宫腔镜下Nd:YAG激光治疗子宫内疾病78例分析

目的 :评价宫腔镜对子宫内疾病的诊断价值和采用Nd :YAG激光治疗子宫内疾病的效果。方法 :对 78例子宫内疾病 (包括子宫内粘连、子宫粘膜下肌瘤、子宫纵隔、子宫粘膜息肉、宫颈息肉及宫颈管囊肿 )采用宫腔镜进行诊断 ,并用Nd :YAG激光进行治疗。结果 :宫腔镜诊断子宫内疾病的准确率高于超声诊断及放射诊断。采用Nd :YAG激光治疗的一次性成功率为 97.43 %。手术时间为 2 0 5 5分钟 ,平均 3 5 .7± 18.5分钟。无明显并发症。术后 1 3个月随访 2例病人有残留的粘连带及纵隔组织而进行二次手术。其余患者均恢复正常。 8例患者 (有生育要求者 )在一年内妊娠。结论 :对于子宫内疾病宫腔镜有较高的临床价值 ,采用Nd :YAG激光治疗具有更简便、安全、疗效确切等优点 ,具有广泛的应用前景     

激光泪道成形术治疗泪道阻塞的临床观察

目的 观察激光泪道成形术治疗泪道阻塞的效果及复发病例再次激光联合插管治疗的效果。方法 采用Nd：YAG激光泪道成形术治疗泪道阻塞102例。132眼。对复发病例。再次行激光联合插管治疗。结果 113眼一次治愈，有效9眼。术后10眼复发，再次行激光联合插管治疗，7眼治愈，3眼未愈。本组总治愈率90．9％，有效率97．7％。结论 Nd：YAG激光泪道成形术治疗泪道阻塞操作简单，安全有效，复发病例联合插管治疗可以提高治愈率。     

Efficacy of pulsed-dye laser for viral warts--an internal audit

Pulsed-dye laser (PDL) surgery is a recognized treatment of viral warts. Initial studies in 1993 by Tan et al achieved a 72% cure rate for 39 patients after a mean of 1.68 treatments. Since then, conflicting response rates ranging from 47-95% have been reported. The records of 44 patients, who attended the Laser Unit at St. James's Hospital between January 1999 to June 2000, were reviewed. Follow-up was conducted by telephone interview or questionnaire. Twenty-eight (64%) patients identified for the study responded. The average number of treatments was 4 (range 1-12) and mean treatment intervals were 4.9 weeks (3-10). Our results showed 64% complete clearance of all the areas treated, and 46% complete clearance of the 13 areas identified as recalcitrant. Rates for complete clearance varied with anatomic site: 73% for the face, 68% for the hands, and 40% for feet. Seventy-eight percent (7/9) of periungal warts completely cleared, and 70% (7/10) mosaic warts cleared. Twenty-five percent of the patients complained of severe pain during treatment. Post-operative complications were few, and rarely affected the patients' lifestyle. The recurrence of warts, in weeks to months following the last treatment, was reported by 36% of the patients. Seventy-nine percent of patients were satisfied with the treatment they were given. PDL may be useful in treatment of refractory warts in selected patient populations. The study identified a need to address pain control in a significant number of patients.     

Endoscopic laser surgery for subglottic stenosis in Wegener's granulomatosis

PURPOSE: Wegener's granulomatosis (WG) is a rare multisystem inflammatory disease, which infrequently involves the subglottic area and trachea. Treatment usually involves the use of immunosuppressive agents with corticosteroids. Some patients, however, continue to have symptoms of airway obstruction after clinical remission following the standard therapeutic regimen. OBJECTIVE: To investigate laser treatment for subglottic stenosis in five patients suffering from WG. MATERIALS AND METHODS: We endoscopically treated 5 patients with subglottic stenosis due to WG and airway obstruction by Nd:YAG and CO2 lasers. One of the patients had preoperative tracheostomy and after treatment was decannulated and could not breathe without dyspnea. Another patient required stenting of the subglottic area. RESULTS: All five patients were able to breathe without dyspnea after the treatment. Three patients were treated with an Nd:YAG laser but needed repeated laser treatment every four to six months, whenever they complained of dyspnea. The other two patients were treated with a CO2 laser; one of these patients had preoperative tracheostomy and was treated twice by CO2 laser and decannulated, with no further difficulty in breathing. The follow-up period was 1-5 years. CONCLUSIONS: Nd:YAG and CO2 lasers are recommended in the treatment of subglottic stenosis (SS) due to WG, particularly when the stenosis is in continuity or close proximity to the vocal cords.     

