Selective photothermolysis

选择性光热解
  • 文章类型: Journal Article
    目的:寻常痤疮的几种治疗方案因其相关不良反应而受到限制。一种创新的方法涉及在使用选择性光热解破坏毛囊之前将光吸收纳米颗粒引入皮脂腺毛囊中。我们旨在研究将金和铂纳米颗粒引入皮脂腺毛囊的有效方法,并确定有效破坏这些毛囊的合适激光设备和参数。
    方法:我们使用猪皮肤作为实验模型。我们比较了thu激光的功效,超声,和手动按摩,并评估了在皮脂腺毛囊附近递送纳米颗粒的最佳方法。随后,使用1064nm波长的掺钕钇铝石榴石(Nd:YAG)激光诱导选择性光热解。我们比较了不同的参数,以确定Nd:YAG激光的最佳脉冲持续时间和通量。使用苏木精和伊红(H&E)染色评估皮脂腺毛囊的渗透和破坏程度,并进行了数值评估。
    结果:H&E染色显示,长脉冲Nd:YAG激光照射后,使用thu激光和超声电泳的组合有效地破坏了皮脂腺毛囊,破坏率超过50%。这些结果对于Nd:YAG激光的长脉冲持续时间和高通量是有效的。
    结论:这项研究表明,通过微通道和超声电泳的组合,可以通过金和铂纳米颗粒的混合物有效地破坏皮脂腺毛囊,随后是1064nm长脉冲高通量Nd:YAG激光引起的选择性热损伤。
    OBJECTIVE: Several treatment options for acne vulgaris are limited by their associated adverse effects. An innovative approach involves introducing light-absorbing nanoparticles into sebaceous follicles before destroying the follicles using selective photothermolysis. We aimed to investigate efficient methods for introducing gold and platinum nanoparticles into sebaceous follicles and to identify suitable laser equipment and parameters for the effective destruction of these follicles.
    METHODS: We used porcine skin as the experimental model. We compared the efficacies of a thulium laser, ultrasound, and manual massage and evaluated the optimal method for delivering nanoparticles in close proximity to sebaceous follicles. Subsequently, a 1064-nm-wavelength neodymium-doped yttrium aluminum garnet (Nd: YAG) laser was employed to induce selective photothermolysis. We compared different parameters to identify the optimal pulse duration and fluence of the Nd: YAG laser. The extent of penetration and destruction of sebaceous follicles was assessed using hematoxylin and eosin (H&E) staining, and a numerical evaluation was conducted.
    RESULTS: H&E staining showed that irradiation with a long-pulsed Nd: YAG laser following a combination of thulium laser and sonophoresis effectively destroyed sebaceous follicles, with destruction rates exceeding 50%. These results were valid with a long pulse duration and a high fluence of the Nd: YAG laser.
    CONCLUSIONS: This study demonstrated that sebaceous follicles can be effectively destroyed through a mixture of gold and platinum nanoparticle delivery by a combination of microchanneling and sonophoresis, followed by selective thermal damage induced by a 1064-nm long-pulsed high-fluence Nd: YAG laser.
