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Sample records for holmium laser enucleation

  1. Laser Prostatectomy: Holmium Laser Enucleation and Photoselective Laser Vaporization of the Prostate

    PubMed Central

    Bostanci, Yakup; Kazzazi, Amir; Djavan, Bob

    2013-01-01

    Historically, transurethral resection of the prostate has been the gold standard for the treatment of benign prostatic hyperplasia (BPH). Laser technology has been used to treat BPH for > 15 years. Over the past decade, it has gained wide acceptance by experienced urologists. This review provides an evidence-based update on laser surgery for BPH with a focus on photoselective laser vaporization and holmium laser enucleation of the prostate surgeries and assesses the safety, efficacy, and durability of these techniques. PMID:23671400

  2. Holmium laser enucleation of the prostate: a paradigm shift in benign prostatic hyperplasia surgery

    PubMed Central

    2013-01-01

    Holmium laser enucleation (HoLEP) was developed in the 1990s as a more efficient and cost effective method of benign prostatic hyperplasia surgery than laser vaporization and resection techniques. As a true anatomical enucleation it mimics open prostatectomy and is as durable. There is a significant body of level 1 evidence in support of HoLEP, including 2 meta-analyses and 14 randomized trials which compare HoLEP with a number of other procedures. This review describes the development of and summarizes the evidence for HoLEP. PMID:24082919

  3. Holmium laser enucleation of the prostate: a paradigm shift in benign prostatic hyperplasia surgery.

    PubMed

    Aho, Tevita F

    2013-10-01

    Holmium laser enucleation (HoLEP) was developed in the 1990s as a more efficient and cost effective method of benign prostatic hyperplasia surgery than laser vaporization and resection techniques. As a true anatomical enucleation it mimics open prostatectomy and is as durable. There is a significant body of level 1 evidence in support of HoLEP, including 2 meta-analyses and 14 randomized trials which compare HoLEP with a number of other procedures. This review describes the development of and summarizes the evidence for HoLEP. PMID:24082919

  4. Holmium laser enucleation of the prostate: a review of the clinical trial evidence.

    PubMed

    Cynk, Mark

    2014-04-01

    Transurethral resection of the prostate (TURP) has remained the procedure of choice for the surgical treatment of bladder outflow obstruction for almost five decades, but holmium laser enucleation of the prostate (HoLEP) is now emerging as a challenger as the gold standard procedure. This review summarizes the evidence base for HoLEP, with particular reference to randomized, controlled (level 1) evidence. PMID:24688602

  5. Holmium laser enucleation of the prostate: a review of the clinical trial evidence

    PubMed Central

    2014-01-01

    Transurethral resection of the prostate (TURP) has remained the procedure of choice for the surgical treatment of bladder outflow obstruction for almost five decades, but holmium laser enucleation of the prostate (HoLEP) is now emerging as a challenger as the gold standard procedure. This review summarizes the evidence base for HoLEP, with particular reference to randomized, controlled (level 1) evidence. PMID:24688602

  6. Bipolar, Monopolar, Photovaporization of the Prostate, or Holmium Laser Enucleation of the Prostate: How to Choose What's Best?

    PubMed

    Cornu, Jean-Nicolas

    2016-08-01

    Endoscopic management of benign prostatic obstruction is based on resection, vaporization, or enucleation. Enucleation provides the best efficacy and long-term outcome. Lasers have advantages in patients at high risk of bleeding. Holmium enucleation is the best evaluated technique, but has a steep learning curve. Greenlight photovaporization is a safe alternative to transurethral resection of the prostate (TURP) in prostates of less than 100 mL, especially in patients at high risk of bleeding. Bipolar devices can be used for resection, vaporization, and enucleation and provides efficacy results similar to TURP in the short term with better safety. PMID:27476130

  7. Holmium Laser Enucleation of the Prostate and Iatrogenic Arteriovenous Fistula Treated by Superselective Arterial Embolization.

    PubMed

    Asimakopoulos, Anastasios D; Dutto, Lorenzo; Preziosi, Paolo; Spera, Enrico; Micali, Francesco; De Carolis, Andrea; Iorio, Beniamino

    2016-01-01

    Iatrogenic pelvic pseudoaneurysm with concomitant arteriovenous fistula has been described as a rare and challenging complication, which may occur during transurethral resection of the prostate. We provide the first report of this complication after holmium laser enucleation of the prostate for the treatment of benign prostatic hyperplasia. The attempt to control the bleeding by conversion to open surgery and placement of haemostatic stitches into the prostatic fossa failed. Angiography with superselective arterial embolization proved to be a modern, quick, safe, and efficient treatment of this uncommon complication. PMID:27022498

  8. Holmium Laser Enucleation of the Prostate and Iatrogenic Arteriovenous Fistula Treated by Superselective Arterial Embolization

    PubMed Central

    Dutto, Lorenzo; Preziosi, Paolo; Spera, Enrico; Micali, Francesco; De Carolis, Andrea; Iorio, Beniamino

    2016-01-01

    Iatrogenic pelvic pseudoaneurysm with concomitant arteriovenous fistula has been described as a rare and challenging complication, which may occur during transurethral resection of the prostate. We provide the first report of this complication after holmium laser enucleation of the prostate for the treatment of benign prostatic hyperplasia. The attempt to control the bleeding by conversion to open surgery and placement of haemostatic stitches into the prostatic fossa failed. Angiography with superselective arterial embolization proved to be a modern, quick, safe, and efficient treatment of this uncommon complication. PMID:27022498

  9. Technical Aspects of Holmium Laser Enucleation of the Prostate for Benign Prostatic Hyperplasia

    PubMed Central

    Kim, Myong; Lee, Hahn-Ey

    2013-01-01

    Holmium laser enucleation of the prostate (HoLEP) is a minimally invasive procedure and a size-independent treatment for benign prostatic hyperplasia with excellent long-term surgical outcome. HoLEP has become an alternative to conventional transurethral resection of the prostate or open prostatectomy owing to its efficacy and safety. Although HoLEP is known to have a steep learning curve, very few articles have addressed the technical aspects of HoLEP. Herein, we described detailed techniques and tips for HoLEP as performed at Seoul National University Hospital in a step-by-step manner with extensive review of the literature. PMID:24044089

  10. Technical aspects of holmium laser enucleation of the prostate for benign prostatic hyperplasia.

    PubMed

    Kim, Myong; Lee, Hahn-Ey; Oh, Seung-June

    2013-09-01

    Holmium laser enucleation of the prostate (HoLEP) is a minimally invasive procedure and a size-independent treatment for benign prostatic hyperplasia with excellent long-term surgical outcome. HoLEP has become an alternative to conventional transurethral resection of the prostate or open prostatectomy owing to its efficacy and safety. Although HoLEP is known to have a steep learning curve, very few articles have addressed the technical aspects of HoLEP. Herein, we described detailed techniques and tips for HoLEP as performed at Seoul National University Hospital in a step-by-step manner with extensive review of the literature. PMID:24044089

  11. Acute abdominal compartment syndrome as a complication of Holmium laser enucleation of the prostate: a case report

    PubMed Central

    2014-01-01

    Background In 1996, Holmium laser enucleation of the prostate was introduced and has been shown to be safe and highly effective. Case presentation We report a case of a rare complication that resulted in intra-abdominal compartment syndrome with prolonged intubation and intensive care, involving an 74-year-old male after holmium laser enucleation of prostate, with a massive irrigant fluid leakage into the retroperitoneal space. The elevated abdominal pressure was reduced by forced diuresis. The tracheal tube was removed 18 hours after the patient’s transfer to the ICU. The patient was discharged to home one week after the operation. Conclusion In rare cases when no obvious ruptures of the prostate capsule or the bladder occur during laser enucleation of prostate, knowledge regarding possible emersion of massive amounts of irrigant fluid into the retroperitoneal space leading to intra-abdominal compartment syndrome aids in the diagnosis and subsequent successful therapy of intra-abdominal hypertension. PMID:24910537

  12. Holmium Laser Enucleation of the Prostate in a 400 cc Prostate: Case Report.

    PubMed

    Gopee, Esha L; Hong, Matthew K H; Pham, Trung

    2016-01-01

    The modality of choice in the surgical management of benign prostatic hyperplasia for large prostates has traditionally been open prostatectomy. Advances in minimally invasive techniques have begun to challenge this notion with advantages such as lower bleeding and transfusion rates and shorter hospital stay. In this case report, we illustrate the use of holmium laser enucleation of the prostate (HoLEP) in a gland measuring more than 400 cc. We describe the case of a 71-year-old man with persistent voiding urinary symptoms despite two previous transurethral resections of his prostate. With greater experience in HoLEP and declining experience in open prostatectomy, there may be a shift toward HoLEP as the preferred treatment choice for large prostate glands. PMID:27579406

  13. Holmium Laser Enucleation of the Prostate in a 400 cc Prostate: Case Report

    PubMed Central

    Hong, Matthew K.H.; Pham, Trung

    2016-01-01

    Abstract The modality of choice in the surgical management of benign prostatic hyperplasia for large prostates has traditionally been open prostatectomy. Advances in minimally invasive techniques have begun to challenge this notion with advantages such as lower bleeding and transfusion rates and shorter hospital stay. In this case report, we illustrate the use of holmium laser enucleation of the prostate (HoLEP) in a gland measuring more than 400 cc. We describe the case of a 71-year-old man with persistent voiding urinary symptoms despite two previous transurethral resections of his prostate. With greater experience in HoLEP and declining experience in open prostatectomy, there may be a shift toward HoLEP as the preferred treatment choice for large prostate glands. PMID:27579406

  14. Holmium Laser Enucleation of Prostate for Benign Prostatic Hyperplasia: Seoul National University Hospital Experience

