The effect of holmium laser radiation on stress, temperature and structure of cartilage

It is difficult to permanently alter the shape of cartilage in a controlled way. In otolaryngology and plastic surgery several procedures are done to alter the shape of cartilage, for example the correction of a deviated nasal septum and surgery for bat ears. The aim of this paper is to study the main parameters which are necessary for the phenomenon of reshaping of cartilage under non-destructive laser radiation. We have measured temperature and stress in cartilage when it is being reshaped with a holmium laser, It has been shown that laser-induced stress relaxation in cartilage takes place when the tissue temperature exceeds 70°C. We have determined the conditions which allow the shape of cartilage to be altered without producing any pronounced alteration to matrix structure or chondrocytes.     

Effects of near-infrared low-level laser irradiation on microcirculation

BACKGROUND AND OBJECTIVE: Recently, there has been an increase in the clinical application of low-level laser irradiation (LLLI) in various fields. The present study was conducted to explore the effects of LLLI on microcirculation. STUDY DESIGN/MATERIAL AND METHODS: We investigated the effects of LLLI on rat mesenteric microcirculation in vivo, and on cytosolic calcium concentration ([Ca2+]i) in rat vascular smooth muscle cells (VSMCs) in vitro. RESULTS: LLLI caused potent dilation in the laser-irradiated arteriole, which led to marked increases in the arteriolar blood flow. The changes were partly attenuated in the initial phase by the superfusion of 15 microM L-NAME, but they were not affected by local denervation. Furthermore, LLLI caused a power-dependent decrease in [Ca2+]i in VSMCs. CONCLUSION: The circulatory changes observed seemed to be mediated largely by LLLI-induced reduction of [Ca2+]i in VSMCs, in addition to the involvement of NO in the initial phase.     

Continuous laser radiation effect at 1.06 microns on gastrointestinal tract

The thermal effect of 1.06 microns YAG:Nd laser irradiation at temperature conditions up to 100 degrees C without crater formation on gastrointestinal (GI) tissue samples was investigated. The theoretical and experimental data show that at an intensity of 160-400 W/cm2 laser-induced heating of the tissue with an initial temperature of 20 degrees C leads to coagulation lesions at a temperature no less than 60 degrees C and at a depth of 1.7-2.1 mm.     

犬气管插管全麻下吸入不同浓度氧时自由基及肺超微结构的变化

目的　观察犬气管插管全麻下吸入不同浓度氧时的自由基及肺超微结构变化。方法　健康杂种犬 2 0只 ,随机分为纯氧组 (1组 ,FIO2 =1,n =10 )及 4 0 %氧气组 (2组 ,FIO2 =0 4 ,n =10 )。两组麻醉方法相同 ,均行气管内插管 ,接呼吸机机械控制呼吸。监测SOD、MDA在气管插管后1、3、5、7h的变化 ,并在电镜下观察肺组织的超微结构变化。结果　 (1)与基础值比较 ,1组插管后 1、3、5、7hSOD活力明显下降、MDA值明显升高 (P <0 0 1) ;(2 )组间比较 ,1组SOD活力较 2组明显下降 (P <0 0 1)、MDA值明显上升 (P <0 0 1或P <0 0 5 ) ;(3)肺超微结构变化 ,1组观察到的肺损伤重于 2组。结论　纯氧通气氧自由基产生明显增多 ,纯氧通气 7h后观察到的肺超微结构损伤较多 ,推测氧自由基在高氧肺损伤中发挥重要作用     

The effect of intravenous indigo carmine on near-infrared cerebral oximetry

The effects of IV-administered dyes on pulse oximetry have been well described. However, the effects on near-infrared cerebral oximetry have not been well documented. We report a series of four patients undergoing radical prostatectomy who were monitored with cerebral oximetry during surgery. After the administration of indigo carmine, intraoperative desaturations were observed for an extended period. Because clinical use of near-infrared cerebral oximetry is increasing, anesthesiologists should be aware of this issue.     

Effects of argon laser radiation on aortic endothelial cells: early membrane changes and proliferative response

