Lasers in Surgery and Medicine最新文献

{"title":"Impact of Fractional Ablative Laser Therapy on Function, Symptoms, and Quality of Life in the Management of Traumatic Scars: A Review.","authors":"Vy X Pham, Bobak T Pousti, Gerd Gauglitz, Peter R Shumaker","doi":"10.1002/lsm.23858","DOIUrl":"https://doi.org/10.1002/lsm.23858","url":null,"abstract":"<p><strong>Objectives: </strong>A substantial and expanding body of literature addresses the safety and efficacy of fractional ablative laser therapy for traumatic scarring resulting from burns and other trauma. However, available scar research commonly employs standardized assessment scales that generally do not directly address the impact on function and overall quality of life. Unlike past reviews, this manuscript will explore available evidence with a focus explicitly on function and quality of life (QoL) outcomes and de-emphasize surrogate outcome measures that rely primarily on visual characteristics.</p><p><strong>Methods: </strong>Through literature review conducted up to January 2024, the authors examined relevant studies focusing on function and quality of life outcomes in traumatic and burn scar management with fractional ablative laser therapy. PubMed, EMBASE, MEDLINE, and Cochrane Library were utilized as primary databases. Reference lists were secondarily reviewed to supplement the literature review process. Studies that did not highlight functional or QoL endpoints or were not in the English language were excluded.</p><p><strong>Results: </strong>The reviewed studies demonstrated that fractional ablative therapy led to consistent significant and meaningful improvements in functional outcomes, relief from pruritus and pain, and overall enhancements in quality of life for patients with traumatic scarring. Adverse events associated with fractional ablative therapy were infrequent and generally of mild severity, indicating a favorable safety profile.</p><p><strong>Conclusions: </strong>The findings from this literature review document ample existing evidence supporting the efficacy and safety of fractional ablative therapy to enhance function, mobility, reduce pruritus and pain, and improve overall QoL. Fractional ablative laser therapy should be integrated more widely into standard management protocols. Given the previous reliance on standardized scar assessment tools that heavily integrate visual characteristics, future studies should prioritize functional and QoL outcomes to further advance scar management protocols and optimize patient care.</p>","PeriodicalId":17961,"journal":{"name":"Lasers in Surgery and Medicine","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2024-11-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142623239","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Computational Study on Effects of PID Temperature Target and RF Frequency for PID-Controlled Nonablative RF Cosmetic Systems","authors":"Lu-Xiao Wang,&nbsp;Xiang-Yong Kong,&nbsp;Tong-Juan Zhou","doi":"10.1002/lsm.23855","DOIUrl":"10.1002/lsm.23855","url":null,"abstract":"<div>\u0000 \u0000 <p><b>Background and Objectives:</b> Commonly adopted in cosmetic dermatology, nonablative radiofrequency (RF) devices convert high-frequency electromagnetic energy into thermal energy to induce a wound-healing response in skin tissue. However, differences in the electrical properties of different skin layers raise questions about the impact of different RF frequencies and target temperatures on treatment effectiveness. This paper presents a finite element analysis (FEA)-based computational study aimed at simulating and optimizing the effects of a proportional integral derivative (PID)-controlled RF cosmetic devices under different combinations of these two parameters during treatment.</p>\u0000 <p><b>Study Design/Materials and Methods:</b> A 3D physical model for the application of a nonablative RF device was constructed using COMSOL, which included the human tissue and RF electrodes, electromagnetic and thermal boundary conditions, as well as the PID controller. FEA was performed for each of the twelve models with parameter combinations of three RF frequencies (0.1, 0.5, and 1 MHz) and three PID-controlled target temperatures (60°C, 65°C, and 70°C) plus one group without PID control. Treatment effectiveness was quantitatively assessed using the integration of tissue thermal damage fraction, i.e., thermal damage volume.</p>\u0000 <p><b>Results:</b> In the earlier stage of heating (0–10 s), higher RF frequency resulted in a larger thermal damage volume. At 10 s, among models with a temperature target of 70°C, there is a 6.04% difference between the thermal damage volume at RF frequencies of 1.0 and 0.1 MHz. In the later stage of heating(11–80 s), the impact of RF frequency decreases. The difference in thermal damage volume caused by higher temperature targets is more significant, at 80 s, among models with an RF frequency of 1.0 MHz, the 70°C model produces 1.15 and 1.36 times more tissue thermal damage than the 65°C and 60°C models.