Lasers in Surgery and Medicine最新文献

{"title":"In Vivo Imaging Techniques for the Human Scalp: A Systematic Review of the Literature","authors":"Bobak Hedayati,&nbsp;Luke Horton,&nbsp;Brittany Urso,&nbsp;Chloe Ekelem,&nbsp;Arash Babadjouni,&nbsp;Ajay N. Sharma,&nbsp;Natasha Atanaskova Mesinkovska","doi":"10.1002/lsm.23835","DOIUrl":"10.1002/lsm.23835","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Scalp inflammation and alopecia are distressing conditions for which patients regularly present to dermatology. Although some diagnoses can be made clinically, others require biopsy, which carries the risk of pain, infection, bleeding, and scarring. This review examines the existing literature regarding noninvasive in vivo imaging techniques and their evidence and utility in evaluating scalp pathology, with a focus on the diagnostics of hair conditions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A systematic literature search was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines without timeframe restrictions. The PubMed and Clarivate (Web of Science) databases were searched using the terms (“imaging” OR “in-vivo imaging” OR “non-invasive imaging” OR “non-invasive in vivo imaging” “imaging,” “in-vivo imaging) AND (“human scalp disorders” OR “scalp” OR “hair loss” OR “alopecia”). Peer-reviewed randomized control trials (RCTs), prospective studies, retrospective studies, and case series or reports discussing in vivo imaging of the scalp published before 2022 were selected.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Forty-two studies were included and discussed; modalities included laser devices (<i>n</i> = 27), ultrasound (US) (<i>n</i> = 13), infrared thermography (<i>n</i> = 1), skin capacitance imaging (SCI), and ultraviolet light–enhanced visualization (ULEV) (<i>n</i> = 1). The most common laser devices used were reflectance confocal microscopy (RCM), multiphoton microscopy (MPM), and optical coherence tomography (OCT). US techniques included high-frequency US (HFUS) and US biomicroscopy (UBM).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Quality imaging of the scalp in the setting of alopecic, neoplastic, and inflammatory diseases is highly sought after. Many of these noninvasive imaging techniques show promise, each with individual advantages and disadvantages in imaging-specific conditions. Ultimately, noninvasive imaging techniques may be used to optimize patient management and minimize morbidity associated with scalp biopsies.</p>\u0000 </section>\u0000 </div>","PeriodicalId":17961,"journal":{"name":"Lasers in Surgery and Medicine","volume":"56 9","pages":"741-754"},"PeriodicalIF":2.2,"publicationDate":"2024-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/lsm.23835","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142349300","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":"Timing of Laser Intervention on Facial Scars: A 3D Imaging and Scar Scale Analysis in a Retrospective Study","authors":"Shuai Qiang,&nbsp;Xing Fan,&nbsp;Yue Yin,&nbsp;Ping Xue,&nbsp;Wen-Jie Dou,&nbsp;Tong Li,&nbsp;Qing Yang","doi":"10.1002/lsm.23846","DOIUrl":"10.1002/lsm.23846","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;Scars resulting from injuries or surgical procedures often present both physical and aesthetic challenges. Recent studies have indicated promising results in improving postoperative scar outcomes through the combined use of specific laser technologies. Nevertheless, there remains a crucial need for further exploration to ascertain the optimal timing for initiating such treatments.&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;In this retrospective investigation, a cohort of 47 adult patients who did not require hospitalization was analyzed. These patients were divided into two distinct groups: Group A, which received intervention beginning 2 weeks after their respective operations, and Group B, which commenced intervention 4 weeks postoperation. Each group underwent a comprehensive treatment protocol consisting of five laser sessions. Initially, patients underwent three sessions of V-beam pulsed-dye laser (PDL) therapy followed by two sessions of ablative fractional CO&lt;sub&gt;2&lt;/sub&gt; laser (AFL) therapy. Evaluation of outcomes was conducted using advanced imaging techniques such as Antera 3D imaging, in conjunction with established scar assessment tools including the Vancouver Scar Scale (VSS) and the University of North Carolina “4P” Scar Scale (UNC4P).