    PubMed Central

    Bae, Jungbum; Choo, Minsoo; Park, Ji Hyun; Oh, Jin Kyu; Paick, Jae-Seung

    2011-01-01

    Purpose The objective of this study was to report the experience acquired at the Seoul National University Hospital with Holmium Laser Enucleation of Prostate (HoLEP), combined with mechanical morcellation for symptomatic benign prostatic hyperplasia (BPH). Methods A retrospective review was performed on the clinical data of 309 consecutive patients who underwent HoLEP at our institution between July 2008 and June 2010. All patients were evaluated preoperatively for prostate volume by transrectal ultrasound, maximum urinary flow rate (Qmax), International Prostate Symptoms Score (IPSS) and quality of life (QoL) score. Peri- and postoperative parameters were evaluated and patients were followed-up at 1-, 3-, 6-, and 12- months with the aforementioned investigations. Results The patients' mean age was 68.3 (±6.5) years and mean prostate volume was 55.6 (±23.6) mL. Mean enucleation time was 56.2 (±25.1) minutes, mean morcellation time was 11.3 (±9.5) minutes, and the mean resected weight of the prostate was 20.8 (±16.9) g. The mean catheter indwelling period was 1.9 (±1.7) days and mean hospital stay was 2.9 (±1.5) days. Significant improvement was noted in Qmax, IPSS, and QoL at the 1-year follow-up compared with baseline (P<0.01). At 1 month 17.2% of patients complained of irritative urinary symptoms, which were typically self-limiting within 3 months. Transient stress incontinence was reported in 15.2% of patients. No patient experienced persistent obstructive symptoms that required reoperation. Conclusions Our study showed that HoLEP is a safe and effective therapeutic modality for BPH. PMID:21468284

  15. Salvage Holmium laser enucleation of prostate to treat residual benign prostatic hyperplasia

    PubMed Central

    Oh, Jin Kyu; Bae, Jungbum; Jeong, Chang Wook; Paick, Jae-Seung; Oh, Seung-June

    2014-01-01

    Introduction: The Holmium laser enucleation of the prostate (HoLEP) technique to remove residual adenoma has not been reported. Salvage HoLEP enables anatomical enucleation of residual adenoma in patients who have previously undergone surgical treatment. We describe not only anatomical insights into the frequent location of adenoma recurrence, but also the feasibility of the salvage HoLEP technique. Methods: We retrospectively reviewed a database containing HoLEP video records for 35 patients out of a total of 535 individuals on whom HoLEP was performed by 2 surgeons (SJO & JSP) between July 2008 and June 2011. Group 1 consisted of patients who underwent salvage HoLEP due to recurring adenoma and Group 2 of patients who underwent HoLEP as an initially surgical management to treat benign prostate hyperplasia (BPH). We compared the dataset of pre-, intra- and postoperative parameters between Groups 1 and 2. Results: In the analysis of the video records of Group 1 (n = 35), there was significant remnant tissue around the verumontanum and the lateral lobes were also incompletely removed by previous conventional procedures. When we compared pre-, intra- and postoperative parameters between the 2 groups, there were no significant differences, including operation time, duration of hospital stay. However, the duration of the catheterization of Group 1 was shorter than that of Group 2 (1.38 ± 0.55 vs. 1.90 ± 1.81 days, p < 0.001). Conclusions: Even for cases of residual BPH, salvage HoLEP is a feasible and effective procedure for treating residual adenoma along the anatomical plane. PMID:24839489

  16. An Improved Morcellation Procedure for Holmium Laser Enucleation of the Prostate

    PubMed Central

    Chen, Qi; Chen, Yan-Bo; Zheng, Da-Chao; Cai, Zhi-Kang; Li, Wen-Ji; Zhou, Juan

    2012-01-01

    Abstract Purpose We modified the conventional morcellation procedure for holmium laser enucleation of the prostate (HoLEP), and its outcomes are presented in this article. Materials and Methods As 395 patients were included, the conventional morcellation procedure was performed in the first 100 cases (group 1, cases 1–100), and an improved procedure was used in the last 100 cases (group 2, cases 296–395). The improved morcellation process has three steps to execute. The morcellation time, collected tissue weight, morcellation rate, and associated complications were recorded. Results The tissue-resected weight was similar between group 1 (60.7±33.9 g) and group 2 (62.4±36.8 g). The mean morcellation time in group 1 was greater than that in group 2 (11.3±7.1 and 8.3±4.1 minutes, respectively), and the mean morcellation rate was better in group 2 than in group 1 (5.75±1.7 g/minutes in group 1 v 7.3±1.1 g/minutes in group 2). Complications, such as bladder injury, were similar in both groups. Conclusion The improved morcellation procedure described in this article can be used in various situations of suction and can be performed in a more fluent manner and with better efficiency. PMID:22788738

  17. Efficacy of Holmium Laser Enucleation of the Prostate Based on Patient Preoperative Characteristics

    PubMed Central

    Suh, Yoon Seok; Kim, Tae Heon; Sung, Hyun Hwan; Jeong, Jeongyun

    2015-01-01

    Purpose: To evaluate the efficacy of holmium laser enucleation of the prostate (HoLEP) in relation to prostate size and urodynamic parameters, including bladder outlet obstruction index (BOOI), presence of detrusor overactivity, and detrusor contractility, and to investigate factors predictive of HoLEP success. Methods: This retrospective analysis of prospective data included 174 consecutive patients treated with HoLEP at Samsung Medical Center from 2009 to 2013. Prostate-specific antigen, prostate size, urodynamic parameters, and International Prostate Symptom Score (IPSS)/quality of life (QoL) were evaluated preoperatively, while prostate-specific antigen, uroflowmetry/postvoid residual (PVR) urine, and IPSS were measured six months after HoLEP. Two definitions of treatment success were established based on the following three variables: IPSS, maximum flow rate (Qmax), and QoL index. Factors predictive of HoLEP success were identified using multiple logistic regression analysis. Results: IPSS/QoL, Qmax, and PVR improved significantly following HoLEP. Improvements in IPSS and PVR were more significant in the BOOI≥40 group compared to the BOOI<40 group, with overall success rates of 93.7% and 73.6%, respectively. Thus, the BOOI≥40 group had a significantly higher success rate, and BOOI≥40 was a significant predictor of HoLEP success based on the multivariate analyses. Conclusions: We found good surgical outcomes after HoLEP, and specifically patients with a higher BOOI had a greater chance of surgical success. PMID:26739183

  18. Holmium Laser Enucleation of the Prostate is Safe for Patients Above 80 Years: A Prospective Study

    PubMed Central

    2016-01-01

    Purpose: To evaluate the effect of age on the efficacy and safety of holmium laser enucleation of the prostate (HoLEP) for the treatment of symptomatic benign prostatic hyperplasia (BPH). Methods: A total of 579 patients underwent HoLEP procedure performed by a single surgeon (SJO) between December 2009 and May 2013. The perioperative and functional outcomes of patients in the age groups of 50–59 (group A, n=44), 60–69 (group B, n=253), 70–79 (group C, n=244), and ≥80 years (group D, n=38) were compared. The Clavien-Dindo system was used to evaluate clinical outcomes. The International Prostate Symptom Score (IPSS), maximum urinary flow rate (Qmax), postvoid residual (PVR) urine volume, and urinary continence were used to assess functional outcomes. Results: In this study, the patients ≥80 years had significantly higher presence of hypertension (P=0.007), total prostate volumes (P=0.024), transitional zone volume (P=0.002), American Society of Anesthesiologists scores (P=0.006), urinary retention (P=0.032), and anticoagulation use (P=0.008) at preoperative period. Moreover, the mean values of operation time, enucleation time, morcellation time, and enucleation weight were higher in group D compared with other group patients (P=0.002, P=0.010, P<0.01, and P=0.009, respectively). Patients aged ≥80 years had a longer hospital stay time (2.9±1.8 days) than other groups (group A, 2.3±0.7 days; group B, 2.3±0.7 days vs. group C, 2.4±0.7 days; P=0.001). All groups were similar in regard to the incidence of complications (Clavien-Dindo grade) post operatively (P>0.05). All the patients in the present study showed improvement in functional outcomes after HoLEP. By the sixth month, there were no significant differences in IPSS, quality of life, Qmax, and PVR among the groups (P>0.05). Conclusions: Compared with younger patients, the patients aged ≥80 years had a similar overall morbidity and 6-month functional outcomes of HoLEP. HoLEP is a safe and

  19. Risk Factors for Transient Urinary Incontinence after Holmium Laser Enucleation of the Prostate

    PubMed Central

    Nam, Jong Kil; Kim, Hyeon Woo; Lee, Dong Hoon; Han, Ji-Yeon; Lee, Jeong Zoo

    2015-01-01

    Purpose To investigate the factors associated with the occurrence of and recovery from transient urinary incontinence (TUI) after holmium laser enucleation of the prostate (HoLEP). Materials and Methods From March 2009 to December 2012, 391 consecutive patients treated with HoLEP for benign prostatic hyperplasia were enrolled. Information regarding age, prostate volume, International Prostate Symptom Score, Overactive Bladder Symptom Score, peak urinary flow rate, postvoid residual urine, and operation time was collected. TUI was defined as a patient complaint of urine leakage, regardless of type. Logistic regression was used to investigate the factors associated with the occurrence of TUI, and the Kaplan-Meier test was used to analyze the TUI recovery period. Results TUI after HoLEP occurred in 65 patients (16.6%), 52 patients of whom (80.0%) showed recovery within three months. Stress and urge urinary incontinence and postvoid dribbling occurred in 16 patients (4.1%), 29 patients (7.4%), and 33 patients (8.4%), respectively. Age (odds ratio [OR]=3.494; 95% confidence interval [CI]=1.565~7.803; p=0.002) and total operation time (OR=3.849; 95% CI=1.613~9.185; p=0.002) were factors that significantly affected the occurrence of TUI. Conclusions TUI, defined as any type of urine leakage, occurred after HoLEP in some patients, most of whom recovered within three months. Stress urinary incontinence occurred in only 4% of patients after HoLEP. Age and total operation time were associated with the occurrence of postoperative TUI. PMID:26331125