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  • 文章类型: Journal Article
    寻常痤疮(AV),皮脂腺中的皮脂产生过多和痤疮杆菌增殖,显着影响身心健康。最近的治疗进展集中在皮脂腺的选择性光热解。这篇综述评估了两种创新疗法:1726nm激光和纳米粒子辅助激光治疗。我们使用主要术语“寻常痤疮”或“痤疮”和“激光”对PubMed和Embase进行了全面搜索,\"\"光热疗法,\"\"纳米粒子,\"\"治疗,“或”1726nm激光。“纳入标准是在同行评审的期刊上以英文发表的文章,重点是通过针对皮脂腺来治疗AV,产生11项研究。金纳米粒子,与800纳米激光一起使用,1064-nmNd:YAG激光器,或光气动装置,和铂纳米粒子与1450纳米二极管激光,显示痤疮病变的严重程度和数量显着改善,安全,患者满意度。1726nm激光治疗也显示出相当大的损伤减少和耐受性,具有最小的副作用,如红斑和水肿。它的效率归功于它的简短,有效靶向皮脂腺的高功率脉冲,提供精确的治疗与更少的副作用相比,低功率脉冲。使用纳米粒子辅助激光治疗或1726nm激光的选择性光热分解为传统AV治疗提供了有希望的替代方案,展示疗效和高患者满意度。1726纳米激光流线治疗,但涉及新的设备成本,虽然纳米粒子辅助疗法很好地整合到现有的设置中,但依赖于外部药物,不适合某些过敏。未来的研究应包括长期研究和比较分析。治疗方式的选择应考虑患者的喜好,成本影响,以及特定疗法的可用性。
    Acne vulgaris (AV), characterized by excessive sebum production and Cutibacterium acnes proliferation in the sebaceous glands, significantly impacts physical and psychological health. Recent treatment advancements have focused on selective photothermolysis of sebaceous glands. This review evaluates two innovative therapies: the 1726-nm laser and nanoparticle-assisted laser treatments. We conducted a comprehensive search of PubMed and Embase using the primary terms \"acne vulgaris\" or \"acne\" AND \"laser,\" \"photothermal therapy,\" \"nanoparticles,\" \"treatment,\" or \"1726 nm laser.\" Inclusion criteria were articles published in English in peer-reviewed journals that focused on treating AV through targeting the sebaceous glands, yielding 11 studies. Gold nanoparticles, used with 800-nm laser, 1064-nm Nd: YAG laser, or photopneumatic device, and platinum nanoparticles with 1450-nm diode laser, showed notable improvements in severity and number of acne lesions, safety, and patient satisfaction. The 1726-nm laser treatments also showed considerable lesion reduction and tolerability, with minimal side effects such as erythema and edema. Its efficiency is credited to its short, high-power pulses that effectively target sebaceous glands, offering precise treatment with fewer side effects compared to lower-power pulses. Selective photothermolysis using nanoparticle-assisted laser therapy or the 1726-nm laser offers a promising alternative to conventional AV treatments, showcasing efficacy and high patient satisfaction. The 1726-nm laser streamlines treatment but involves new equipment costs, while nanoparticle-assisted therapy integrates well into existing setups but relies on external agents and is unsuitable for certain allergies. Future research should include long-term studies and comparative analyses. The choice of treatment modality should consider patient preferences, cost implications, and availability of specific therapies.
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  • 文章类型: Journal Article
    目的:评价新型风冷Nd:YAG激光在嘴唇静脉湖(VLL)中的治疗效果。背景:热损伤是静脉湖激光治疗过程中最重要的问题之一。方法:用6片新鲜猪肝提供30个直径6mm的区域进行体外实验,其中15个区域用Nd:YAG激光治疗,空气冷却,直到组织变成灰白色,而其余的则不进行空气冷却作为对照。激光照射的操作时间,温度升高的程度,比较两组的凝血组织深度。然后,选择60例VLL患者进行有或没有空气冷却的Nd:YAG激光治疗。激光照射的操作时间,温度升高的程度,术后疼痛视觉模拟量表(VAS)评分,并比较1个月内切除的病灶百分比。结果:在组织研究中,治疗组激光照射手术时间较长(p<0.01),温度升高程度较低(p<0.01),而凝固组织深度差异无统计学意义(p=0.624)。在临床研究中,治疗组激光照射手术时间较长(p<0.01),温度升高程度较低(p<0.01),第1天和第2天的VAS评分较低,与对照组比较(p<0.01)。结论:Nd:YAG激光治疗VLL可有效延长手术时间。但在保证治疗效果的前提下,在2天内降低了组织温度,减轻了患者的疼痛。
    Objective: To evaluate the therapeutic effect of a novel air-cooled Nd:YAG laser in the venous lakes of the lips (VLL). Background: The thermal injury is one of the most important issues during laser therapy for venous lakes. Methods: Six pieces of fresh pork livers were used to provide 30 regions with a diameter of 6 mm for experiment in vitro, among which 15 regions were treated by Nd:YAG laser with air cooling until the tissue turned gray-white, whereas the rest were treated without air cooling as control. The operation time of laser irradiation, the degree of temperature increase, and the depth of coagulation tissue were compared between two groups. Then, 60 VLL patients were selected for Nd:YAG laser treatment with or without air cooling. The operation time of laser irradiation, the degree of temperature increase, the postoperative pain visual analog scale (VAS) score, and the percentage of lesions removed within 1 month were compared. Results: In tissue studies, the treated group showed a longer operation time of laser irradiation (p < 0.01), a lower degree of temperature increase (p < 0.01), and there was no significant statistical difference in the depth of coagulation tissue (p = 0.624). In clinical studies, the treated group showed a longer operation time of laser irradiation (p < 0.01), a lower degree of temperature increase (p < 0.01), and a lower VAS score on the 1st and 2nd day, compared with the control group (p < 0.01). Conclusions: Air cooling during Nd:YAG laser for the treatment of VLL can prolong the surgical time, but lowered tissue temperature and reduced patient pain within 2 days under the premise of ensuring the treatment effect.
