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Biomedical subjects

J Stuart Nelson

Publications and source records attributed to J Stuart Nelson.

At least 37 records · Page 2Linked to original sources
PubMed2005

Influence of laser wavelength and pulse duration on gas bubble formation in blood filled glass capillaries.

BACKGROUND AND OBJECTIVES: Hypervascular skin lesions (HVSL) are treated with medical lasers characterized by a variety of parameters such as wavelength lambda, pulse duration t(p), and radiant exposure E that can be adjusted for different pathology and blood vessel size. Treatment parameters have been optimized assuming constant optical properties of blood during laser photocoagulation. However, recent studies suggest that this assumption may not always be true. Our objective was to quantify thermally induced changes in blood that occur during irradiation using standard laser parameters. STUDY DESIGN/MATERIALS AND METHODS: Glass capillary tubes (diameter D = 100, 200, and 337 microm) filled with fresh or hemolyzed rabbit blood were irradiated once at lambda = 585, 595, or 600 nm, t(p) = 1.5 milliseconds; and also at lambda = 585 nm, t(p) = 0.45 milliseconds. E was increased until blood ablation caused formation of permanent gas bubbles. In a corroborative study, human blood was heated at 50 degrees C and absorbance spectra were measured as a function of time. RESULTS: Threshold radiant exposure, E(thresh), for gas bubble formation was found not to depend on lambda, which might be surprising in view of the 10-fold lower absorption coefficient at 600 nm as compared to 585 nm. The spectroscopic study revealed heat-induced changes in blood constituent composition of hemoglobins (Hb) from initially 100% oxyhemoglobin (HbO2) to deoxyhemoglobin (HHb) and, ultimately, methemoglobin (metHb) as the major constituent. Model calculations of E(thresh)(lambda,D) based on changing constituent blood composition during heating with milliseconds lasers were found to correlate with experimental results. CONCLUSIONS: For laser treatment of HVSL it appears that lambda is of secondary importance and that the choice of t(p) is a more important factor.

Animals↗
PubMed2005

Use of erythema index imaging for systematic analysis of port wine stain skin response to laser therapy.

BACKGROUND AND OBJECTIVES: Quantitative methods to assess port wine stain (PWS) skin response to laser therapy are needed to improve therapeutic outcome. In this study, PWS skin erythema was analyzed using erythema index difference (DeltaEI: erythema index difference between PWS and normal skin) images before and after treatment to investigate systematically subject-dependent response to laser therapy. STUDY DESIGN/MATERIALS AND METHODS: Cross-polarized digital skin color images were acquired from 17 subjects with facial PWS and the associated DeltaEI images were computed. Qualitative and quantitative analyses of PWS skin erythema were performed with DeltaEI images, in which ranges of 40-6 and 5-0 represented PWS and normal skin, respectively. RESULTS: After laser therapy, we qualitatively observed a reduction in the DeltaEI values for all subjects. Regression fitting of DeltaEI values before and after PWS laser therapy was associated with strong positive linear correlation. CONCLUSIONS: The imaging modality and analysis method allowed systematic analysis of PWS skin erythema in response to laser therapy. PWS skin response was dependent on pretreatment DeltaEI values, suggesting that erythema can be utilized as an effective parameter to monitor PWS response to laser therapy.

Erythema↗
PubMed2005

Determination of an optimized conversion matrix for device independent skin color image analysis.

