فهرست مطالب
فصلنامه لیزر در پزشکی
سال ششم شماره 1 (پیاپی 30، بهار 1388)
- تاریخ انتشار: 1388/03/11
- تعداد عناوین: 7
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صفحه 5هدفبرای تسکین درد آفت های دهانی راجعه مینور: این کارآزمایی بالینی تصادفی شده به منظور بررسی اثر تابش یک جلسه لیزر کربن دی اکسید غیر تخریبی(Non-ablative CO2 Laser Therapy، NACLT)به عنوان نمونه زخم های دهانی دردناک طرح ریزی و اجرا (minor recurrent aphthous stomatitis miRAS)گردید.با به عنوان لیزر و ضایعه دیگر به عنوان پلاسبو در نظر گرفته شد آب و بدون خاصیت بی حس کنندگی قرار داده شد 30 ضایعه آفت دهانی مینور، بعد از انطباق با معیارهای ورود و خروج طرح، miRASمواد و روش ها15 بیمار مبتلا به(random allocation) به این مطالعه وارد شدند. در هر بیمار یک ضایعه بصورت تصادفی. قبل از لیزر درمانی؛ بر روی هر دو ضایعه لیزر و کنترل، یک لایه ژل شفاف با محتوای بالای. بر روی ضایعات گروه پلاسبو از لیزر خاموش استفاده گردید. در مورد1با قطر حدود 2 میلیمتر استفاده شد. از W با توان (continuous wave) موج پیوسته CO ضایعات گروه لیزر، از لیزر 2بیماران درخواست گردید که شدت درد ایدیوپاتیک و تماسی ضایعات گروه لیزر و کنترل را قبل از تابش لیزر، بلافاصله بعد از72و 96 ساعت بعد از لیزر، بر اساس سیستم درجه بندی، 48، 24، 12، 8، آن و نیز در ساعات پی گیری یعنی ساعات 4بیان نمایند. (Visual analogue scale VAS) چشمی نتایج تفاوت شدت درد، در ضایعات گروه پلاسبو و لیزر در زمان های پیگیری بعدی: بلافاصله بعد از لیزر درمانی، کاهش شدت درد ایدیوپاتیک و تماسی در ضایعات گروه لیزر بصورت قابل توجهی بیشتر.(P< از ضایعات گروه پلاسبو بود (0.001تابش لیزر، با درد، سوزش و احساس گرما همراه نبود و هیچ نیازی به بی حسی موضعی. (P< همچنان معنی دار بود (0.001وجود نداشت. پس از تابش لیزر، هیچ نوع عوارض قابل مشاهده ای از جمله تخریب بافتی، زخم و یا حتی اریتم ایجاد نشد. NACLT بودموید کم توان بودن تابش لیزر با روش (thermometry) و دماسنجی (powermetery) نتایج توان سنجی.از ورای یک ژل شفاف با CO Bنتیجه گیرینتایج این کارآزمایی بالینی تصادفی شده، نشان داد که با تابش نور لیزر 2محتوای زیاد آب و فاقد اثر بیحسی، می توان از آن به عنوان یک سیستم لیزر کم توان و غیر تخریبی جهت تسکین فوری و چشمگیر درد آفت های دهانی راجعه بدون عوارض جانبی (non ablative، low power laser)قابل مشاهده استفاده نمودکلیدواژگان: NACLT، آفت دهانی مینور، تسکین درد، معیار اندازه گیری چشمی VAS
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آنچه که پرستاران در هنگام کار با لیزر باید بدانند: مراقبت های قبل و حینصفحه 7
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Page 5Objectiveshis randomized controlled clinical trial was designed to evaluate the efficacy of single-session, nonthermal, carbon dioxide (CO2) laser irradiation in relieving the pain of minor recurrent aphthous stomatitis (miRAS) as a prototype of painful oral ulcers. Fifteen patients, each with two discrete aphthous ulcers, were included. One of the ulcers was randomly allocated to be treated with CO2 laser (1 W of power in de-focused continuous mode) and the other one served as a placebo. Before laser irradiation, a layer of transparent, nonanesthetic gel was placed on both the laser lesions and the placebo lesions. The patients were requested to grade their pain on a visual analog scale up to 96 h post-operatively. The reduction in pain scores was significantly greater in the laser group than in the placebo group. The procedure itself was not painful, so anesthesia was not required. Powermetry revealed the CO2 laser power to be 2–5 mW after passing through the gel, which caused no significant temperature rise or any visual effect of damage to the oral mucosa. Our results showed that a lowintensity, non-thermal, single-session of CO2 laser irradiation reduced pain in miRAS immediately and dramatically, with no visible side effects.Keywords: Pain relief, Randomized controlled clinical trial, Recurrent aphthous stomatitis, Visual analog scale
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Page 12IntroductionOral mucositis is a common morbid condition which is associated with chemotherapy and radiotherapy for which there is no standard treatment or prophylactic method. According to past studies the use of low level laser therapy (LLLT) can reduce the severity of mucositis and xerostomia in such conditions, both as treatment and a prophylactic factor.Material And MethodThirty nine patients with head and neck cancer who were being treated with radiotherapy in Cancer Insittiue of Iran enrolled in the study. Patients were randomized to LLLT and placebo treatment starting on the 1st day of radiotherapy through the whole period of their treatment. Objective assessment of the degree of mucositis and xerostomia was recorded every other day by a physician blinded to the type of treatment.ResultsAll 39 patients developed degrees of mucositis during their course of radiotherapy. The patient in placebo groups had experienced sever mucositis (grade III and IV) more than LLLT treatment group significantly (p=0.04) (75.6% v.s. 57.1%). The median of incidence time of sever mucositis in LLLT group 21 days after beginning of radiotherapy in which it is 16 days in placebo group. There was no significant difference between LLLT and placebo group according to xerostomia.ConclusionLLLT is capable of reducing the severity and duration of oral mucositis associated with radiation therapy. However for detection of LLLT efficacy on xerostomia, it is necessary long time follow-up.Keywords: Low, energy laser, Oral mucositis, Radiotherapy, Head, neck cancer