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    文章类型: Review
    寻常痤疮的治疗传统上包括局部和口服药物的组合。使用激光治疗这种情况一直是一个越来越多的研究领域,和几种类型以前被用于治疗痤疮。新的1726nm激光专门针对皮脂腺,这在痤疮的病理生理学中是关键的。这种激光波长证明了作为中度至重度痤疮的安全和有效治疗选择的巨大潜力,而没有全身治疗的风险。本文综述了1726nm激光治疗寻常痤疮的研究进展。
    The treatment of acne vulgaris traditionally consists of a combination of topical and oral medications. The use of lasers to treat this condition has been an area of increasing research, and several types have previously been used in the treatment of acne. New 1726 nm lasers specifically target the sebaceous gland, which is known to be pivotal in acne pathophysiology. This laser wavelength demonstrates substantial potential as a safe and effective therapeutic option for moderate to severe acne without the risks of systemic therapy. This paper reviews the 1726 nm lasers for acne vulgaris.
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  • 文章类型: Journal Article
    随着对无创嫩肤技术的需求不断增加,已经介绍了几种基于光的设备。由于它能够将热能从真皮的表层传递到深层,三波长组合激光器(755nm,810nm,和1064nm)可用于嫩肤。这项研究的目的是评估联合三波长激光嫩肤的有效性和安全性。共包括28名寻求嫩肤治疗的女性患者。所有患者以两周的间隔进行连续五次治疗。治疗皮肤科医生和患者注意到与衰老相关的皮肤变化的临床改善。在最终治疗之前和之后两周对同意的患者的面部进行活检。患者和评估皮肤科医生均观察到了显着的临床改善。根据患者满意度问卷,78%的患者报告自我评估的改善超过25%。此外,86%的患者在皮肤科医生的客观评估中表现出超过25%的改善。组织病理学发现显示整个真皮中胶原蛋白和弹性束增加。除了治疗期间的一过性疼痛,未报告严重不良反应.这项研究的结果表明,组合式三波长激光可能是一种有效且安全的非消融性嫩肤选择。
    With an increasing demand for noninvasive skin rejuvenation techniques, several light-based devices have been introduced. Due to its ability to deliver thermal energy from the superficial to deeper levels of the dermis, a combined triple-wavelength laser (755 nm, 810 nm, and 1064 nm) can be used for skin rejuvenation. The objective of this study was to assess the effectiveness and safety of a combined triple-wavelength laser for skin rejuvenation. A total of 28 female patients seeking skin rejuvenation treatment were included. All patients underwent five consecutive treatment sessions at a two-week interval. Clinical improvement of aging-related cutaneous change was noted by the treating dermatologists and patients. Biopsies were performed on the faces of consenting patients before and two weeks after the final treatment. Significant clinical improvements were observed by both patients and evaluating dermatologists. Based on the patient satisfaction questionnaire, 78% of patients reported a self-assessed improvement of more than 25%. Additionally, 86% of patients showed an improvement of more than 25% on objective assessment by dermatologists. Histopathological findings revealed increased collagen and elastic bundles throughout the dermis. Except for transient pain during treatment, no serious adverse effects were reported. The findings of this study suggest that the combined triple-wavelength laser may be an effective and safe nonablative option for skin rejuvenation.
