Nd: YAG laser

Nd: YAG 激光器
  • 文章类型: Journal Article
    评价最新的根管消毒剂的影响,也就是碳量子点(CQDs),同步微泡-光动力激活(SYMPA),和Nd:YAG激光与乙二胺四乙酸(EDTA)一起作为马氏体硬度(MH)的最终冲洗剂,去除涂抹层(SL),以及氧化锆桩与牙本质的挤出粘结强度(EBS)。获得80颗完整的单根前磨牙,并用0.5%氯胺-T溶液消毒。使用ProTaper文件进行根管准备,然后进行闭塞。为预制氧化锆桩准备桩空间,并根据使用的消毒方法将所有牙齿随机分为四组(每组n=20)第1组:5.25%NaOCl17%EDTA(对照),第二组:Nd:YAG激光+17%EDTA,第三组:SYMPA+17%EDTA,和第4组:CQDs+17%EDTA。MH,SL移除,使用显微硬度计对与牙根牙本质后结合的氧化锆进行EBS,扫描电子显微镜(SEM),和万能试验机,分别。组内和组间比较均使用单向方差分析(ANOVA)和post-Tukey检验进行显着差异(p<0.05)。第2组样品(Nd:YAG激光+17%EDTA)(0.24±0.06GPa)表现出最高的MH值。第3组(SYMPA+17%EDTA)处理的牙齿中的样品显示出最低的MH评分(0.13±0.02GPa)。此外,第3组标本的冠状三分之一(SYMPA和17%EDTA)(1.54±0.31)以最大的功效消除了管道中的SL,并表现出最高的EBS(10.13±0.69MPa)。然而,第1组样品的顶端三分之一(5.25%NaOCl17%EDTA)(2.95±0.33)表现出从神经根牙本质中消除SL的效率最低,氧化锆与牙本质的粘结强度最低(5.11±0.19MPa)。具有17%EDTA的SYMPA技术被证明可以非常有效地从牙本质中去除SL并增强氧化锆桩的EBS。发现用于SL去除和MH改善的最不优选的方法是5.25%NaOCl+17%EDTA。CQDs和Nd:YAG激光显示出令人满意的从运河中去除涂抹层的性能,随着氧化锆柱达到适当的粘结强度。研究重点:Nd:YAG激光和17%EDTA作为管道消毒剂显示出最高的MH值。用SYMPA和17%EDTA冲洗的标本以最大的功效消除了管道中的SL。第3组的冠状第三组(SYMPA+17%EDTA)样品揭示了与牙本质的最高氧化锆结合后完整性评分。内聚失败是不同实验组中的主要失败类型。
    Evaluation of the impact of the latest root canal disinfectant, that is carbon quantum dots (CQDs), synchronized microbubble-photodynamic activation (SYMPA), and Nd: YAG laser along with ethylenediaminetetraacetic acid (EDTA) as a final irrigant on the Marten hardness (MH), smear layer (SL) removal, and extrusion bond strength (EBS) of zirconia post to the canal dentin. Eighty intact single-rooted premolars were obtained and disinfected using 0.5% chloramine-T solution. Root canal preparation was performed using ProTaper files followed by obturation. The post space was prepared for prefabricated zirconia post and all the teeth were randomly divided into four groups based on the disinfection used (n = 20 each) Group 1: 5.25% NaOCl + 17% EDTA (Control), Group 2: Nd: YAG laser + 17% EDTA, Group 3: SYMPA + 17% EDTA, and Group 4: CQDs + 17% EDTA. MH, SL removal, and EBS of zirconia post-bonded to root dentin were performed using a microhardness tester, scanning electron microscope (SEM), and universal testing machine, respectively. Both intragroup and intergroup comparisons were performed using one-way analysis of variance (ANOVA) and posthoc-Tukey test for significant difference (p < .05). Group 2 samples (Nd: YAG laser + 17% EDTA) (0.24 ± 0.06 GPa) exhibited highest values of MH. Samples in group 3 (SYMPA + 17% EDTA) treated teeth unveiled the lowest MH scores (0.13 ± 0.02 GPa). Moreover, the coronal third of Group 3 specimens (SYMPA and 17% EDTA) (1.54 ± 0.31) eliminated SL from the canal with the greatest efficacy as well as presented the highest EBS (10.13 ± 0.69 MPa). However, the apical third of Group 1 samples (5.25% NaOCl + 17% EDTA) (2.95 ± 0.33) exhibited the least efficient elimination of SL from the radicular dentin as well as the lowest bond strength (5.11 ± 0.19 MPa) of zirconia post to the dentin. The SYMPA technique with 17% EDTA proved highly effective in removing the SL from canal dentin and enhancing the EBS of zirconia posts. The least preferable method for SL removal and MH improvement was found to be 5.25% NaOCl + 17% EDTA. CQDs and Nd: YAG laser demonstrated satisfactory smear layer removal properties from the canal, along with achieving appropriate bond strength of zirconia posts. RESEARCH HIGHLIGHTS: Nd: YAG laser and 17% EDTA as canal disinfectant exhibited the highest values of MH. Specimens irrigated with SYMPA and 17% EDTA eliminated SL from the canal with the greatest efficacy. The coronal third of Group 3 (SYMPA + 17% EDTA) samples unveiled the highest zirconia post-bond integrity score to the canal dentin. Cohesive failure was a dominant failure type among different experimental groups.
