Your browser doesn't support javascript.
loading
Show: 20 | 50 | 100
Results 1 - 20 de 48
Filter
1.
Eur Ann Otorhinolaryngol Head Neck Dis ; 134(4): 217-220, 2017 Sep.
Article in English | MEDLINE | ID: mdl-28209412

ABSTRACT

OBJECTIVE/HYPOTHESIS: To develop an injection-based enzymatic technique that selectively softens cartilage tissue for reshaping cartilaginous structures in the head and neck. MATERIALS AND METHODS: Two groups were formed using fresh rabbit ears: (1) whole rabbit ear group; (2) composite graft group (2.5mm×3.0cm specimens sectioned from the central region of the pinna). Subperichondrial injections using three enzymes (hyaluronidase, pronase, and collagenase II) in sequence were performed for the experimental specimens from both groups. In the control specimens, phosphate buffered saline was injected in a similar fashion. The whole ear specimens were then photographed while held upright in the anatomical vertical position to evaluate for buckling, which corresponds to the integrity of the cartilage. In addition, backlight photography was performed for all specimens to further evaluate the effect of the enzymes, such that increased light intensity represents increased cartilage digestion. RESULTS: The application of the digestive enzymes resulted in marked reduction of cartilage tissue matrix resiliency, while preserving overlying skin layers. Enzymatically treated whole pinnae buckled at the site where enzymes were delivered. Backlit images revealed increased local light intensity at the regions of digestion. There was no obvious destruction of the overlying skin upon visual inspection. CONCLUSIONS: This study demonstrates the feasibility of injectable chondroplasty as a potential alternative method to conventional surgery for auricular cartilage reshaping. Sequential injection of hyaluronidase, pronase, and collagenase II into the subperichondrial space can be performed to digest and soften cartilage structure with minimal involvement of surrounding tissue. Future studies will need to include chondrocyte viability testing and optimization of delivery techniques.


Subject(s)
Ear Auricle/pathology , Ear Cartilage/transplantation , Hyaluronoglucosaminidase/administration & dosage , Matrix Metalloproteinase 8/administration & dosage , Photography , Pronase/administration & dosage , Animals , Disease Models, Animal , Feasibility Studies , Injections, Subcutaneous/methods , Rabbits , Plastic Surgery Procedures/methods , Time Factors , Treatment Outcome
2.
Facial Plast Surg ; 32(6): 646-655, 2016 Dec.
Article in English | MEDLINE | ID: mdl-28033641

ABSTRACT

The alar lobule, alar margin, and soft triangle facet are receiving more attention in the literature as critical elements to address both preoperatively and during rhinoplasty. We have found that the use of the articulated alar rim graft (AARG) corrects deficiencies in these areas as well as provides mechanical stability to the external valve. In this article, we describe indications for AARG, describe in detail the procedure for AARG placement, and highlight the transformation AARGs can achieve in two illustrated case studies.


Subject(s)
Costal Cartilage/transplantation , Nasal Cartilages/transplantation , Nose/anatomy & histology , Rhinoplasty/methods , Adolescent , Adult , Esthetics , Female , Humans , Suture Techniques
3.
J Clin Neurosci ; 21(3): 456-61, 2014 Mar.
Article in English | MEDLINE | ID: mdl-24290904

ABSTRACT

Glomus jugulare tumours (GJT) are one of a family of benign hypervascular neoplasms that arise from chief cells of the paraganglionic tissue from the dome of the jugular bulb. Historically, these tumours have primarily been managed surgically but radiation is an alternative treatment modality. The purpose of this retrospective review was to determine the patient survival, tumour control, clinical control rates and long term toxicity of GJT treated with radiation in South Australia. Between 1996 and 30 June 2012, 15 patients with GJT (16 tumours) were managed with radiotherapy. Twelve patients were female and the median age was 62 years. Thirteen patients (87%) were treated with conventional external beam radiotherapy and two patients (13%) with stereotactic radiosurgery. The mean duration of follow-up was 4 years (range 1 month-15 years 4 months). The close-out date for survival analyses was 31 October 2012. Crude overall survival, tumour control, clinical control and long term grade >2 toxicity rates were 100%, 94% (15/16), 94% and 7% (1/16), respectively. The Kaplan-Meier 5 and 10 year clinical and tumour control rates were both 93% (95% confidence interval: 61-99%). Radiation is an effective treatment modality for GJT. With comparable patient survival, arguably improved tumour and clinical control rates relative to surgery, minimal toxicity and ongoing advances in radiotherapy technologies, radiation should be strongly considered for the primary management of GJT.


