Influence of a pulsed CO2 laser operating at 9.4 μm on the surface morphology, reflectivity, and acid resistance of dental enamel below the threshold for melting

Below the threshold for laser ablation, the mineral phase of enamel is converted into a purer phase hydroxyapatite with increased acid resistance. Studies suggest the possibility of achieving the conversion without visible surface alteration. In this study, changes in the surface morphology, reflectivity, and acid resistance were monitored with varying irradiation intensity. Bovine enamel specimens were irradiated using a CO 2 laser operating at 9.4 ?? ? m with a Gaussian spatial beam profile—1.6 to 3.1 mm in diameter. After laser treatment, samples were subjected to demineralization to simulate the acidic intraoral conditions of dental decay. The resulting demineralization and erosion were assessed using polarization-sensitive optical coherence tomography, three-dimensional digital microscopy, and polarized light microscopy. Distinct changes in the surface morphology and the degree of inhibition were found within the laser-treated area in accordance with the laser intensity profile. Subtle visual changes were noted below the melting point for enamel that appear to correspond to thresholds for denaturation of the organic phase and thermal decomposition of the mineral phase. There was significant protection from laser irradiation in areas in which the reflectivity was not increased significantly, suggesting that aesthetically sensitive areas of the tooth can be treated for caries prevention.

A Low-Level Carbon Dioxide Laser Promotes Fibroblast Proliferation and Migration through Activation of Akt, ERK, and JNK

BACKGROUND

Low-level laser therapy (LLLT) with various types of lasers promotes fibroblast proliferation and migration during the process of wound healing. Although LLLT with a carbon dioxide (CO2) laser was also reported to promote wound healing, the underlying mechanisms at the cellular level have not been previously described. Herein, we investigated the effect of LLLT with a CO2 laser on fibroblast proliferation and migration.

MATERIALS AND METHODS

Cultured human dermal fibroblasts were prepared. MTS and cell migration assays were performed with fibroblasts after LLLT with a CO2 laser at various doses (0.1, 0.5, 1.0, 2.0, or 5.0 J/cm2) to observe the effects of LLLT with a CO2 laser on the proliferation and migration of fibroblasts. The non-irradiated group served as the control. Moreover, western blot analysis was performed using fibroblasts after LLLT with a CO2 laser to analyze changes in the activities of Akt, extracellular signal-regulated kinase (ERK), and Jun N-terminal kinase (JNK), which are signaling molecules associated with cell proliferation and migration. Finally, the MTS assay, a cell migration assay, and western blot analysis were performed using fibroblasts treated with inhibitors of Akt, ERK, or JNK before LLLT with a CO2 laser.

RESULTS

In MTS and cell migration assays, fibroblast proliferation and migration were promoted after LLLT with a CO2 laser at 1.0 J/cm2. Western blot analysis revealed that Akt, ERK, and JNK activities were promoted in fibroblasts after LLLT with a CO2 laser at 1.0 J/cm2. Moreover, inhibition of Akt, ERK, or JNK significantly blocked fibroblast proliferation and migration.

CONCLUSIONS

These findings suggested that LLLT with a CO2 laser would accelerate wound healing by promoting the proliferation and migration of fibroblasts. Activation of Akt, ERK, and JNK was essential for CO2 laser-induced proliferation and migration of fibroblasts.

[The application of stapedoplasty for the treatment of hearing loss in the patients suffering from obliterative otosclerosis]

This article presents the results of analysis of the data obtained during the examination and the surgical treatment of the patients presenting with the obliterative form of otosclerosis and suffering from hearing impairment with special reference to the intraoperative findings, technical aspects of stapedoplasty, and its effectiveness. A total of 14 patients (17 ears) were recruited for the participation in the present study including 10 women at the mean age of 38.8±6.2 years and 4 men (mean age 44.8±3.9 years). The duration of the hearing loss in the period preceding the surgical treatment in 7 (50%) patients was more than 8 years. According to the results of tonal threshold audiometry (TTA), the mean bone conduction (BC) threshold for conductive hearing loss in the frequency range from 0.5 to 4.0 kHz was 24.9±8.1 dB with the mean bone air gap (BAG) equaling 38±5.1 dB. Computed tomography (CT) of the temporal bones revealed grade 1 obliterative otosclerosis in 4 patients, grade II of the same condition in 6 patients, and grade III in 7 ones. These findings were confirmed intraoperatively. In 15 cases, stapedostomy was carried out with the use of the non-contact CO2 laser-based system, in the remaining cases a microdrill was employed. Five patients underwent laser-assisted piston stapedoplasty while in 11 others the stapes prosthesis was placed on the autovein. One patient was treated by the same method with the use of the autocartilaginous prosthesis. The functionally acceptable results within 1 year after the surgical intervention were obtained in all the treated patients with the mean bone air gap equaling 13.2±3.4 dB. The best outcome (the reduction of the BC threshold and BAG by 7 dB and 25.9 db on the average respectively within 1 year after surgery was achieved in the patients with grade III obliterative otosclerosis.