Membrane fluidity, transmembrane signaling responses, and proliferative characteristics of endothelial cells were studied to characterize biochemical and molecular changes after treatment with argon laser energy. Bovine aortic endothelial cells grown in monolayers were irradiated at 50, 100, and 200 J with an argon laser (wavelength, 488 and 514 nm). Proliferation, assayed by [3H]thymidine incorporation, was measured daily for 6 days. An initial lag phase was observed for irradiated cells when compared to nonirradiated controls (P less than 0.03), with eventual recovery by the third day. Membrane fluidity, determined by fluorescence anisotropy, was measured 1 hr after irradiation. A decrease in static rotational motion of 1,6-diphenyl-1,3,5-hexatriene (DPH) was noted in irradiated versus nonirradiated cells indicating a decrease in membrane fluidity (P less than 0.02). Dynamic studies of intracellular calcium and pH flux utilizing fluorescent probes demonstrated a preserved response to mitogenic stimulation. An increase in intracellular Ca2+ with a concomitant alkalinization of the intracellular milieu was observed in irradiated and non-irradiated cells in response to stimulation with endothelial cell growth factor (ECGF). These responses resemble those characterized for other mitogens. Argon laser energy applied to aortic endothelial cells decreases membrane fluidity early after irradiation. These alterations probably cause the initial lag observed in their proliferative response; however, the capacity to respond to exogenous mitogenic stimulation is maintained.     

激光治疗对腋臭根治手术的影响

目的：探讨激光治疗对腋臭根治手术的影响。方法：采用2011年2月～2013年2月于郑州大学第一附属医院整形外科手术治疗腋臭患者72例,其中手术前有激光治疗史者23例（实验组）,初诊选择手术治疗者（对照组）49例。所有病例均获随访,随访时间6月～3年。结果：实验组手术时间为（128．04±16．29）min,术中出血量为（10．13±2．24）ml,术后随访瘢痕增生8例,瘢痕增生率34．78％,1例复发,复发率4．35％;对照组手术时间为（91．55±8．04）min,术中出血量为（6．22±1．60）ml,术后随访瘢痕增生5例,瘢痕增生率10．20％,3例复发,复发率6．12％。结论：激光治疗史对于腋臭根治手术在手术时间、术中出血量及术后瘢痕增生方面有负面影响,但对腋臭术后复发率无明显影响。     

Effect of laser radiation on tissue during laser angioplasty

The thermal properties of adipose and ceramic atherosclerotic plaque deposits and normal arterial vessel wall were measured in the temperature range of 25-95 degrees C. In general, the data indicate that fatty plaques exhibit the lowest thermal conductivity and thermal diffusivity of the three types, whereas calcified plaques seem to have the highest values. By using a video scanning thermograph, temperature rise was recorded in normal vessel wall and plaque during ablation of tissue. Theoretical analysis suggested that realistic modeling of laser angioplasty should account for scattering of light, water content, and ablation. This paper is a preliminary report of these results.     

Visible and near-infrared laser radiation in a biological tissue. A forward model for medical imaging by optical tomography

We present a numerical model for the study of a general, two-dimensional, time-dependent, laser radiation transfer problem in a biological tissue. The model is suitable for many situations, especially when the external laser source is pulsed or continuous. We used a control volume discrete-ordinate method associated with an implicit, three-level, second-order, time-differencing scheme. In medical imaging by laser techniques, this could be an optical tomography forward model. We considered a very thin rectangular biological tissue-like medium submitted to a visible or a near-infrared laser source. Different cases were treated numerically. The source was assumed to be monochromatic and collimated. We used either a continuous source or a short-pulsed source. The transmitted radiance was computed in detector points on the boundaries. Also, the distribution of the internal radiation intensity for different instants is presented. According to the source type, we examined either the steady-state response or the transient response of the medium. First, our model was validated by experimental results from the literature for a homogeneous biological tissue. The space and angular grid independency of our results is shown. Next, the proposed model was used to study changes in transmitted radiation for a homogeneous background medium in which were imbedded two heterogeneous objects. As a last investigation, we studied a multilayered biological tissue. We simulated near-infrared radiation in human skin, fat and muscle. Some results concerning the effects of fat thickness and positions of the detector source on the reflected radiation are presented.     

The cell membrane and receptors

The plasma membrane forms the interface between the cell and its environment. It is composed essentially of a phospholipid matrix and many different types of protein molecules which may be embedded within the matrix (integral proteins) or more loosely associated with the cytoplasmic ‘face’ of the membrane (peripheral proteins). The passage of essential ions and molecules across the membrane is controlled by integral proteins acting as channels or transporters. Intercellular communication is mediated by protein receptors, which are activated by signalling molecules such as hormones and neurotransmitters. Physical contact between the cell and its environment (and between cells) is mediated by membrane adhesion proteins. The plasma membrane is a highly dynamic structure in terms of molecular composition and topological configuration. The linkage of the internal cytoskeleton to the plasma membrane (via peripheral and integral proteins) expedites cellular shape changes or amoeboid motion of some types of cell. The process of endocytosis enables the cell to internalize small volumes of extracellular fluid (pinocytosis) by invagination and formation of intracellular vesicles or to engulf entire cells by phagocytosis. Secretion of molecules, such as hormones, is accomplished by fusion of intracellular vesicles with the plasma membrane. This mechanism of exocytosis is mediated by another type of protein: the SNARE proteins.     