强脉冲光联合Nd:YAG激光治疗黄褐斑疗效观察

目的:探讨强脉冲光联合Nd:YAG激光治疗黄褐斑的疗效。方法:60例患者按治疗方法不同分成3组:强脉冲光组、Nd:YAG激光组、联合组（强脉冲光联合Nd:YAG激光组）,每组20例患者,观察3组患者疗效和副作用。结果:3组之间疗效两两比较采用Mann-Whitney秩和检验,强脉冲光组和激光组疗效无显著差异,而联合组疗效显著好于强脉冲光组（Z=7.123, P=0.024）和激光组（Z=6.024, P=0.030）。3组患者治疗后均无出现色素沉着加重、色素脱失病等不良反应。强脉冲光组和激光组的满意度无显著差异,而联合组的满意度显著好于强脉冲光组（Z=7.361, P=0.029）和激光组（Z=6.831, P=0.027）。结论:强脉冲光联合Nd:YAG激光治疗黄褐斑是一种安全有效的治疗方法,值得临床推广。     

Q开关Nd：YAG激光联合左旋维生素C离子导入治疗黄褐斑的临床观察

目的：探讨Q开关Nd：YAG激光联合左旋维生素C离子导入治疗黄褐斑的临床疗效和安全性,为黄褐斑的治疗提供疗效确切并安全的治疗方法。方法：将90例黄褐斑的患者随机分为3组,每组30例。治疗组给予Q开关Nd：YAG激光联合左旋维生素C离子导入治疗;对照1组单纯给予Q开关Nd：YAG激光治疗;对照2组单纯给予左旋维生素C离子导入治疗。激光治疗每两周1次,左旋维生素C离子导入每周1次,共治疗16周。分别在治疗8周后和16周后通过MSAI评分进行疗效分析,并在治疗结束后以水疱、座疮以及色素沉着和色素减退来进行不良反应分析。结果：在治疗8周后,联合治疗组与对照1组疗效差异无统计学意义（尸〉0．05）,与对照2组疗效差异有统计学意义（P＜O．05）;16周时治疗组有效率为73．33％,对照1组为73．33％,对照2组为36．67％,差异有统计学意义（P均〈O．05）;治疗组不良反应发生率为20．00％,对照l组为33．33％,对照2组为3．33％,差异无统计学意义（P〉0．05）结论：治疗8周后,Q开关Nd：YAG激光联合左旋维生素C离子导人治疗的方法疗效并不优于单纯激光治疗,但优于单纯左旋维生素C离子导人的方法;治疗16周后,Q开关Nd：YAG激光联合左旋维生素C离子导入治疗黄褐斑比两者单独应用效果好;安全性有保障,值得临床推广。     

Nd:YAG激光治疗儿童后发障的临床观察

目的探讨Nd:YAG激光治疗儿童后发障的时机、效果及并发症。方法用Nd:YAG激光对65例87眼儿童后发障患者进行治疗。结果术后视力提高1行者7眼,占8%;提高2行者20眼,占22.9%;提高3行及以上者54眼,占62%;术后视力未提高者6眼,占6.8%。结论Nd:YAG激光治疗儿童后发障是一种安全有效的方法,并应尽早进行。     

Immediate cutaneous hypersensitivity after treatment of tattoo with Nd:YAG laser: a case report and review of the literature.

BACKGROUND: To our knowledge this is the first reported case of an immediate cutaneous reaction to Q-switched neodymium:yttrium-aluminum-garnet (Nd:YAG) laser tattoo removal. A 26-year-old female presented with two 6-year-old tattoos placed at different times. These were of different colors and had remained entirely asymptomatic since placement. There was a Mardi Gras mask on her thigh and a Tasmanian devil on her chest. With laser treatment of the Tasmanian devil, she experienced no untoward effects. However, with treatment of the Mardi Gras mask tattoo, she developed an extensive urticarial and indurated reaction 30 minutes posttreatment. The identical reaction occurred twice with subsequent laser treatments. Dermatology consulted allergy to provide prophylaxis against possible systemic reaction with subsequent Nd:YAG laser therapy. The patient was treated with 3 days of prednisone, cetirizine, and ranitidine before subsequent laser treatments. Prophylactic treatment suppressed all subsequent reactions to laser therapy. RESULTS: Delayed hypersensitivity to tattoo pigments occurring days to weeks after placement is well documented. There are no previous reports of immediate hypersensitivity during placement or laser removal. However, there are two previous reports of local and systemic delayed reactions after laser therapy. CONCLUSIONS: As far as we know, this is the first case report of immediate hypersensitivity after Nd:YAG laser treatment of a tattoo. Prophylactic treatment with steroids and antihistamines prevented reactions with subsequent laser treatments. Reactions after laser removal are rare, but may increase as popularity of skin art increases with the need for subsequent removal.     

