Background and Objective: The objective of this study was to compare the efficacy and safety of Endovenous Laser Photocoagulation (EVLP) at wavelengths of 1064 nm versus 810 nm for chronic venous insufficiency (varicose veins) in a large series of patients. Study Design/Materials and Methods: A retrospective review was conducted of 108 patients with chronic venous insufficiency treated over a 8-year period. Subjects' ages ranged between 16 to 79 years; there were 83 females and 25 males, all of whom were Asian. Patients (n=54) received EVLP at wavelengths of 1064 nm (EVLP-1064 nm), Nd:YAG laser. Subsequent patients (n=54) received 810 nm (EVLP-810 nm), Diode laser. The primary efficacy measurement was the quantitative assessment of final outcome for 1064 nm versus 810 nm. Patients were monitored for adverse effects as well. Results: Complications were observed at 3 weeks (early), 6 weeks (late) and 6 months after EVLP. In both groups, the commonest complication in early convalescence was swelling. This was followed by Local paraesthesia, pigmentation, superficial burns, superficial phlebitis, and localized hematomas. At 6 weeks postoperatively, local paraesthesia, persistent hyperpigmentation, and minimal scarring were presented. These problems all disappeared completely after the 6 months study period. Based on chi-squared analysis, there were clinical, and statistically significant differences in the severity score of final results favoring the EVLP-810 nm group. Conclusion: All patients achieved good or excellent improvement after EVLP-1064nm and EVLP-810nm. However, the difference of final outcome was significant, and indicates that improvement was greater in the Diode group. Further studies of different wavelengths and optimization of cryogen spray cooling (CSC) may lead to improved results in the eradication of varicose veins.
Background and Aims: Scars are common and cause functional problems and psychological morbidity. Recent advances in optical technologies have produced various laser systems capable of revising the appearance of scars from various etiologies to optimize their appearance. Methods: Laser treatment can commence as early as the time of the initial injury and as late as several years after the injury. Several optical technologies are currently available and combined laser/light treatments are required for treatment of scars. Since 2006, we have set up a scar management department in our clinic and more than 2000 patients have been treated by our combined laser irradiation techniques. Herein, we review several available light technologies for treatment of surgical, traumatic, and inflammatory scars, and discuss our combined laser treatment of scars, based upon our clinical experience. Results and Conclusions: Because scars have a variety of potential aetiologies and take a number of forms, no single approach can consistenty provide good scar treatment and management. The combination of laser and devices is essential, the choice of wavelength and approach being dictated by each patient as an individual.
Background and aims: Electromyography (EMG) is considered the gold-standard for the evaluation of muscle activity. Transversal and dimensional changes of the muscle, during muscle activity, generate vibrational phenomena which can be measured by Laser Doppler Vibrometry (LDVi). There is a relationship between muscle contraction and vibrational activity, therefore, some information on fundamental muscle parameters can be assessed without contact with LDVi. In this paper, we explore the possibility to relate the EMG signal causing the muscle contraction and the vibrational activity also measureable on the muscle. A novel non-contact measurement method - Laser Doppler myography (LDMi) - aiming to measure the vibrational behavior of muscle during contraction, is presented herein. Correlations with some parameters normally measured with EMG are reported. Materials and methods: The proposed method has been compared with standard superficial EMG (sEMG). Signals produced with sEMG and laser Doppler myography have been simultaneously acquired and processed to test correlations on a population of 20 healthy volunteers. Tests have been carried out on the flexor carpi ulnaris and the tibialis anterior muscles (left and right). Results: Results show that it is possible to measure: The timing of muscle activation (max differences: 440 ms), the amplitude of the signals acquired during activation respect to the signals during rest (S/N), the correlation between the S/N of the sEMG and LDMi signals at different levels of force (P> 0.89), and to assess muscle fatigue. Conclusions: LDMi is a valid measurement technique for the assessment of muscle activity and fatigue. It is a non-contact method and this characteristic could suggest its use together with low level laser therapy pre-, intra- and post-LLLT sessions to evaluate the efficacy and effects of the treatments without the need for invasive electrodes.
Aim:, To show our experience in the surgical treatment of superficial vein insufficiency of the lower limbs. Subjects and methods: Since 2002 we have performed 659 procedures of endovascular laser therapy (EVLT) (group A) in the treatment of chronic venous insufficiency of the great saphenous vein using a 980 nm diode laser. A closely matched group of 100 patients (50 Group A, 50 Group B) with homogeneous clinical findings (CEAP classification) was controlled with a mean follow-up of 18 months in our more recent experience (3 years). Most patients operated on in this period were lost to follow-up. Results: The Final results showed that EVLT can be used only in a specific selected group of cases based on anatomy and hemodynamics and while 980 nm EVLT could not be selected as the best treatment for this pathology, it could be placed side by side with conventional therapy. Conclusions: In our one year's more recent experience, we observed an increased number of patients treated with conventional therapy. The development of new laser tools (new wavelengths and continuous radial laser) and the improvement of clinical follow up may lead us to a more correct application of EVLT in the absence of randomized trials because of widespread clinical findings and poor pathological follow-up of this approach to superficial venous insufficiency.
Background and aims: Stabilization of implant abutments through electric impulses at high voltage for a very short time (electrowelding) was developed in the Eighties. In 2009, the same procedure was performed through the use of laser (laser welding). The aim of this study is to compare electrowelding and laser welding for intra-oral implant abutments stabilization on “ex vivo models” (pig jaws). Materials and methods: Six bars were welded with two different devices (Nd:YAG laser and Electrowelder) to eighteen titanium implant abutment inserted in three pig jaws. During the welding process, thermal increase was recorded, through the use of k-thermocouples, in the bone close to the implants. The strength of the welded joints was evaluated by a traction test after the removal of the implants. For temperature measurements a descriptive analysis and for traction test “values unpaired t test with Welch's correction” were performed: the significance level was set at P<0.05. Results: Laser welding gives a lower thermal increase than Electrowelding at the bone close to implants (Mean: 1.97 and 5.27); the strength of laser welded joints was higher than that of Electrowelding even if nor statistically significant. (Mean: 184.75 and 168.29) Conclusion: Electrowelding seems to have no advantages, in term of thermal elevation and strength, while laser welding may be employed to connect titanium implants for immediate load without risks of thermal damage at surrounding tissues.
Background and aims: Regarding the laser energy delivery with non-tissue alteration when irradiating CO2 laser to the transparent gel, it was worth exploring the clinical efficacy of pain relief on oral ulceration using aphthous stomatitis as a model for painful oral ulcer. The aims of this study were to compare pain scores, daily activity-disturbance scores and sizes of the ulcers between the laser group and the placebo group. Subjects and methods: The double blind- randomized- placebo- controlled trial was conducted in 14 patients with aphthous ulcers. The subjects were allocated into 2 groups; namely, the laser group and the placebo group. The two baselines were measured on the day before and the treatment day. Then the lesions were covered with the transparent gel and irradiated by either 2 W defocused CO2 laser for 5 seconds or the sham laser. The outcomes were collected immediately, on day 1, 3, 5 and 7 after treatment. Results: The means of pain and daily activity-disturbance scores of the laser group were lesser than the placebo group in every episode. A statistically significant difference between the groups was found only the pain score on day 3 after treatment (P-value<0.001, 95% CI of the difference = 8.8 to 19.20 mm). There were no statistically significant differences in the daily activity-disturbance scores and the sizes of the ulcers between the groups (P value > 0.05). Conclusion: The CO2 laser therapy used in this clinical study was able to relieve pain from aphthous stomatitis compared with the placebo on the day 3 after treatment.