Subject(s)
Glomus Jugulare Tumor/mortality , Glomus Jugulare Tumor/radiotherapy , Adolescent , Adult , Aged , Female , Humans , Kaplan-Meier Estimate , Male , Middle Aged , Radiotherapy, Conformal/adverse effects , Radiotherapy, Conformal/methods , Retrospective Studies , South Australia , Treatment Outcome , Young Adult
4.
Exp Physiol ; 97(7): 849-60, 2012 Jul.
Article in English | MEDLINE | ID: mdl-22467760

ABSTRACT

Current assessments of the effects of shear patterns on vascular function assume that a parabolic velocity profile is always present. Any substantial deviation in the profile away from this may result in misinterpretation of the importance that shear patterns have on vascular function. The present investigation tested the hypothesis that anterograde and retrograde blood flow would have a parabolic velocity profile at rest, during cold pressor test and exercise. Eight healthy subjects completed a cold pressor test and a graded knee-extension exercise test. Doppler ultrasound was used to determine time-averaged mean velocity (V(mean)) and time-averaged peak velocity (V(peak)) for both anterograde and retrograde flow in the femoral artery (FA) and brachial artery (BA). The V(mean)/V(peak) ratio was used to interpret the shape of the blood velocity profile (parabolic, V(mean)/V(peak) = 0.5; plug-like, V(mean)/V(peak) = 1.0). At rest, BA and FA V(mean)/V(peak) ratios of anterograde and retrograde flow were not significantly different from 0.5. During cold pressor test, anterograde V(mean)/V(peak) in the BA (0.56 ± 0.02) and FA (0.58 ± 0.03) were significantly greater than 0.5. During peak exercise, the V(mean)/V(peak) ratio of anterograde flow in the FA (0.53 ± 0.04) was not significantly different from 0.5. In all conditions, the retrograde V(mean)/V(peak) ratio was lower than anterograde. These data demonstrate that blood flow through two different conduit arteries during two different physiological stressors maintains a velocity profile that resembles a slightly blunted parabolic velocity profile.


Subject(s)
Blood Flow Velocity/physiology , Blood Pressure/physiology , Brachial Artery/physiology , Cold Temperature , Exercise/physiology , Female , Femoral Artery/physiology , Humans , Male , Ultrasonography, Doppler , Young Adult
5.
Acta Physiol (Oxf) ; 205(3): 403-10, 2012 Jul.
Article in English | MEDLINE | ID: mdl-22356216

ABSTRACT

AIM: The precise mechanisms underlying reflex cutaneous vasodilatation during hyperthermia remain unresolved. The purpose of this study was to investigate a potential contribution of adenosine A1/A2 receptor activation to reflex cutaneous vasodilatation. METHODS: Eight subjects were equipped with four microdialysis fibres on the left forearm, and each fibre was randomly assigned one of four treatments: (1) lactated Ringer's (control); (2) 4 mm of the non-selective A1/A2 adenosine receptor antagonist theophylline; (3) 10 mm L-NAME to inhibit nitric oxide (NO) synthase; and (4) combined 4 mm theophylline and 10 mm L-NAME. Laser-Doppler flowmetry (LDF) was used as an index of skin blood flow, and blood pressure was measured beat-by-beat via photoplethysmography and verified via brachial auscultation. Whole-body heat stress to raise oral temperature 0.8 °C above baseline was induced via water-perused suits. Cutaneous vascular conductance (CVC) was calculated as LDF/mean arterial pressure and normalized to maximal (%CVC max) via infusion of 28 mm nitroprusside and local heating to 43 °C. RESULTS: There was no difference between control (65 ± 5%CVC max) and theophylline (63 ± 5%CVC max) sites. L-NAME (44 ± 4%CVC max) and theophylline + L-NAME (32 ± 3%CVC max) sites were significantly attenuated compared to both control and theophylline only sites (P<0.05), and combined theophylline + L-NAME sites were significantly reduced compared to L-NAME only sites (P<0.05). CONCLUSION: These data suggest A1/A2 adenosine receptor activation does not directly contribute to cutaneous active vasodilatation; however, a role for A1/A2 adenosine receptor activation is unmasked when NO synthase is inhibited.