&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;All patients successfully completed the full course of five treatment sessions, with no dropouts and no reported adverse events. Baseline cosmetic assessments of scars were equivalent across both groups. In Group A, the mean VSS scores decreased from 7.04 before treatment to 5.29 at 3 months posttreatment and further to 4.33 at 6 months posttreatment. Meanwhile, in Group B, scores decreased from 7.52 to 6.83 at 3 months and 6.17 at 6 months. There were no statistically significant differences in baseline VSS scores between the two groups (&lt;i&gt;p&lt;/i&gt; = 0.34). At both the 3- and 6-month follow-up points, mean VSS scores were significantly lower in Group A compared to Group B (&lt;i&gt;p&lt;/i&gt; &lt; 0.05). Similar trends were observed in UNC4P scores. Statistically significant differences were noted across all time points (baseline, 3 months, and 6 months posttreatment) for both VSS and UNC4P scores (&lt;i&gt;p&lt;/i&gt; &lt; 0.05). Subset analysis revealed greater improvements in texture and depression volume at 3 months posttreatment, while improvements in depression area, depth, elevation variation, and area were more pronounced at the 6-month mark.&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;Early intervention using the combined 595-nm pulse dye laser and CO&lt;sub&gt;2&lt;/sub&gt; ablative fractional laser (AFL) 2- and 4-week","PeriodicalId":17961,"journal":{"name":"Lasers in Surgery and Medicine","volume":"56 9","pages":"770-775"},"PeriodicalIF":2.2,"publicationDate":"2024-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142290324","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":"Use of Optical Coherence Tomography to Assess Properties of Cutaneous Defects Following Radiofrequency Microneedling and Laser Treatment","authors":"Kira Seiger,&nbsp;William Driscoll,&nbsp;Feben Messele,&nbsp;Nicole M. Golbari,&nbsp;Xiying Fan,&nbsp;Jon Holmes,&nbsp;Christopher B. Zachary","doi":"10.1002/lsm.23840","DOIUrl":"10.1002/lsm.23840","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To characterize the properties of cutaneous defects created by energy-based devices using optical coherence tomography.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>Radiofrequency (RF) microneedling and non-ablative fractional laser (NAFL) treatment were performed in vivo with various parameters. Following treatment, optical coherence tomography (OCT) was used to image and measure cutaneous defects at multiple time points over a 24 h period.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Channel-like cutaneous defects were visible with OCT following bipolar RF microneedling and NAFL treatment. Using a double pulse technique with RF microneedling yielded a greater number of defects visible with OCT, as well as defects that were deeper and more durable over time. Following treatment with 1927 nm thulium fiber laser, the average diameter of the defects was greater when the energy level was 20 mJ as compared to 10 mJ (0.33 mm vs. 0.27 mm, <i>p</i> &lt; 0.01).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Cutaneous defects were observed following both RF microneedling and NAFL treatment. Properties of the cutaneous defects varied based on device, treatment setting, and technique, which may be useful in guiding further study of device-assisted drug delivery.</p>\u0000 </section>\u0000 </div>","PeriodicalId":17961,"journal":{"name":"Lasers in Surgery and Medicine","volume":"56 9","pages":"762-769"},"PeriodicalIF":2.2,"publicationDate":"2024-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/lsm.23840","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142290325","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":"Defining the Treatment Window: Early Versus Late Pulsed Dye Laser Therapy for Posttraumatic and Surgical Scars in Asian Patients.","authors":"Han-Yuan Chang, Bing-Qi Wu, Chang-Cheng Chang, Yu-Tsung Chen, Yen-Jen Wang","doi":"10.1002/lsm.23844","DOIUrl":"https://doi.org/10.1002/lsm.23844","url":null,"abstract":"<p><strong>Objectives: </strong>This retrospective study evaluates the effectiveness of pulsed dye laser (PDL) treatment in early versus late treatment groups for traumatic or postoperative scars. The study aims to determine the threshold between early and late treatment. Additionally, it investigates factors that may influence wound healing outcomes.