Nd：YAG泪道激光成形术治疗泪道阻塞的体会

目的 探讨应用泪道激光治疗泪道阻塞的方法及疗效。方法 应用Nd：YAG泪道激光仪按泪道探通方法连续击射阻塞部位。用抗生素和丝裂霉素C混合液冲洗畅通后植入义管，每周冲洗一次，1月后拔管。结果共治疗53例60眼，随访1～3月。治愈57眼占95％，好转2眼占3．33％，无效1眼仍有溢脓，1月后行泪囊鼻腔吻合术治愈。结论 激光泪道成形术治疗泪总管、鼻泪管阻塞及泪囊炎，方法简单、疗效满意。     

Nd：YAG激光泪道成形术和鼻泪管支架术治疗慢性泪囊炎的疗效对比

目的比较Nd：YAG激光泪道成形术和鼻泪管支架术治疗慢性泪囊炎的临床效果。方法 93例（102眼）慢性泪囊炎患者随机分成两组,一组应用Nd：YAG激光泪道成形术治疗,另一组应用鼻泪管支架术治疗,比较两组的治疗效果。结果应用Nd：YAG激光泪道成形术治疗57眼,有效39眼（68.42%）;鼻泪管支架术治疗45眼,有效40眼（88.89%）,两组疗效差异有统计学意义（χ2=6.03,P〈0.01）。结论鼻泪管支架术相对于同样微创的Nd：YAG激光泪道成形术治疗慢性泪囊炎疗效更加稳定,手术成功率更高,不失为微创治疗慢性泪囊炎的首选术式。     

Perception of difficulties with vision-related activities of daily living among patients undergoing unilateral posterior capsulotomy

OBJECTIVES

To assess the influence of Nd:YAG (neodymium: yttrium-aluminum- garnet) laser unilateral posterior capsulotomy on visual acuity and patients’ perception of difficulties with vision-related activities of daily life.

METHODS

We conducted an interventional survey that included 48 patients between 40 and 80 years of age with uni- or bilateral pseudophakia, posterior capsule opacification, and visual acuity ≤0.30 (logMAR) in one eye who were seen at a Brazilian university hospital. All patients underwent posterior capsulotomy using an Nd:YAG laser. Before and after the intervention, patients were asked to complete a questionnaire that was developed in an exploratory study.

RESULTS

Before posterior capsulotomy, the median visual acuity (logMAR) of the included patients was 0.52 (range 0.30–1.60). After posterior capsulotomy, the median visual acuity of the included patients improved to 0.10 (range 0.0–0.52). According to the subjects’ perceptions, their ability to perform most of their daily life activities improved after the intervention (p<0.05).

CONCLUSIONS

After patients underwent posterior capsulotomy with an Nd:YAG laser, a significant improvement in the visual acuity of the treated eye was observed. Additionally, subjects felt that they experienced less difficulty performing most of their vision-dependent activities of daily living.     

Three-dimensional topographic scanning electron microscope and Raman spectroscopic analyses of the irradiation effect on teeth by Nd:YAG, Er: YAG, and CO(2) lasers

A three-dimensional analyzer installed in a scanning electron microscope was used to evaluate the morphology and surface roughness using noncontact profilometry. Observations were carried out on the enamel and dentin surface irradiated by three different lasers: Nd:YAG (wavelength 1.06 microm), Er:YAG (2.94 microm), and CO(2) (10.6 microm). Spectroscopic analysis was done by Raman spectroscopy for nonirradiated and laser-irradiated surfaces. The lasers were applied perpendicularly to vertically sectioned and polished human extracted caries-free molars. The tooth was sectioned at each cavity for cross-section analysis after laser irradiation. Irradiation by Nd:YAG and CO(2) lasers of the enamel surface showed an opaque white color, different from dentin where the surface turned black. The Er:YAG laser induced no changes in color of the dentin. Numerous cracks associated with thermal stress were observed in the CO(2) laser-irradiated dentin. Noncontact surface profile analysis of Er:YAG laser-irradiated enamel and dentin showed the deepest cavities, and direct cross-sectional observations of them showed similar cavity outlines. The CO(2) laser-irradiated dentin had the least surface roughness. Raman spectroscopic analysis showed that fluorescence from the laser-irradiated tooth was generally greater than from nonirradiated teeth. Bands in dentin attributed to organic collagen matrix were lost after Nd:YAG and CO(2) laser irradiation, and a broad peak due to amorphous carbon appeared. The Er:YAG laser-irradiated dentin showed no sign of a carbon band and had more suitable results for dental ablation. Noncontact surface profile analysis was effective to evaluate the structural change in the tooth in the microarea of study after laser irradiation.     