Subject(s)
Heat-Shock Response/physiology , Receptor, Adenosine A1/physiology , Receptors, Adenosine A2/physiology , Skin/blood supply , Vasodilation/physiology , Adult , Enzyme Inhibitors/pharmacology , Female , Humans , Male , Microdialysis , NG-Nitroarginine Methyl Ester/pharmacology , Nitric Oxide Synthase/antagonists & inhibitors , Nitric Oxide Synthase/drug effects , Nitroprusside/pharmacology , Purinergic P1 Receptor Antagonists/pharmacology , Receptor, Adenosine A1/drug effects , Receptors, Adenosine A2/drug effects , Theophylline/pharmacology , Vasodilation/drug effects , Vasodilator Agents/pharmacology
6.
Acta Physiol (Oxf) ; 201(3): 339-47, 2011 Mar.
Article in English | MEDLINE | ID: mdl-20946237

ABSTRACT

UNLABELLED: Hypoxia impairs body temperature regulation and abolishes the decline in skin temperature associated with cold exposure, suggesting that cutaneous vasoconstriction is impaired. AIM: The purpose of this study was to test the hypothesis that cutaneous vasoconstriction to intradermal tyramine, an index of post-junctional vasoconstrictor responsiveness, is reduced during hypoxia. METHODS: Twelve subjects (six males, six females) had three microdialysis fibres placed in the ventral forearm. Fibres received either lactated ringers, 5 mm yohimbine (α-adrenergic blockade), or 10.5 µm BIBP-3226 (to antagonize neuropeptide Y Y(1) receptors). Skin blood flow was assessed at each site (laser-Doppler flowmetry) and cutaneous vascular conductance (CVC) was calculated (red blood cell flux/mean arterial pressure) and scaled to baseline. Vasoconstrictor responses to tyramine (173 µm) were tested during normoxia and steady-state isocapnic hypoxia (SaO(2) = 80%) in random order. RESULTS: During normoxia, tyramine reduced CVC by 56.0±5.6 and 50.3±8.0% in control and BIBP-3226 sites (both P<0.05 vs. pre-tyramine; P=0.445 between sites) whereas CVC in the yohimbine site did not change (P=0.398 vs. pre-tyramine). During isocapnic hypoxia, tyramine reduced CVC by 55.9±5.1 and 54.2±5.4% in control and BIBP-3226 sites (both P<0.05 vs. pre-tyramine; P=0.814 between sites) whereas CVC was unchanged in the yohimbine site (P=0.732 vs. pre-tyramine). Isocapnic hypoxia did not affect vasoconstrictor responses at any site (all P>0.05 vs. normoxia). CONCLUSION: We conclude that post-junctional α-adrenergic vasoconstrictor responsiveness is not affected by hypoxia in non-acral skin.


Subject(s)
Blood Flow Velocity/physiology , Receptors, Adrenergic, alpha/metabolism , Skin Physiological Phenomena , Vasoconstriction/physiology , Adult , Cell Hypoxia , Female , Humans , Male , Skin/blood supply
7.
Clin Otolaryngol ; 34(5): 460-6, 2009 Oct.
Article in English | MEDLINE | ID: mdl-19793279

ABSTRACT

OBJECTIVES: Optical coherence tomography, an imaging modality using near-infrared light, produces cross-sectional tissue images with a lateral pixel resolution of 10 microm. However, normative data is first needed on epithelial thickness for lesion characterisation, and, to date, little exists. The purpose of our study is to measure normal laryngeal epithelial thickness by in vivo optical coherence tomography, and compare these values to those obtained from fixed ex-vivo laryngectomy specimens. DESIGN AND SETTING: Prospective at a single medical center in California, United States. PARTICIPANTS: A total of 116 patients undergoing operative endoscopy. MAIN OUTCOME MEASURES: Optical coherence tomography images of clinically normal laryngeal subsites were selected. Calibrated measurements of epithelial thickness at various laryngeal subsites were recorded. Measurements of epithelial thickness from corresponding areas were obtained using optical micrometry on histologically normal regions of 15 total laryngectomy specimens. Descriptive statistics were performed. RESULTS: Mean epithelial optical coherence tomography thicknesses were: true vocal cords (81 microm), false vocal cords (78 microm), subglottis (61 microm), aryepiglottic folds (111 microm), laryngeal epiglottis (116 microm) and lingual epiglottis (170 microm). Epithelial thicknesses in fixed tissues were: true vocal cords (103 microm), false vocal cords (79 microm), aryepiglottic folds (205 microm) subglottis (61 microm), laryngeal epiglottis (38 microm) and lingual epiglottis (130 microm). CONCLUSIONS: Optical coherence tomography does not have the artifacts associated with conventional histologic techniques. The inevitable development of office-based optical coherence tomography devices will increase the precision of laryngeal measurements and contribute to the clinical application of this technology in diagnosing laryngeal disease.