</p><p><strong>Methods: </strong>The medical records of 147 patients who underwent PDL treatment at our institution between January 2018 and December 2022 were retrospectively reviewed. Inclusion criteria were patients receiving PDL treatment for traumatic or postoperative scars. Out of these patients, we selected those who were willing to receive telephone interviews or re-visit at a scheduled time. Eventually, 52 participants were included in our study. A standardized questionnaire was administered to all participants during telephone interviews, encompassing inquiries regarding their medical history, treatment experiences, and the patient component of the Patient and Observer Scar Assessment Scale. Among the enrolled patients, 38 were contacted and interviewed via telephone, while the remaining 14 patients attended follow-up visits where photographs of their current skin condition were captured. The pretreatment and latest follow-up photographs obtained from the clinical database were independently scored in a blinded manner by two dermatologist reviewers using both the Vancouver Scar Scale and the Manchester Scar Scale.</p><p><strong>Results: </strong>Among the 52 patients, 43 (82.7%) were successfully treated with good response. The correlation coefficients between week-to-treatment initiation and posttreatment MSS and VSS among patients with good response were 0.50 (p < 0.001) and 0.46 (p = 0.002), respectively. Given these findings, we established a treatment initiation threshold of 10 weeks, distinguishing patients into early and late treatment groups. The early treatment group showed borderline significantly lower posttreatment MSS and VSS scores than the late treatment group (MSS: 7.5 ± 2.1 vs. 9.3 ± 2.5, p = 0.011; VSS: 2.8 ± 2.0 vs. 4.5 ± 2.3, p = 0.011). Furthermore, both MSS and VSS of posttreatment showed significantly greater improvement in the early treatment group (4.4 ± 1.6 vs. 3.2 ± 1.9; p = 0.03 and 3.8 ± 1.8 vs. 2.8 ± 1.4; p = 0.04).</p><p><strong>Conclusions: </strong>Early intervention using a PDL within 10 weeks post-injury achieved better outcomes in treating traumatic and postoperative scars based on both clinical and patient opinions.</p>","PeriodicalId":17961,"journal":{"name":"Lasers in Surgery and Medicine","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2024-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142290319","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":"The 2910-nm Fiber Laser Is Safe and Effective for Improving Acne Scarring","authors":"Eric Bernstein,&nbsp;Ali Alajmi,&nbsp;Jennifer Wang,&nbsp;Edward Hochman,&nbsp;Brian Biesman,&nbsp;James F. Sanzo","doi":"10.1002/lsm.23845","DOIUrl":"10.1002/lsm.23845","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Acne scarring results from the inflammation associated with acne papules, which alters dermal collagen, typically producing depressed scars. Lasers have been used to remodel skin improving the texture and appearance of acne scars. Herein, we investigate a new 2910 nm, erbium-doped, fluoride glass, fiber laser for improving acne scars. This novel laser delivers up to 5000 Hz low-energy pulses, providing a unique treatment modality.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Fourteen subjects with rolling and/or boxcar acne scars were enrolled in this study. Thirteen subjects completed the final visit and received three treatments with the 2910 nm fiber laser at 6–8-week intervals. Eight subjects were Fitzpatrick type II and five were Fitzpatrick type III. Digital images were taken pre- and 1- and 3-months posttreatment and evaluated by two blinded reviewers in a randomized fashion for improvement. Subjects and the treating physician completed a Global Aesthetic Improvement Scale (GAIS) before treatment and at each visit to subjectively evaluate treatment effect. Histological analysis was performed on ex vivo lower eyelid skin samples. Side effects were evaluated by the treating physician and included erythema, edema, and pinpoint bleeding.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Evaluation of blinded digital images revealed a mean improvement of 47.3% ± 14.2% (mean ± SEM) 3 months following the final treatment. GAIS scores demonstrated improvement as evaluated by both the subjects and the treating physician. Side effects averaged trace-to-mild erythema, edema, and pinpoint bleeding.