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Biomedical subjects

J Neev

Publications and source records attributed to J Neev.

At least 19 recordsLinked to original sources

XeCl laser surgery of the vocal cords: a histologic comparison with CO2 laser in a porcine model.

Fresh cadaveric pig larynxes were ablated with a CO2 (lambda = 10.6 microm) and a XeCl excimer (lambda = 308 nm) laser. Histologic comparison of the ablation craters created by the two lasers was performed, and ablation crater depth and marginal tissue damage were measured. Crater depth for both laser treatments is correlated with energy deposition and exposure time. The CO2 laser creates three times more nonspecific, marginal tissue damage than the XeCl laser at the ranges of total energy and exposure times used. This study demonstrates the potential of the XeCl laser as an alternative to the CO2 laser in microlaryngeal surgery.

Animals

Ablation of human nail by pulsed lasers.

BACKGROUND AND OBJECTIVE: The hard and resistant structure of the nail plate forms a natural barrier that limits the penetration of topical drugs. To overcome this barrier, the use of pulsed laser systems has been suggested. The purpose of this study was to evaluate the effect of four laser systems on nail plate ablation rates, ablation efficiencies, and subsequent craters morphology. STUDY DESIGN/MATERIAL AND METHODS: Solid state Er:YAG (2.94 microns, 250 microseconds), a Ho:YSGG (2.08 microns, 250 microseconds), a XeC1 Excimer (308 nm, 15 ns), and a novel solid-state ultrashort pulse laser (1.05 microns, 350 fs) were used. Ablation rates, surface morphology, and extent of collateral damage were evaluated using light and electron microscopy. RESULTS: Best ablation efficiencies were demonstrated with the ultrashort pulsed laser (1 micron/mJ), whereas maximum material removal per pulse was obtained with the Er:YAG laser (80 microns/ pulse). Scanning electron microscopy showed cracking damage with both Ho:YSGG and Er:YAG. XeC1 and the ultrashort pulse system left tissue surfaces free of cracks or thermal damage. CONCLUSION: With its minimal acoustical and mechanical impact, high efficiency, and negligible collateral damage, the ultrashort pulse laser at 3 J/cm2 was found to be the optimal laser system for nail ablation.

Humans

Thermal imaging of the temporal bone in CO2 laser surgery: an experimental model.

The unique properties of lasers create an enormous potential for specific treatment of chronic ear disease. Despite the widespread acceptance and use of the laser, however, a complete understanding of the time- and space-dependent temperature distribution in otic capsule bone immediately after pulsed laser exposure has not been elucidated. Using a liquid nitrogen-cooled mercury-cadmium telluride infrared detector, the temperature distribution in human cadaveric otic capsule bone was determined immediately after pulsed (100 msec) carbon dioxide laser exposure (0.3 to 4.0 W; 200 microm spot diameter). The time- and space-dependent temperature increases and thermal diffusion were determined as a function of the laser power density and were found to vary linearly.

Carbon Dioxide

The influence of laser parameter configurations at 9.3 microns on incisional and collateral effects in soft tissue.

These investigations were performed to determine histologic and incisional consequences of varying pulse duration, duty cycle, and average powers during laser incision at 9.3 microns in soft tissue. In 19 fresh pigs' jaws six standardized incisions 3 cm long were made per parameter with a template and motorized jig. Laser parameters investigated were average power: 1 to 9 W, duty cycle: 10% to 80%, and pulse duration: 1 to 200 msec. The gated Cw mode was used. Incision width and depth and collateral tissue effects were assessed statistically with general linear procedures. Multiple factors were found to influence the outcome of laser irradiation. Depth of incision correlated positively with average power. Tissue damage correlated strongly and negatively with all three variables. These results demonstrate that a wide range of surgical and collateral effects can be achieved with one specific laser device depending on the parameter configuration selected.

Animals

Effect of XeCl-308nm excimer laser on the mineral content of human dentin.

The effect of the XeCl-308nm excimer laser on the mineral content and surface morphology of cut dentin was examined in ten extracted human teeth. Each dentin specimen was lased for 4 s at a fluence of 1 J/cm2 and a frequency of 25 Hz. Non-lased area of the same specimen served as control. Scanning electron microscopy and energy dispersive spectrometry revealed a significant decrease in the phosphorus levels following laser treatment. A decrease in calcium levels also occurred but was not statistically significant. Nonsignificant changes in sulphur and potassium levels were also noted. Morphologically, the lased dentin showed an apparently melted surface with partial obstruction of the dentin tubules as well as cracks along the lased surface. Therefore, it appeared that laser treatment may alter the chemical structure as well as the surface morphology of the dentin.

Calcium

Surface temperature distributions in carbon dioxide, argon, and KTP (Nd:YAG) laser ablated otic capsule and calvarial bone.