The evaluation of the effect of carbon dioxide laser radiation on dentine tissue

of this study was to analyze the effects of carbon dioxide (CO2) laser light on the structure and elemental composition of dentine.

METHODS

The evaluation was conducted on samples from extracted teeth. The surface of the dentine was exposed to the radiation from a CTL 1401 CO2 laser (Centre of Laser Technology, Poland). The radiation and frequency parameters were as follows: group I with 5 W and 1 Hz, group II with 10 W and 1 Hz, group III with 5 W and 5 Hz, and group IV with 10 W and 5 Hz. The altered dentine structure was macroscopically and microscopically evaluated using a Nova NanoSEM 200 Scanning Electron Microscope (FEI Europe) with integrated microanalysis X-ray system for elemental analysis in points.

RESULTS

There were significant differences between groups in the macro- and microstructure of laser defects.

CONCLUSIONS

CO2 laser radiation causes irreversible, destructive changes in dentine. The structural dentine lesions developed under the influence of the CO2 laser radiation may hinder proper adhesion of bonding systems with the damaged tissue. Laser defects in the structure should be treated like defects of noncarious origin requiring preparation and filling with composite materials in accordance with the procedures.

Comparison of HeNe laser and sinusoidal non-uniform magnetic field seed pre-sowing treatment effect on Glycine max (Var 90-I) germination, growth and yield

Recently, laser and magnetic field pre-sowing seed treatments attracted the attention of the scientific community in response to their positive effect on plant characteristics and the present study was exemplified for Glycine max Var 90-I. Seeds were exposed to laser (HeNe-wave length 632nm and density power of 1mW/cm2) and magnetic field (sinusoidal non-uniform-50, 75 and 100mT for 3, 5min with exposure) and seed germination, seedling growth and yield attributes were compared. The germination (mean germination, germination percentage, emergence index, germination speed, relative germination coefficient, emergence coefficient of uniformity) growth (root dry weight, root length, shoot fresh weight and shoot dry weight, leaf dry & fresh weight, root fresh weight, leaf area, shoot length, plant total dry weight at different stages, stem diameter, number of leaves, vigor index I & II), biochemical (essential oil) and yield attributes (seed weight, count) were enhanced significantly in response to both laser and magnetic field treatments. However, magnetic field treatment furnished slightly higher response versus laser except relative water contents, whole plant weight and shoot length. Results revealed that both laser and magnetic field pre-sowing seed treatments affect the germination, seedling growth, and yield characteristics positively and could possibly be used to enhance Glycine max productivity.

Evaluation of Laser-Assisted Trans-Nail Drug Delivery with Optical Coherence Tomography

The nail provides a functional protection to the fingertips and surrounding tissue from external injuries. The nail plate consists of three layers including dorsal, intermediate, and ventral layers. The dorsal layer consists of compact, hard keratins, limiting topical drug delivery through the nail. In this study, we investigate the application of fractional CO₂ laser that produces arrays of microthermal ablation zones (MAZs) to facilitate drug delivery in the nails. We utilized optical coherence tomography (OCT) for real-time monitoring of the laser-skin tissue interaction, sparing the patient from an invasive surgical sampling procedure. The time-dependent OCT intensity variance was used to observe drug diffusion through an induced MAZ array. Subsequently, nails were treated with cream and liquid topical drugs to investigate the feasibility and diffusion efficacy of laser-assisted drug delivery. Our results show that fractional CO₂ laser improves the effectiveness of topical drug delivery in the nail plate and that OCT could potentially be used for in vivo monitoring of the depth of laser penetration as well as real-time observations of drug delivery.