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This study shows that the 2910 nm, erbium-doped, fluoride glass, fiber laser is safe and effective for improving the appearance of acne scars.</p>\u0000 </section>\u0000 </div>","PeriodicalId":17961,"journal":{"name":"Lasers in Surgery and Medicine","volume":"56 9","pages":"755-761"},"PeriodicalIF":2.2,"publicationDate":"2024-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/lsm.23845","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142290323","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":"Physician Level Assessment of Hirsute Women and of Their Eligibility for Laser Treatment With Deep Learning.","authors":"Kenneth Thomsen, Raluca Jalaboi, Ole Winther, Hans Bredsted Lomholt, Henrik F Lorentzen, Trine Høgsberg, Henrik Egekvist, Lene Hedelund, Sofie Jørgensen, Sanne Frost, Trine Bertelsen, Lars Iversen","doi":"10.1002/lsm.23843","DOIUrl":"https://doi.org/10.1002/lsm.23843","url":null,"abstract":"<p><strong>Objectives: </strong>Hirsutism is a widespread condition affecting 5%-15% of females. Laser treatment of hirsutism has the best long-term effect. Patients with nonpigmented or nonterminal hairs are not eligible for laser treatment, and the current patient journey needed to establish eligibility for laser hair removal is problematic in many health-care systems.</p><p><strong>Methods: </strong>In this study, we compared the ability to assess eligibility for laser hair removal of health-care professionals and convolutional neural network (CNN)-based models.</p><p><strong>Results: </strong>The CNN ensemble model, synthesized from the outputs of five individual CNN models, reached an eligibility assessment accuracy of 0.52 (95% CI: 0.42-0.60) and a κ of 0.20 (95% CI: 0.13-0.27), taking a consensus expert label as reference. For comparison, board-certified dermatologists achieved a mean accuracy of 0.48 (95% CI: 0.44-0.52) and a mean κ of 0.26 (95% CI: 0.22-0.31). Intra-rater analysis of board-certified dermatologists yielded κ in the 0.32 (95% CI: 0.24-0.40) and 0.65 (95% CI: 0.56-0.74) range.</p><p><strong>Conclusion: </strong>Current assessment of eligibility for laser hair removal is challenging. Developing a laser hair removal eligibility assessment tool based on deep learning that performs on a par with trained dermatologists is feasible. Such a model may potentially reduce workload, increase quality and effectiveness, and facilitate equal health-care access. However, to achieve true clinical generalizability, prospective randomized clinical intervention studies are needed.</p>","PeriodicalId":17961,"journal":{"name":"Lasers in Surgery and Medicine","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2024-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142290322","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":"In Vivo Histological Study Evaluating Non-Ablative Fractional 1940-nm Laser.","authors":"Konika Patel Schallen, Madelyn Seder, Michael Jorgenson, Kevin Schomacker, Jag Bhawan","doi":"10.1002/lsm.23842","DOIUrl":"https://doi.org/10.1002/lsm.23842","url":null,"abstract":"<p><strong>Objectives: </strong>Non-ablative fractional lasers (NAFL) have increased in demand compared to ablative laser treatments as they provide lesser down time, fewer side-effects, and are safer to use. Non-ablative fractional treatment with lasers ranging from 1320 to 1927-nm have been shown to be safe and effective for skin resurfacing procedures. The objective of this study is to investigate healing of the 1940-nm NAFL-induced microthermal treatment zones (MTZs) in human skin from a histologic perspective.</p><p><strong>Methods: </strong>Three subjects received 1940-nm NAFL treatment to test areas on the abdomen at various timepoints during the study. The minimum 5 mJ/MTZ and maximum 20 mJ/MTZ energy settings were used at 20% coverage. Biopsies were taken coinciding with immediately posttreatment, 1, 3, 7 days, and 6 weeks posttreatment. Blinded analysis of hematoxylin and eosin stained slides was performed to measure the width and depth of the MTZs and evaluate the inflammatory and healing response of the skin over time (immediately to 6 weeks posttreatment). Safety was evaluated by assessing local skin responses and adverse events immediately after treatment and at all study visits.