HYPOTHESIS: The spatial and temporal surface temperature distribution was measured after laser irradiation in fresh porcine otic capsule and calvarial bone tissue using an HgCdTe (mercury-cadmium-tellurium) infrared camera. BACKGROUND: Carbon dioxide (CO2) (lambda = 10.6 mm), argon (lambda = 514 nm), and Potassium-Titanyl-Phosphate Neodynium: Yttrium-Aluminum-Garnet (KTP[Nd:YAG]) (lambda = 532 nm) lasers are used for stapes surgery and in the treatment of chronic ear disease. Despite extensive clinical use, little is known about the thermal perturbations in otic capsule calcified tissues and what are safe energy parameters for laser use. METHODS: A microspot manipulator, lens, and microfiber were used for continuous wave (CW) and super-pulse (SP) CO2, argon, and KTP(Nd:YAG) lasers, respectively. Peak temperatures after ablation were measured simultaneously along with the full-width--half-maximum of the thermal disturbance and fitted to a Gaussian distribution. The cooling time for the hot spot to return to ambient temperature also was recorded. RESULTS: Temperature changes with CW CO2 irradiation were markedly elevated relative to SP mode and also required longer to cool. The KTP and argon-treated bone were irradiated in the presence and absence of an initiator (black ink): minimal surface temperature elevation was recorded in the absence of an initiator. Further, no surface modification was observed. In contrast, the addition of an initiator resulted in marked temperature elevations and significant surface carbonization with these two visible wavelength lasers. Cooling times varied from 10-40 seconds. No consistent relation to the measured thermal values and tissue microarchitecture was observed. CONCLUSIONS: The measured cooling times and Gaussian distribution of surface temperatures serve as empiric guidelines for minimizing thermal injury to critical structures during laser surgery in the middle ear.

Animals

Dentin ablation with three infrared lasers.

BACKGROUND AND OBJECTIVE: Lasers are used for caries removal in enamel and dentin, but are currently limited in their ability to remove sound tooth structure. In this study plasma interaction regimes are investigated as the principal factor determining the ablation characteristics. STUDY DESIGN/MATERIALS AND METHODS: Three ablation parameters are considered: ablation rates (AR), surface temperatures (ST), and surface morphological characteristics. The three lasers investigated were Er:YSGG with wavelength (WL) of 2.94 mu m and pulse duration (PD) of 250 mu s, Ho:YSGG at 2.1 mu m and 250 mu s and an Nd:YAG with WL of 1.06 mu M and PD of 15ns. RESULTS: The highest surface temperatures were observed during Er:YSGG treatment (> 300 degrees C), moderate temperatures with the Ho:YSGG (150 degrees C), and lowest with the Nd:YAG (with highest surface temperature generally lower than 80 degrees C). Ablation rates were also compared and were shown to be highest with the Er:YSGG and Ho:YSGG, and lower with the Nd:YAG (< 3 mu m). In all systems, efficient ablation was observed only in the presence of plasma. In spite of their different wavelengths, for similar spot sizes, energy, and pulse duration, ablation rates of Ho:YSGG and Er:YSGG were found to be comparable. These were an order of magnitude larger than the ablation rates observed with the nanosecond system. CONCLUSION: Possible explanation for these observations is given in terms of plasma characteristics.

Dentin

Two-lasers assisted ablation: a method for enhancing conventional laser ablation of materials.

A new method for enhanced ablation by pulsed laser radiation has been demonstrated. The method utilizes an "impulse" ablation laser in conjunction with cyclical heating of the tissue by an auxiliary source: the "primer." In this study we use an auxiliary laser as the "primer" heat source, which sets up a thermal and stress field modulation in the target material. The cyclical stress associated with the thermal modulation reduces material strength thus enhancing ablation (larger mass removed per pulse) by the "impulse" laser. Ablation rate enhancement of more than twice the single-laser value is demonstrated.

Hot Temperature

Identification of photoacoustic transients during pulsed laser ablation of the human temporal bone: an experimental model.

Laser ablation of hard tissues during neurotologic operations has been accomplished with continuous-wave (CW) lasers in the visible and midinfrared spectrum. The mechanism of ablation at these wavelengths is secondary to photothermal-induced tissue destruction. As a result, significant thermal damage to surrounding tissue may occur. Pulsed ultraviolet (UV) lasers have been suggested as an alternative to the argon, KTP-532, and CO2 lasers currently used in clinical practice. The pulse length of Excimer lasers are considerably shorter than the thermal diffusion time of bone tissue, and as a consequence thermal injury is minimal. This makes pulsed lasers an attractive tool for tissue ablation in the ear: in essence a "cold knife." However, the short pulse width of Excimer lasers (typically 10-150 ns) can create large thermoelastic stresses in the ablation specimen. This study identifies the presence of these photoacoustic waves during the Excimer laser treatment of the cadaveric human temporal bone. A XeCl (lambda = 308 nm, tau p = 12 ns) excimer laser was used to ablate hard tissue surrounding the oval window and facial ridge with energies of 75, 45, 25, and 12 mJ/pulse. Spot size was estimated to be 0.5 mm2. Custom high-frequency polyvinyldifluoride (PVDF) piezoelectric film transducers were fabricated and attached to the promontory, round window niche, and facial ridges. The signals were amplified using a low-noise preamplifier and recorded on a digitizing oscilloscope. Photoacoustic waves were clearly identified. Notably, large acoustic waves were measured on the promontory and on both sides of the facial ridge. The implications and clinical relevance of these findings is discussed and compared to findings obtained from a model system.