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  • 文章类型: Journal Article
    博士对选择性光热解的介绍。1983年,JohnParrish和RoxAnderson彻底改变了激光在皮肤病学中的应用。该理论允许激光器安全有效地用于各种应用,应用程序的数量只会随着时间的推移而扩大。从血管胎记的首次应用到痤疮的最新应用,这篇综述涵盖了激光从一开始到我们前进的方向的演变。
    The introduction of selective photothermolysis by Drs. John Parrish and Rox Anderson in 1983 revolutionized how lasers are used in dermatology. The theory allowed for lasers to be used in a variety of applications both safe and effectively, and the number of applications has only expanded with time. From the first application on vascular birthmarks to more recent applications for acne, this review covers the evolution of lasers from the beginning to where we are headed.
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  • 文章类型: Journal Article
    背景:传统痤疮治疗与局部治疗,全身性抗生素,荷尔蒙剂,或口服异维A酸需要依从性,并可能产生明显的副作用。然而,激光治疗的替代疗法未能显示出持久的清除。
    目的:评估新型1726-nm激光治疗不同皮肤类型的中度至重度痤疮的耐受性和治疗结果。
    方法:前瞻性,开放标签,单臂,IDE批准,进行了IRB批准的104名患有中度至重度面部痤疮和Fitzpatrick皮肤类型从II至VI的受试者的研究。受试者以3(-1/+2)周的间隔接受三次激光治疗。
    结果:最终治疗后,在4周随访时,活动性痤疮炎性病变减少≥50%,为32.6%,在12周和26周时进一步增加到79.8%和87.3%,分别。受试者清除或几乎清除的百分比从基线时的0%增加到9%,36.0%,和41.8%在4-,12周和26周随访。未观察到与装置或方案相关的严重不良事件;治疗耐受性良好,不需要麻醉.所有皮肤类型的治疗结果和不适相似。
    结论:缺乏对照组。
    结论:研究结果表明,新型1726nm激光对于不同皮肤类型的中度至重度痤疮具有良好的耐受性,治疗后至少26周的持续进行性改善。
    Traditional acne management with topical therapy, systemic antibiotics, hormonal agents, or oral isotretinoin requires compliance and may produce significant side effects. However, alternative treatments with lasers had failed to demonstrate durable clearance.
    To assess the tolerability and therapeutic outcomes of a novel 1726 nm laser treatment of moderate-to-severe acne across skin types.
    A prospective, open-label, single-arm, Investigational Device Exemption-approved, institutional review board-approved study of 104 subjects with moderate-to-severe facial acne and Fitzpatrick Skin Types ranging from II-to-VI was conducted. Subjects received 3 laser treatments at 3 (-1/+2)-week intervals.
    Following final treatment, ≥50% reduction in active acne inflammatory lesions was 32.6% at 4-weeks follow-up, increasing further to 79.8% and 87.3% at 12 and 26-weeks, respectively. The percentage of subjects clear or almost clear increased from 0% at baseline to 9%, 36.0%, and 41.8% at 4-, 12-, and 26-weeks follow-up. No serious adverse events were observed related to device or protocol; treatments were well tolerated, requiring no anesthetic. Therapeutic outcomes and discomfort were similar across all skin types.
    Lack of control group.
    The study findings demonstrate the novel 1726 nm laser is well tolerated with durable progressive posttreatment improvement to at least 26 weeks for moderate-to-severe acne across skin types.