</p>\u0000 <p><b>Conclusion:</b> PID controller has ensured treatment safety and uniformity, in exchange for some efficiency. Among 12 parameter combinations, the one with a temperature of 70°C and RF frequency of 1.0 MHz achieved the highest thermal damage volume, which could potentially result in the best esthetic effect. Considering users' different susceptibility to heat, engineers or physicians can select better temperature targets and RF frequencies to bring the desired cosmetic results based on thermal damage volume curves from this study.</p>\u0000 </div>","PeriodicalId":17961,"journal":{"name":"Lasers in Surgery and Medicine","volume":"56 10","pages":"865-879"},"PeriodicalIF":2.2,"publicationDate":"2024-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142576261","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Vapor Channel Oscillations in Laser Lithotripsy","authors":"James J. Childs,&nbsp;Anastasia Kovalenko,&nbsp;Gregory Altshuler,&nbsp;Artur Smirnov,&nbsp;Tyler W. Iorizzo,&nbsp;Dilip Paithankar,&nbsp;Ilya Yaroslavsky","doi":"10.1002/lsm.23856","DOIUrl":"10.1002/lsm.23856","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Objectives&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Laser-based endoscopic procedures present special challenges to deliver energy for ablation or coagulation of target tissues. When optical fiber–target quasi-contact (&lt; 0.5 mm distance) cannot be maintained or is undesirable, the creation of intervening vapor bubbles and channels provide for the necessary transmission of laser energy to the target. This work investigates the characteristics and the dynamics of vapor channels that directly affect ablation efficiency and ablation rate and are known to effect stone movement, all of which impact procedure efficiency and safety.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Methods&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;A simplified, experimental model for thulium fiber laser (1940 nm) lithotripsy consists of a water-filled cuvette and a vertically oriented laser fiber (200 μm core diameter) with its tip at 9 mm for “quasi-free” bubble generation and at vapor channel working distances 1–5 mm from and centered on the transparent cuvette bottom simulating a target's surface. Laser power transmission is recorded and synchronized with video frames from a high-speed camera (24,260 frames per second) to capture the induced vapor channels' and bubbles' development.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Results&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Laser-induced channel transmission from 0% to 100% for 1, 2, and 3 mm fiber–target distances undergoes oscillations with average periods of 0.32, 0.64, and 1.0 ms, respectively, for 500 W laser output power. For fixed fiber–target distances of 0.5, 1, and 2 mm, the variation of these average oscillation frequencies across laser powers from 500 to 1000 W is much smaller, not exceeding 14%. For fiber–target distances in the range of 1–5 mm, the fraction of the 500 W laser's total pulse energy delivered to the target for 1, 2, and 3 ms pulses linearly decreases from 0.78 to less than 0.2. The channel and bubble dynamics begin with a spherical seed bubble expansion centered on the distal fiber tip that evolves into a pear shape whose surface exhibits periodic irregularities attributable to laser beam interruption by water droplets within the developing bubble.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Conclusions&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;The study of laser-induced channel oscillations provides quantitative information relating fiber–target distance to channel oscillation frequency and energy transmission onto a target. These oscillations directly effect ablation efficiency and ablation rates that are important parameters for the optimization of a procedure's safety and duration. Insights that may lead to further reduction in retropulsion are also presented. Lasers Surg. Med. 00:00–00, 2024. © 2024 Wiley Periodicals LLC.&lt;/p","PeriodicalId":17961,"journal":{"name":"Lasers in Surgery and Medicine","volume":"56 10","pages":"821-828"},"PeriodicalIF":2.2,"publicationDate":"2024-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142576265","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Study on the Synergistic Mechanism of Photodynamic Therapy Combined With Ferroptosis Inducer to Induce Ferroptosis in Cholangiocarcinoma","authors":"Sifan Dong,&nbsp;Shiqi An,&nbsp;Qifan Liu,&nbsp;Xujia Wang,&nbsp;Yongmei Hu,&nbsp;An Jiang","doi":"10.1002/lsm.23857","DOIUrl":"10.1002/lsm.23857","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Photodynamic therapy (PDT) induced lipid peroxidation reaction can lead to necrosis and apoptosis of extrahepatic cholangiocarcinoma (ECC) cells, reducing the tumor load. However, the depth of action of PDT is shallow, and its therapy efficacy is weak, making it difficult to achieve eradication even with multiple treatments.