Acoustics

Assisted hatching in mouse embryos using a noncontact Ho:YSGG laser system.

PURPOSE: A noncontact holmium:yttrium scandium gallium garnet (Ho:YSGG) laser system has been designed and tested for the micromanipulation of mammalian embryos. The purpose of this preliminary investigation was to determine the effectiveness of this laser for assisted hatching and evaluate its impact on embryo viability. The Ho:YSGG system, utilizing 250-microsecond pulses at a wavelength of 2.1 microns and 4 Hz, was used to remove a portion of the zona pellucida (ZP) of two- to four-cell FVB mouse embryos. RESULTS: In the first experiment there was no difference in blastocyst production or hatching rates following laser or conventional assisted hatching (LAH or AH, respectively) in contrast to control embryos cultured in a 5% CO2 humidified air incubator at 37 degrees C. In the second experiment a blastocyst antihatching culture model was employed and LAH-treated embryos were cultured in a serum-free HTF medium (HTF-o). Blastocyst formation was not influenced by LAH treatment and hatching was increased (P < 0.01) from 4 to 60% compared to HTF-o control group. CONCLUSIONS: These preliminary data demonstrate the utility and nontoxic properties of the Ho:YSGG laser system for quick and precise ZP drilling.

Animals

Efficacy of XeCl 308-nm excimer laser in reducing dye penetration through coronal dentinal tubules.

The efficacy of XeCl excimer laser irradiation in reducing dye penetration through human coronal dentinal tubules was studied. The roots of 20 freshly extracted human molars were resected, and the apical aspect of the crowns was ground until the pulp chamber was completely exposed. Following total removal of the pulp chamber and further grinding of the occlusal and apical surfaces up to the intact dentin, the teeth were randomly divided into experimental and control groups of 10 each. The teeth in the experimental group were completely coated with nail polish and then irradiated with XeCl 308-nm excimer laser at a fluence of 0.7 J/cm2 to form an elliptical lased area. The teeth in the control group were also coated with nail polish, but with a similar elliptical spot of exposed dentin corresponding to the irradiated spot created in the lased teeth left uncoated. All specimens were placed in 0.5% methylene blue dye for 48 h, rinsed, and air-dried. The specimens were then ground to reach the experimental area in order and photographed. The total area of penetrated dye was determined by three independent evaluators and then measured with a computerized planimeter. The mean total areas (mm2) measured in the lased specimens were significantly smaller than those in the controls (p = 0.012).

Dental Leakage

Developmental competence of mouse embryos following zona drilling using a non-contact holmium:yttrium scandian gallium garnet (Ho:YSGG) laser system.

The purpose of this study was to assess the efficacy of the holmium:yttrium scandian gallium garnet (Ho:YSGG) laser, operating in a pipette-free, non-contact mode, to assist hatching and sustain normal embryonic development. Two-cell mouse embryos were recovered and assigned to laser-assisted hatching (LAH) treatment or control human tubal fluid (HTF) culture with or without serum (HTF-s, HTF-o) or with late serum supplementation (HTF-o/s). The basic experimental apparatus for LAH consisted of a stationary 2.1 microns Ho:YSGG laser beam directed through a mechanical shutter into an input port of a Zeiss Axiomat inverted microscope. Fewer (P < 0.05) embryos developed to the blastocyst stage in the HTF-s group (81%) than in the LAH (90%), HTF-o (94%) and HTF-o/s (92%) groups. The level of hatching was significantly increased (P < 0.01) after the LAH treatment (57%) compared to HTF-o/s (32%), HTF-s (18%) or HTF-o (5%). Implantation rates were not significantly impaired following the LAH treatment (21%). These data demonstrate that LAH using the Ho:YSGG laser is a simple, accurate and effective procedure for assisted hatching.

Animals

Efficacy of XeCl-308 excimer laser in fusing hydroxyapatite to seal the root apex.