</p><p><strong>Results: </strong>Histological analysis of tissue following NAFL 1940-nm treatments showed mild early inflammatory response (presence of lymphotic infiltrate) in some test areas and zones of necrosis and coagulation having widths and depths (immediately-3 days posttreatment) that scaled with the 1940-nm pulse energy. Signs of healing such as presence of dermal mucin, evidence of fibrosis, and absence of necrosis were observed long-term (7 days to 6 weeks posttreatment). Evidence of the MTZ persisted beyond the 6-week study and was predicted to last for 100 days. All local clinical skin responses healed within 6 weeks and were limited to mild, transient erythema and edema which resolved in less than 12-24 h following treatment. No serious adverse events occurred during the study.</p><p><strong>Conclusions: </strong>NAFL 1940-nm treatments are safe for inducing small fractional coagulation and necrosis zones in abdominal skin. NAFL 1940-nm laser creates fractional columns of injury with sufficient depth and coverage that suggest effective skin resurfacing, like other non-ablative fractional lasers.</p>","PeriodicalId":17961,"journal":{"name":"Lasers in Surgery and Medicine","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2024-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142290320","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":"Is HMME-PDT the First Choice of Treatment for Young Children With Port-Wine Stain Birthmarks?","authors":"Jiang Xian","doi":"10.1002/lsm.23831","DOIUrl":"10.1002/lsm.23831","url":null,"abstract":"&lt;p&gt;Recently, Lasers in Surgery and Medicine published a meta-analysis based on 40 PDL studies and 18 HMME-PDT studies [&lt;span&gt;1&lt;/span&gt;]. The authors indicate that “HMME-PDT has emerged as the first choice for PWB treatment, particularly for young children” and at the same time raise many questions regarding the use of HMME-PDT in China. On behalf of the Consensus Development Expert Group of Expert consensus on HMME-PDT, I appreciate American colleagues' interest and concern in HMME-PDT.&lt;/p&gt;&lt;p&gt;PDT's potential for PWS treatment was suggested in the mid-1980s and PDT protocols were developed for PWS treatment in China in the early 1990s [&lt;span&gt;2, 3&lt;/span&gt;]. Two photosensitizing drugs, HiPorfin and Hemoporfin (also known as HMME) are approved for PWS treatment. There is no specific age restriction in HiPorfin production information. Because HMME Phase II and III trials only included patients &gt; 14 years old, “lack of pediatric information in prescribe drug label” is stated in HMME production information. The post-marketing requirements suggest including pediatric patients in Phase IV trials to benefit them more. Clinical trials have been launched for 7−14 years old (NCT03125057, CTR20170189) and 2−7 years old (NCT04106258), respectively. Concerning “young children,” with therapeutic intention and on the premise of obtaining explicit informed consent from the parents, I believe the prescribing of HMME-PDT is regulatory adherence and in compliance with current regulations of rational off-label use of medicines [&lt;span&gt;4-6&lt;/span&gt;].&lt;/p&gt;&lt;p&gt;The authors cite a paper published in 1934 and state that “hematoporphyrin derivatives have been used as antidepressants, indicating potential effects on brain function by this category of compounds. Therefore, the risk of HMME exposure to CNS in neonates, infants, and young children cannot be ignored.” In fact, the paper suggests it requires “intramuscular and oral administration of hematoporphyrin hydrochloride for an average period of 50 to 60 days” to see psychological benefit in depressive psychoses [&lt;span&gt;7&lt;/span&gt;]. The remote risk of short-term HMME exposure to CNS in young children is likely small. Neurological and neuropsychiatric adverse reactions similar to that of porphyria have not been reported for HMME-PDT.