：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.     

Dual-photon excitation of albumin

Fluorescence emission after two-photon excitation at 580 nm is observed in albumin by means of Nd:YAG laser at room temperature. The two-photon excitation spectral range 550-590 nm was obtained. The experimental results show that albumin fluorescence originates from tryptophan residues.     

Characterization of laser produced plasma using laser induced breakdown spectroscopy

The plasma parameter studies of the Nd:YAG (neodymium-doped yttrium aluminum garnet, Nd:Y₃Al₁₅O₁₂) crystal by using the fundamental (1064 nm) and second (532 nm) harmonics of Nd:YAG laser are reported. The electron temperature (T _e ) and electron number density (N _e) were determined using the Boltzmann plot method and the Stark-broadened line profile, respectively. An increase in the plasma parameters have been observed with an increase in the laser irradiance for both laser modes. The electron temperatures were calculated in the range of 0.53–0.66 eV for 1064 nm and 0.47–0.60 eV for 532 nm, and the electron number densities were determined in the range of 7.43 × 10¹⁵–3.27 × 10¹⁶ cm^?3 for 1064 nm and 1.35 × 10¹⁶–3.97 × 10¹⁶ cm^?3 for 532 nm in the studied irradiance range of 1.19–12.5 GW/cm². However, the spatial evolution of the plasma parameters investigated up to 2.75 mm away from the target surface at a fixed laser irradiance of 6.51 GW/cm2 showed a decreasing trend. In addition, the estimated values of the inverse bremsstrahlung (IB) absorption coefficients at both laser wavelengths showed that the IB process is dominant for the 1064-nm laser.     

Image-guided navigation for the control interstitial laser therapy of vascular malformations in the head and neck region]

Laser-induced interstitial thermal therapy (LITT) is a proven minimally invasive surgical technique for the treatment of haemangiomas and vascular malformations, and various tumours. The intra-lesion application of thermal energy destroys regional tissue. The percutaneous placement of the laser fibre for photocoagulation is done without the benefit of direct visual control. Image-data-based LITT was performed in patients (five procedures) with extensive venous malformations in the maxillofacial area. The system comprised a specially developed Nd:YAG laser fibre introducer set used in conjunction with fused high-resolution computed tomography, and magnetic resonance image-data--based surgical navigation. In all cases, follow-up examination clearly showed a diminishment in tumour volume, and all patients reported significant subjective improvement. The results suggest that navigation-guided LITT can be performed safely, preserving vital structures from collateral thermal damage.