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  • 文章类型: Journal Article
    针对太田痣(NO)的个性化激光治疗,采用局部热非平衡模型来优化激光波长,脉冲持续时间,不同黑色素深度和体积分数下的能量密度。根据我们的模拟,最佳脉冲持续时间在15到150ns之间,以限制增生黑色素内部的热传递,建议50ns以减少表皮中正常黑色素的能量吸收。对于755nm和1064nm激光器,提出了最小和最大能量密度与黑色素深度和体积分数的相关性。对于相同的NO类型,755nm激光的治疗窗口大于1064nm。对于深度浅或体积分数低的NO,755nm激光被推荐,以使治疗更稳定,由于其更大的治疗窗口。对于更深的深度或更高的体积分数,建议使用1064-nm激光以避免表皮的热损伤。通过与临床资料的对比,优化的激光参数被证明是可行的,因为当能量密度落入预测的治疗窗口范围内时,可以实现高治愈率。随着黑色素含量和分布的无创检测技术的发展,在不久的将来,可能会对NO进行个性化治疗。
    Aiming to the personalized laser therapy of nevus of Ota (NO), a local thermal non-equilibrium model was employed to optimize laser wavelength, pulse duration, and energy density under different melanin depth and volume fraction. According to our simulation, the optimal pulse duration is between 15 and 150 ns to limit heat transfer inside the hyperplastic melanin, and 50 ns is recommended to decrease the energy absorption by normal melanin in epidermis. Correlations of the minimum and the maximum energy densities are proposed with respect to melanin depth and volume fraction for the 755-nm and 1064-nm lasers. For the same NO type, the therapy window of the 755-nm laser is larger than that of 1064-nm. For NO with shallow depth or low volume fraction, the 755-nm laser is recommended to make the treatment more stable owing to its lager therapy window. For deeper depth or higher volume fraction, the 1064-nm laser is recommended to avoid thermal damage of epidermis. Through comparison with clinical data, the optimized laser parameters are proved practicable since high cure rate can be achieved when energy density falls into the range of predicted therapy window. With developing of non-invasive measurement technology of melanin content and distribution, personalized treatment of NO maybe possible in the near future.
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  • 文章类型: Journal Article
    针对黑色素的脱毛激光已广泛应用于多毛症的治疗。选择性光热解和热扩散都被提出了它的效果,但永久性减发的确切机制尚不清楚。在这项研究中,我们探讨了热扩散在脱毛激光诱导的永久性脱发中的作用,并确定热扩散是否会损害非色素细胞。
    C57BL/6小鼠在生长期和调生期用翠绿宝石激光(波长755nm,脉冲持续时间3毫秒,注量12J/cm2,光斑尺寸12毫米),分别。组织学分析,末端脱氧核苷酸转移酶dUTP缺口末端标记测定,和透射电子显微镜成像用于评估毛囊(HF)细胞的损伤。通过5-溴-2'-脱氧尿苷脉冲标记检查HF细胞的增殖状态。通过荧光激活细胞分选对HF干细胞的数量进行定量。通过测量其长度和宽度来确定再生毛发的大小。
    我们发现,在生长期中,用翠绿宝石激光照射C57BL/6小鼠会导致下一个生长期中的毛发小型化。除了前皮质区域含黑色素细胞的热破坏,我们还检测到邻近的无色素毛乳头细胞由于热扩散而坏死。激光损伤后毛乳头细胞减少24%,而凸起干细胞的数量保持不变。当激光被传递到皮肤乳头附近没有黑色素的静止期HFs时,在毛乳头中未检测到热坏死和细胞减少,也未观察到头发小型化。
    我们的结果表明,脱毛激光通过诱导真皮乳头细胞的热坏死来使头发小型化,这是由于在生长期毛球中含有黑色素的前皮质细胞的二次热扩散所致。
    Depilatory laser targeting melanin has been widely applied for the treatment of hypertrichosis. Both selective photothermolysis and thermal diffusion have been proposed for its effect, but the exact mechanism of permanent hair reduction remains unclear. In this study, we explore the role of thermal diffusion in depilatory laser-induced permanent hair loss and determine whether nonpigmented cells are injured by thermal diffusion.
    C57BL/6 mice in anagen and telogen were treated with alexandrite laser (wavelength 755 nm, pulse duration 3 milliseconds, fluence 12 J/cm2 , spot size 12 mm), respectively. Histological analysis, terminal deoxynucleotidyl transferase dUTP nick-end labeling assay, and transmission electron microscopic imaging were employed to evaluate the injury to hair follicle (HF) cells. The proliferation status of HF cells was examined by 5-bromo-2\'-deoxyuridine pulse labeling. The number of HF stem cells was quantified by fluorescence-activated cell sorting. The size of the regenerated hair was determined by measuring its length and width.