  20. Predictive risk factors of postoperative urinary incontinence following holmium laser enucleation of the prostate during the initial learning period

    PubMed Central

    Kobayashi, Shuichiro; Yano, Masataka; Nakayama, Takayuki; Kitahara, Satoshi

    2016-01-01

    ABSTRACT Purpose: To determine the predictive factors for postoperative urinary incontinence (UI) following holmium laser enucleation of the prostate (HoLEP) during the initial learning period. Patients and Methods: We evaluated 127 patients with benign prostatic hyperplasia who underwent HoLEP between January 2011 and December 2013. We recorded clinical variables, including blood loss, serum prostate-specific antigen levels, and the presence or absence of UI. Blood loss was estimated as a decline in postoperative hemoglobin levels. The predictive factors for postoperative UI were determined using a multivariable logistic regression analysis. Results: Postoperative UI occurred in 31 patients (24.4%), but it cured in 29 patients (93.5%) after a mean duration of 12 weeks. Enucleation time >100 min (p=0.043) and blood loss >2.5g/dL (p=0.032) were identified as significant and independent risk factors for postoperative UI. Conclusions: Longer enucleation time and increased blood loss were independent predictors of postoperative UI in patients who underwent HoLEP during the initial learning period. Surgeons in training should take care to perform speedy enucleation maneuver with hemostasis. PMID:27564285

  1. Factors Affecting De Novo Urinary Retention after Holmium Laser Enucleation of the Prostate

    PubMed Central

    Kim, Sung Han; Yoo, Changwon; Choo, Minsoo; Paick, Jae-Seung; Oh, Seung-June

    2014-01-01

    Objective Patients can experience urinary retention (UR) after Holmium laser enucleation of the prostate (HoLEP) that requires bladder distension during the procedure. The aim of this retrospective study is to identify factors affecting the UR after HoLEP. Materials and Methods 336 patients, which underwent HoLEP for a symptomatic benign prostatic hyperplasia between July 2008 and March 2012, were included in this study. Urethral catheters were routinely removed one or two days after surgery. UR was defined as the need for an indwelling catheter placement following a failure to void after catheter removal. Demographic and clinical parameters were compared between the UR (n = 37) and the non-urinary retention (non-UR; n = 299) groups. Results The mean age of patients was 68.3 (±6.5) years and the mean operative time was 75.3 (±37.4) min. Thirty seven patients (11.0%) experienced a postoperative UR. UR patients voided catheter free an average of 1.9 (±1.7) days after UR. With regard to the causes of UR, 24 (7.1%) and 13 (3.9%) patients experienced a blood clot-related UR and a non-clot related UR respectively. Using multivariate analysis (p<0.05), we found significant differences between the UR and the non-UR groups with regard to a morcellation efficiency (OR 0.701, 95% CI 0.498–0.988) and a bleeding-related complication, such as, a reoperation for bleeding (OR 0.039, 95% CI 0.004–0.383) or a transfusion (OR 0.144, 95% CI 0.027–0.877). Age, history of diabetes, prostate volume, pre-operative post-void residual, bladder contractility index, learning curve, and operative time were not significantly associated with the UR (p>0.05). Conclusions De novo UR after HoLEP was found to be self-limited and it was not related to learning curve, patient age, diabetes, or operative time. Efficient morcellation and careful control of bleeding, which reduces clot formation, decrease the risk of UR after HoLEP. PMID:24465454

  2. Clinical and Pathological Characteristics of Hard Nodules Resistant to Morcellation During Holmium Laser Enucleation of the Prostate

    PubMed Central

    Piao, Songzhe; Choo, Min Soo; Wang, Yue; Lee, Young Ju; Bae, Jungbum; Oh, Seung-June

    2015-01-01

    Purpose: To identify the clinical and pathological characteristics of hard nodules resistant to morcellation (HNRM) during holmium laser enucleation of the prostate (HoLEP) for benign prostatic hyperplasia (BPH). Methods: Between July 2008 and October 2011, 246 patients underwent HoLEP for symptomatic BPH. The first 30 patients were excluded from the analysis due to the learning curve of the procedure. The remaining patients were divided into HNRM (n=29) and non-HNRM groups (n=187), and comparative analysis of the clinical parameters of the two groups was performed. International prostate symptom score analysis and urodynamic studies were performed preoperatively. Histological analysis was performed after hematoxylin and eosin staining and Masson trichrome staining of the HNRM specimens. Results: Twenty-nine patients (13.4%) had HNRM. The patients in the HNRM group had significantly higher proportions of advanced age (≥65 years, P=0.029), total prostate volume ≥65 mL (P<0.001), transition zone volume ≥35 mL (P<0.001), serum prostate-specific antigen levels ≥10 ng/mL (P=0.007), and functional urethral length ≥70 mm (P=0.009); larger enucleation weight (P<0.001); longer operation (P=0.001), enucleation (P=0.042), and morcellation times (P<0.001); and higher enucleation ratio (P=0.028) and enucleation efficacy (P=0.001). After adjusting for confounding factors, multivariate logistic regression analysis revealed that age ≥65 years and total prostate volume ≥65 mL were independent risk factors for HNRM. Pathological examination did not reveal any malignant cells, with mainly dense fibrous tissue found in the HNRM. Conclusions: HNRM can make morcellation cumbersome and time-consuming, and older patients with larger prostates have a higher incidence of HNRM. However, the histopathology of HNRM revealed mainly fibrotic tissue. PMID:26126438

  3. The Impact of Increased Bladder Blood Flow on Storage Symptoms after Holmium Laser Enucleation of the Prostate.

    PubMed

    Saito, Keisuke; Hisasue, Shin-ichi; Ide, Hisamitsu; Aoki, Hiroaki; Muto, Satoru; Yamaguchi, Raizo; Tsujimura, Akira; Horie, Shigeo

    2015-01-01

    In order to investigate how holmium laser enucleation of the prostate (HoLEP) improves urinary storage symptoms, we assessed blood flow in the urinary bladder mucosa of patients with benign prostatic hyperplasia (BPH) before and after laser surgery. Seventy-four consecutive patients with BPH (median age 69 years, range; 53-88) underwent HoLEP at our institution and are included in this study. We prospectively assessed the International Prostate Symptom Score (IPSS), IPSS-QOL Score, the Overactive Bladder Symptom Score (OABSS), uroflowmetry, and blood flow in the urinary bladder, before and after surgery. Blood flow in the bladder mucosa was measured using the OMEGA FLOW (OMEGAWAVE, Tokyo, Japan) laser Doppler flowmeter. The median volume of the enucleated adenomas was 45.0 g (range: 25.0 to 83.2). The median IPSS improved significantly from 20 (range: 6-35) to 3 (0-22) (p < 0.001; Wilcoxon signed-rank test), as did the storage symptoms score, which decreased from 13 (2-20) to 3 (1-8) (p < 0.001). Median bladder blood flow increased at the trigone from 9.57 ± 0.83 ml/sec to 17.60 ± 1.08 ml/sec. Multiple regression analysis for the improved storage symptom score eliminated all explanatory variables except increased bladder perfusion. The data suggest that HoLEP improves blood flow in the bladder mucosa, which independently leads to the improvement of storage symptoms. PMID:26090819

  4. The Impact of Increased Bladder Blood Flow on Storage Symptoms after Holmium Laser Enucleation of the Prostate

    PubMed Central

    Ide, Hisamitsu; Aoki, Hiroaki; Muto, Satoru; Yamaguchi, Raizo; Tsujimura, Akira; Horie, Shigeo

    2015-01-01

    In order to investigate how holmium laser enucleation of the prostate (HoLEP) improves urinary storage symptoms, we assessed blood flow in the urinary bladder mucosa of patients with benign prostatic hyperplasia (BPH) before and after laser surgery. Seventy-four consecutive patients with BPH (median age 69 years, range; 53–88) underwent HoLEP at our institution and are included in this study. We prospectively assessed the International Prostate Symptom Score (IPSS), IPSS-QOL Score, the Overactive Bladder Symptom Score (OABSS), uroflowmetry, and blood flow in the urinary bladder, before and after surgery. Blood flow in the bladder mucosa was measured using the OMEGA FLOW (OMEGAWAVE, Tokyo, Japan) laser Doppler flowmeter. The median volume of the enucleated adenomas was 45.0 g (range: 25.0 to 83.2). The median IPSS improved significantly from 20 (range: 6–35) to 3 (0–22) (p<0.001; Wilcoxon signed-rank test), as did the storage symptoms score, which decreased from 13 (2–20) to 3 (1–8) (p<0.001). Median bladder blood flow increased at the trigone from 9.57±0.83 ml/sec to 17.60±1.08 ml/sec. Multiple regression analysis for the improved storage symptom score eliminated all explanatory variables except increased bladder perfusion. The data suggest that HoLEP improves blood flow in the bladder mucosa, which independently leads to the improvement of storage symptoms. PMID:26090819

  5. [Investigation of changes in sexual and ejaculatory functions after holmium laser enucleation of the prostate (HoLEP)].