Subject(s)
Laryngeal Neoplasms/pathology , Larynx/pathology , Aged , Female , Humans , Laryngeal Neoplasms/surgery , Laryngectomy , Laryngoscopy , Larynx/surgery , Male , Middle Aged , Tomography, Optical Coherence
8.
Acta Physiol (Oxf) ; 195(3): 367-74, 2009 Mar.
Article in English | MEDLINE | ID: mdl-18945271

ABSTRACT

AIM: Mechanical factors such as the muscle pump have been proposed to augment flow by several mechanisms. The potential for limb angular motion to augment local perfusion pressure (pressure = (1/2)rhor(2)omega(2), where rho is the fluid density, r the radius and omega the angular velocity) has been overlooked. We sought to test the hypothesis that limb angular motion augments limb arterial pressure. METHODS: Nine human subjects performed horizontal shoulder flexion ( approximately +/-90 degrees at 0.75 Hz for 30 s). We measured finger arterial pressure (photoplethysmography) in the moving (Trial 1) and non-moving arm (Trial 2) in separate trials along with the pressure (strain gauge) generated at the fingers within a length of water-filled tubing mounted on the moving arm in both trials. RESULTS: Arm swinging raised (P < 0.05) the mean pressure measured in the tubing by 11 +/- 2 and 14 +/- 2 mmHg (Trials 1 and 2 respectively). In response to exercise, the rise in mean finger arterial pressure in the swinging limb (18 +/- 3 mmHg, Trial 1) exceeded (P < 0.05) the rise in the resting limb (8 +/- 2 mmHg, Trial 2) by an amount similar to the 11 mmHg rise in pressure generated in the tubing in Trial 1. CONCLUSIONS: We conclude that the swinging of a limb creates centrifugal force (a biomechanical centrifuge) which imparts additional pressure to the arteries, but not the veins owing to the venous valves, which further widens the arterial-venous pressure difference.


Subject(s)
Arm/blood supply , Blood Pressure/physiology , Movement/physiology , Acceleration , Adult , Arm/physiology , Female , Fingers/blood supply , Heart Rate/physiology , Humans , Male , Photoplethysmography , Regional Blood Flow/physiology , Rotation , Shoulder Joint/physiology , Young Adult
9.
J Therm Anal Calorim ; 95(3): 937-943, 2009 Mar 01.
Article in English | MEDLINE | ID: mdl-25425960

ABSTRACT

Cartilage thermoforming is an emerging surgical technology which uses heat to accelerate stress relaxation in mechanically deformed tissue specimens. Heat induced shape change in cartilage is associated with complex thermo mechanical behavior of which the mechanisms are still a subject of debate. Differential scanning calorimetry (DSC) was used to characterize the threshold temperatures and enthalpies in cartilage as a function of water content. The DSC identified two enthalpic events in porcine nasal septal cartilage, which depend on the water content. The change in the water content of cartilage impacts the interactions between matrix macromolecules and water molecules, which may be associated with a bound-free water transformation (reversible process) and a denaturation of cartilage (irreversible process).

10.
Lasers Med Sci ; 18(3): 148-53, 2003.
Article in English | MEDLINE | ID: mdl-14505198

ABSTRACT

Laser cartilage reshaping is a temperature-dependent process that results in stress relaxation with subsequent formation of a new and stable specimen geometry. The objective of this study was to quantitatively measure changes in the elastic moduli of porcine cartilage following laser heating. The elastic modulus of porcine nasal septal cartilage specimen (25 x 5 x 2 mm) was measured before and after Nd: YAG laser (lambda=1.32 Irvinem, 21.22 W/cm2) irradiation and following rehydration in saline solution. Specimens were secured in a single beam cantilever configuration and displaced using a calibrated thin beam load cell attached to a motorised micropositioner. Elastic modulus was calculated using elastic beam theory. Measurements were recorded before and immediately after laser heating, and following rehydration in saline solution (40 minutes, 25 degrees C). Specimens heated in saline (100 degrees C and then re-hydrated) were used as controls to determine the effect of total thermal denaturation. The calculated moduli before and after irradiation were 4.86 +/- .145 MPa and 1.166 +/- .055 MPa respectively. Following rehydration in saline, the modulus returned to near-baseline values (5.119 +/- .163 MPa). In contrast, elasticity remained lower in specimens boiled and re-hydrated (3.25 +/- .130 MPa). These findings suggest that cartilage matrix does not undergo complete thermal denaturation during laser reshaping, given the return in tissue properties with rehydration.