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>This study aims to investigate the mechanism and main pathways of ferroptosis in cholangiocarcinoma under Hematoporphyrin-mediated photodynamic therapy, and to compare the effects of different ferroptosis inducers on photodynamic therapy-induced ferroptosis in cholangiocarcinoma. To provide an experimental basis for selecting appropriate ferroptosis-inducing agents and synergizing with photodynamic therapy during the clinical perioperative period.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The Cell Counting Kit-8 (CCK-8) was used to examine the cytotoxicity of cholangiocarcinoma cells following PDT. Flow cytometry was used to detect apoptotic cell percentage and cell cycle changes to assess the enhanced photodynamic production of reactive oxygen species (ROS) by different ferroptosis inducers, confocal imaging was used to de-assay ROS content. Western blot analysis was employed to detect the expression of GPX4 、FSP1、ASCL4 and SLC7A11. Furthermore, a fluorescence spectrophotometric assay was used to quantify the alterations in lipid peroxides (MDA, LPO, GSH, and Fe²⁺).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The combination of PDT with Lenvatinib or Erastin resulted in increased ROS levels, and decreased GSH content, tumor cells were inhibited in the G2 phase, and the proportion of apoptotic cells increased. Additionally, GPX4, FSP1, and SLC7A11 protein expression decreased, whereas ASCL4 increased This was accompanied by heightened levels of Fe²⁺, LPO, and MDA. Induction of the ferroptosis pathway was observed to enhance the therapeutic efficacy of PDT.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Our findings suggest that Erastin or Lenvatinib can enhance the induction of ferroptosis in cholangiocarcinoma cells by photodynamic therapy by increasing intracellular ROS and inhibiting intracellular antioxidant pathways.</p>\u0000 </section>\u0000 </div>","PeriodicalId":17961,"journal":{"name":"Lasers in Surgery and Medicine","volume":"56 10","pages":"845-853"},"PeriodicalIF":2.2,"publicationDate":"2024-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142522263","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Novel Applicator Utilizing HIFES and Enhanced Synchronized Radiofrequency+ for Subcutaneous Fat Reduction: Porcine Model Study","authors":"Chris W. Robb,&nbsp;Jan Bernardy,&nbsp;Rea Jarosova,&nbsp;Nikola Hodkovicova","doi":"10.1002/lsm.23854","DOIUrl":"10.1002/lsm.23854","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Submental fullness has been associated with being perceived as unattractive. Technology combining radiofrequency and muscle stimulation offers submental contouring through fat reduction, muscle stimulation, and skin tightening. This study aims to demonstrate the effectiveness and safety of fat reduction aspect with a novel submentum applicator delivering HIFES and synchronized radiofrequency+ (RF+) energies.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>Six white pigs (<i>sus scrofa domesticus</i>, <i>n</i> = 6, 60–80 kg) were recruited for this study, five in the active group (<i>n</i> = 5) received four treatments on the abdominal area, one sow served as a control (<i>n</i> = 1). Ultrasound, histological, and RT-qPCR methods were used as evaluation methods.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Fat thickness decreased at 1 month by −17.35% and at 2 month by 31.40%. Proapoptotic caspase-9 gene expression increased (at 1 h, 6 h, 24 h to +43.45%, +21.22%, −8.36%), as well as caspase-3 (+15.28%, +21.77%, −6.71%), while <i>bcl2l1</i> activity decreased (−11.46% at 1 h, −17.02% at 6 h, −3.9% at 24 h). While the AI in the control animal had minimal change (at 1 h −0.08%, at 6 h −0.09%, and at 24 h −0.025%), the active group's AI increased from the baseline of 9.14 to 44.85 at 1 h (+391%), peaked at 6 h to 53.50 (+485%), and at 24 h to 38.17 (+318%).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The study results indicate the efficacy and safety of subcutaneous fat reduction following the novel technology combining HIFES and RF+ energies, designed to target small localized areas.