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  • 文章类型: Clinical Trial Protocol
    背景:玻璃体漂浮物是一种常见的眼部疾病,会影响所有年龄段的个体。虽然玻璃体漂浮物通常是良性的,它们会显著损害视力和生活质量。激光玻璃分解,使用Nd:YAG激光蒸发胶原玻璃体混浊,越来越多地被用作治疗选择。然而,目前缺乏关于其疗效和适当应用时机的证据.本研究旨在评估YAG激光玻璃体溶解术早期干预治疗有症状的玻璃体漂浮物的疗效和安全性。
    方法:本研究是一项随机研究,控制,双盲临床试验。前瞻性招募了70名患有症状性漂浮物1个月的参与者。这些参与者将被随机分配到两组,每组35例:早期治疗组和延迟治疗组。分配到早期治疗组的参与者将立即进行YAG激光玻璃体溶解,3个月后进行假激光治疗。另一方面,延迟治疗组的参与者将接受假激光治疗,3个月后接受YAG激光玻璃体溶解术.随访时间点将是从随机化开始的1、3、6和12个月。主要结果是参与者自我报告的视力障碍改善程度为1至10,以及他们在国家眼科研究所视觉功能问卷25(NEIVFQ-25)上的得分。次要结果将是通过OCT和眼底照相以及跟踪与眼睛或整体健康相关的任何不良事件来客观评估治疗在减少玻璃体漂浮物方面的有效性。
    结论:本临床试验旨在评估YAG激光玻璃体溶解术治疗有症状的玻璃体漂浮物的有效性,并评估YAG激光玻璃体溶解术早期干预的安全性。
    背景:ClinicalTrials.govNCT05800353。2023年3月10日注册。
    BACKGROUND: Vitreous floaters are a common ocular condition that affects individuals of all ages. Although vitreous floaters are typically benign, they can significantly impair visual acuity and quality of life. Laser vitreolysis, which uses an Nd: YAG laser to vaporize collagenous vitreous opacities, is increasingly being used as a treatment option. However, there is currently a lack of evidence regarding its efficacy and the appropriate timing of its application. This study aims to evaluate the efficacy and safety of early intervention with YAG laser vitreolysis in treating symptomatic vitreous floaters.
    METHODS: The present study is a randomized, controlled, double-blind clinical trial. A total of 70 participants with symptomatic floaters for 1 month were prospectively recruited. These participants will be randomly assigned to two groups, with 35 individuals in each group: the early treatment group and the delayed treatment group. Participants assigned to the early treatment group will undergo YAG laser vitreolysis immediately, followed by a sham laser treatment 3 months later. On the other hand, participants assigned to the delayed treatment group will receive a sham laser treatment and then undergo YAG laser vitreolysis 3 months later. The follow-up time points will be 1, 3, 6, and 12 months from randomization. Primary outcomes will be participants\' self-reported improvement in visual disturbance on a scale of 1 to 10 and their scores on the National Eye Institute Visual Functioning Questionnaire 25 (NEI VFQ-25). Secondary outcomes will be an objective evaluation of the effectiveness of the treatment in reducing vitreous floaters through OCT and fundus photography and tracking any adverse events related to the eyes or overall health.