A combination of He-Ne laser irradiation and exogenous NO application efficiently protect wheat seedling from oxidative stress caused by elevated UV-B stress

The elevated ultraviolet-B (UV-B) stress induces the accumulation of a variety of intracellular reactive oxygen species (ROS), which seems to cause oxidative stress for plants. To date, very little work has been done to evaluate the biological effects of a combined treatment with He-Ne laser irradiation and exogenous nitric oxide (NO) application on oxidative stress resulting from UV-B radiation. Thus, our study investigated the effects of a combination with He-Ne laser irradiation and exogenous NO treatment on oxidative damages in wheat seedlings under elevated UV-B stress. Our data showed that the reductions in ROS levels, membrane damage parameters, while the increments in antioxidant contents and antioxidant enzyme activity caused by a combination with He-Ne laser and exogenous NO treatment were greater than those of each individual treatment. Furthermore, these treatments had a similar effect on transcriptional activities of plant antioxidant enzymes. This implied that the protective effects of a combination with He-Ne laser irradiation and exogenous NO treatment on oxidative stress resulting from UV-B radiation was more efficient than each individual treatment with He-Ne laser or NO molecule. Our findings might provide beneficial theoretical references for identifying some effective new pathways for plant UV-B protection.

Fractional CO₂ Laser Pretreatment Facilitates Transdermal Delivery of Two Vitamin C Derivatives

BACKGROUND

Topical vitamin C derivatives have been used to treat melasma and used as a skin whitener. The aim of this study was to compare skin histology and permeation of l-ascorbic acid 2-phosphate sesquimagnesium salt (MAP-1) and magnesium l-ascorbic acid-2-phosphate (MAP-2) after fractional CO₂ laser pretreatment.

METHODS

The effect of fractional laser treatment on porcine skin was examined by scanning electron microscopy and confocal laser scanning electron microscopy. The effect of fractional CO₂ laser treatment of different fluencies and pass numbers on transdermal flux of the two vitamin C derivatives through porcine skin was examined in vitro using a Franz diffusion chamber.

RESULTS

Fluxes of MAP-1 and MAP-2 across fractional CO₂ laser-treated (5 W) skin were eight- to 13-fold, and 20- to 22-fold higher, respectively, than the fluxes of these compounds across intact skin. Fluxes of MAP-1 and MAP-2 across fractional CO₂ laser-treated (9 W) skin were 14- to 19-fold, and 30- to 42-fold higher, respectively, than their fluxes across intact skin.

CONCLUSION

Fractional CO₂ laser treatment is an effective way of delivering vitamin C derivatives into the skin.

Laser-assisted delivery of topical methotrexate - in vitro investigations

Ablative fractional lasers (AFXL) are increasingly used to treat dermatological disorders and to facilitate laser-assisted topical drug delivery. In this thesis, laser-tissue interactions generated by stacked pulses with a miniaturized low-power 2,940 nm AFXL were characterized (study I). Knowledge of the correlation between laser parameters and tissue effects was used to deliver methotrexate (MTX) topically through microscopic ablation zones (MAZs) of precise dimensions. MTX is a well-known chemotherapeutic and anti-inflammatory drug that may cause systemic adverse effects, and topical delivery is thus of potential benefit. The impact of MAZ depth (study II) and transport kinetics (study III) on MTX deposition in skin as well as transdermal permeation was determined in vitro. Quantitative analyses of dermal and transdermal MTX concentrations were performed by high performance liquid chromatography (HPLC) (study II & III), while qualitative analyses of MTX biodistribution in skin were illustrated and semi-quantified by fluorescence microscopy (study II & III) and desorption electro spray mass spectrometry imaging (DESI-MSI) (study III). Laser-tissue interactions generated by AFXL: AFXL-exposure generated a variety of MAZ-dimensions. MAZ depth increased linearly with the logarithm of total energy delivered by stacked pulses, but was also affected by variations in power, pulse energy, pulse duration, and pulse repetition rate. Coagulation zones lining MAZs increased linearly with the applied total energy, while MAZ width increased linearly with the logarithm of stacked pulses. Results were gathered in a mathematical model estimating relations between laser parameters and specific MAZ dimensions. Impact of MAZ depth on AFXL-assisted topical MTX delivery: Pretreatment by AFXL facilitated topical MTX delivery to all skin layers. Deeper MAZs increased total MTX deposition in skin compared to superficial MAZs and altered the intradermal biodistribution profile towards maximum accumulation in deeper skin layers. Biodistribution of MTX occurred throughout the skin without being compromised by coagulation zones of varying thickness. The ratio of skin deposition versus transdermal permeation was constant, regardless of MAZ depth. Impact of transport kinetics on AFXL-assisted topical MTX delivery: MTX accumulated rapidly in AFXL-processed skin. MTX was detectable in mid-dermis after 15 min. and saturated the skin after 7 h at a ten-fold increased MTX-concentration compared to intact skin. Transdermal permeation stayed below 1.5% of applied MTX before skin saturation, and increased afterwards up to 8.0% at 24h. MTX distributed radially into the coagulation zone within 15 min of application and could be detected in surrounding skin at 1.5 h. Upon skin saturation, MTX had distributed in an entire mid-dermal skin section. In conclusion, adjusting laser parameters and application time may enable targeted treatments of dermatological disorders and potentially pose a future alternative to systemic MTX in selected dermatological disorders.