    PubMed

    Ishikawa, Ryuta; Shitara, Toshiya; Hirayama, Takahiro; Wakatabe, Yoji; Dobashi, Masato; Sugita, Yoshiko; Kubo, Seiichi; Fujita, Tetsuo; Iwamura, Masatsugu; Baba, Shiro

    2014-06-01

    Changes in sexual function and ejaculatory function in patients who had undergone holmium laser enucleation of the prostate (HoLEP) were investigated using questionnaires. In this study, 77 patients on whom HoLEP was performed at our department from July 2010 to December 2010 were included. Of the 77 patients, the number of patients who could achieve an erection increased from 36 (46.8%) preoperatively to 52 (67.5%) postoperatively after HoLEP. Although postoperative ejaculatory dysfunction was found in 38 (73%) of 52 patients, 47 (90%) experienced orgasms, regardless of ejaculation, which is a high rate. With respect to ejaculatory satisfaction, patients who experienced an ejaculation had significantly higher satisfaction levels than those who did not. These results suggest that changes in postoperative ejaculatory function might affect satisfaction levels of ejaculation. PMID:25001640

  6. Transurethral Surgical Anatomy of the Arterial Bleeder in the Enucleated Capsular Plane of Enlarged Prostates During Holmium Laser Enucleation of the Prostate

    PubMed Central

    Choo, Min Soo; Lee, Hahn-Ey; Bae, Jungbum; Cho, Sung Yong

    2014-01-01

    Purpose To identify the endoscopic vascular anatomy of the prostate during Holmium laser enucleation of the prostate (HoLEP), and analyze the clinical risk factors associated with significant arterial bleeding. Methods We identified 107 consecutive patients with benign prostatic hyperplasia who underwent HoLEP between September 2009 and August 2010, performed by a single surgeon (S.J.O.). Two independent reviewers reviewed the surgery video database and completed a prespecified form. The location of bleeding arteries was marked at the level of the bladder neck, proximal prostate, distal prostate, and verumontanum. Arterial bleeding was classified into one of three grades according to bleeding severity (grades 2 and 3 indicate significant bleeding). Results The mean prostate volume was 65.1±31.5 mL, and the mean prostate-specific antigen (PSA) level was 3.69±3.58 ng/mL. During the HoLEP procedure, the most common locations of significant bleeders were the 2-5 and 7-10 o'clock positions in the proximal prostate. The average number of bleeding arteries was 12.1±7.9 per procedure, and 1.93±1.20 per 10 mL of prostate volume. Multivariate analysis revealed that prostate volume and serum PSA were significant parameters for estimating the number of bleeding vessels. Conclusions During the HoLEP procedure, the most common locations of significant bleeders were the 2-5 and 7-10 o'clock positions in the proximal prostate. Prostate volume was associated with the number of bleeders. A careful approach to the capsular plane of the proximal prostate facilitates early hemostasis during the HoLEP procedure, especially with larger adenomas. PMID:25279241

  7. Comparison of Photoselective Vaporization versus Holmium Laser Enucleation for Treatment of Benign Prostate Hyperplasia in a Small Prostate Volume

    PubMed Central

    Kim, Kang Sup; Choi, Jin Bong; Bae, Woong Jin; Kim, Su Jin; Cho, Hyuk Jin; Hong, Sung-Hoo; Lee, Ji Youl; Kim, Sang Hoon; Kim, Hyun Woo; Cho, Su Yeon; Kim, Sae Woong

    2016-01-01

    Objective Photoselective vaporization of the prostate (PVP) using GreenLight and Holmium laser enucleation of the prostate (HoLEP) is an important surgical technique for management of benign prostate hyperplasia (BPH). We aimed to compare the effectiveness and safety of PVP using a 120 W GreenLight laser with HoLEP in a small prostate volume. Methods Patients who underwent PVP or HoLEP surgery for BPH at our institutions were reviewed from May 2009 to December 2014 in this retrospective study. Among them, patients with prostate volumes < 40 mL based on preoperative trans-rectal ultrasonography were included in this study. Peri-operative and post-operative parameters—such as International Prostate Symptom Score (IPSS), quality of life (QoL), maximum urinary flow rate (Qmax), post-void residual urine volume (PVR), and complications—were compared between the groups. Results PVP was performed in 176 patients and HoLEP in162 patients. Preoperative demographic data were similar in both groups, with the exception of PVR. Operative time and catheter duration did not show significant difference. Significant improvements compared to preoperative values were verified at the postoperative evaluation in both groups in terms of IPSS, QoL, Qmax, and PVR. Comparison of the postoperative parameters between the PVP and HoLEP groups demonstrated no significant difference, with the exception of IPSS voiding subscore at 1 month postoperatively (5.9 vs. 3.8, P< 0.001). There was no significant difference in postoperative complications between the two groups. Conclusion Our data suggest that PVP and HoLEP are efficient and safe surgical treatment options for patients with small prostate volume. PMID:27227564

  8. Introducing holmium laser enucleation of the prostate alongside transurethral resection of the prostate improves outcomes of each procedure

    PubMed Central

    Wilson, N; Acher, P; Lodge, R; Young, A

    2013-01-01

    Introduction Holmium laser enucleation of the prostate (HoLEP) is recognised as an alternative to transurethral resection of the prostate (TURP). HoLEP has been demonstrated to be at least as effective as TURP with less morbidity but its introduction to practice has been limited in part by the learning curve of a novel procedure. This study examined the effects of introducing HoLEP alongside an established practice of TURP on early morbidity and length of hospital stay (LOS). Methods A retrospective review of all patients who underwent HoLEP and TURP between April 2007 and July 2011 was undertaken. HoLEP was introduced in April 2008; patients undergoing TURP before this were considered as a historical control group. Data were collected concerning resection/enucleation weight, blood transfusions and LOS. Results Overall, 772 patients underwent HoLEP or TURP within the 52-month study period: 164 underwent TURP prior to the introduction of HoLEP (TURP-A), 425 had TURP after the introduction of HoLEP (TURP-B) and 183 underwent HoLEP. The mean removed weight was 24g (standard deviation [SD]: 21g) for TURP-A, 19g for TURP-B (SD: 16g) and 38g (SD: 32g) for HoLEP (p<0.005). Blood transfusion rates were 5.5%, 2.2% and 1.6% for the TURP-A, TURP-B and HoLEP groups respectively (p<0.05). For TURP-A patients, the mean LOS was 5.6 days (SD: 3.5 days, 95% confidence interval [CI]: 5.3–6.0 days). The mean LOS for TURP-B patients was 4.4 days (SD: 4.4 days, 95% CI: 4.2–4.8 days). HoLEP patients had a mean LOS of 3.0 days (SD: 3.0 days, 95% CI: 2.6–3.4 days). Conclusions The introduction of HoLEP alongside TURP is associated with lower rates of blood transfusion and shorter LOS for all patients. This is likely to be due to the use of HoLEP rather than TURP in patients with larger prostates, who are more likely to have complications. PMID:23838502

  9. Holmium Laser Enucleation of the Prostate for Benign Prostatic Hyperplasia: Effectiveness, Safety, and Overcoming of the Learning Curve

    PubMed Central

    Hwang, Jin Chul; Park, Sang Myung

    2010-01-01

    Purpose To examine the efficacy and safety of holmium laser enucleation of the prostate (HoLEP) for the surgical treatment of benign prostatic hyperplasia and to estimate the time to overcome the learning curve. Materials and Methods From May 2008 to October 2009, 164 consecutive patients treated with HoLEP were enrolled in this study. International Prostate Symptom Score (IPSS), peak urinary flow rate (Qmax), and postvoid residual urine (PVR) were documented preoperatively and at 6 weeks and 3, 6, 12, and 18 months postoperatively. The 164 study subjects were divided into 3 groups (group 1 the first 50 patients treated, group 2 the second 50, and group 3 the third 64), and perioperative data and complications were analyzed in these groups to determine the learning curve. In addition, the inverse and upward techniques were compared in terms of the effects and the stability of morcellation. Results The mean patient age was 69 years, and the average operation time was 62 minutes (range, 20-208 minutes). Mean prostate volume was 54.2 ml and mean resected tissue weight was 18.6 g. Postoperatively, IPSS and PVR decreased and Qmax increased significantly. Postoperative complications were transient incontinence (8.5%), urinary retention (4.3%), hematuria (3.0%), urinary tract infection (1.2%), and urethral stricture (0.6%), and intraoperative complications were minor capsular perforation (4%) and bladder injury (8%). Conclusions HoLEP was found to be effective and safe regardless of prostate size. We recommend that a systematic educational program be established to reduce the learning curve. PMID:20856646

  10. Holmium laser enucleation of the prostate: surgical, functional, and quality-of-life outcomes upon extended follow-up

    PubMed Central

    Alkan, Ilter; Ozveri, Hakan; Akin, Yigit; Ipekci, Tumay; Alican, Yusuf

    2016-01-01

    ABSTRACT Objectives: To evaluate the long-term surgical, functional, and quality-of-life (QoL) outcomes after Holmium laser enucleation of the prostate (HoLEP) in patients with symptomatic benign prostatic hyperplasia (BPH). Materials and Methods: We retrospectively reviewed recorded data on patients who underwent HoLEP between June 2002 and February 2005. Ninety-six patients were enrolled. Demographic, perioperative, and postoperative data were recorded. On follow-up, International Prostate Symptom Scores (IPSSs), prostate-specific antigen (PSA) levels, QoL scores, peak uroflowmetric data (Qmax values), and post-voiding residual urine volumes (PVR volumes), were recorded. Complications were scored using the Clavien system. Statistical significance was set at p<0.05. Results: The mean follow-up time was 41.8±34.6 months and the mean patient age 73.2±8.7 years. The mean prostate volume was 74.6±34.3mL. Significant improvements in Qmax values, QoL, and IPSSs and decreases in PSA levels and PVR volumes were noted during follow-up (all p values=0.001). The most common complication was a requirement for re-catheterisation because of urinary retention. Two patients had concomitant bladder tumours that did not invade the muscles. Eight patients (8.3%) required re-operations; three had residual adenoma, three urethral strictures, and two residual prostate tissue in the bladder. Stress incontinence occurred in one patient (1%). All complications were of Clavien Grade 3a. We noted no Clavien 3b, 4, or 5 complications during follow-up. Conclusions: HoLEP improved IPSSs, Qmax values, PVR volumes, and QoL and was associated with a low complication rate, during extended follow-up. Thus, HoLEP can be a viable option to transurethral resection of the prostate. PMID:27256184

  11. Preoperative Factors Affecting Postoperative Early Quality of Life During the Learning Curve of Holmium Laser Enucleation of the Prostate