    CONCLUSIONS: This clinical trial aims to evaluate the effectiveness of YAG laser vitreolysis in treating symptomatic vitreous floaters and assess the safety of performing early intervention with YAG laser vitreolysis.
    BACKGROUND: ClinicalTrials.gov NCT05800353 . Registered on 10 March 2023.
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  • 文章类型: Journal Article
    通过一次激光治疗成功地完成了完全清除和无副作用的治疗扩大静脉的方法。这是皮肤科医生和患者的野心和梦想。大多数血管化治疗方案都显示出一些令人不快的不良反应。目前工作的目的是制定,提前,为了治疗面部静脉曲张,激光脉冲持续时间和注量的准确剂量,胳膊和腿没有不良影响。此任务需要计算扩大静脉的确切温度升高;在激光治疗之前。使用基频(1064nm)脉冲Nd:YAG激光,在20个受试者上测试这些预先计算的温度升高值,以便具有最佳的临床结果。这项工作需要使用脉冲长度(15-30ms),光斑尺寸(3,5毫米),通量(110-190J/cm2)和皮肤冷却温度(3-18°C)。需要在治疗之前和之后冷却皮肤以保证最终有影响力的结果而没有副作用。
    Full clearance and no side effects method of treating enlarged veins was successfully accomplished by one laser session. This is the ambition and dream of both dermatologists and patients. Most vascularity treatment protocols had shown some unpleasant adverse effects. The purpose of the present work is to work out, in advance, the accurate dose of laser pulse duration and fluence in order to treat varicose veins in the face, arms and legs with no adverse effects. This mission required the calculation of the exact rise in temperature of the enlarged vein; prior to laser treatment. These pre-calculated temperature rise values were tested on 20 subjects in order to have the best clinical outcomes; using fundamental frequency (1064 nm) pulsed Nd: YAG laser. This work necessitated the use of pulse length (15-30 ms), spot size (3, 5 mm), fluence (110-190 J/cm2) and skin cooling temperature (3-18 °C). Cooling of the skin before and after the treatment was needed to guarantee ultimate impactful results without side effects.
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  • 文章类型: Journal Article
    目的:对比分析次氯酸钠联合Nd:YAG激光与次氯酸钠单独用于牙髓炎患者根管消毒的临床疗效。
    方法:将牙髓炎患者按照随机数字表法分为对照组和观察组。两组均接受根管治疗,对照组给予1%次氯酸钠根管冲洗。观察组采用1%次氯酸钠联合Nd:YAG激光灌注。牙周指数,炎症指数,比较两组患者治疗前和治疗3个月后的生活质量评分和细菌感染清除率。
    结果:观察组总有效率为95.35%,高于对照组的79.07%(p<.05)。治疗3个月后,两组牙周指数和炎症水平均下降,观察组低于对照组(p<0.05)。观察组患者的生活质量评分和感染清除率均显著高于对照组(p<0.05)。
    结论:与单独使用1%次氯酸钠的根管冲洗相比,合用次氯酸钠联合Nd:YAG激光进行根管消毒可显著提高治疗效果,缓解炎症反应,减少细菌感染。
    To compare and analyze the clinical therapeutic effects of sodium hypochlorite combined with Nd: YAG laser and sodium hypochlorite alone for root canal disinfection in patients with pulpitis.
    Patients with pulpitis were divided into control group and observation group according to random number table method. Both groups received root canal treatment, while the control group received root canal irrigation with 1% sodium hypochlorite. The observation group was irrigated with 1% sodium hypochlorite combined with Nd: YAG laser. Periodontal index, inflammatory index, life quality score and bacterial infection clearance rate of the two groups were compared before and 3 months after treatment.
    The total effective rate of the observation group was 95.35%, which was higher than that of the control group 79.07% (p < .05). After 3 months of treatment, the periodontal index and inflammation level of both groups decreased, and the observation group was lower than that in the control group (p < .05). The life quality score and infection clearance rate of observation group were significantly higher than control group (p < .05).
    Compared with root canal irrigation with 1% sodium hypochlorite alone, sodium hypochlorite combined with Nd: YAG laser for root canal disinfection can significantly improve the therapeutic effect, relieve inflammatory reaction, and decrease bacterial infection.