Helium-neon laser irradiation of cryopreserved ram sperm enhances cytochrome c oxidase activity and ATP levels improving semen quality

This study examines whether and how helium-neon laser irradiation (at fluences of 3.96-9 J/cm(2)) of cryopreserved ram sperm helps improve semen quality. Pools (n = 7) of cryopreserved ram sperm were divided into four aliquots and subjected to the treatments: no irradiation (control) or irradiation with three different energy doses. After treatment, the thawed sperm samples were compared in terms of viability, mass and progressive sperm motility, osmotic resistance, as well as DNA and acrosome integrity. In response to irradiation at 6.12 J/cm(2), mass sperm motility, progressive motility and viability increased (P < 0.05), with no significant changes observed in the other investigated properties. In parallel, an increase (P < 0.05) in ATP content was detected in the 6.12 J/cm(2)-irradiated semen samples. Because mitochondria are the main cell photoreceptors with a major role played by cytochrome c oxidase (COX), the COX reaction was monitored using cytochrome c as a substrate in both control and irradiated samples. Laser treatment resulted in a general increase in COX affinity for its substrate as well as an increase in COX activity (Vmax values), the highest activity obtained for sperm samples irradiated at 6.12 J/cm(2) (P < 0.05). Interestingly, in these irradiated sperm samples, COX activity and ATP contents were positively correlated, and, more importantly, they also showed positive correlation with motility, suggesting that the improved sperm quality observed was related to mitochondria-laser light interactions.

[CO2 laser assisted posterior cordotomy for bilateral vocal cord paralysis]

OBJECTIVE

To investigate the feasibility and efficacy of CO2 laser assisted posterior cordotomy for patients with bilateral paralysis of the vocal cord.

METHOD

Twenty-one patients with bilateral paralysis of the vocal cord underwent CO2 laser assisted posterior cordotomy in our hospital from Jul. 2009 to Jun. 2015. The causes of the bilateral paralysis of the vocal cord were thyroidectomy in 15 cases, cervical trauma in 2 cases, resection of pituitary tumor in 1 case, inflammation in 1 case and without cause in 2 cases. Ten patients underwent tracheotomy before the operation; 9 patients underwent tracheotomy after the operation; 2 cases without tracheotomy.

RESULT

The tracheotomy tube was plugged next day after posterior cordotomy. Lots of patients were breathing well without any effort. A few patients were breathing hard, so the tracheotomy tube was plugged discontinuously. Seventeen patients were decannulated 1 year after operation. Two patients were failed to decannulated. The patients were followed up for 3 months 6 years after operation, and all of them were breathing well.

CONCLUSION

Our limited experience showed that CO2 laser assisted posterior cordotomyis an effective and reliable surgical procedure for patients with bilateral paralysis of the vocal cord.

[Investigation of the Problems and Solutions for CO2 Laser Treatment Apparatus in Hospital]

The current situation of the CO2 laser treatment apparatus in hospital was evaluated through actual investigation and testing data in this paper. The existing problems have been analyzed and the solutions are proposed, which wil play a role in maintenance, testing and drafting standards for this kind of medical devices being used in hospital.