Subject(s)
Cartilage/surgery , Laser Therapy/methods , Nasal Septum/radiation effects , Plastic Surgery Procedures/methods , Animals , Cartilage/physiopathology , Cartilage/radiation effects , Elasticity/radiation effects , In Vitro Techniques , Nasal Septum/physiopathology , Regression, Psychology , Swine
11.
Tissue Eng ; 7(5): 599-606, 2001 Oct.
Article in English | MEDLINE | ID: mdl-11694193

ABSTRACT

Two-photon excitation laser scanning microscopy (TPM) was used to image human, porcine, and rabbit nasal septal cartilage. TPM provides optical sections of thick tissue specimens in situ without the use of exogenous dyes or need for tissue fixation. The cartilage tissue was imaged using near-infrared light generated by a mode-locked titanium/sapphire laser that was raster-scanned and coupled to an inverted microscope. Absorption of two photons by endogenous molecules and subsequent fluorescence was filtered to specific spectral bandwidths and detected with photomultiplier tubes. Two-photon stimulated fluorescence was detected with photomultiplier tubes optimized to specific spectral bandwidths. Signal intensity corresponds to the concentration of fluorophores, principally NADH, NADPH, and flavoproteins hence providing a means of redox imaging the cellular metabolic state. Specimens were scanned from the surface to a depth of about 150 microm. Image size was 50 x 50 microm with a diffraction limited pixel size of 0.4 microm. Cell membranes, nuclei, and matrix structures were identified in human, pig, and rabbit tissues. TPM provides a means to study three dimensional chondrocyte structure and matrix organization in situ at substantial depths, and permits longitudinal examination of cultured tissue explants without the need for exogenous dyes, tissue preparation, or fixation.


Subject(s)
Microscopy, Confocal/methods , Nasal Septum/anatomy & histology , Animals , Cell Membrane/ultrastructure , Cell Nucleus/ultrastructure , Humans , Microscopy, Fluorescence/methods , Nasal Septum/ultrastructure , Photons , Rabbits , Swine
12.
Laryngoscope ; 111(8): 1390-4, 2001 Aug.
Article in English | MEDLINE | ID: mdl-11568574

ABSTRACT

OBJECTIVES/HYPOTHESIS: Arteriovenous malformations involving the external ear are relatively uncommon in adults. Arteriovenous malformations in the head and neck can poses difficult therapeutic challenges. STUDY DESIGN: Case report. METHODS: We report a case of a large arteriovenous malformation in the external ear in a 41-year-old man. RESULTS: Extensive enlargement of the previously latent and asymptomatic arteriovenous malformation was triggered by blunt trauma to the ear. CONCLUSION: We discuss the definition, clinical findings, diagnostic approaches, and therapeutic management of arteriovenous malformations.


Subject(s)
Arteriovenous Malformations/surgery , Ear, External/blood supply , Adult , Arteriovenous Malformations/diagnosis , Arteriovenous Malformations/pathology , Ear, External/surgery , Humans , Male
13.
Lasers Surg Med ; 29(2): 160-4, 2001.
Article in English | MEDLINE | ID: mdl-11553905

ABSTRACT

BACKGROUND AND OBJECTIVE: Photothermal heating of mechanically deformed cartilage accelerates stress relaxation and results in sustained shape change. In this study, shape retention was measured in Nd:YAG laser reshaped porcine septal cartilage. MATERIALS AND METHODS: Specimens were laser reshaped either 4 (Group I) or 28 hours (Group II) following extraction from the crania. Specimens were bent into approximately semicircular shapes and irradiated half way between the endpoints of the semicircle. Resultant bend angle was calculated based on linear measurements. Shape retention was calculated by comparing resultant curvature with pre-irradiation measurements. RESULTS: Mechanical deformation alone resulted in initial bend angles varying from 188 degrees to 229 degrees. Resultant bend angles varied from 84 degrees to 194 degrees corresponding to shape retention varying from 58 to 75%. Non-irradiated cartilage retained less than 46% of the original bend. Shape retention was greater in Group II, compared to Group I. In Group I, no cephalocranial difference in shape retention was observed, though in Group II greater shape retention was observed in rostral specimens. CONCLUSION: While laser heating does significantly reshape cartilage, clinical use of this technology will require "overbending" of the cartilage graft to compensate for this memory effect. The degree of overbending is likely to vary with cartilage type and location.


