Depth-Resolved Attenuation Mapping of the Vaginal Wall under Prolapse and after Laser Treatment Using Cross-Polarization Optical Coherence Tomography: A Pilot Study.

Vaginal wall prolapse is the most common type of pelvic organ prolapse and is mainly associated with collagen bundle changes in the lamina propria. Neodymium (Nd:YAG) laser treatment was used as an innovative, minimally invasive and non-ablative procedure for the treatment of early-stage vaginal wall prolapse. The purpose of this pilot study was to assess connective tissue changes in the vaginal wall under prolapse without treatment and after Nd:YAG laser treatment using cross-polarization optical coherence tomography (CP OCT) with depth-resolved attenuation mapping. A total of 26 freshly excised samples of vaginal wall from 26 patients with age norm (n = 8), stage I-II prolapses without treatment (n = 8) and stage I-II prolapse 1-2 months after Nd:YAG laser treatment (n = 10) were assessed. As a result, for the first time, depth-resolved attenuation maps of the vaginal wall in the B-scan projection in the co- and cross-polarization channels were constructed. Two parameters within the lamina propria were target calculated: the median value and the percentages of high (≥4 mm-1) and low (<4 mm-1) attenuation coefficient values. A significant (p < 0.0001) decrease in the parameters in the case of vaginal wall prolapse compared to the age norm was identified. After laser treatment, a significant (p < 0.0001) increase in the parameters compared to the normal level was also observed. Notably, in the cross-channel, both parameters showed a greater difference between the groups than in the co-channel. Therefore, using the cross-channel achieved more reliable differentiation between the groups. To conclude, attenuation coefficient maps allow visualization and quantification of changes in the condition of the connective tissue of the vaginal wall. In the future, CP OCT could be used for in vivo detection of early-stage vaginal wall prolapse and for monitoring the effectiveness of treatment.

Comparative study of soft tissue surgery by visible and infrared laser radiation.

To compare the cutting properties of lasers with different wavelengths (445 nm, 532 nm and 808 nm) used in cutting blood-rich tissues. Porcine myocardial tissue was cut using 2.3-15 W laser radiation in contact and non-contact modes with an optical fiber or focusing handpiece. The cut depth and coagulation zone width were determined histologically. The 445-nm laser achieved the greatest cut depth for all cutting parameters (p < 0.01). The blue laser gave the smallest coagulation width to cut depth ratio. Results of the study are consistent with the assumption that a 445 nm blue laser may have better cutting properties than green and infrared lasers due to the high absorption of radiation at this wavelength in hemoglobin and, consequently, in the biological blood-rich tissue.

Peroxide dental bleaching via laser microchannels and tooth color measurements.

The aim of this study was to use microchannels drilled by an Er:YAG laser into a human tooth through the enamel into the dentin for direct injection of hydrogen peroxide (HP) to produce a minimally invasive, rapid, tooth bleaching effect. The experiments were conducted in vitro. Five microchannels with a diameter of ?200???m and a depth of ?2??mm were drilled through the palatal side of a human tooth crown using the microbeam of an Er:YAG-laser with a wavelength of 2.94???m. After injection of an aqueous solution of 31%-HP through the microchannels, the tooth color was evaluated using a VITA shade guide and International Commission on Illumination L*ab color parameters. A tooth model used for the evaluation of the distribution of HP concentration was created and the amount of HP which can be injected into tooth dentin to bleach it safely was estimated. Injection of 1.5±0.1??mm3 of 31%-HP into the tooth led to noticeable bleaching within 3 h and significant improvement of tooth color within 24 h.

Multi-beam laser-induced hydrodynamic shock waves used for delivery of microparticles and liquids in skin.

BACKGROUND AND OBJECTIVES: Laser radiation is often used to provide micro and nanoparticle delivery into the skin for medical and cosmetic purposes. This technique inherently has limited speed and effective penetration. We proposed and investigated a new method of rapid delivery of solid microparticles, nanoparticles and liquids into tissue through multiple microchannels created by a fractional laser microablation (FLMA) using Er:YAG-laser. The dependence of microchannel depth on laser pulse temporal structure and number of pulses and dermal coloration changes are studied in this paper. STUDY DESIGN/MATERIALS AND METHODS: Microchannels created in the porcine skin in vitro by a fractional Er:YAG-laser were used to deliver Zirconium oxide (ZrO2) microparticles or hydrocortisone solution. Each laser pulse consisted of subpulses. Number of laser pulses (Np) and subpulses (Nsp) can be adjusted. The enhancement of delivery is expected due to hydrodynamic impact of laser pulse on the layer of the aqueous suspension of the particles or hydrocortisone solution placed on the skin surface. For color investigation, we used standard CIE Lab parameter analysis. RESULTS: The relationship between microchannel depth in the skin and number of laser pulses and subpulses was established. We found that free filling of microchannels with ZrO2-particle suspension has a low speed of ∼4 × 10(-5) mm/s. Particle delivery into microchannels induced by the hydrodynamic shock waves generated by Er:YAG-laser pulses is carried out with a high speed of 28.5 mm/s. We also found that skin color at ZrO2 -particle delivery differs from color of the intact skin, namely: the parameter L, which characterizes the "lightness" increased by 9 ± 1%; parameter a, which characterizes the "redness" decreased by 38 ± 4%; and parameter b, which characterizes the "yellowness" decreased by 21 ± 2%. The effective delivery of hydrocortisone was demonstrated using fluorescence method technique. CONCLUSION: Multi-beam laser-induced hydrodynamic shock waves generated by Er:YAG-laser pulses on the layer of the aqueous suspension of the particles or solution of a high molecular weight drug placed on the skin can be used for their rapid delivery into the skin.

The influence of laser-textured dentinal surface on bond strength.

OBJECTIVE: To assess the influence of laser-textured surfaces on the adhesion of composite to dentin after being rotary prepared. METHODS: Thirty healthy teeth were kept in 0.1% thymol solution prior to being ground down to dentin to create a 4 × 4 mm² flat surface. Teeth were divided into 3 groups (n=10). Groups 1 and 2 utilized the prototype Erbium doped, Yttrium-Aluminum-Garnet Er:YAG laser by Dental Photonics, Inc. A single pulse was delivered to each spot to create an equally spaced square 4 × 4 mm² matrix of micro craters. All craters had 100 µm diameter/45 µm depth; two different spacing patterns were prepared in Groups 1 and 2. In Group 1, distance between crater centers was 50 µm; Group 2 had 100 µm. In Group 3 (control), 10 samples were prepared without laser texturing. G-bond (GC America) was applied to testing area of all samples in all groups according to manufacturer's instructions. Bonding resin was applied and shear-bond strength tests were employed using an Instron machine to measure adhesive strength. RESULTS: One-way analysis of variance (ANOVA) was used to compare the 3 groups. Pair wise t-tests implementing the Bonferroni correction for multiple comparisons found a statistically significant difference between Group 3 and Group 2 (p=0.019) but no statistically significant difference between Group 3 and Group 1 (p=0.263) or Group 1 and Group 2 (p=0.743). SIGNIFICANCE: The bond strengths between bonded composite to laser-textured dentinal surfaces with larger spacing patterns are greater than that of non-textured surfaces.