</p>\u0000 </section>\u0000 </div>","PeriodicalId":17961,"journal":{"name":"Lasers in Surgery and Medicine","volume":"56 10","pages":"803-810"},"PeriodicalIF":2.2,"publicationDate":"2024-10-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11629285/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142503129","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Expert Consensus on Clinical Recommendations for Fractional Ablative CO₂ Laser, in Facial Skin Rejuvenation Treatment.","authors":"Tal Levy, Ilana Lerman, Jill Waibel, Gerd G Gauglitz, Matteo T Clementoni, Daniel P Friedmann, Kevin Duplechain, Peter Peng, Davin Lim, Firas Al-Niaimi, Shangli Lin, Gilly Munavalli, Brian S Biesman, Greg J Goodman, Alina Fratila, Thomas M Beachkofsky, E Victor Ross, Asif Hussein, Arielle Kauvar, Suzanne L Kilmer, Robert Langdon, Ronald L Moy, Ofir Artzi","doi":"10.1002/lsm.23850","DOIUrl":"https://doi.org/10.1002/lsm.23850","url":null,"abstract":"<p><strong>Background: </strong>For three decades, fractional ablative CO₂ lasers have been used for skin rejuvenation. With breakthroughs in laser technology and expanding popularity, new recommendations and suggestions arise on a regular basis.</p><p><strong>Objective: </strong>To develop up-to-date clinical recommendations on safety measures, therapeutic framework, and techniques to improve treatment outcomes.</p><p><strong>Methods: </strong>Using Google Forms, a questionnaire with 188 questions was given to a varied sample of 21 dermatologists and plastic surgeons from various countries and practice contexts. A second questionnaire with 11 items was created to resolve any gaps or discrepancies.</p><p><strong>Results: </strong>Active face infections are considered a treatment contraindication by 95% of panelists. Burns, recent sun exposure, and pregnancy or breastfeeding were also considered contraindications (according to 67% of panelists). Over 90% employ bacterial and viral prophylaxis, however the majority (67%) do not prescribe antifungal prophylaxis. The most often stated anesthetic treatments by panelists are topical anesthetic cream, nerve blocks, and oral analgesics (according to 95%, 81%, and 62% of panelists respectively). Over 90% of panel members suggested treatment setting alterations for individuals with Fitzpatrick skin types III-IV. Following reepithelization, which happens between 8 and 42 days after the treatment, the majority (76%) of panelists advocate continuing standard skin care routines including active ingredients. Eighty-one percent of panelists recommend using supplementary treatment to maximize results. Supplementary treatment recommendations included use of neuromodulators (76% of panelists), Intense Pulsed Light Therapy treatments pre and postprocedure (61% of panelists), and injection-based therapies such as (Hyaluronic Acid fillers, and biostimulatory fillers) (recommended by 48% of panelists). 60% of panelists perform FACL to improve skin laxity treatment in nonfacial areas and adjust their settings accordingly.</p><p><strong>Limitations: </strong>Our results reflect only a modest panel size; with a focus on a specific device. Although experienced, the small number of panelists, recommendations, and personal adverse reactions encounters for resurfacing indication, might be biased.</p><p><strong>Conclusion: </strong>Fractional CO₂ laser is a popular and effective skin rejuvenation treatment with minimal downtime and side effects. This study presents new therapy recommendations to resolve treatment uncertainty and provide complete care suggestions for best results.</p>","PeriodicalId":17961,"journal":{"name":"Lasers in Surgery and Medicine","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2024-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142468983","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Laser NIR Irradiation Enhances Antimicrobial Photodynamic Inactivation of Biofilms of Staphylococcus aureus","authors":"Leandro Mamone,&nbsp;Roberto Tomás,&nbsp;Gabriela Di Venosa,&nbsp;Lautaro Gándara,&nbsp;Edgardo Durantini,&nbsp;Fernanda Buzzola,&nbsp;Adriana Casas","doi":"10.1002/lsm.23847","DOIUrl":"10.1002/lsm.23847","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Objectives&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Photodynamic inactivation (PDI) is a powerful technique for eradicating microorganisms, and our group previously demonstrated its effectiveness against planktonic cultures of Staphylococcus aureus bacteria using 5,10,15,20-tetrakis[4-(3-&lt;i&gt;N,N&lt;/i&gt;-dimethylaminopropoxy)phenyl]porphyrin (TAPP) and visible light irradiation. However, biofilms exhibit a lower sensitivity to PDI, mainly due to limited penetration of the photosensitizer (PS). In the context of emerging antibacterial strategies, near-infrared treatments (NIRTs) have shown promise, especially for combating resistant strains. NIRT can act either through photon absorption by water, causing a thermal effect on bacteria, or by specific chromophores without a significant temperature increase. Our objective was to enhance biofilm sensitivity to TAPP-PDI by pretreatment with NIRT. This combined approach aims to disrupt biofilms and increase the efficacy of TAPP-PDI against bacterial biofilms.