BACKGROUND AND OBJECTIVE: A cross-polarized diffuse reflectance (CDR) color imaging system was developed for quantitative evaluation of port wine stain (PWS) response to laser therapy. To obtain calibrated Commission International de l'Eclairage (CIE) color space images from RGB (red, green, and blue) images, it was necessary to derive an optimized conversion matrix specific to our imaging system. STUDY DESIGN/MATERIALS AND METHODS: A chromameter (CR-200, Minolta) and CDR imaging system were used to acquire CIELAB (CIE L*, a*, and b*) tristimulus values and RGB image values, respectively. A cost function was defined using these sample data sets and then a minimization algorithm was applied to obtain an optimized conversion matrix for our imaging system and illumination conditions. CIELAB color space values (L*, a*, and b*) obtained with the chromameter and CDR color images were compared to assess the accuracy of the derived matrix. RESULTS: In measurements using in vitro standard color patch or in vivo human skin samples, use of the optimized conversion matrix resulted in a good correlation with standard chromameter values for PWS human skin sites. CONCLUSIONS: The cost function minimization algorithm resulted in an optimized conversion matrix for our CDR imaging system. Use of the optimized matrix improved the utility of CDR color image analysis as a simple non-contact measurement technique to monitor quantitatively PWS response to laser therapy.

Color↗
PubMed2005

Low-noise broadband light generation from optical fibers for use in high-resolution optical coherence tomography.

Broadband light generation from a single-mode optical fiber was developed for high-resolution optical coherence tomography (OCT). No noise amplification was observed for light broadened by self-phase modulation. The investigation showed that the intensity noise of light broadened by self-phase modulation in a single-mode optical fiber was much lower than that of continuum light from a microstructure fiber (MSF). The spectral width of a femtosecond input laser pulse was successfully broadened by a factor of 11, and a coherence length of 3.7 microm was achieved with this source. The application of light broadened by a single-mode optical fiber and MSF was compared for use in OCT imaging. The results showed that a single-mode fiber with a small core diameter is a useful way to generate low-noise, broadband light for high-resolution OCT imaging.

Algorithms↗
PubMed2004

Heat-transfer dynamics during cryogen spray cooling of substrate at different initial temperatures.

Cryogen spray cooling (CSC) is used to minimize the risk of epidermal damage during laser dermatologic therapy. However, the dominant mechanisms of heat transfer during the transient cooling process are incompletely understood. The objective of this study is to elucidate the physics of CSC by measuring the effect of initial substrate temperature (T0) on cooling dynamics. Cryogen was delivered by a straight-tube nozzle onto a skin phantom. A fast-response thermocouple was used to record the phantom temperature changes before, during and after the cryogen spray. Surface heat fluxes (q") and heat-transfer coefficients (h) were computed using an inverse heat conduction algorithm. The maximum surface heat flux (q"max) was observed to increase with T0. The surface temperature corresponding to q"max also increased with T0 but the latter has no significant effect on h. It is concluded that heat transfer between the cryogen spray and skin phantom remains in the nucleate boiling region even if T0 is 80 degrees C.

Aerosol Propellants↗
PubMed2004

Depth-resolved birefringence and differential optical axis orientation measurements with fiber-based polarization-sensitive optical coherence tomography.

Conventional polarization-sensitive optical coherence tomography (PS-OCT) can provide depth-resolved Stokes parameter measurements of light reflected from turbid media. A new algorithm that takes into account changes in the optical axis is introduced to provide depth-resolved birefringence and differential optical axis orientation images by use of fiber-based PS-OCT. Quaternion, a convenient mathematical tool, is used to represent an optical element and simplify the algorithm. Experimental results with beef tendon and rabbit tendon and muscle show that this technique has promising potential for imaging the birefringent structure of multiple-layer samples with varying optical axes.

Algorithms↗
PubMed2004

Influence of angle between the nozzle and skin surface on the heat flux and overall heat extraction during cryogen spray cooling.

High speed video imaging and an inverse heat conduction problem algorithm were used to observe and measure the effect of the angle between the nozzle and surface of a skin phantom on: (a) surface temperature; (b) heat flux q; and (c) overall heat extraction Q during cryogen spray cooling (CSC). A skin phantom containing a fast-response temperature sensor was sprayed with 50 ms cryogen spurts from a commercial nozzle placed 30 mm from the surface. The nozzle was systematically positioned at angles ranging from 5 to 90 degrees (perpendicular) with respect to the phantom surface. It is shown that angles as low as 15 have an insignificant impact on the surface temperature, q and Q. Only exaggerated angles of 5 show up to 10% lower q and 30% lower Q with respect to the maximal values measured when nozzles are aimed perpendicularly. This study proves that the slight angle that many commercial nozzles have does not affect significantly the CSC efficiency.

