The physics of surgical lasers.
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Biomedical subjects
Publications and source records attributed to T A Fuller.
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A single case of erythroplasia of Queyrat successfully treated by rapid superpulsed carbon dioxide laser emission is presented. The results of this single case and previous studies are compared with thos obtained by different modalities used in the past.
A carbon dioxide laser which functions in both rapid superpulsed and continuous wave mode for use in ophthalmic surgery is described. Rapid superpulsed mode was found more effective in the creation of trabeculectomy-like procedures in glaucomatous human eyes with satisfactory results in 12 of 14 eyes treated. Continuous wave energy was found to be superior when full thickness eye wall resection was performed. The carbon dioxide laser was found to be effective in hemostatic resection and ablation of skin lesions about the eye. Rapid superpulse was found to be more effective when puckering and tissue loss were to be minimized, while continuous wave was found to be effective when shrinkage of tissue, as in the performance of a Ziegler cautery type repair for ectropion, was preferred. Rapid superpulse was found to be more controllable in experimental phacovaporization in cats with anterior capsulotomy being easily performed. Continuous wave was found to be a more efficacious modality for corneal shrinkage although attempts at present to create permanent corneal alterations have been fruitless.
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A comparison of eye bank eyes using continuous wave or rapid superpulsed carbon dioxide laser energy indicated that rapid superpulsed was the superior modality for scleral dissection, because there is less charring and puckering of tissue. The results of filtering procedures in five glaucomatous eyes by using rapid superpulsed carbon dioxide energy to perform the scleral dissection revealed the possible advantages of performing the procedure this way might be: (1) the technical ease by which the microdissection is performed under direct microscopic observation with the absence of blood or instruments in the field; (2) the safety factor of never having penetrated into the anterior chamber with a sharp instrument; (3) the possible advantage of the inhibition of healing at the wound margin because of coagulation of tissue at the wound edge by the laser beam; and (4) the bacteriocidal effect of thermal cutting.
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Recent evidence implicates the endogenous excitotoxin, glutamate (Glu), in several neurologic disorders, including seizure-related brain damage. Ketamine, phencyclidine, and MK-801, which are noncompetitive antagonists of the N-methyl-D-aspartate (NMDA) subtype of Glu receptor (but do not antagonize kainic acid receptors) were tested in the present study for their effects on behavioral and/or electrographic seizures and seizure-related brain damage induced by kainic acid. Behavioral seizure activity was reduced by these agents, as was spread of electrographic seizures to neocortex, but seizures recorded from deep brain regions such as hippocampus, piriform cortex, and amygdala were not significantly diminished. All three agents prevented seizure-related brain damage in the amygdala, piriform cortex, thalamus, and CA1 region of the hippocampus but conferred little or no protection in the lateral septum and CA3 region of the hippocampus. The regional selectivity of the neuroprotective effect suggests that NMDA receptors may play a more dominant role in seizure-related brain damage in some brain regions than in others. The ability of NMDA antagonists to prevent seizure-related damage in several brain regions without suppressing seizure activity suggests that in these brain regions persistent seizure activity can be maintained by other transmitter systems, with or without NMDA receptor participation, but that seizure-related brain damage is critically dependent on NMDA receptor participation.
Lasers are being used more often in podiatric medicine than ever before. New modalities have certain characteristics that might endanger either the patient and/or the operator or the supportive staff. "Laser Safety in Podiatry" will outline the safety measures in patient protection, operator protection, and supportive staff protection.
Treatment of plantar verrucae has been discussed frequently in medical literature. The present authors discuss a regimen that combines skin currettement with CO2 laser vaporization. They claim that this method provides predictable, successful results (54.5% to 89%) with additional advantages of diminished pain and reduced healing time.