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Page 18In this paper, the temperature distribution in denthin when radiated by a pulse Er:YAG laser has been evaluated. For this reason, we consider dentin expose by a pulse laser and heat is generated. The nonhemogenous time dependent heat conduction equation has been solved analytically and by using the boundary conditions the temperature distributin has been derived. The obtained results then applied for dentin and by using the dentin datas, the temperature distribution has been plotted. The effect of pulse energy and pulse duration on the temperature distribution have been studied and discussed comprehensivelyKeywords: Er:YAG, heat conduction equation, temperature distribution in dentin
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Page 25Background/ObjectiveDiagnosis of melanoma in the early stages can have a significant effect on decreasing the mortality rate caused by this type of skin cancer. Melanoma is hard to be diagnosed in the early stages, even by the best physicians. Therefore, providing a method to easier the early diagnosis of this type of cancer is very valuable and vital.Materials and MethodsIn this research, by extraction of images’ features and classifying them, we proposed an algorithm which enables the melanoma diagnosis. In the first step, before proper features’ extraction, we used polarized filter with proper angle for determining accurate boundaries between the normal and affected tissue. In the next step, with help of dermatologists we extracted the lesion’s features. Moreover, we optimized the different features in order to have an exact and accurate classification of skin lesion and reduction in classifier training time.ResultsFeatures optimization occurred via three followingMethodsPrincipal Component analysis, sequential forward selection and consultation with the dermatologist. By classifier help, all the optimized features were classified, enabled us to complete the algorithm. In the condition that we used the SVM classifier and optimized features with the direct ordinal selection method, the algorithm succeeded in diagnosing melanoma with the approximate accuracy of 91%.ConclusionThe proposed method is useful for diagnosing the melanoma with a convenient price and considerable high accuracy. Also, this software package has the connection capability to dermatoscopy and is helpful for diagnosing the melanoma.Keywords: Segmentation, Melanoma, Feature extraction, Feature optimization, Classify
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Page 34Basal cell carcinoma (BCC) is the most common skin cancer which has significant local invasion and morbidity. Hence the development of new therapeutic strategies is of almost interest. Surgical excision has been the most often used therapy for BCC for many years but the development of a new treatment with best cosmetic outcome and minimum scar formation is of increasing interest. Photodynamic therapy (PDT) is a novel non-invasive therapy for BCC, especially in patients who are not suitable candidates for surgery, which leads to minimum injuries in surrounding non-tumoral tissue. Furthermore, PDT may have some prop hylactic roles against new BCC formation in certain patients. In this article we are going to present a brief history of PDT and review its potential role in treatment and prevention of different types of BCC.Keywords: basal cell carcinoma, photodynamic therapy, photo chemotherapy
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Page 40ObjectivesIn this paper a noninvasive quantitative assessment tool has been developed for studying the effectiveness of nonablative Pulsed Dye laser rejuvenation, using high frequency ultrasound imaging. Using the proposed method, and by monitoring the region of interest before and after rejuvenation, changes in tissue conditions as a result of skin rejuvenation can be investigated.Materials And MethodsHigh frequency ultrasound scans were obtained from 30 patients undergoing Pulsed Dye laser skin rejuvenation. Two markers were extracted from the obtained images, exploiting image processing techniques. A combinational score was developed based on the extracted markers for quantitative analysis of high frequency ultrasound images.ResultsThe extracted markers illustrated meaningful changes through skin rejuvenation phases. They were also able to discriminate before and after images properly (p<0.05). The combinational score was able to detect before and after images in 87% of cases.ConclusionsThe introduced noninvasive and quantitative approach may be used for assessment of tissue rejuvenation after nonablative laser treatments. The proposed measure is a good candidate for studying collagen regeneration as a result of tissue rejuvenation.Keywords: Skin rejuvenation, Pulsed Dye laser, high frequency ultrasound, image processing, nonablative lasers, quantitative analysis
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