    PubMed Central

    Cho, Kang Jun; Kim, Hyo Sin; Koh, Jun Sung; Han, Seung Bum; Kim, Sang Hoon; Kim, Hyun Woo; Cho, Su Yeon

    2013-01-01

    Purpose The aim of this study was to investigate the preoperative factors related to early quality of life (QoL) in patients with benign prostatic hyperplasia after holmium laser enucleation of the prostate (HoLEP) during the surgeon's learning curve. Methods The medical records of 82 patients with a follow-up period of at least 3 months who were treated with HoLEP during the time of a surgeon's learning curve were analyzed retrospectively. We divided the patients into two groups on the basis of the QoL component of the International Prostate Symptom Score (IPSS) 3 months after HoLEP: the high QoL group (IPSS/QoL≤3) and the low QoL group (IPSS/QoL≥4). Preoperative factors in each group were compared, including prostate volume, prostate-specific antigen, history of acute urinary retention (AUR), urgency incontinence, IPSS, and urodynamic parameters. Detrusor underactivity was defined as a bladder contractility index less than 100 on urodynamic study. Results A total of 61 patients (74.3%) had a high QoL, whereas 21 (25.7%) had a low QoL. A history of AUR, detrusor pressure on maximal flow (PdetQmax), bladder outlet obstruction grade, bladder contractility index, and detrusor underactivity were associated with postoperative QoL in the univariate analysis. In the multivariate analysis, a history of AUR and PdetQmax were independent factors affecting postoperative QoL. Conclusions A history of AUR and bladder contractility affect early QoL, and preoperative urodynamic study plays an important role in the proper selection of patients during the HoLEP learning curve. PMID:23869273

  12. Holmium Laser Enucleation of the Prostate: Comparison of Immediate Postoperative Outcomes in Patients with and without Antithrombotic Therapy

    PubMed Central

    Bishop, Conrad V.; Liddell, Heath; Ischia, Joseph; Paul, Eldho; Appu, Sree; Frydenberg, Mark; Pham, Trung

    2013-01-01

    Objective To compare the immediate postoperative outcomes of patients with benign prostatic hyperplasia undergoing Holmium laser enucleation of the prostate (HOLEP) with and without full anticoagulation or antiplatelet therapy at the time of surgery. Materials and Methods A retrospective review was performed on a series of consecutive patients undergoing HOLEP at our institution by a single surgeon from February 2004 to September 2010. Demographic, surgical, pathological and outcome data were collected. Two cohorts were identified on the basis of antithrombotic therapy at the time of surgery. Patients who continued on aspirin, aspirin/dipyridamole, clopidogrel and warfarin throughout the surgery were included in the antithrombotic cohort. Univariate analysis was performed to determine differences in outcomes between the 2 cohorts. Results Total 125 consecutive patients underwent HOLEP with 52 patients on antithrombotic therapy at the time of surgery and 73 patients were not on antithrombotic therapy during surgery. Patients in the antithrombotic group were older (75.1 ±7.5 vs. 71.7 ± 8.3 years; p = 0.02) and had a higher median ASA physical status (3 (3-3) vs. 2 (2-3), p < 0.0001). The mean operating time and median specimen volume were not significantly different between the 2 cohorts. The median length of stay (2 (1-3) vs. 1 (1-2) d, p = 0.014) was longer in the antithrombotic cohort. The transfusion rate (7.7 vs. 0%, p = 0.028) was predictably higher in the antithrombotic cohort. No patients required re-operation for bleeding. Conclusions The use of HOLEP in patients on antithrombotic therapy is safe despite the higher surgical risk profile of that particular patient population and the potential increased risk for significant bleeding. PMID:24917753

  13. Relationship of Postoperative Recatheterization and Intraoperative Bladder Distention Volume in Holmium Laser Enucleation of the Prostate for Benign Prostatic Hyperplasia

    PubMed Central

    Kim, Hyeon Jun; Lee, Han Yi; Song, Sang Hun

    2013-01-01

    Purpose The purpose of this study was to identify the risk factors for recatheterization after holmium laser enucleation of the prostate (HoLEP). Materials and Methods A total of 166 consecutive patients treated with HoLEP by a single surgeon from January 2010 to June 2011 were enrolled in this study. We collected data on preoperative and intraoperative parameters, including intraoperative bladder distention volume. The patients were divided into two groups. Group 1 included patients who voided successfully after removal of the catheter, and group 2 included patients who required recatheterization. Analysis and comparison of the perioperative parameters of both groups was performed for identification of risk factors for recatheterization. Results Recatheterization was required in 9 of 166 (5.4%) patients. No significant differences in age or preoperative parameters, including prostate-specific antigen, prostate volume, International Prostate Symptom Score, peak flow rate, postvoid residual urine, maximal bladder capacity, and Abrahams Griffiths number, were observed between the two groups. Of the intraoperative parameters, intraoperative bladder distention volume was significantly smaller in group 1 than in group 2 (700.65 mL vs. 897.78 mL, p<0.001). In the multivariate logistic regression analysis, after adjustment for other variables, intraoperative bladder distention volume was found to be a statistically significant risk factor for postoperative recatheterization (hazard ratio, 1.006; confidence interval, 1.002 to 1.010; p=0.002). Conclusions Nine of 166 (5.4%) patients failed to void after HoLEP and required catheterization. Intraoperative bladder distention volume was found to be a statistically significant risk factor for recatheterization in this patient group. PMID:23549294

  14. Postoperative Infectious Complications in Our Early Experience With Holmium Laser Enucleation of the Prostate for Benign Prostatic Hyperplasia

    PubMed Central

    Tanaka, Kazushi; Haraguchi, Takahiro; Yamamichi, Fukashi; Muramaki, Mototsugu; Miyake, Hideaki; Fujisawa, Masato

    2013-01-01

    Purpose The objective of this study was to retrospectively investigate postoperative infectious complications (PICs) in our early experience with holmium laser enucleation of the prostate (HoLEP) followed by mechanical morcellation for symptomatic benign prostatic hyperplasia. Materials and Methods A retrospective review was performed of the clinical data for 90 consecutive patients who underwent HoLEP at our institution between February 2008 and March 2011. All patients were evaluated for the emergence of PICs, including prophylactic antibiotic administration (PAA) and the influence of the kind or duration of PAA on PIC. The details of cases with PICs were also examined. Results The patients' mean age was 71 years (range, 50 to 95 years), and their mean prostate volume was 60 mL (range, 2 to 250 mL). There were 7 cases (7.78%) with PICs; in detail, 3 patients were diagnosed with prostatitis, 2 with pyelonephritis, and 2 with epididymitis. Three patients had positive urine cultures: 1 had Serratia marcescens/Proteus mirabilis, 1 had S. marcescens, and 1 had Klebsiella pneumonia; only one case had urological sepsis. Our statistical data showed no significant differences between 2 or fewer days and 3 or more days of PAA and PIC occurrence. There was also no significant effect on PIC occurrence of sulbactam/ampicillin compared with other antibiotics. Conclusions The results of this retrospective study showed that PIC occurrence did not depend on the duration or the kind of PAA. Further prospective study is necessary for the evaluation and establishment of prophylactic measures for PICs. PMID:23526729

  15. Towards optimizing prostate tissue retrieval following holmium laser enucleation of the prostate (HoLEP): Assessment of two morcellators and review of literature

    PubMed Central

    Elshal, Ahmed M.; Mekkawy, Ramy; Laymon, Mahmoud; El-Assmy, Ahmed; El-Nahas, Ahmed R.

    2015-01-01

    Introduction: We assess different approaches to retrieve the enucleated adenoma after transurethral enucleation of the prostate, particularly using the holmium laser. Methods: A retrospective review through our prospectively maintained database was performed looking for safety and efficacy of two morcellators. The enucleation phase of the holmium laser enucleation of the prostate (HoLEP) was classically performed followed by retrieval of the intravesical adenoma using either the Piranha (Wolf Inc., Knittlingen, Germany) or VersaCut (Lumenis) morcellator. A PubMed-MEDLINE search was conducted for all transurethral enucleation procedures and relevant data regarding methods of prostate tissue retrieval were extracted. Results: Strictly limiting the study to 3 reusable blades with each morcellator, we performed 67 and 55 consecutive procedures with Piranha and VersaCut, respectively. There was no significant difference between the two morcellators regarding perioperative complications, apart from 5 bladder mucosal injuries with the VersaCut (9%). Furthermore, there were similar retrieved tissue weight, mechanical problems-rate, catheter-time and hospital-stay in both morcellators. However, the Piranha morcellator needed significantly less morcellation-time, needed to use cold loop to remove non-morcellated pieces and to score the adenoma by laser for better bite of the adenoma, and had a higher median morcellation-rate 6.2 (rate: 2.8–12) g/min. Despite little reporting on morcellation, we had data on the tissue retrieval rate (2.6 to 6.5 g/min with Piranha and 1.9 to 11 g/min with VersaCut. Furthermore, bladder mucosal injury was reported in 1.4% and 0.7 to 5.7% with Piranha and VersaCut, respectively; bladder perforation with VersaCut was experienced in about 0.1 to 1.5% of patients. Our study is limited by its non-randomization. Conclusion: The Piranha morcellator was the most efficient and safe way to retrieve tissue after a transurethral enucleation of a prostate

  16. Holmium laser enucleation versus simple prostatectomy for treating large prostates: Results of a systematic review and meta-analysis

    PubMed Central

    Jones, Patrick; Alzweri, Laith; Rai, Bhavan Prasad; Somani, Bhaskar K.; Bates, Chris; Aboumarzouk, Omar M.