ENDOCRINE DILEMMA: Managing menopausal symptoms after breast cancer

Managing the symptoms of menopause after a diagnosis of breast cancer offers some unique clinical challenges. For some women, vasomotor symptoms can be severe and debilitating, and hormone therapy is at least relatively contraindicated. Non-oestrogen therapies for hot flushes include SSRIs, clonidine, gabapentin and perhaps black cohosh extracts. Vulvovaginal atrophy can usually be alleviated by simple moisturizers, although some may need specialized physiotherapy such as vaginal dilators. In a small number, topical oestrogens may be the only treatment that works. The CO2 laser may be a novel, non-oestrogen therapy to alleviate this unpleasant symptom. Bone loss can be accelerated in some patients on AIs or those who had early menopause induced by chemotherapy.

Assessment of the Effect of CO2 Laser Irradiation on the Reduction of Bacteria Seeded on Commercially Available Sandblasted Acid-Etched Titanium Dental Implants: An In Vitro Study

PURPOSE

To evaluate the capability of carbon dioxide (CO₂) laser in reducing Escherichia coli on sandblasted acid-etched (SAE) titanium dental implants.

MATERIALS AND METHODS

SAE dental implants were contaminated with E coli, incubated in a sterile bacterial culture medium for 24 hours, and then exposed to CO₂ laser (10,600-nm wavelength) in superpulsed waves (SPW) at 1.5, 1.7, and 2 W at 100-Hz frequency and continuous wave (CW) at 1.5, 2, and 2.5 W. The presence of bacteria trapped in the implant surfaces after contamination and decontamination was verified using spectrophotometry. Scanning electron microscopy (SEM) was used to evaluate the topography of laser irradiation. After implant surface contamination was verified, implants were exposed to CO₂ laser irradiation, and bacterial growth was measured with spectrophotometry.

RESULTS

The control implants showed the highest bacterial growth (100% growth). Implants exposed to laser showed progressive increase in the percentage of decontamination (DC%) corresponding to the higher wattage in the SPW and CW groups. The DC% were 20.4%, 49.6%, and 51.7% in the SPW group at 100 Hz, at 1.5, 1.7, and 2 W of power, respectively. In the CW group, the DC% were 34.3%, 69.9%, and 85.5% at 1.7, 2, and 2.5 W, respectively. Kruskal-Wallis statistical analysis showed a significant difference between the groups (P < .05). In the pulsed mode (100-Hz) group, statistical analysis showed that the DC% of 1.5 W was significantly lower than the 2 W power. In the CW group, statistical analysis showed that the DC% at 1.7 W was significantly lower (P < .05) than with the other treatments. SEM assessment showed craterlike wear damages and accretions to the implant surfaces that increased progressively as the laser wattage increased.

CONCLUSION

CO₂ laser irradiation failed to completely decontaminate the implant surfaces. SEM analysis demonstrated damage to the top of the dental implant threads at all settings studied. Thus, CO₂ laser irradiation may not be the optimal method to decontaminate implants.

Plasma-assisted quadruple-channel optosensing of proteins and cells with Mn-doped ZnS quantum dots

Information extraction from nano-bio-systems is crucial for understanding their inner molecular level interactions and can help in the development of multidimensional/multimodal sensing devices to realize novel or expanded functionalities. The intrinsic fluorescence (IF) of proteins has long been considered as an effective tool for studying protein structures and dynamics, but not for protein recognition analysis partially because it generally contributes to the fluorescence background in bioanalysis. Here we explored the use of IF as the fourth channel optical input for a multidimensional optosensing device, together with the triple-channel optical output of Mn-doped ZnS QDs (fluorescence from ZnS host, phosphorescence from Mn(2+) dopant, and Rayleigh light scattering from the QDs), to dramatically improve the protein recognition and discrimination resolution. To further increase the cross-reactivity of the multidimensional optosensing device, plasma modification of proteins was explored to enhance the IF difference as well as their interactions with Mn-doped ZnS QDs. Such a sensor device was demonstrated for highly discriminative and precise identification of proteins in human serum and urine samples, and for cancer and normal cells as well.