Subject(s)
Lasers , Nasal Septum , Animals , Plastic Surgery Procedures , Swine
14.
Lasers Surg Med ; 28(1): 1-10, 2001.
Article in English | MEDLINE | ID: mdl-11430436

ABSTRACT

BACKGROUND AND OBJECTIVE: Recent studies have indicated that chondrocyte viability decreases with prolonged or repeated laser irradiation. To optimize laser-mediated cartilage reshaping, the heating process must be finely controlled. In this study, we use high-power Nd:YAG laser irradiation (lambda = 1.32 microm) combined with cryogen spray cooling (CSC) in an attempt to reshape porcine septal cartilage while enhancing chondrocyte viability. STUDY DESIGN/MATERIALS AND METHODS: Chondrocyte viability was determined after high-power (50 W/cm2) Nd:YAG-mediated cartilage reshaping with and without cryogen spray cooling (CSC) and correlated with dynamic measurements of tissue optical and thermal properties. RESULTS: After 1.5 to 2.0 seconds of laser exposure, characteristic changes in diffuse reflectance (indicating the onset of accelerated stress relaxation) was observed in both laser only and laser with CSC specimens. After 2 seconds of laser exposure, specimens in both groups retained the curved shape for up to 14 days. After one laser exposure, chondrocyte viability was 94.35 +/- 6.1% with CSC and 68.77 +/- 20.1% (P < 0.05) without CSC. After two laser exposures, a similar trend was observed with CSC (70.18 +/- 16.44%) opposed to without CSC (28 +/- 45%; P < 0.05). CONCLUSION: CSC during high-power laser irradiation allows rapid heating while minimizing extreme front surface temperature elevations and axial thermal gradients. Laser irradiation with CSC can be used to effectively reshape cartilage tissue with the additional advantage of increasing chondrocyte viability.


Subject(s)
Laser Therapy , Nasal Septum/surgery , Plastic Surgery Procedures/methods , Aerosol Propellants , Animals , Cartilage/transplantation , Chondrocytes/physiology , Hydrocarbons, Fluorinated , Nasal Septum/transplantation , Swine
15.
Am J Rhinol ; 15(2): 109-16, 2001.
Article in English | MEDLINE | ID: mdl-11345149

ABSTRACT

Interest in reconstruction and modification of the facial cartilaginous frameworks using advanced technology and instrumentation is growing rapidly. Despite this maturing interest, no animal model has been established to provide morphologic cartilage tissue with similar characteristics to human septum in suitable quantities. The objective of this study was to characterize porcine and lagomorph (rabbit) nasal septal cartilage tissue. Both models share great similarity with their human counterpart and provide a low-cost, high-volume, and easily obtained source of bulk cartilage tissue. We present a technique for harvesting intact septal cartilages from these species, and characterize select cellular, metabolic, and physical properties using pulse-chase radiolabeling, flow cytometry, and mechanical analysis. Our selective evaluation of key tissue properties establishes these species as appropriate animal models for nasal septal cartilaginous surgery.


Subject(s)
Models, Animal , Nasal Septum , Animals , Biomechanical Phenomena , Biomedical Engineering , Cell Count , Cells, Cultured , Elasticity , Flow Cytometry , Nasal Septum/anatomy & histology , Nasal Septum/physiology , Proteoglycans/biosynthesis , Rabbits , Swine
16.
Dermatol Surg ; 27(4): 335-42, 2001 Apr.
Article in English | MEDLINE | ID: mdl-11298702

ABSTRACT

BACKGROUND: Various laser wavelengths and devices have been advocated for use in the creation of recipient channels during hair transplant surgery, including flash-scanned CO2, Ho:YAG (lambda = 2.12 microm), and Er:YAG (lambda = 2.94 microm). OBJECTIVE: To determine the tissue injury caused by flash-scanned CO2 and pulsed Ho:YAG lasers during the creation of hair transplant recipient channels and to assess the efficacy of the Ho:YAG laser. METHODS: Recipient channels were created in vivo in human scalp tissue using both lasers, and were excised and prepared for histologic examination. Optical micrometry of tissue sections was used to assess thermal injury. RESULTS: The Ho:YAG laser created jagged, irregular-shaped channels with larger zones of thermal injury (superficial deepithelialization, thermal necrosis, and thermal damage). In contrast, the CO2 laser produced well-defined cylindrically shaped channels free of cellular debris with minimal epithelial disruption and significantly less lateral thermal injury. CONCLUSION: Given that the Ho:YAG produced larger regions of thermal injury and recipient channels that were unacceptable for graft, the CO2 laser remains the better choice for the creation of recipient channels during hair transplant surgery. However, ongoing research will be necessary to determine the optimal laser wavelength and/or devices for this procedure.