Algorithms↗
PubMed2004

Characterization of port wine stain skin erythema and melanin content using cross-polarized diffuse reflectance imaging.

BACKGROUND AND OBJECTIVES: Objective methods to assess quantitatively port wine stain (PWS) blanching in response to laser therapy are needed to improve laser therapeutic outcome. Previous studies have attempted to assess objectively PWS color based on point measurement devices. To date, these approaches have typically been limited by a number of factors such as small test area and need for contact. To address these issues, a cross-polarized diffuse reflectance imaging system and color image analysis method has been developed to evaluate quantitatively erythema and melanin content in PWS skin. STUDY DESIGN/MATERIALS AND METHODS: A cross-polarized diffuse reflectance system has been constructed to acquire high resolution digital images while minimizing artifacts such as glare, shadowing, and nonuniform illumination effects that can compromise image fidelity. Furthermore, an image analysis algorithm has also been developed to analyze normal and PWS skin in terms of CIEL*a*b* color space parameters. Using the algorithm, images of color space intensity, L*, and saturation, a*, indices have been calculated to extract quantitative metrics of melanin and erythema, respectively. RESULTS: Compared to the cross-polarized diffuse reflectance image, the a* index image enhanced the contrast in regions of high and low erythema and seems to have quasi correlation with the L* index image. In the presented PWS patient example, the relative a* index difference (Deltaa*) image showed less erythema in PWS skin after laser treatment when compared to pre-treatment values. CONCLUSIONS: Our cross-polarized imaging system and color image analysis method is a simple, noncontact technique that can indirectly provide quantitative measurement of erythema and melanin content in PWS skin.

Algorithms↗
PubMed2004

Evaluation of cryogen spray cooling exposure on in vitro model human skin.

BACKGROUND AND OBJECTIVES: Cryogen spray cooling (CSC) is commonly used during dermatologic laser surgery. The epidermal and dermal effects of CSC have not been adequately evaluated. To study the potential for epidermal and dermal injury after CSC using an in vitro model of human skin (RAFT). STUDY DESIGN/MATERIALS AND METHODS: RAFT specimens were exposed to continuous CSC spurt durations of 10, 20, 40, 80, 100, 200, or 500 milliseconds. Biopsies were taken acutely, 3 and 7 days post-CSC exposure. Sections were stained with hematoxylin and eosin for evaluation of possible injury, Ki-67 to determine keratinocyte viability, and Melan-A, to identify and evaluate melanocytes. RESULTS: Minimal, transient epidermal changes were noted in specimens exposed to continuous CSC spurts of 80 milliseconds or less. Keratinocytes and melanocytes remained viable. Continuous CSC spurts of 100, 200, or 500 milliseconds (much longer than recommended for clinical use) resulted in significant epidermal injury acutely, with partial or full thickness epidermal necrosis at 7 days. Only the 500 milllisecond specimen demonstrated dermal change, decreased fibroblast proliferation at 3 days. CONCLUSIONS: Continuous CSC spurts of 80 milliseconds or less induce minimal, if any, epidermal or dermal damage and are unlikely to produce cryo-injury when used during dermatologic laser surgery.

Administration, Topical↗
PubMed2004

Increase of dermal blood volume fraction reduces the threshold for laser-induced purpura: implications for port wine stain laser treatment.