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  • 文章类型: Randomized Controlled Trial
    本研究旨在评估肿瘤坏死因子-α(TNF-α)的水平,白细胞介素-1β(IL-1β)和干扰素-γ(IFN-γ)与无症状根尖周炎(AP)。将60名参与者随机分为两组:常规灌溉(对照)和Nd:YAG激光照射。在根管清洁后(第0天)和1周后(第7天)获得间质液。TNF-α,使用酶联免疫吸附测定法测定IL-1β和IFN-γ水平。Mann-WhitneyU,连续性校正卡方,使用Pearson卡方检验和Fisher精确检验。观察到对照组第7天的细胞因子水平升高,差异无统计学意义(p>0.05)。在激光组中,所有细胞因子水平随时间降低。仅IL-1β水平显示显著差异(p<0.05)。Nd:YAG照射对降低促炎细胞因子水平具有积极作用,并可能有助于控制AP牙齿的感染。
    This study aimed to evaluate the levels of tumour necrosis factor-alpha (TNF-α), interleukin-1beta (IL-1β) and interferon-gamma (IFN-γ) with asymptomatic apical periodontitis (AP). A total of 60 participants were randomly divided into two groups: the conventional irrigation (control) and the Nd: YAG laser irradiation. The interstitial fluids were obtained after root canal cleaning (day 0) and 1 week later (day 7). The TNF-α, IL-1β and IFN-γ levels were assayed using the enzyme-linked immunosorbent assay. The Mann-Whitney U, continuity correction chi-square, Pearson chi-square and Fisher exact tests were used. An increased level of cytokines on day 7 in the control group was observed, without statistically significant differences (p > 0.05). All cytokine levels decreased over time in the laser group. Only the IL-1β level showed a significant difference (p < 0.05). Nd: YAG irradiation has a positive effect on decreasing the proinflammatory cytokine level and may help to control infection in teeth with AP.
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  • 文章类型: Journal Article
    背景和目的:在医学文献中,Fitzpatrick皮肤III-IV型的亚洲患者是研究较少的患者亚型。Q开关,具有分割光束轮廓(QSF)的1064nm掺钕钇铝石榴石(Nd:YAG)激光是一种新的模式,据报道可有效治疗疤痕。本研究旨在评估QSFNd:YAG激光治疗亚洲患者瘢痕的有效性和安全性。材料和方法:用1064nmQSF激光治疗共29名受试者。每位患者每8周用一个分割的微透镜阵列手持件进行三次治疗)。末次治疗前和治疗后3个月采用Goodman和Baron的量化分级量表评价治疗效果。结果:根据Goodman和Baron的定量全球痤疮疤痕分级系统,所有29例患者的痤疮疤痕均有显着改善。除了三名患者的一些轻微的红斑反应外,没有观察到副作用。结论:我们的结果证实,1064nmQSFNd:YAG激光治疗亚洲人的疤痕是一种安全有效的技术。
    Background and Objectives: Asian patients with Fitzpatrick skin type III-IV are a less studied subtype of patients in the medical literature. Q-Switched, 1064 nm neodymium-doped yttrium aluminum garnet (Nd: YAG) laser with a fractionated beam profile (QSF) is a new modality that was reported to be effective in the treatment of scars. This study aims to evaluate the efficacy and safety of QSF Nd: YAG laser in treating scars in Asian patients. Materials and Methods: A total of 29 Subjects were treated with 1064 nm QSF laser. Each patients had three treatments with a fractionated microlens array handpiece every 8 weeks). Efficacy of treatment was evaluated using the Goodman and Baron\'s quantitative grading scale before and 3 months after the last treatment. Results: All 29 patients treated had significant improvement of acne scars according to Goodman and Baron\'s Quantitative Global Acne Scarring Grading System. No side effect has been observed except some minor erythematous reactions in three patients. Conclusions: Our results confirm that the 1064 nm QSF Nd: YAG laser is a safe and effective technique for treating scars in Asians.