The cell membrane and receptors

The plasma membrane forms the interface between the cell and its environment. It is composed essentially of a phospholipid matrix and many different types of protein molecules which may be embedded within the matrix (integral proteins) or more loosely associated with the cytoplasmic ‘face’ of the membrane (peripheral proteins). The passage of essential ions and molecules across the membrane is controlled by integral proteins acting as channels or transporters. Intercellular communication is mediated by protein receptors, which are activated by signalling molecules such as hormones and neurotransmitters. Physical contact between the cell and its environment (and between cells) is mediated by membrane adhesion proteins. The plasma membrane is a highly dynamic structure in terms of molecular composition and topological configuration. The linkage of the internal cytoskeleton to the plasma membrane (via peripheral and integral proteins) expedites cellular shape changes or amoeboid motion of some types of cell. The process of endocytosis enables the cell to internalize small volumes of extracellular fluid (pinocytosis) by invagination and formation of intracellular vesicles or to engulf entire cells by phagocytosis. Secretion of molecules, such as hormones, is accomplished by fusion of intracellular vesicles with the plasma membrane. This mechanism of exocytosis is mediated by another type of protein: the SNARE proteins.     

The cell membrane and receptors

The plasma membrane forms the interface between the cell and its environment. It is composed essentially of a phospholipid matrix and many different types of protein molecules which may be embedded within the matrix (integral proteins) or more loosely associated with the cytoplasmic ‘face’ of the membrane (peripheral proteins). The passage of essential ions and molecules across the membrane is controlled by integral proteins acting as channels or transporters. Intercellular communication is mediated by protein receptors, which are activated by signalling molecules such as hormones and neurotransmitters. Physical contact between the cell and its environment (and between cells) is mediated by membrane adhesion proteins. The plasma membrane is a highly dynamic structure in terms of molecular composition and topological configuration. The linkage of the internal cytoskeleton to the plasma membrane (via peripheral and integral proteins) expedites cellular shape changes or amoeboid motion of some types of cell. The process of endocytosis enables the cell to internalize small volumes of extracellular fluid (pinocytosis) by invagination and formation of intracellular vesicles or to engulf entire cells by phagocytosis. Secretion of molecules, such as hormones, is accomplished by fusion of intracellular vesicles with the plasma membrane. This mechanism of exocytosis is mediated by another type of protein: the SNARE proteins.     

The cell membrane and receptors

The plasma membrane forms the interface between the cell and its environment. It is composed essentially of a phospholipid matrix and many different types of protein molecules which may be embedded within the matrix (integral proteins) or more loosely associated with the cytoplasmic ‘face’ of the membrane (peripheral proteins). The passage of essential ions and molecules across the membrane is controlled by integral proteins acting as channels or transporters. Intercellular communication is mediated by protein receptors, which are activated by signalling molecules such as hormones and neurotransmitters. Physical contact between the cell and its environment (and between cells) is mediated by membrane adhesion proteins. The plasma membrane is a highly dynamic structure in terms of molecular composition and topological configuration. The linkage of the internal cytoskeleton to the plasma membrane (via peripheral and integral proteins) expedites cellular shape changes or amoeboid motion of some types of cell. The process of endocytosis enables the cell to internalize small volumes of extracellular fluid (pinocytosis) by invagination and formation of intracellular vesicles or to engulf entire cells by phagocytosis. Secretion of molecules, such as hormones, is accomplished by fusion of intracellular vesicles with the plasma membrane. This mechanism of exocytosis is mediated by another type of protein: the SNARE proteins.     

The effect of radiation therapy after radical prostatectomy in patients with elevated prostate specific antigen levels.

We analyzed the effects of pelvic radiation therapy given to patients who had an elevated prostate specific antigen level after radical prostatectomy. Among men who previously received adjuvant radiation therapy and had appropriately stored serum 15 had elevated prostate specific antigen levels after radical prostatectomy but before radiation therapy. After radiation therapy the prostate specific antigen level decreased by more than 50% in 80% and to female levels in 53% of the patients. We also prospectively treated 29 men who had increasing levels of prostate specific antigen 9 to 95 months after radical prostatectomy but who were otherwise without evidence of disease by the usual criteria. However, 19 of the patients had local disease as evidenced by random needle biopsy of the urethrovesical anastomosis. Complications of radiation therapy were minimal and maximal prostate specific antigen decrease occurred by 6 months after treatment. In 82% of the patients prostate specific antigen levels decreased by more than 50% and in 43% they decreased to female levels. Female levels were achieved after radiation therapy given many years postoperatively even in stage D1 cancer patients but some of the patients subsequently had increasing prostate specific antigen levels. These data suggest that local-regional disease may be the only site of disease persistence after radical prostatectomy in some of the patients who subsequently have distant metastasis. We conclude that radiation therapy after radical prostatectomy can cause elevated prostate specific antigen to decrease to undetectable levels in many patients but the durability and ultimate therapeutic value of this effect are unknown.     