Impact of CO2 laser and stannous fluoride on primary tooth erosion

This study evaluated in vitro the effect of input power of CO2 laser, either associated or not to stannous fluoride (SnF2) gel, for the control of intrinsic erosion in primary teeth. One hundred four enamel slabs (3 × 3 × 2 mm) from human primary molars were flattened and polished. Adhesive tapes were placed on their surface leaving a window of 3 × 1 mm. Slabs were then cycled four times in 0.01 M hydrochloric acid (pH 2, 2 min) and in artificial saliva (2 h) for creation of erosive lesions. Specimens were randomly assigned into eight groups (n = 13) according to fluoride application [absent (control) or 0.4% stannous fluoride gel (SnF2)] and input power of CO2 laser [unlased (control), 0.5, 1.0 or 1.5 W]. The CO2 laser irradiation was performed in an ultra-pulse mode (100 μs of pulse duration), 4-mm working distance, for 10 s. Specimens were then submitted to further erosive episodes for 5 days and evaluated for enamel relative permeability. Fluoride did not show any protective effect for any of the laser-treated groups or control (p = 0.185). However, a significant effect was detected for input power of CO2 laser (p = 0.037). Tukey's test showed that there was a significant statistically difference between specimens irradiated with 0.5 and 1.5 W (p = 0.028). The input power of 0.5 W showed lower permeability. Variation of input power CO2 laser can influence enamel permeability, at the power of 1.5 W which promoted greater permeability.

Broadband two-stage frequency conversion of CO laser in AgGaSe(2) crystal

For the first time, to the best of our knowledge, a broadband two-stage frequency conversion of multiline CO laser radiation was theoretically and experimentally demonstrated in a single AgGaSe₂ crystal. The first stage is sum frequency generation of CO laser radiation. The second stage is concurrent difference frequency generation within 4.3-4.9 μm spectral range when mixing sum frequency radiation with the pump radiation in the same AgGaSe₂ crystal. Internal sum frequency generation efficiency of multiline CO laser was up to 1%, while internal difference frequency generation efficiency was up to 0.065%.

High-Performance Pseudocapacitive Microsupercapacitors from Laser-Induced Graphene

All-solid-state, flexible, symmetric, and asymmetric microsupercapacitors are fabricated by a simple method in a scalable fashion from laser-induced graphene on commercial polyimide films, followed by electrodeposition of pseudocapacitive materials on the interdigitated in-plane architectures. These microsupercapacitors demonstrate comparable energy density to commercial lithium thin-film batteries, yet exhibit more than two orders of magnitude higher power density with good mechanical flexibility.

Comparison of four different lasers for acne scars: Resurfacing and fractional lasers

BACKGROUND

Acne scars are common and cause cosmetic problems. There is a multitude of treatment options for acne scars, including dermabrasion, chemical peeling, and fillers, but the advent of laser technology has greatly improved the treatment of acne scars. Although several laser systems are available, studies comparing their efficacy are limited. This study compares the results of treatments using resurfacing (carbon dioxide, CO2; erbium-doped yttrium aluminum garnet, Er:YAG) versus fractional (nonablative fractional laser, NAFL; ablative fractional laser, AFL) lasers.

METHODS

A retrospective photographic analysis of 58 patients who underwent laser treatment for facial atrophic acne scars was performed. Clinical improvement was assessed by six blinded investigators with a scale graded from 0 to 10. Adverse events were also noted.

RESULTS

Mean improvement scores of the CO2, Er:YAG, NAFL, and AFL groups were 6.0, 5.8, 2.2, and 5.2, respectively. The NAFL group showed a significantly lower score than the other groups. The mean number of treatments was significantly greater in the fractional laser groups than in the resurfacing laser groups. The resurfacing laser groups had a prolonged recovery period and high risk of complications. The Er:YAG laser caused less erythema or pigmentation compared to the CO2 laser.

CONCLUSIONS

Although the CO2 laser, Er:YAG laser, and AFL improved the acne scars, the CO2 laser had a greater downtime. Three consecutive AFL treatments are as effective as a single treatment with resurfacing lasers, with shorter social downtime periods and less adverse effects.