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  • 文章类型: Journal Article
    贝克尔痣(BN)是一种良性的皮肤错构瘤,在青春期发展,主要影响年轻男性。痣通常位于单侧,其特征是多毛症和色素沉着过度。尽管最近在治疗方式上取得了进展,尚未建立有效的BN色素沉着治疗方法。我们试图评估分数铒:YAG2940nm和调QNd:YAG1064nm激光治疗BN色素沉着过度的有效性和安全性。23例BN患者被纳入前瞻性研究,随机对照,观察者失明,分裂病变比较技术试验。在每个病人中,两个相似的正方形测试区域被随机分配使用分数铒:YAG2940nm激光或Q开关Nd:YAG1064nm激光进行处理.每个患者以六周的间隔进行三次治疗。在后续行动中,色素沉着过度的清除是通过医生的整体评估来评估的。视觉模拟量表,改进的等级,患者全球评估,患者满意度。与用Q开关Nd:YAG1064nm(p值=0.001)激光处理的区域相比,用分数铒:YAG2940nm激光处理的区域显示出显著更好的改善。随访期间未报告色素沉着和肥厚性瘢痕形成等不良反应。结果在美容上是可以接受的,在纳入的患者中总体满意度很高。我们的数据表明,与Q开关Nd:YAG(1064nm)激光相比,分数铒:YAG(2940nm)激光在治疗BN色素沉着中的作用更好。同时是一种更安全的方法,没有报道的副作用。
    Becker\'s nevus (BN) is a cutaneous hamartoma of benign nature that develops through adolescence and affects mostly young men. The nevus is usually located unilaterally and is characterized by hypertrichosis and hyperpigmentation. Despite recent advances in treatment modalities, no effective treatment has been established for BN hyperpigmentation. We sought to assess the efficacy and safety of fractional Erbium: YAG 2940 nm and Q-switched Nd: YAG 1064 nm lasers in the treatment of BN hyperpigmentation. Twenty-three patients with BN were included in a prospective, randomized-controlled, observer-blinded, split-lesion comparative technique trial. In each patient, two similar square test regions were randomized to either be treated with a fractional Erbium: YAG 2940 nm laser or with a Q-switched Nd: YAG 1064 nm laser. Each patient was treated with three sessions at six-week intervals. At the follow-up, clearance of hyperpigmentation was assessed by physician global assessment, visual analogue scale, grade of improvement, patient global assessment, and patient satisfaction. Regions treated with the fractional Erbium: YAG 2940 nm laser demonstrated significantly better improvement compared to ones treated with the Q-switched Nd: YAG 1064 nm (p-value = 0.001) laser. Adverse effects such as repigmentation and hypertrophic scarring were not reported during the follow-up period. The outcomes were cosmetically acceptable with overall high satisfaction among the included patients. Our data suggest a superior role for the fractional Erbium: YAG (2940 nm) laser in the treatment of BN hyperpigmentation compared to the Q-switched Nd: YAG (1064 nm) laser, along with being a safer method and having no reported side effects.
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  • 文章类型: Journal Article
    背景:每次肺叶切除术都需要横切叶间裂。切除表面必须是气密的,以避免泄漏和感染。使用基于猪肺的离体模型,我们比较了三种技术在不同吸气压力下的初始气密性。
    方法:在第一种技术(第1组)中,我们用单极切割器横切叶间裂,并用单丝线覆盖切除区域的边缘。在第二种技术(第2组)中,叶间裂用钉合装置切开。在第三种技术(第3组)中,使用连接到Nd:YAG激光器的激光纤维切割叶间裂缝。切除区域未重叠;每组进行15次横切。
    结果:在第1组中,三个实质桥在25mbar的压力下开始泄漏。在其他两组中,在这个压力下,所有的准备都是气密的。如果通风压力增加到40mbar,第1组的所有接缝在35mbar的压力下都有渗漏。四个钉缝在40毫巴的压力下是气密的。在第3组中,11种制剂(73.3%)在高达40mbar的压力下是气密的。
    结论:根据我们的结果,Nd:YAG激光的使用适用于叶间裂隙的横切。实际上,这项技术与所研究的其他技术相比很好。
    BACKGROUND: Every lobectomy requires the transection of the interlobar fissure. Resection surfaces must be airtight in order to avoid leakage and infection. Using an ex vivo model based on porcine lung, we compared three techniques with respect to initial airtightness at different inspiratory pressures.
    METHODS: In the first technique (group 1), we transected the interlobar fissure with a monopolar cutter and overstitched the edges of the resection area with a monofilament thread. In the second technique (group 2), the interlobar fissure was cut with a stapling device. In the third technique (group 3), the interlobar fissure was cut using a laser fibre connected to an Nd: YAG laser. The resection areas were not overstitched; 15 transections were performed in each group.