Sealing the root apex during apical surgery is important for a successful outcome. The effect of XeCl-308 nm excimer laser irradiation on the fusion and seal of hydroxyapatite to the root apex was tested in extracted human teeth. Twenty-four roots of intact single-rooted premolars were instrumented to size 30 K-file at the apex leaving a patent apical foramen. The apex of each tooth was covered with a freshly prepared paste of hydroxyapatite powder mixed with saline. The samples were then divided into two groups. In 12 teeth, the apical area was irridiated with XeCl-308 nm excimer laser at a fluence of 0.7 J/cm2 for 5 s with pulse repetition rate of 25 Hz and a spot size of 0.13 cm2 immediately after the hydroxyapatite application. In the other 12 teeth, no laser treatment was performed after the hydroxyapatite application. The roots were mounted on a model for the detection of radicular leakage of hydrogen peroxide. The hydrogen peroxide leakage of each sample was measured and the difference between the test groups compared. The ability of the hydroxyapatite plug to prevent hydrogen peroxide leakage at the apex was also tested by applying compressed air from the triple syringe on the coronal access preparation for 2 min. Apical leakage was found in four teeth in the lased group and in eight teeth in the non-plased group. However, the difference between the groups was not statistically significant. Compressed air applied to the coronal access caused hydrogen peroxide leakage in all the teeth.(ABSTRACT TRUNCATED AT 250 WORDS)

Chi-Square Distribution

Scanning electron microscopy and thermal characteristics of dentin ablated by a short-pulse XeCl excimer laser.

The interaction of a short pulse XeCl excimer laser radiation with human dentin was investigated. The dependence of surface temperatures and temperature gradients into the treated teeth on laser parameters such as fluence (0.5J/cm2-7J/cm2), pulse repetition rate (1Hz-35Hz), and spot size (0.004cm2-0.12cm2) was studied. Additionally, the effect of fluence and pulse repetition rate on dentin microstructure was studied using scanning electron microscopy (SEM). It is demonstrated that this "cold ablation" excimer laser can result in significant thermal modification in the dentin surfaces. Changes include the formation of melted dentin grains, which uniformly cover the surface and the exposed dentin tubules. Maximum temperatures of the ablated surfaces, however, remained relatively low at most laser parameters used. Also, the immediate neighborhood of the root canal was essentially undisturbed at most laser parameters. These observations suggest that with the appropriate choice of parameters XeCl lasers can be effective in producing surface structures that may prove useful in enhancing bond strength or other applications in dentistry, without exposing tooth pulp to significant temperature elevation.

Absorption

Effect of ArF-193 nm excimer laser on human dentinal tubules. A scanning electron microscopic study.

The purpose of this study was to evaluate the effects of the ArF-193 nm excimer laser on the dentinal tubules of extracted human teeth under a scanning electron microscope. Fifteen 3 mm thick slices were cut with an electric saw at the cementoenamel junction from 15 extracted human teeth. A diamond bur was used to remove the cementum layer and expose the dentinal tubules. Each slice was scored by a permanent marker into four equal quadrants. The ArF excimer laser was applied for 5 seconds on three of the quadrants with fluences that ranged from 0.2 J/cm2 to 15 J/cm2 and pulse repetition of 25 Hz. The untouched quadrant served as a control. The specimens were mounted on stubs, sputter coated by gold, and examined by a scanning electron microscope. The effects of the ArF excimer laser irradiation varied. Laser fluences of 0.2, 0.5, and 1.0 J/cm2 had no effect. Although fluence of 15 J/cm2 caused significant removal of peritubular dentin, melting and resolidification of the dentinal smear layer was also observed under the scanning electron microscope with a laser fluence of 5 J/cm2.

Argon

Sealing of human dentinal tubules by XeCl 308-nm excimer laser.

Root hypersensitivity occurs as a result of exposed dentinal tubules. Various methods and materials have been tried in an attempt to occlude these tubules. The purpose of this investigation was to study by scanning electron microscope the effects of XeCl excimer laser on exposed dentinal tubules of human extracted teeth. Fifteen 3-mm-thick slices were cut at the cementoenamel junction from 15 extracted human teeth by an electric saw. By using a diamond bur to remove the cementum layer the dentinal tubules were exposed. Each slice was scored by a permanent marker into four equal quadrants. Three of the quadrants were lased for 4 s by XeCl excimer laser with fluences ranging from 0.5 to 7.0 J/cm2 and pulse repetition of 25 Hz. The unlased quadrant served as control. The specimens were mounted on a stub, sputter coated by gold, and examined by scanning electron microscope. Nonlased surfaces showed numerous exposed dentinal tubules. In contrast, all specimens lased at fluences of up to 1 J/cm2 showed the presence of melted dentin which closed the dentinal tubules. At fluences of 4 J/cm2 and higher, rupture of molten materials and exposure of dentinal tubules were noted. The results indicate the application of XeCl excimer laser at specific fluences can cause melting of dentin and closure of exposed dentinal tubules.

Dentin