BACKGROUND AND OBJECTIVES: The average success rate in achieving total blanching of port wine stain (PWS) lesions treated with laser-induced selective photothermolysis is below 25%, even after multiple treatments. This is because smaller diameter (5-20 microm) PWS blood vessels are difficult to destroy with selective photothermolysis since the volumetric heat generated by absorption of laser light is insufficient to adequately heat the entire vessel wall. The aim of this study was to investigate a potential technique for more efficient photocoagulation of small diameter PWS blood vessels in PWS that respond poorly to selective photothermolysis. STUDY DESIGN/MATERIALS AND METHODS: The blood volume fraction (BVF) in the upper dermis of the forearm of human volunteers was increased by placing an inflated blood pressure cuff on the upper arm. Applied pressures were in the range of 80-100 mm Hg for up to 5 minutes. The increased BVF was determined by matching reflectance spectra measured with that computed using a diffusion model. The impact of increased BVF on purpura formation induced by a 0.45 milliseconds pulsed dye laser (PDL) at 585 nm wavelength was investigated in normal and in PWS skin. RESULTS: In the presence of a 100 mm Hg pressure cuff, the BVF, as determined from the diffusion model, increased by a factor of 3 in the forearm and by 6 in the hand. Increasing BVF by a factor of 3 corresponds to an increase in blood vessel diameters by a factor of radical 3 approximately 1.7. BVF increased at 1-3 minutes after application of the pressure cuff, remained constant at 3-5 minutes, and returned to baseline values at 3 minutes after removal of the pressure cuff. Approximately 40% less radiant exposure was needed to induce the same amount of purpura after PDL irradiation when the blood pressure cuff was used. Applying an 80 mm Hg pressure cuff reduced the required radiant exposure for purpura formation by 30%. Heating of blood vessels was calculated as a function of vessel diameter and of radiant exposure (at 585 nm and at 0.5 and 1.5 milliseconds pulse duration). CONCLUSIONS: Enlarging the vessel lumen, for example, by obstructing venous return, can significantly reduce the "small-vessel-limitation" in PDL treatment of PWS. Dilation of PWS blood vessels enables a more efficient destruction of smaller vessels without increasing the probability of epidermal damage.

Adult↗
PubMed2004

Effect of skin indentation on heat transfer during cryogen spray cooling.

BACKGROUND AND OBJECTIVES: Cryogen spray cooling (CSC) is used to pre-cool the epidermis during dermatological laser procedures such as treatment of port wine stain (PWS) birthmarks, hair removal, and non-ablative photorejuvenation. Thus far, heat transfer studies related to CSC optimization have assumed a flat surface but clinical observation suggests that human skin indents due to the force of an impinging cryogen spray. STUDY DESIGN/MATERIALS AND METHODS: High-speed videos of cryogen spray impingement on in vivo human skin were taken and the resulting indentations characterized as a function of both nozzle-to-skin distance and anatomic location. Detectors with pre-formed indentations were constructed and heat flux measurements were performed at two nozzle-to-surface distances. RESULTS: Indentation causes cryogen accumulation that reduces the efficiency of heat transfer when compared to spray impingement on a flat surface. Large indentations, however, encourage convective flow within the cryogen pool that mitigates many of the negative effects of liquid layer thickening and improves the heat flux. CONCLUSIONS: Flat surfaces produce the most efficient heat transfer, but once indentation exists (as it does in all clinically relevant cases), larger indentations produce a higher maximum heat flux. This suggests that higher momentum sprays (which produce larger skin indentations for identical spurts) than those in current clinical use may improve CSC efficiency.

Administration, Topical↗
PubMed2004

Passive mass deposition control of cryogen sprays through the use of wire meshes.

BACKGROUND AND OBJECTIVES: Cryogen spray cooling (CSC) is used for epidermal protection during laser dermatologic surgery. However, further research is necessary to optimize the use of CSC for many applications, particularly in patients with darker skin types, and in procedures with deep-targeted chromophores. STUDY DESIGN/MATERIALS AND METHODS: With the objective to enhance cryogen spray atomization and introduce a passive mass deposition control, stainless steel wire meshes of various sizes were positioned in the spray path of two nozzles of different diameters (0.7 and 1.4 mm). A temperature sensor placed at a fixed distance below the nozzle tips measured variations in temperature as a function of time. Calculations for heat flux (q), and overall heat extraction (Q) were done through an inverse heat conduction problem (IHCP) algorithm. RESULTS: The use of wire meshes reduced maximum q and thus cooling efficiency for both nozzles. However, for the larger diameter nozzle (1.4 mm), cooling duration was prolonged significantly when compared to the case without mesh, which led to an increase in Q. CONCLUSIONS: Wire meshes, within the range of wire diameters used, are not desirable for use with the smaller diameter nozzle because they reduce cooling efficiency. For the larger diameter nozzle, however, the prolonged cooling duration and increase in Q may be beneficial for laser dermatological procedures directed towards deeper targeted chromophores, such as hair removal.