Subject(s)
Hair/transplantation , Laser Therapy/methods , Scalp/surgery , Carbon Dioxide , Holmium , Humans , Scalp/pathology
17.
Lasers Surg Med ; 28(3): 248-54, 2001.
Article in English | MEDLINE | ID: mdl-11295760

ABSTRACT

UNLABELLED: BACKGROUND AND OBJECTIVE To examine the biophysical effects of photothermal heating on herniated intervertebral discs during laser decompression surgery. STUDY DESIGN/MATERIALS AND METHODS: Ex vivo bovine nucleus pulposus specimens were irradiated with a Nd: YAG laser (lambda = 1.32 microm, 100 seconds exposure time, 9-31 W/cm(2), 4.8 mm spot diameter), whereas changes in tissue thermal, mechanical, and optical properties were monitored by using, respectively, infrared radiometry, tissue tension measurements, and diffuse reflectance from a HeNe probe laser. Morphologic changes and mass reduction were monitored by recording shape changes on video and weighing specimens before and after laser exposure. RESULTS: At power densities below 20 W/cm(2), evaporation of water and specimen volume reduction (shrinking) were consistently observed on video during irradiation. In contrast, above 20 W/cm(2), vapor bubbles formed within the specimen matrix and subsequently ruptured (releasing heated vapors). When radiometric surface temperature approaches approximately 60 to 70 degrees C (denaturation threshold for tissue), tissue tension begins to increase, which is consistent with observations of specimen length reduction. The onset of this change in tissue tension is also reflected in characteristic alterations in diffuse reflectance. With cessation of laser irradiation, a sustained increase in tissue tension is observed, which is consistent with changes in specimen length and volume. Higher laser power results in a faster heating rate and subsequently an accelerated tension change. Specimen mass reduction increased with irradiance from 19 to 72% of the initial mass for 9--31 W/cm(2), respectively. Irradiated specimens did not return to their original shape after immersion in saline (48 hours) in contrast to air-dried specimens (24 hours), which returned to their original shape and size. CONCLUSION: These observations suggest that photothermal heating results in irreversible matrix alteration causing shape change and volume reduction (observed on video and evidenced by the increase in tissue tension) taking place at approximately 65 degrees C. Inasmuch as high laser power results in vapor bubble formation and specimen tearing, the heating process must be controlled. Diffuse reflectance measurements provide a noncontact, highly sensitive means to monitor dynamically changes in tension of nucleus purposus.


Subject(s)
Intervertebral Disc/physiopathology , Intervertebral Disc/surgery , Laser Therapy , Phototherapy , Animals , Biomechanical Phenomena , Cattle , In Vitro Techniques , Intervertebral Disc/pathology , Neodymium , Sensitivity and Specificity , Video Recording
18.
Arch Facial Plast Surg ; 3(1): 24-7, 2001.
Article in English | MEDLINE | ID: mdl-11176715

ABSTRACT

BACKGROUND: The chick chorioallantoic membrane (CAM) model allows direct observation of vascularization acutely in explanted or cultured tissues in an immunologically isolated environment. In vivo, angioinvasion of the tissue matrix does not occur in viable cartilage tissue, whereas denatured or nonviable grafts are readily vascularized and/or resorbed. OBJECTIVE: To determine, using the CAM model, whether angioinvasion of thermally altered cartilage explants occurs acutely. MATERIALS AND METHODS: Porcine septal cartilage specimens were removed from freshly killed animals and divided into 3 groups (n = 10): an untreated control group, a group in which cartilage was boiled in isotonic sodium chloride solution (normal saline) for 1 hour, and a laser-irradiated group (Nd:YAG, lambda = 1.32 microm, 30.8 W/cm2, irradiation time = 10 seconds). Tissue specimens were then washed in antibiotic solutions, cut into small cubes (approximately 1.5 mm3), placed on the surface of 30 CAMs (7 days after fertilization), and allowed to incubate for an additional 7 days. After incubation, the membranes and specimens were fixed in situ with formaldehyde and then photographed using a dissection microscope. RESULTS: Examination with a dissecting microscope showed no obvious vascular invasion of the cartilage or loss of gross tissue integrity in any of the 3 experimental groups, although all specimens were completely enveloped by the CAM vascular network. No vascular invasion of the tissue matrix was observed histologically. CONCLUSION: These experiments demonstrate that cartilage specimens remain acutely resistant to angioinvasion or metabolism by the immunologically immature CAM whether native unmodified tissue, completely denatured (boiled), or thermally modified following laser irradiation.