    2015-01-01

    Objective To compare and evaluate the safety and efficacy of holmium laser enucleation of the prostate (HoLEP) and simple prostatectomy for large prostate burdens, as discussion and debate continue about the optimal surgical intervention for this common pathology. Materials and methods A systematic search was conducted for studies comparing HoLEP with simple prostatectomy [open (OP), robot-assisted, laparoscopic] using a sensitive strategy and in accordance with Cochrane collaboration guidelines. Primary parameters of interest were objective measurements including maximum urinary flow rate (Qmax) and post-void residual urine volume (PVR), and subjective outcomes including International Prostate Symptom Score (IPSS) and quality of life (QoL). Secondary outcomes of interest included volume of tissue retrieved, catheterisation time, hospital stay, blood loss and serum sodium decrease. Data on baseline characteristics and complications were also collected. Where possible, comparable data were combined and meta-analysis was conducted. Results In all, 310 articles were identified and after screening abstracts (114) and full manuscripts (14), three randomised studies (263 patients) were included, which met our pre-defined inclusion criteria. All these compared HoLEP with OP. The mean transrectal ultrasonography (TRUS) volume was 113.9 mL in the HoLEP group and 119.4 mL in the OP group. There was no statistically significant difference in Qmax, PVR, IPSS and QoL at 12 and 24 months between the two interventions. OP was associated with a significantly shorter operative time (P = 0.01) and greater tissue retrieved (P < 0.001). However, with HoLEP there was significantly less blood loss (P < 0.001), patients had a shorter hospital stay (P = 0.03), and were catheterised for significantly fewer hours (P = 0.01). There were no significant differences in the total number of complications recorded amongst HoLEP and OP (P = 0.80). Conclusion The results of the meta

  17. Efficacy and Safety of 120-W Thulium:Yttrium-Aluminum-Garnet Vapoenucleation of Prostates Compared with Holmium Laser Enucleation of Prostates for Benign Prostatic Hyperplasia

    PubMed Central

    Hong, Kai; Liu, Yu-Qing; Lu, Jian; Xiao, Chun-Lei; Huang, Yi; Ma, Lu-Lin

    2015-01-01

    Background: This study compared the efficacy and safety between 120-W thulium:yttrium-aluminum-garnet (Tm:YAG) vapoenucleation of prostates (ThuVEP) and holmium laser enucleation of prostates (HoLEP) for patients with lower urinary tract symptoms (LUTS) due to benign prostatic hyperplasia (BPH). Methods: A retrospective analysis of 88 consecutive patients with symptomatic BPH was carried out, who underwent either 120-W ThuVEP or HoLEP nonrandomly. Patient demographics and peri-operative and 12-month follow-up data were analyzed with the International Prostate Symptom Score (IPSS), quality of life (QoL) score, maximum flow rate (Qmax), postvoid residual urine volume (PVR), and rates of peri-operative and late complications. Results: The patients in each group showed no significant difference in preoperative parameters. Compared with the HoLEP group, patients in the 120-W ThuVEP group required significantly shorter time for laser enucleation (58.3 ± 12.8 min vs. 70.5 ± 22.3 min, P = 0.003), and resulted in a significant superiority in laser efficiency (resected prostate weight/laser enucleation time) for 120-W Tm:YAG laser compared to holmium:YAG laser (0.69 ± 0.18 vs. 0.61 ± 0.19, P = 0.048). During 1, 6, and 12 months of follow-ups, the procedures did not demonstrate a significant difference in IPSS, QoL score, Qmax, or PVR (P > 0.05). Mean peri-operative decrease of hemoglobin in the HoLEP group was similar to the ThuVEP group (17.1 ± 12.0 g/L vs. 15.2 ± 10.1 g/L, P = 0.415). Early and late incidences of complications were low and did not differ significantly between the two groups of 120-W ThuVEP and HoLEP patients (P > 0.05). Conclusions: 120-W ThuVEP and HoLEP are potent, safe and efficient modalities of minimally invasive surgeries for patients with LUTS due to BPH. Compared with HoLEP, 120-W ThuVEP offers advantages of reduction of laser enucleation time and improvement of laser efficiency. PMID:25836607

  18. Transurethral holmium laser enucleation of prostates (HoLEP) larger than 80 g

    NASA Astrophysics Data System (ADS)

    Kuntz, Rainer M.; Lehrich, Karin; Fayad, Amr

    2001-05-01

    In this prospective study, the efficiency of HoLEP inpatients with prostates larger than 80 grams was to be evaluated. 64 urodynamically obstructed patients with prostate glands of 103 (80-230) grams of weight underwent HoLEP (80 W, 2.0 J, 40 Hz, 550 nm bare laser fibers). The resected weight was 70 (50-200) grams, the resection time was 120.5 (83-170) min., the average resection weight was 0.7 gm/min. The postoperative catheter time was 1.3 (1-3) days. The postoperative hospital stay was 2.5 (1-7) days. HoLEP induced a significant, pronounced and immediate improvement of lower urinary tract symptoms and micturition. The symptom score decreased from 22.3 preoperatively to 5.7 one week and 2.8 one year postoperatively. The peak urinary flow rate of 4.3 ml/sec preoperatively increased to 22 ml/sec one week and 32 ml/sec one year postoperatively. The residual urine dropped from 267 ml preoperatively to 11.5 ml one week and 5.0 ml one year postoperatively. There was one incident of postoperative arterial bleeding, one patient developed urethral stricture and two patients needed a second HoLEP. HoLEP appeared to be a highly effective treatment for prostates larger than 80 grams, with excellent functional results, minor blood loss, low complication rate and very short catheter time and hospital stay.

  19. Holmium Laser Enucleation of the Prostate With Percutaneous Nephrostomy Into the Transplanted Kidney in Patient With Severe Benign Prostatic Hyperplasia With Vesicoureteral Reflux - A Case Report.

    PubMed

    Nohara, Takahiro; Matsuyama, Satoko; Shima, Takashi; Kawaguchi, Shohei; Seto, Chikashi

    2016-01-01

    A 66-year-old male, who had received renal transplantation 10 years before, was admitted to our hospital with urinary retention. The prostate volume was 169.2 ml. Furthermore, grade 5 vesicoureteral reflux (VUR) was shown in the cystography. Holmium laser enucleation of prostate (HoLEP) was performed, and percutaneous nephrostomy to the transplanted kidney was performed simultaneously to prevent from severe perioperative infection. After that, renal graft function improved and no urinary retention reoccurred, although surgical repair against VUR was necessary 10 months after HoLEP. We conclude that surgical treatment for BPH after kidney transplantation should be strongly considered with care for infections. PMID:26793574

  20. Holmium Laser Enucleation of the Prostate With Percutaneous Nephrostomy Into the Transplanted Kidney in Patient With Severe Benign Prostatic Hyperplasia With Vesicoureteral Reflux – A Case Report

    PubMed Central

    Nohara, Takahiro; Matsuyama, Satoko; Shima, Takashi; Kawaguchi, Shohei; Seto, Chikashi

    2015-01-01

    A 66-year-old male, who had received renal transplantation 10 years before, was admitted to our hospital with urinary retention. The prostate volume was 169.2 ml. Furthermore, grade 5 vesicoureteral reflux (VUR) was shown in the cystography. Holmium laser enucleation of prostate (HoLEP) was performed, and percutaneous nephrostomy to the transplanted kidney was performed simultaneously to prevent from severe perioperative infection. After that, renal graft function improved and no urinary retention reoccurred, although surgical repair against VUR was necessary 10 months after HoLEP. We conclude that surgical treatment for BPH after kidney transplantation should be strongly considered with care for infections. PMID:26793574

  1. Efficacy and safety of holmium laser enucleation of the prostate for extremely large prostatic adenoma in patients with benign prostatic hyperplasia

    PubMed Central

    Kim, Myong; Piao, Songzhe; Lee, Hahn-Ey; Kim, Sung Han

    2015-01-01

    Purpose To evaluate the efficacy and safety of holmium laser enucleation of the prostate (HoLEP) for extremely large prostates. Materials and Methods Patients undergoing HoLEP between July 2008 and December 2013 from the Seoul National University Hospital Benign Prostatic Hyperplasia Database Registry were retrospectively analyzed. The patients were divided into three groups according to their total prostate volume (TPV): group A (TPV<100 mL), group B (100 mL≤TPV<200 mL), and group C (TPV≥200 mL); the clinical data of the three groups were compared. All patients were followed up 2 weeks, 3 months, and 6 months after surgery. Results A total of 502 patients (group A, 426; group B, 70; group C, 6) with a mean age of 69.0 (standard deviation, ±7.3) years were included in our analysis. The mean prostate volume and prostate-specific antigen level were 68.7±36.9 mL and 4.15±4.24 ng/mL, respectively. The enucleation and morcellation times were longer in group C (p<0.001), and the enucleation efficacy was higher in this group (p<0.001, R2=0.399). Moreover, the mean postoperative catheterization and hospitalization periods were significantly longer in group C (p=0.004 and p=0.011, respectively). However, there were no significant differences between the groups in any other postoperative events, including recatheterization, reoperation, urinary tract infection, clot retention, and bladder neck contracture (p range, 0.516-0.913). One patient in group C experienced recurrence of the urethral stricture. Conclusions HoLEP in patients with an extremely large prostate can be performed efficiently and safely. PMID:25763126

  2. Pilot study of the clinical efficacy of ejaculatory hood sparing technique for ejaculation preservation in Holmium laser enucleation of the prostate.