Administration, Topical↗
PubMed2004

Combined photodynamic and photothermal induced injury enhances damage to in vivo model blood vessels.

BACKGROUND AND OBJECTIVES: The degree of port wine stain (PWS) blanching following pulsed dye laser (PDL) therapy remains variable and unpredictable. Because of the limitations of current PDL therapy, alternative treatment approaches should be explored. The objective was to evaluate a novel methodology for selective vascular damage, combined photodynamic (PDT) and photothermal (PDL) treatment, using the in vivo chick chorioallantoic membrane (CAM) model. STUDY DESIGN/MATERIALS AND METHODS: Thirty microliters of benzoporphyrin derivative monoacid ring A (BPD) solution was administered intraperitoneally into chick embryos at day 12 of development. Study groups were: (1) control (no BPD, no light); (2) BPD alone; (3) continuous wave irradiation (CW) alone (576 nm, 60 mW/cm2, 125 seconds); (4) CW + PDL; (5) BPD+PDL; (6) PDT (BPD+CW); (7) PDL alone (585 nm, 4 J/cm(2)); and (8) PDT+PDL (BPD + CW followed immediately by PDL). Vessels were videotaped prior to, and at 1 hour post-intervention and then assessed for damage based on the following scale: 0, no damage; 1, coagulation; 1.5, vasoconstriction; 2.0, coagulation+vasoconstriction; 2.5, angiostasis; 3.0, hemorrhage. Damage scores were weighted by vessel "order." RESULTS: PDT + PDL resulted in significantly (P < 0.01) more severe vascular damage than was observed in any other study group: 127% more than PDT, 47% more than PDL alone. CONCLUSIONS: PDT + PDL is a novel and promising approach for selective vascular damage and may offer a more effective method for treatment of PWS and other vascular skin lesions.

Allantoin↗
PubMed2004

Feasibility study of normal and septic tracheal imaging using optical coherence tomography.

BACKGROUND AND OBJECTIVES: Optical coherence tomography (OCT) is an imaging technology that may be adapted for use with flexible fiberoptic bronchoscopy, potentially allowing it to play an important role in pulmonary diagnostics. The goal of this study was to evaluate the feasibility of OCT to image tracheal pathology. STUDY DESIGN/MATERIALS AND METHODS: Tracheas were harvested from normal and septic New Zealand White rabbits and imaged using OCT. Two delivery devices were employed. One was a moving stage with an objective lens and collimator, the other a linear scanning flexible fiberoptic catheter using a GRIN lens and prism for endoscopic OCT. After OCT images were obtained from normal and septic tracheas, the excised tissues were prepared for standard histologic examination. Areas imaged by OCT were compared with corresponding histology slides. RESULTS: OCT images demonstrated in detail tracheal sub-surface structures such as the epithelium, lamina propria, submucosa, and cartilage. The appearance of structures imaged by OCT corresponded very well with histologic pictures obtained by light microscopy. The OCT images from septic tracheas showed marked swelling of the mucosal and submucosal layers. Such pathology was equally imaged by either the moving stage or fiberoptic catheter for endoscopic OCT. CONCLUSIONS: OCT images of the trachea can distinguish many sub-surface structural features usually requiring biopsy and light microscopy for visualization. Marked differences between normal and septic trachea were apparent in OCT images. In the future, OCT may be a valuable tool for evaluating tracheal pathology in situ with high image resolution.

Animals↗