    We found that irradiating C57BL/6 mice in anagen with alexandrite laser led to hair miniaturization in the next anagen. In addition to thermal disruption of melanin-containing cells in the precortex region, we also detected necrosis of the adjacent nonpigmented dermal papilla cells due to thermal diffusion. Dermal papilla cells decreased by 24% after laser injury, while the number of bulge stem cells remained unchanged. When the laser was delivered to telogen HFs where no melanin was present adjacent to the dermal papilla, thermal necrosis and cell reduction were not detected in the dermal papilla and no hair miniaturization was observed.
    Our results suggest that depilatory laser miniaturizes hair by inducing thermal necrosis of dermal papilla cells due to secondary thermal diffusion from melanin-containing precortex cells in the anagen hair bulbs.
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  • 文章类型: Journal Article
    基于众所周知的选择性光热解原理,激光一直是治疗葡萄酒色斑(PWS)的一种有前途的方法。用于PWS临床治疗的激光波长包括但不限于585-600nm的脉冲染料激光(PDL),长脉冲755-nm翠绿宝石,和1064-nmNd:YAG激光器。本研究的目的是探讨PWS激光治疗的最佳波长。构建了双尺度数学模型,以同时量化两层块状皮肤中的宏观激光能量衰减和Krogh单元内目标血管上的微观局部能量吸收。形态参数的影响,包括表皮黑色素含量,表皮厚度,皮肤血液含量,血管深度,和目标血管内激光能量沉积的直径,从可见光到近红外波段(500-1100nm)进行了研究。提出了目标血管与表皮表面的能量沉积比,以确定具有不同皮肤形态参数的PWS的最佳激光波长。还进行了生物传热建模和动物实验以证明我们的波长优化。具有小而浅的目标血管的轻度色素皮肤的最佳波长在可见波段中为580-610nm。该波长与商业使用的PDL一致。随着表皮色素沉着的增加或大小和血管深度的增加,最佳波长移至940nm。随着表皮色素沉着或目标血管的大小和掩埋深度进一步增加,最佳波长变为1005nm。在PWS处理中可以选择九百四十纳米作为一般波长,以满足最广泛的形态结构的需要。波长在580-610、940和1005nm区域的激光器对于治疗PWS是有效的,因为它们在表皮上的血液中具有高的光学选择性。
    Based on the well-known principle of selective photothermolysis, laser has been a promising way for the treatment of port wine stains (PWSs). The laser wavelengths used for PWS\'s clinical treatment include but are not limited to pulsed dye laser (PDL) in 585-600 nm, long-pulse 755-nm alexandrite, and 1064-nm Nd:YAG lasers. The objective of this study was to investigate the optimal wavelength for PWS\'s laser treatment. A two-scale mathematic model was constructed to simultaneously quantify macroscale laser energy attenuation in two-layered bulk skin and microscale local energy absorption on target blood vessels within Krogh unit. The effects of morphological parameters, including epidermal melanin content, epidermal thickness, dermal blood content, blood vessel depth, and diameter on laser energy deposition within target blood vessels, were investigated from the visible to near-infrared bands (500-1100 nm). The energy deposition ratio of target blood vessel to epidermal surface was proposed to determine the optimal laser wavelength for PWS with different skin morphological parameters. The bioheat transfer modeling and animal experiment are also conducted to prove our wavelength optimization. The optimal wavelengths for lightly pigmented skin with small and shallow target blood vessels are 580-610 nm in the visible band. This wavelength coincides with commercially used PDL. The optimal wavelength shifts to 940 nm as the epidermal pigmentation increases or the size and blood vessel depth increases. The optimal wavelength changes to 1005 nm as the epidermal pigmentation or the size and burying depth of target blood vessel further increases. Nine hundred forty nanometers can be selected as a general wavelength in PWS treatment to meet the need in most widely morphological structure. Lasers with wavelengths in the 580-610, 940, and 1005 nm regions are effective for treating PWS because of their high optical selectivity in blood over the epidermis.
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