    PubMed

    Kim, M; Song, S H; Ku, J H; Kim, H-J; Paick, J-S

    2015-01-01

    We explored the effectiveness of ejaculatory hood sparing technique to Holmium laser enucleation of the prostate (HoLEP) for ejaculation preservation. From June 2010 to July 2011, 52 sexually active patients with sufficient ejaculate underwent HoLEP. Twenty-six patients received the ejaulatory hood sparing technique during HoLEP (EH-HoLEP group). The other 26 patients underwent conventional HoLEP (conventional-HoLEP group). In the EH-HoLEP group, paracollicular and supracollicular tissue >1 cm proximal to the verumontanum was preserved. The mean follow-up period was 9.7 months (range 3-12). There was no significant difference in patient characteristics and perioperative parameters, including age, prostate volume, International Index of Erectile Function score, operation time, weight of the enucleated tissue and the amount of laser energy. Semen was unchanged, decreased or vanished in 4 (15.4%), 8 (30.8%) and 17 (53.8%) EH-HoLEP patients, respectively. In the conventional-HoLEP group, semen was unchanged, decreased or vanished in 0 (0.0%%), 7 (26.9%) and 19 (73.1%) patients, respectively. Overall success rate of ejaculation preservation was 46.2% in the EH-HoLEP group and 26.9% in the conventional-HoLEP group (P = 0.249). Application of an ejaculatory hood sparing technique to HoLEP could not improve the success rate for ejaculation preservation. This was likely due to the surgical characteristics of HoLEP, which enable complete removal of the apical tissue. In this condition, simply preserved ejaculatory hood tissue seems not to be sufficient to obviate retrograde ejaculation. For the maintenance of antegrade ejaculation, it is postulated that a part of apical tissue should be preserved as well. PMID:25007827

  3. AB070. Comparison of photoselective vaporization versus holmium laser enucleation for treatment of benign prostate hyperplasia in a small prostate volume

    PubMed Central

    Bae, Woong Jin; Bashraheel, Fahad; Choi, Sae Woong; Kim, Su Jin; Yoon, Byung Il; Kim, Sae Woong

    2016-01-01

    Objective Photoselective vaporization of the prostate (PVP) using GreenLight and Holmium laser enucleation of the prostate (HoLEP) is an important surgical technique for management of benign prostate hyperplasia (BPH). We aimed to compare the effectiveness and safety of PVP using a 120 W GreenLight laser with HoLEP in a small prostate volume. Methods Patients who underwent PVP or HoLEP surgery for BPH at our institutions were reviewed from May 2009 to December 2014 in this retrospective study. Among them, patients with prostate volumes <40 mL based on preoperative trans-rectal ultrasonography were included in this study. Peri-operative and post-operative parameters—such as International Prostate Symptom Score (IPSS), quality of life (QoL), maximum urinary flow rate (Qmax), post-void residual urine volume (PVR), and complications—were compared between the groups. Results PVP was performed in 176 patients and HoLEP in162 patients. Preoperative demographic data were similar in both groups, with the exception of PVR. Operative time and catheter duration did not show significant difference. Significant improvements compared to preoperative values were verified at the postoperative evaluation in both groups in terms of IPSS, QoL, Qmax, and PVR. Comparison of the postoperative parameters between the PVP and HoLEP groups demonstrated no significant difference, with the exception of IPSS voiding subscore at one month postoperatively (5.9 vs. 3.8, P<0.001). There was no significant difference in postoperative complications between the two groups. Conclusions Our data suggest that PVP and HoLEP are efficient and safe surgical treatment options for patients with small prostate volume.

  4. Application of the Modified Clavien Classification System to 402 Cases of Holmium Laser Enucleation of the Prostate for Benign Prostatic Hyperplasia

    PubMed Central

    Choi, Jong In; Moon, Kyung Young; Yoon, Jong Hyun; Na, Woong

    2014-01-01

    Purpose We attempted to evaluate the perioperative complications of holmium laser enucleation of the prostate (HoLEP) for benign prostatic hyperplasia by using the modified Clavien classification system (MCCS). Materials and Methods Targeting 402 patients who underwent HoLEP for benign prostatic hyperplasia performed by a single surgeon between July 2008 and January 2011, we investigated complications that occurred during and within 1 month after surgery and classified them into grade I to grade V on the basis of the MCCS. If two or more complications occurred in one patient, each complication was graded and counted. Results The mean age, prostate volume, operation time, hospital stay, and average follow-up period of 402 patients who underwent HoLEP were 68.8 years (range, 52-84 years), 53.2 g (range, 23-228 g), 58.2 minutes (range, 20-230 minutes), 4.5 days (range, 2-7 days), and 9 months (range, 4-27 months), respectively; 78 complications occurred in 71 of the patients (morbidity rate, 17.6%). In MCCS grade I, complications occurred in 54 cases (69.2%); in grade II, complications occurred in 19 cases (24.3%); in grade III, complications occurred in 4 cases (5.1%); and in grade IV, 1 patient required intensive care unit care because of cerebral infarction (1.2%). There were no grade V complications. Conclusions The HoLEP-based MCCS complications classification was performed very quickly. However, MCCS, when compared with other measures of endoscopic prostate surgery experiences, including HoLEP, exposed the lack of accuracy in low grade classification and the inability to include late complications. PMID:24648872

  5. Holmium Laser Enucleation of the Prostate is Effective in the Treatment of Symptomatic Benign Prostatic Hyperplasia of Any Size Including a Small Prostate

    PubMed Central

    Lee, Min Ho; Yang, Hee Jo; Kim, Doo Sang; Lee, Chang Ho

    2014-01-01

    Purpose Although transurethral resection of the prostate (TURP) is considered the standard surgical treatment for benign prostatic hyperplasia (BPH), Holmium laser enucleation of the prostate (HoLEP) is replacing TURP. We compared TURP with HoLEP with matching for prostate size. Materials and Methods We retrospectively reviewed the medical charts of patients who underwent TURP and HoLEP performed by one surgeon at our institute. All patients were categorized into 3 groups on the basis of prostate size (group 1, <40 g; group 2, 40-79 g; and group 3, >80 g), and 45 patients were selected for each method. Results No major intraoperative complications were encountered. The mean resected tissue weight was 6.3, 18.3, and 28.0 g for groups 1, 2, and 3, respectively, for TURP and 8.7, 25.0, and 39.8 g, respectively, for HoLEP. The mean operation time was 51.8, 89.3, and 101.9 minutes for TURP and 83.6, 122.8, and 131.2 minutes for HoLEP in groups 1, 2, and 3, respectively. HoLEP had better resection efficacy than TURP for any size prostate, but there was no statistical difference between the methods. Both methods resulted in an immediate and significant improvement of International Prostate Symptom Score, peak urinary flow rates, and postvoid residual urine volume. Conclusions HoLEP is effective for BPH treatment, regardless of prostate size, even in a small prostate. The perioperative morbidity of HoLEP is also comparable to that of TURP. PMID:25405016

  6. Nonspecific Genitourinary Pain Improves after Prostatectomy Using Holmium Laser Enucleation of Prostate in Patients with Benign Prostatic Hyperplasia: A Prospective Study

    PubMed Central

    Kim, Sung Han; Oh, Seung-June

    2014-01-01

    Objective To investigate changes in nonspecific genitourinary discomfort or pain (GUDP) before and after holmium laser enucleation of prostate (HoLEP). GUDP associated with lower urinary tract symptoms (LUTS) is a common complaint among benign prostatic hyperplasia (BPH) patients, but very little is known about this clinical entity. Methods From February 2010 to August 2011, 100 HoLEP patients with complete clinical data at a single institution were enrolled in the study to analyze the degree of GUDP with a visual analog scale (VAS) from 0 to 10 points at baseline and at 3 and 6 months postoperatively, and to investigate any relationships between GUDP and urodynamics, uroflowmetry, and scores from the International Prostate Symptom Score (IPSS) questionnaire. Results Fifty-six patients had LUTS only, while the remaining 44 had both LUTS and GUDP. Pain was located in the suprapubic (42.0%), perineal/penile (33.0%), back (17.0%), and perianal (8.0%) regions. During the post-operative period, at six months, the VAS, IPSS, peak flow rate and post-void residual volume had improved significantly in 44 GUDP patients (p<0.010). GUDP had completely resolved in 40 (90.9%) patients and had decreased in four (9.1%) patients, while seven (12.5%) patients developed GUDP with voiding in the urethral and perineal areas by the third month postoperatively. When compared to patients with complete resolution, those with persistent GUDP were found to have a significantly higher preoperative presence of bladder outlet obstruction (BOO) as an independent risk factor (OR 6.173, 95% CI 1.132–1.323). Conclusion Both GUDP and LUTS improved significantly after HoLEP. Patients with significant preoperative BOO tended to have persistent GUDP after surgery. PMID:24901224

  7. Comparison of Predictive Factors for Postoperative Incontinence of Holmium Laser Enucleation of the Prostate by the Surgeons’ Experience During Learning Curve

    PubMed Central

    Tanaka, Kazushi; Yamamichi, Fukashi; Chiba, Koji; Fujisawa, Masato

    2016-01-01

    Purpose: To detect predictive factors for postoperative incontinence following holmium laser enucleation of the prostate (HoLEP) according to surgeon experience (beginner or experienced) and preoperative clinical data. Methods: Of 224 patients, a total of 203 with available data on incontinence were investigated. The potential predictive factors for post-HoLEP incontinence included clinical factors, such as patient age, and preoperative urodynamic study results, including detrusor overactivity (DO). We also classified the surgeons performing the procedure according to their HoLEP experience: beginner (<21 cases) and experienced (≥21 cases). Results: Our statistical data showed DO was a significant predictive factor at the super-short period (the next day of catheter removal: odds ratio [OR], 3.375; P=0.000). Additionally, patient age, surgeon mentorship (inverse correlation), and prostate volume were significant predictive factors at the 1-month interval after HoLEP (OR, 1.072; P=0.004; OR, 0.251; P=0.002; and OR, 1.008; P=0.049, respectively). With regards to surgeon experience, DO and preoperative International Prostate Symptom Score (inverse) at the super-short period, and patient age and mentorship (inverse correlation) at the 1-month interval after HoLEP (OR, 3.952; P=0.002; OR, 1.084; P=0.015; and OR,1.084; P=0.015; OR, 0.358; P=0.003, respectively) were significant predictive factors for beginners, and first desire to void (FDV) at 1 month after HoLEP (OR, 1.009; P=0.012) was a significant predictive factor for experienced surgeons in multivariate analysis. Conclusions: Preoperative DO, IPSS, patient age, and surgeon mentorship were significant predictive factors of postoperative patient incontinence for beginner surgeons, while FDV was a significant predictive factors for experienced surgeons. These findings should be taken into account by surgeons performing HoLEP to maximize the patient’s quality of life with regards to urinary continence. PMID