Anterior commissure laryngeal neoplasm endoscopic management

The CO2 laser surgery represents a treatment method of laryngeal bicordal and anterior commissure glottic cancer T1b, T2, N0. In Department of ENT, Timisoara, Romania, during 1.01.2001-31.12.2011 were analyzed 781 files from patients with laryngeal neoplasm. One hundred twenty-seven patients presented the tumor that involved both vocal cords and anterior commissure, stages T1b, T2 and T3. Therapeutic options included CO2 laser microsurgical excision for 55 (43.30%) patients, frontolateral hemilaryngectomy for 16 (12.59%) patients, total laryngectomy for 42 (33.07%) patients, radiotherapy for 10 (7.87%) patients, and four (3.14%) patients, initially, refused any treatment modality. Endoscopic laser CO2 microsurgery was the primary and solitary management for curative resection of the glottic cancer. All operations were performed under general anesthesia with orotracheal intubations. The mean follow-up was 58 months, with the range between 36 to 84 months. Suspended microlaryngoscopy with CO2 laser surgery has been performed in 43 (33.85%) patients staged T1bN0Mx and 12 (9.44%) patients staged T2N0Mx. In five (9.09%) patients, we encountered local recurrences. The endoscopic CO2 laser surgery is in our view the elective and preferable surgical method in laryngeal glottic cancer stage T1b and T2 for cure, with oncological and functional results superior to those of conventional surgical procedures.

Retrospective analysis of laser vs other therapeutic modalities for laryngeal papillomatosis: European multicenter study

PURPOSE

Laryngeal papillomatosis can be an aggressive and potentially life-threatening disease, affecting both children and adults. Local excision is the gold standard of treatment, but recurrences are frequently inevitable. The purpose of this study was to present the experience of three institutions with different therapeutic modalities and discuss them in relation with the relevant literature.

METHODS

Sixty patients underwent papilloma resection during the last decade in three institutions (Homburg/Saar and Marburg, Germany and Athens,Greece). Patient data were retrospectively analyzed for therapeutic modalities applied, rate of complications and synechia formation, necessary operations and need for tracheostomy.

RESULTS

Carbon dioxide laser therapy was the most common modality applied alone or combined with other treatment modalities. No major complication was observed, while glottic synechia was the most common minor complication in 5 (8.3%) patients. Of the patient cohort 55.6% required reoperation, while no patient required tracheostomy.

CONCLUSIONS

Surgical debulking with or without adjuvant treatment remains the mainstay of treatment, which mainly aims to reduce the number and frequency of recurrences since no definitive curative therapy is known so far.

Fractional Ablative Laser Followed by Transdermal Acoustic Pressure Wave Device to Enhance the Drug Delivery of Aminolevulinic Acid: In Vivo Fluorescence Microscopy Study

BACKGROUND

Topical drug delivery is the foundation of all dermatological therapy. Laser-assisted drug delivery (LAD) using fractional ablative laser is an evolving modality that may allow for a greater precise depth of penetration by existing topical medications, as well as more efficient transcutaneous delivery of large drug molecules. Additional studies need to be performed using energy-driven methods that may enhance drug delivery in a synergistic manner. Processes such as iontophoresis, electroporation, sonophoresis, and the use of photomechanical waves aid in penetration. This study evaluated in vivo if there is increased efficacy of fractional CO2 ablative laser with immediate acoustic pressure wave device.

METHODS

Five patients were treated and biopsied at 4 treatment sites: 1) topically applied aminolevulinic acid (ALA) alone; 2) fractional ablative CO2 laser and topical ALA alone; 3) fractional ablative CO2 laser and transdermal acoustic pressure wave device delivery system; and 4) topical ALA with transdermal delivery system. The comparison of the difference in the magnitude of diffusion with both lateral spread of ALA and depth diffusion of ALA was measured by fluorescence microscopy.

RESULTS

For fractional ablative CO2 laser, ALA, and transdermal acoustic pressure wave device, the protoporphyrin IX lateral fluorescence was 0.024 mm on average vs 0.0084 mm for fractional ablative CO2 laser and ALA alone. The diffusion for the acoustic pressure wave device was an order of magnitude greater.

CONCLUSION

We found that our combined approach of fractional ablative CO2 laser paired with the transdermal acoustic pressure wave device increased the depth of penetration of ALA.