    RESULTS: In group 1, three parenchymatous bridges leaked starting at a pressure of 25 mbar. In the other two groups, all preparations were airtight at this pressure. If the ventilation pressure was increased up to 40 mbar, all seams in group 1 were leaky at a pressure of 35 mbar. Four staple seams were airtight at a pressure of 40 mbar. In group 3, 11 preparations (73.3 %) were airtight up to a pressure of 40 mbar.
    CONCLUSIONS: Based on our results, the use of an Nd: YAG laser is suitable for the transection of the interlobar fissure. In effect, this technique compares well with the other techniques examined.
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  • 文章类型: Journal Article
    激光焊接是一种创新的方法,经常被不同的学科使用和要求,并且由于精度等重要优点,在广泛的应用中代表了一种选择技术,速度,和灵活性。然而,焊接方法必须正确使用,否则可能会恶化焊接金属的机械性能及其环境。因此,激光参数应精确确定并仔细应用于样品。这项研究的主要目的是研究和提出最佳的焊接参数,应调整在钕掺杂钇铝石榴石(Nd:YAG)-奥氏体不锈钢316L脉冲激光焊接在空气焊接环境中使用氩气保护气体和血清介质中的湿焊接设置。对血清介质中的焊接过程进行了研究,以提出最合适的焊接参数,这些参数对于体内环境中激光焊接的未来可能的医学应用很重要,从而研究人体内焊接过程的可能性。为了评估空气焊接和湿焊接(血清)的质量,通过激光能量的变化进行了详细的参数研究,焊接速度和焦点位置。还评估了穿透深度与比点能量(SPE)之间的关系。通过光学显微镜和扫描电子显微镜(SEM)检查了焊接金属的微观结构。根据显微镜的结果,发现在空气介质中使用19J激光能量实现了最大的穿透深度(1380µm),而在血清培养基中,在28J激光能量下,深度达到最大值(1240µm)。增加的能量水平对空气和血清表现出相反的行为。我们的研究结果表明,当316L不锈钢焊接在体液中正确实施时,这将是未来体内研究的一个有希望的开端。
    Laser welding is an innovative method that is frequently used and required by different disciplines and represents a technique of choice in a wide range of applications due to important advantages such as precision, speed, and flexibility. However, the welding method must be used properly otherwise it may deteriorate the mechanical properties of the welded metal and its environment. Therefore, the laser parameters should be precisely determined and carefully applied to the sample. The primary objective of this study was to investigate and propose optimal welding parameters that should be adjusted during the neodymium-doped yttrium aluminum garnet (Nd: YAG)-pulsed laser welding of austenitic stainless steel 316L in an air welding environment by using Argon shielding gas and in wet welding settings in serum medium. The investigation of the welding process in serum medium was conducted in order to propose the most suitable welding parameters being important for future possible medical applications of laser welding in in-vivo settings and thus to investigate the possibilities of the welding process inside the human body. In order to evaluate the quality of welding in air and of wet welding (in serum), a detailed parameter study has been conducted by variation of the laser energy, the welding speed and the focal position. The relationship between the depth of penetration and specific point energy (SPE) was also evaluated. The microstructure of the welded metal was examined by an optical microscope and scanning electron microscope (SEM). Based on the microscopy results, it was found that the largest depth of penetration (1380 µm) was achieved with 19 J laser energy in air medium, while the depth reached the largest value (1240 µm) in serum medium at 28 J laser energy. The increasing energy level showed opposite behavior for air and serum. The results of our study imply that when welding of 316L stainless steel is implemented properly in the body fluid, it would be a promising start for future in-vivo studies.
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  • 文章类型: Journal Article
    Lichen amyloidosis (LA) is a type of primary localized cutaneous amyloidosis characterized by multiple localized, hyperpigmented, grouped papules, in which the deposition of amyloid materials from altered keratinocytes usually resists to current treatments. We presented two LA patients with non-satisfactory results of topical treatments. After the first treatment using 1064-nm Nd: YAG picosecond (ps-Nd:YAG) laser, there was an improvement with persistence up to 3-month follow up after five sessions of 4-week interval, as well as a decrease in number, thickness, and darkness of lesions from clinical and dermoscopic evaluation. Thus, the ps-Nd:YAG laser could be efficacious for LA treatment.
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