Pulsed laser deposition of pseudowollastonite coatings

Pseudowollastonite (alpha-CaSiO3) is a bioactive ceramic material that induces direct bone growth. A process to obtain pseudowollastonite coatings that may be applied to implants is described and evaluated in this work. The coatings were first deposited on titanium alloy by laser ablation with a pulsed Nd:YAG laser tripled in frequency. After deposition, they were submitted to a soft laser treatment with a continuous wave Nd:YAG infrared laser. Coatings were characterised by X-ray diffractometry, Raman spectroscopy, scanning electron microscopy and energy dispersive spectroscopy before and after the laser treatment. As-deposited coatings are composed of pseudowollastonite and amorphous material. They have a porous structure of gathered grains and poor cohesion. After the laser treatment the coatings crystallinity and cohesion are improved. The laser treatment also makes the coatings dense and well adhered to the substrate. Therefore, this two-step process has been demonstrated as a valuable method to coat titanium implants with pseudowollastonite.     

Clinical effectiveness of coblation-assisted inferior turbinoplasty

Background: Laser-assisted inferior turbinoplasty has become accepted as a common treatment for patients displaying allergic rhinitis with severe nasal obstruction. Coblation-assisted inferior turbinoplasty has recently been reported. The aim of this study was to evaluate the effectiveness of coblation-assisted inferior turbinoplasty, compared with laser surgery. Methods: Between November 2004 and May 2007, a total of 29 patients were treated with coblation-assisted inferior turbinoplasty. We evaluated symptom scores at 1 month, 1 year and 2 years after surgery, compared with the results of Nd: YAG laser surgery. Results: At 1 month after surgery, improvement rates of symptom scores were good and similar between coblation- and laser-assisted surgery. At 1 year after surgery, improvement rates of laser surgery had significantly decreased. However, improvement rates of coblation surgery had not changed at 1 and 2 years (sneeze, 64%; nasal discharge, 71%; nasal obstruction, 79%) after surgery. Conclusion: Coblation-assisted inferior turbinoplasty appears effective for the treatment of patients with allergic rhinitis and nasal obstruction.     

Fertilization and early embryology: Use of lasers in assisted fertilization and hatching

The erbium-yttrium-aluminium-garnet (Er: YAG) laser has beenapplied to micromanipulation in humans. It was used in the fertilizationprocess for both subzonal insemination (SUZI) and for partialzona dissection (PZD). Laser-assisted micromanipulation achievedsignificantly higher fertilization rates (34.8%) when comparedto mechanical SUZI (16.1%), but use of the laser did not improvethe PZD results (laser 14.8% versus mechanical 14%). The Er:YAG laser was used to assist hatching. In the mouse it significantlyimproved the hatching rate (80 versus 29.3%) 110 h after administrationof human chorionic gonadotrophin. This technique was appliedin two different centres to patients with previous in-vitrofertilization (IVF) failures. The implantation rate per embryo(14.4% laser-assisted hatching versus 6% control group) andthe pregnancy rate per transfer (40 versus 16.2%) were improved.     

Effect of Nd: YAG laser on titanium dental implants studied by AFM

Bacterial contamination of dental implants is considered the main cause of implant failure. Recently, the laser treatment of the implant surface has been proposed as an useful method for decontamination. In such a view, the present study was conducted to investigate the effects of a Nd:YAG laser on the surface morphology of a titanium dental implant by means of an atomic force microscope. We demonstrated that, when the pulse energy of the laser was kept below 30 mJ, independently from the pulse rate, the laser-treated specimens exhibited a qualitatively similar surface morphology when compared to the untreated titanium implants, suggesting that the implant surface was unaffected by the treatment, in these particular conditions. We also found that, by cooling the implant surface with an air flow? during laser irradiation, the mean temperature of the implant was maintained under 37 degrees C. All these data taken together suggest the possibility to use Nd:YAG laser for the treatment of failing dental implants.     