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Materials and Methods&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;In vitro biofilm models of &lt;i&gt;S. aureus&lt;/i&gt; RN6390 were utilized. NIRTs involved a 980 nm laser (continuous mode, 7.5 W/cm&lt;sup&gt;2&lt;/sup&gt;, 30 s, totaling 225 J/cm&lt;sup&gt;2&lt;/sup&gt;) post-TAPP exposure to enhance photosensitizer accumulation. Subsequent visible light irradiation at 180 J/cm&lt;sup&gt;2&lt;/sup&gt; was employed to perform PDI. Colony-forming unit counts evaluated the synergistic effect on bacterial viability. Scanning electron microscopy visualized the architectural changes in the biofilm structure. TAPP was extracted from bacteria to estimate the impact of NIRT on biofilm penetration.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Results&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Using in vitro biofilm models, NIRT application following biofilm exposure to TAPP increased PS accumulation per bacteria. Under these conditions, NIRT induced a transient increase in the temperature of PBS to 46.0 ± 2.6°C (Δ&lt;i&gt;T&lt;/i&gt; = 21.5°C). Following exposure to visible light, a synergistic effect emerged, yielding a substantial 4.4 ± 0.1-log CFU reduction. In contrast, the PDI and NIRT treatments individually caused a decrease in viability of 0.9 ± 0.1 and 0.8 ± 0.2-log respectively. Interestingly, preheating TAPP-PBS to 46°C had no significant impact on TAPP-PDI efficacy, suggesting the involvement of thermal and nonthermal effects of NIR action. In addition to the enhanced TAPP penetration, NIRT dispersed the biofilms and induced clefts in the biofilm matrix.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Conclusion&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Our findings suggest that NIR irradiation serves as a complementary treatment to PDI. This combined strategy reduces bacterial numbers at lower PS concentration","PeriodicalId":17961,"journal":{"name":"Lasers in Surgery and Medicine","volume":"56 9","pages":"783-795"},"PeriodicalIF":2.2,"publicationDate":"2024-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142365740","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Picosecond 532 nm Laser: An Optimal Device for the Reduction of Acquired Agminated Nevi.","authors":"Briana R Halle, Nicole M Golbari, Janellen Smith, Christopher Zachary","doi":"10.1002/lsm.23851","DOIUrl":"https://doi.org/10.1002/lsm.23851","url":null,"abstract":"<p><strong>Objectives: </strong>Agminated nevi are rare, grouped lesions, which are confined to one anatomic area. Herein, we report a case of successful cosmetic treatment of bilateral, acquired agminated nevi with a picosecond 532 nm Nd:YAG laser device.</p><p><strong>Materials and methods: </strong>Literature search was completed on acquired agminated nevi. A healthy 21-year-old woman presented with numerous, grouped 1-mm brown-to-dark brown macules in the axillae bilaterally. Biopsies revealed lentiginous junctional nevi with mild atypia, leading to the diagnosis of agminated nevi. She was referred for laser treatment to improve cosmetic appearance. Two different laser devices were utilized initially, a picosecond 532 nm Nd:YAG laser on the left axilla and a millisecond domain 532 nm laser on the right. Greater improvement was noted with the picosecond 532 nm device. Three additional treatments were completed with the picosecond laser with significant improvement in pigmentation of melanocytic nevi.</p><p><strong>Results: </strong>Various pigmented and melanocytic lesions have been noted to occur in an agminated pattern although their pathway of development remains unknown. While various devices have demonstrated efficacy for pigmented lesions, treatment of agminated nevi specifically is less reported or established. Our patient's presentation is novel because of the axillary location and bilateral distribution of multiple acquired agminated nevi, neither of which have been previously reported in the literature. We also report successful treatment utilizing a picosecond 532 nm laser. While laser can help improve the cosmetic appearance of pigmented lesions, most lasers do not remove all melanocytes, highlighting the need for close monitoring, as atypia and melanoma have been reported to develop in acquired agminated nevi.</p><p><strong>Conclusion: </strong>Thus, we present a case of acquired agminated nevi in a novel bilateral distribution in a healthy female successfully treated with a picosecond 532 nm laser.