Cerebral and lower limb near-infrared spectroscopy in adults on extracorporeal membrane oxygenation

Percutaneous femoral venoarterial (VA) or jugular venovenous (VV) extracorporeal membrane oxygenation (ECMO) can result in delivery of hypoxic blood to the brain, coronaries, and upper extremities. Additionally, VA-ECMO by percutaneous femoral artery cannulation may compromise perfusion to the lower limbs. Use of near-infrared spectroscopy (NIRS) detects regional ischemia and warns of impending hypoxic damage. We report the first known series with standardized monitoring of this parameter in adults on ECMO. This is an institutional review board-approved single institution retrospective review of patients with NIRS monitoring on ECMO from July 2010 until June 2011. Patients were analyzed for drops in NIRS tracings below 40 or >25% from baseline. VA-ECMO and VV-ECMO were initiated by percutaneous cannulation of the femoral vessels and the internal jugular vein, respectively. Sensors were placed on the patients' foreheads and on the lower limbs. NIRS tracings were recorded, analyzed, and correlated with clinical events. Twenty patients were analyzed (median age: 47.5 years): 17 patients were placed on VA-ECMO, and three patients on VV-ECMO. The median duration on ECMO was 7 days (range 2-26). One hundred percent of patients had a significant drop in bilateral cerebral oximetry tracings resulting in hemodynamic interventions, which involved increasing pressure, oxygenation, and/or ECMO flow. In 16 patients (80%), these interventions corrected the underlying ischemia. Four patients (20%) required further diagnostic intervention for persistent decreased bilateral and/or unilateral cerebral oximetry tracings, and were found to have a cerebrovascular accident (CVA). Six (30%) patients had persistent unilateral lower limb oximetry events, which resolved upon placement or replacement of a distal perfusion cannula. No patient was found to have either lower limb ischemia or a CVA with normal NIRS tracings. Use of NIRS with ECMO is important in detecting ischemic cerebral and peripheral vascular events. This allows for potential correction of the underlying process, thus preventing permanent ischemic damage.     

The effect of vitamin E-bonded dialyzer membrane on red blood cell survival in hemodialyzed patients

Reduced red blood cell (RBC) survival due to oxidative damage is one of the causes of anemia in patients under long-term hemodialysis. Recently, it has been shown that vitamin E-bonded dialyzer membrane is able to reduce the oxidative stress during hemodialysis. In humans, creatine content in RBC is used to measure RBC life span and erythropoietic capacity, since it rapidly declines as the RBCs become old. Therefore this study aimed to elucidate the effect of vitamin E-bonded dialyzer membrane on RBC life span by measuring creatine content in RBC.     

Perineural invasion in transitional cell carcinoma and the effect on prognosis following radical cystectomy

Objectives. The relationship between perineural invasion and prognosis has been demonstrated to be poor in a number of malignancies. This has not been evaluated in the bladder. We performed a study to determine the occurrence of nodal metastases, extranodal metastases, and disease-free survival in patients with perineural invasion (PNI) and/or angiolymphatic invasion (ALI) in transitional cell carcinoma of the bladder (TCCB) from radical cystectomy specimens.Methods. A retrospective review of 27 patients treated with radical cystectomy for TCCB was conducted. Comparisons were performed between three groups: PNI with or without ALI (PNI ± ALI, 12 patients), ALI alone (8 patients), and a control group (no PNI or ALI) (7 patients).Results. The mean patient age was 70 years (range 49 to 83). The overall median follow-up period was 11 months (range 1 to 32). PNI ± ALI was predominantly found in Stage T3b disease (14 of 20 [70%] cases). The overall 1-year disease-free survival was 48%, 67%, and 83% for the PNI ± ALI, ALI alone, and control groups, respectively. Nodal metastases (for all stages combined) were found in 6 of 12 (50%), 3 of 8 (38%), and 1 of 7 (14%) patients in the PNI ± ALI, ALI alone, and control groups, respectively. Similarly, extranodal metastatic disease was found in 5 of 12 (42%), 4 of 8 (50%), and 1 of 7 (14%) patients in the PNI ± ALI, ALI alone, and control groups, respectively. The percentage of deaths for the PNI ± ALI, ALI only, and control groups were 33%, 50%, and 14%, respectively.Conclusions. In TCCB, perineural invasion with or without angiolymphatic invasion and angiolymphatic invasion alone are associated with a higher incidence of nodal and extranodal metastases and death.