Subject(s)
Allantois/blood supply , Cartilage/blood supply , Cartilage/transplantation , Tissue Transplantation/methods , Animals , Chick Embryo , Graft Rejection , Graft Survival , Models, Animal , Nasal Septum/blood supply , Nasal Septum/transplantation , Reference Values , Sensitivity and Specificity , Swine , Vascular Resistance
19.
J Biomed Opt ; 5(4): 367-70, 2000 Oct.
Article in English | MEDLINE | ID: mdl-11092423

ABSTRACT

Optical coherence tomography (OCT) was used to image the internal structure of a rat cochlea (ex vivo). Immediately following sacrifice, the temporal bone of a Sprague-Dawley rat was harvested. Axial OCT cross sectional images (over regions of interest, 1x1 mm-2x8 mm) were obtained with a spatial resolution of 10-15 microm. The osseous borders of the lateral membranous labyrinth overlying the cochlea and the scala vestibuli, media, and tympani, which were well demarcated by the modiolus, Reissner's and the basilar membranes, were clearly identified. OCT can be used to image internal structures in the cochlea without violating the osseous labyrinth using simple surgical exposure of the promontory, and may potentially be used to diagnose inner ear pathology in vivo in both animal and human subjects labyrinth.


Subject(s)
Cochlea/anatomy & histology , Optics and Photonics , Rats, Sprague-Dawley/anatomy & histology , Tomography/methods , Animals , Rats
20.
Lasers Surg Med ; 27(2): 119-28, 2000.
Article in English | MEDLINE | ID: mdl-10960818

ABSTRACT

BACKGROUNDS AND OBJECTIVES: The aim of the study was to measure the spectral dependence of optical absorption and reduced scattering coefficients and thermal conductivity and diffusivity of porcine nasal septal cartilage. Values of optical and thermal properties determined in this study may aid in determining laser dosimetry and allow selection of an optical source wavelength for noninvasive diagnostics for laser-assisted reshaping of cartilage. MATERIALS AND METHODS: The diffuse reflectance and transmittance of ex vivo porcine nasal septal cartilage were measured in the 400- to 1,400-nm spectral range by using a spectrophotometer. The reflectance and transmittance data were analyzed by using an inverse adding-doubling algorithm to obtain the absorption (mu(a)) and reduced scattering (mu(a)') coefficients. A multichannel thermal probe controller system and infrared imaging radiometer methods were applied to measure the thermal properties of cartilage. The multichannel thermal probe controller system was used as an invasive technique to measure thermal conductivity and diffusivity of cartilage at three temperatures (27, 37, 50 degrees C). An infrared imaging radiometer was used as a noninvasive method to measure the thermal diffusivity of cartilage by using a CO(2) laser source (lambda = 10.6 microm) and an infrared focal plane array (IR-FPA) camera. RESULTS: The optical absorption peaks at 980 nm and 1,180 nm in cartilage were observed and corresponded to known absorption bands of water. The determined reduced scattering coefficient gradually decreased at longer wavelengths. The thermal conductivity values of cartilage measured by using an invasive probe at 27, 37, and 50 degrees C were 4.78, 5.18, and 5.76 mW/cm degrees C, respectively. The corresponding thermal diffusivity values were 1.28, 1.31, and 1.40x 10(-3) cm(2)/sec. Because no statistically significant difference in thermal diffusivity values with increasing temperature is found, the average thermal diffusivity is 1.32 x 10(-3) cm(2)/sec. The numerical estimate for thermal diffusivity obtained from infrared radiometry measurements was 1.38 x 10(-3) cm(2)/sec. CONCLUSION: Values of the spectral dependence of the optical absorption and reduced scattering coefficients, and thermal conductivity and diffusivity of cartilage were measured. The invasive and noninvasive diffusivity measurements were consistent and concluded that the infrared imaging radiometric technique has an advantage to determine thermal properties, because damage to the cartilage sample may be avoided. The measured values of absorption and reduced scattering coefficients can be used for predicting the optical fluence distribution in cartilage and determining optical source wavelengths for the laser-assisted cartilage reshaping studies. The thermal conductivity and diffusivity values can play role in understanding thermal-dependent phenomenon in cartilage during laser irradiation and determining laser dosimetry for the laser-assisted cartilage reshaping studies.


Subject(s)
Laser Therapy/methods , Nasal Septum/physiology , Nasal Septum/surgery , Animals , In Vitro Techniques , Optics and Photonics , Swine , Thermal Conductivity
SELECTION OF CITATIONS
SEARCH DETAIL
...