</p>","PeriodicalId":17961,"journal":{"name":"Lasers in Surgery and Medicine","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2024-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142349301","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of Alexandrite Laser in the Treatment of Pigmented Actinic Keratoses: A Pivotal Study","authors":"Stefano Bighetti,&nbsp;Cristina Zane,&nbsp;Nicola Zerbinati,&nbsp;Mariachiara Arisi,&nbsp;Simone Caravello,&nbsp;Vincenzo Maione,&nbsp;Piergiacomo Calzavara-Pinton,&nbsp;Luca Bettolini","doi":"10.1002/lsm.23849","DOIUrl":"10.1002/lsm.23849","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Pigmented actinic keratoses (PAKs), a pigmented variant of actinic keratosis, present diagnostic challenges due to their resemblance to both benign and malignant lesions. Conventional therapies have inconsistent outcomes and may cause undesirable side effects. This study investigates the efficacy of the Alexandrite laser, a pulsed laser with selective melanin absorption, for PAK treatment. Through dermoscopic analysis pretreatment, it aims to identify predictive patterns for better treatment outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>Patients with PAKs were enrolled in a multicenter study, receiving standardized Alexandrite laser therapy. Detailed dermoscopic evaluations were conducted pretreatment. The Physician's Global Assessment (PGA) and Target Lesion Pigmentation (TLP) scales measured treatment efficacy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The study included 50 patients with 60 PAKs. Following treatment, there was a statistically significant reduction in TLP scores, particularly in lesions with pigmented pseudo-networks and gray-brownish dots, which were linked to improved outcomes. No adverse effects were reported, suggesting the safety and tolerability of the laser treatment.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The Alexandrite laser emerges as a promising modality for the management of PAK pigmentation, with specific dermoscopic patterns being indicative of a favorable response. This study reinforces the critical importance of dermoscopic expertise in the selection and optimization of treatment for PAKs. Future research should focus on comparative studies with different lasers or combination therapies to develop a more comprehensive treatment framework for PAKs.</p>\u0000 </section>\u0000 </div>","PeriodicalId":17961,"journal":{"name":"Lasers in Surgery and Medicine","volume":"56 9","pages":"776-782"},"PeriodicalIF":2.2,"publicationDate":"2024-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/lsm.23849","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142349298","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"In Silico Evaluation of Nanosecond Laser Treatment of Pigmented Lesions Based on Skin Optical Properties Using a Model of Melanosome Disruption Threshold Fluence.","authors":"Yu Shimojo, Takahiro Nishimura, Daisuke Tsuruta, Toshiyuki Ozawa, Taro Kono","doi":"10.1002/lsm.23848","DOIUrl":"https://doi.org/10.1002/lsm.23848","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to evaluate the efficacy and safety of nanosecond laser treatment of pigmented lesions in silico using a model of melanosome disruption threshold fluence (MDTF) based on skin optical properties.</p><p><strong>Methods: </strong>Particle size analysis and scanning electron microscopy were performed to determine the threshold fluence for melanosome disruption using a nanosecond laser. By inputting the obtained threshold fluence into the MDTF model and considering the variability in skin optical properties, irradiation parameters were calculated and compared with the results from clinical studies.</p><p><strong>Results: </strong>The threshold fluences for 532 and 755 nm nanosecond laser irradiation were determined to be 3.0 and 15.0 J/cm², respectively. In silico analysis showed that the incident fluence for moderately pigmented skin should be 1.2 times that for lightly pigmented skin, whereas it should be 50% lower than that for lightly pigmented skin to achieve the same level of energy deposition. Clinically applied fluences for moderately pigmented skin are at the low end of the calculated range of values, suggesting that the clinical fluence is chosen to minimize energy deposition in normal tissues.</p><p><strong>Conclusions: </strong>Our results showed that the MDTF model can be used to evaluate nanosecond laser treatments and provide clinical guidance on fluence settings based on laser-tissue interactions in moderately pigmented skin. The in silico method can, therefore, provide a robust and quantitative retrospective evaluation of the treatment effects that accounts for variation in irradiation parameters among patients by combining the MDTF model with the in vivo optical properties of individual skin types.</p>","PeriodicalId":17961,"journal":{"name":"Lasers in Surgery and Medicine","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2024-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142349299","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}