&lt;/p&gt;&lt;p&gt;PDT was used before PDL became available in China. Partially due to this historical reason, many patients and parents would consider PDT as the first choice. For PDL resistance cases and large PWS lesions, clinicians might be inclined more toward PDT. But I am not aware that any publication implies “the use of HMME-PDT as the first choice of treatment for young children.” Hence, it is intriguing that the authors suggest that “HMME-PDT has emerged as the first choice for PWB in many major hospitals in China.” When accurate and thoughtfully presented, reporting of comparison of different modalities should be appreciated. In return, the authors who prefer one modality over another should have factua","PeriodicalId":17961,"journal":{"name":"Lasers in Surgery and Medicine","volume":"56 8","pages":"691-692"},"PeriodicalIF":2.2,"publicationDate":"2024-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/lsm.23831","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142290321","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":"The Implication of Photodynamic Therapy Applied to the Level of Tumor Resection on Postoperative Cerebral Edema and Intracranial Pressure Changes in Gliomas","authors":"Jingxuan Li,&nbsp;Weijun Sun,&nbsp;Shaoshan Hu,&nbsp;Xiuwei Yan","doi":"10.1002/lsm.23837","DOIUrl":"10.1002/lsm.23837","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>The aim of our study was to explore the factors influencing cerebral edema and intracranial pressure in glioblastoma multiforme (GBM) patients who undergo photodynamic therapy (PDT) after resection.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Approach</h3>\u0000 \u0000 <p>This was a retrospective controlled study of GBM patients treated with PDT-assisted resections of varying scope from May 2021 to August 2023. The baseline clinical data, cerebral edema volumes, intracranial pressure values, and imaging data of the GBM patients were collected for statistical analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 56 GBM patients were included. Thirty of the patients underwent gross total resection (GTR), and the other 26 patients underwent subtotal resection (STR). We found that the cerebral edema volume and the mean intracranial pressure in patients who underwent GTR were lower than those in patients who underwent STR. Moreover, univariate analysis showed that the scope of tumor resection was an independent factor affecting cerebral edema and intracranial pressure after PDT.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Compared with STR, PDT combined with GTR significantly reduced postoperative brain edema volume and intracranial pressure in GBM patients.</p>\u0000 </section>\u0000 </div>","PeriodicalId":17961,"journal":{"name":"Lasers in Surgery and Medicine","volume":"56 8","pages":"709-722"},"PeriodicalIF":2.2,"publicationDate":"2024-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142217421","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":"Effects of Cryolipolysis on the Conversion of White Adipose Tissue: Pilot Study","authors":"Christiane Rodrigues Tofoli Palauro, Patrícia Froes Meyer, Ciro Dantas Soares, Eneida de Morais Carreiro, Flávio de Paiva Dumaresq, Fernando Cesar Camara de Oliveira, Ana Laura Martins de Andrade, Priscila da S. P. S. Daumas","doi":"10.1002/lsm.23839","DOIUrl":"https://doi.org/10.1002/lsm.23839","url":null,"abstract":"IntroductionCryolipolysis (CLL) is a widely employed noninvasive procedure for body fat reduction. It operates by inducing cooling, leading to the crystallization of cytoplasmic lipids, loss of cellular integrity, and apoptosis/necrosis of adipocytes, accompanied by local inflammation. Ongoing discussions revolve around CLL's potential to transform white adipocytes into brown adipocytes, potentially yielding more significant effects compared to alternative procedures.ObjectiveThus, this randomized, blinded clinical study aimed to investigate the effects of CLL on adipose tissue and elucidate the mechanisms involved in its application and capacity for adipocyte conversion.MethodologyTissue samples from six patients were assessed at intervals of 45, 60, and 90 days following the application of the CLL protocol during abdominoplasty surgeries.ResultsThe samples underwent immunohistochemical analyses targeting various markers, revealing higher expression of PPAR‐gamma, PPAR‐alpha, and UCP‐1 markers in CLL‐treated samples.ConclusionTherefore, the present study suggests that CLL has the ability to intervene in adipocyte conversion.","PeriodicalId":17961,"journal":{"name":"Lasers in Surgery and Medicine","volume":"293 1","pages":""},"PeriodicalIF":2.4,"publicationDate":"2024-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142217422","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}