Laser-induced damage to transparent polymers: chemical effect of short-pulsed (Q-switched) Nd:YAG laser radiation on ophthalmic acrylic biomaterials. II. Study of monomer release from artificial intraocular lenses

Commercial intraocular lenses and polymer specimens, both poly(methyl methacrylate) (PMMA) and poly(2-hydroxyethyl methacrylate) p(HEMA), were subjected to various levels of irradiation from a Q-switched Nd:YAG laser, and then to extraction and sample-enrichment techniques. The extracts were analysed by capillary gas chromatography. In PMMA samples, residual contents of 0.05-0.89% (wt) MMA were found and it appeared that the laser radiation did not cause a detectable increase of the monomer content. No residual HEMA could be found in p(HEMA) samples before or after laser bombardment. It is concluded that the accidental exposure of lenses to Nd:YAG laser cannot produce a significant release of monomers. Depolymerization induced by laser is a process unlikely to occur at the energy levels used in ophthalmic surgery.     

Human leukocyte interferon-α in cream,for the treatment of genital warts in asian women a placebo-controlled,double-blind study

The purpose of this double-blind, placebo-controlled study was to determine and compare the clinical efficacy and tolerance of human leukocyte -interferon (incorporated 2 × 10⁶ IU/g) in hydrophilic cream to cure genital warts. Preselected Asian female patients (n=150) aged 18–40 years (mean 22.5), with the clinical and biopsy-confirmed diagnosis of genital warts (mean 2.64), predominantly flat vaginal condylomas, were randomly allocated to 3 parallel groups. Each patient was given a coded tube containing 80 g placebo/active preparation with a graduated applicator. Patients were instructed to inject 6 g of the either alloted placebo/active cream deep into the vagina thrice a day for 3 consecutive days (group A) or 4 consecutive days (group B) per week, and if not cured the same treatment was extended to 3 more weeks (maximum 4 weeks active treatment). To assess the clinical efficacy patients were examined on a week-to-week basis. A total clearance of warts (biopsy-confirmed) was evaluated as a complete cure. Patients cured during the treatment were spared further treatment and were requested to visit us after 16 weeks for relapse control. As for the remaining patients, empty tubes were collected, and similarly coded replacement tubes were given for further treatment (in total 588 tubes were used). By the end of the treatment 57.2% lesions (227/397) were eliminated in all the groups: 48% patients in group A, 90% patients in group B, and 10% patients in placebo groups taken as completely cured. Of the 150 patients 128 (85.3%) did not complain of any drug-related adverse symptoms. Transitory increase in body temperature (mean 38.4°C), accompanied by headache (14.6%) and generalized itching (6.6%) were the most frequently reported side effects; however, treatment was well tolerated by all the patients, and there were no dropouts. Our findings indicate that clinical efficacy is dose dependent, that is, the results of group B were significantly superior to that of group A (P < 0.05). Of the 49.3% cured patients (74/150) followed up for 6 months (monthly basis) seven had a relapse, and none had reinfection. It is concluded that clinical efficacy of leukocyte interferon-a to cure genital warts is dose dependent. These results further support the view that leukocyte interferon-a incorporated in hydrophilic cream can be considered a reliable, safe, and home-based treatment to cure vulvar and vaginal warts.Abbreviation HPV human papillomavirus     

Regression of solid tumour using laser and 5-aminolevulinic acid in mice

Solid tumour reducing effect in Swiss albino mice induced with Dalton's Lymphoma Ascites tumour cells (DLA) and Ehrlich Ascites tumour cells (EA) was determined with the application of He-Ne and Nd:YAG lasers along with the photosensitising agent 5-Aminolevulinic acid (ALA). The experiment was designed with six groups and each group consisted of six animals. Animals in Groups I-III were injected with DLA cell lines and Groups IV-VI were injected with EA cell lines (1 x 10(6) in 0.1ml saline) subcutaneously in the right hind limb of mice to induce solid tumours. The tumour was further treated with photosensitiser induced laser therapy. The hyperthermic effect of Nd:YAG laser on tumour reduction was also evaluated. The results of the study suggest that the combination of He-Ne laser and 1 W Nd:YAG laser along with the photosensitiser 5-Aminolevulinic acid is a very effective therapeutic method for the treatment of tumour of DLA and EA cell lines. It is clear from the results that this mode of therapy very well depends on the type of tumour that has to be treated.     

Experimental and clinical aspects of laser destruction of adenohypophysis

Focal destruction of the adenohypophysis by Nd:YAG laser does not destroy other structures of the hypothalamo-pituitary region. During reparative regeneration, the focus of coagulation necrosis after laser destruction of the adenohypophysis is replaced by cicatricial tissue. A method for surgical treatment of pituitary adenomas was developed. The efficiency, safety, and low traumatism of this method were confirmed in 87 patients. Translated fromByulleten' Eksperimental'noi Biologii i Meditsiny, Vol. 130, No. 7, pp. 113–116, July, 2000