  8. Holmium Laser Enucleation versus Transurethral Resection in Patients with Benign Prostate Hyperplasia: An Updated Systematic Review with Meta-Analysis and Trial Sequential Analysis

    PubMed Central

    Ruan, Xiao-Lan; Weng, Hong; Liu, Tong-Zu; Wang, Xiao; Zhang, Chao; Meng, Zhe; Wang, Xing-Huan

    2014-01-01

    Background Holmium laser enucleation (HoLEP) in surgical treatment of benign prostate hyperplasia (BPH) potentially offers advantages over transurethral resection of the prostate (TURP). Methods Published randomized controlled trials (RCTs) were identified from PubMed, EMBASE, Science Citation Index, and the Cochrane Library up to October 10, 2013 (updated on February 5, 2014). After methodological quality assessment and data extraction, meta-analysis was performed using STATA 12.0 and Trial Sequential Analysis (TSA) 0.9 software. Results Fifteen studies including 8 RCTs involving 855 patients met the criteria. The results of meta-analysis showed that: a) efficacy indicators: there was no significant difference in quality of life between the two groups (P>0.05), but compared with the TURP group, Qmax was better at 3 months and 12 months, PVR was less at 6, 12 months, and IPSS was lower at 12 months in the HoLEP, b) safety indicators: compared with the TURP, HoLEP had less blood transfusion (RR 0.17, 95% CI 0.06 to 0.47), but there was no significant difference in early and late postoperative complications (P>0.05), and c) perioperative indicators: HoLEP was associated with longer operation time (WMD 14.19 min, 95% CI 6.30 to 22.08 min), shorter catheterization time (WMD −19.97 h, 95% CI −24.24 to −15.70 h) and hospital stay (WMD −25.25 h, 95% CI −29.81 to −20.68 h). Conclusions In conventional meta-analyses, there is no clinically relevant difference in early and late postoperative complications between the two techniques, but HoLEP is preferable due to advantage in the curative effect, less blood transfusion rate, shorter catheterization duration time and hospital stay. However, trial sequential analysis does not allow us to draw any solid conclusion in overall clinical benefit comparison between the two approaches. Further large, well-designed, multicentre/international RCTs with long-term data and the comparison between the two approaches remain open

  9. Holmium laser pumped with a neodymium laser

    SciTech Connect

    Bowman, S.R.; Rabinovich, W.S.

    1991-07-30

    This patent describes a solid-state laser device. It comprises a holmium laser having a first host material doped with an amount of holmium ions sufficient to produce an output laser emission at about 3 {mu}m when the holmium ions in the holmium laser are pumped by a pump beam at a wavelength of about 1.1 {mu}m; and neodymium laser pump source means for supplying a pump beam to pump the holmium ions in the holmium laser at a wavelength of about 1.1 {mu}m.

  10. Holmium laser for treatment of benign prostatic hyperplasia: old wine in a new bottle?

    NASA Astrophysics Data System (ADS)

    Nelius, Thomas; de Riese, Werner T. W.

    2003-06-01

    Urinary tract symptoms related to benign prostatic hyperplasia affect 70% of men older than 70 years. Complications are common problems and a significant cause of morbidity in this population, placing a considerable burden on health services. In the early 1990s laser treatment of benign prostatic hyperplasia became widely used after the introduction of the side-firing neodym: YAG laser. However, because of technical limitations and inferior results compared to classical transurethral resection of the prostate many Urologists became desinterested in this device. With the introduction of the holmium: YAG laser a new laser generation became available for use in Urology. Beside several other applications the holmium: YAG laser can be used for incision, ablation, resection, and more recently enucleation of the prostate. In this paper we reviewed the current literature regarding the holmium: YAG laser resection and enucleation of the prostate compared to transurethral resection of the prostate and open prostatectomy. The holmium: YAG laser technique is an effective and durable surgical alternative to standard transurethral resection of the prostate. Interestingly, enucleation of the prostate with this device seems to be a safe and effective procedure for large prostatic adenomas, it may become an attractive alternative to open prostatectomy.

  11. Holmium:YAG surgical lasers.

    PubMed

    1995-03-01

    "Holmium:YAG (Ho:YAG)" is the shorthand name for a family of solid-state lasers that use the doping element holmium in a laser crystal (e.g., YAG [yttrium-aluminum-garnet]) and that emit energy at approximately 2.1 microns. This wavelength is relatively new to medicine and has been used in laser surgery for only about the last six years. Like the carbon dioxide (CO2) laser when it was first used clinically, the Ho:YAG laser is poised for rapid and wide-spread use. Ho:YAG lasers, like CO2 lasers, offer precise cutting with minimal damage to adjacent tissue; however, unlike CO2 lasers, they also offer fiberoptic delivery (which is ideal for endoscopic use) and the ability to treat tissue in a liquid-filled environment (e.g., saline, blood). The initial specialty for which the Ho:YAG laser was used was arthroscopic surgery, especially diskectomy. Today, it is effectively used in many surgical specialties, including general surgery, urology, laparoscopy, neurosurgery, lithotripsy, angioplasty, orthopedic surgery (which includes procedures such as meniscectomy, bone sculpting [may also be performed in plastic surgery], and some experimental surgery, such as cartilage shrinking to tighten loose joints), and dentistry. Because of its broad range of potential applications, it has been called the "Swiss Army Knife" of lasers. High-powered Ho:YAG lasers, which enable surgeons to work more quickly and cut more smoothly, have been made available only within the last three years (units offering > 20 W) to 18 months (units offering > 60 W). Because of this rapid increase, high-powered units are still relatively expensive, and it is not yet clear whether maximum power outputs will continue to increase or whether the cost of higher-power units will begin to come down. Although low-power and high-power Ho:YAG lasers can be used for the same procedures, their different ranges of possible clinical techniques make them better suited to different applications: low-power units are

  12. Early complications with the holmium laser

    NASA Astrophysics Data System (ADS)

    Beaghler, Marc A.; Stewart, Steven C.; Ruckle, Herbert C.; Poon, Michael W.

    1997-05-01

    The purpose of this study is to report early complications in our initial experience with the holmium laser in 133 patients. A retrospective study of patients undergoing endourological procedures with the holmium laser was performed. Complications included urinary tract infection (3), post-operative bradycardia (1), inverted T-waves (1), intractable flank pain (1), urinary retention (1), inability to access a lower pole calyx with a 365 micron fiber (9), stone migration (5), termination of procedure due to poor visualization (2). No ureteral perforations or strictures occurred. The holmium laser was capable of fragmenting all urinary calculi in this study. In our initial experience, the holmium laser is safe and effective in the treatment of genitourinary pathology. Use of laser fibers larger than 200 microns occasionally limit deflection into a lower pole or dependent calyx.

  13. Semiconductor disk laser-pumped subpicosecond holmium fibre laser

    SciTech Connect

    Chamorovskiy, A Yu; Marakulin, A V; Leinonen, T; Kurkov, Andrei S; Okhotnikov, Oleg G

    2012-01-31

    The first passively mode-locked holmium fibre laser has been demonstrated, with a semiconductor saturable absorber mirror (SESAM) as a mode locker. Semiconductor disk lasers have been used for the first time to pump holmium fibre lasers. We obtained 830-fs pulses at a repetition rate of 34 MHz with an average output power of 6.6 mW.

  14. [A Case of Holmium: YAG Laser Resection of Superficial Bladder Tumor (HoLRBT)].

    PubMed

    Sugita, Yoshiko; Shitara, Toshiya; Hirayama, Takahiro; Fujita, Tetsuo; Yoshida, Kazunari; Kubo, Seiichi; Iwamura, Masatsugu

    2015-10-01

    We present a case of holmium : YAG laser resection of superficial bladder tumor (HoLRBT). A 73-year-old male was referred to our hospital with elevated prostatic specific antigen. Due to difficulty of urination, holmium : YAG laser enucleation of the prostate was performed under the diagnosis of benign prostatic hyperplasia. During the surgery, superficial bladder tumor was incidentally identified, and HoLRBT was performed. After the operation, histopathological examination revealed urothelial carcinoma, G2 > G1, pTa. The patient has been subsequently followed up for 9 months, and there areno evidence of recurrence. Changing the holmium : YAG laser energy setting can potentially be effective and safe to approach a superficial bladder tumor. PMID:26563623

  15. Evaluation of holmium laser for transurethral deroofing of severe and multiloculated prostatic abscesses

    PubMed Central

    Lee, Chan Ho; Ku, Ja Yoon; Park, Young Joo; Lee, Jeong Zoo

    2015-01-01

    Purpose Our objective was to evaluate the use of a holmium laser for transurethral deroofing of a prostatic abscess in patients with severe and multiloculated prostatic abscesses. Materials and Methods From January 2011 to April 2014, eight patients who were diagnosed with prostatic abscesses and who underwent transurethral holmium laser deroofing at Pusan National University Hospital were retrospectively reviewed. Results Multiloculated or multifocal abscess cavities were found on the preoperative computed tomography (CT) scan in all eight patients. All patients who underwent transurethral holmium laser deroofing of a prostatic abscess had successful outcomes, without the need for secondary surgery. Of the eight patients, seven underwent holmium laser enucleation of the prostate (HoLEP) for the removal of residual adenoma. Markedly reduced multiloculated abscess cavities were found in the follow-up CT in all patients. No prostatic abscess recurrence was found. Transient stress urinary incontinence was observed in three patients. The stress urinary incontinence subsided within 3 weeks in two patients and improved with conservative management within 2 months in the remaining patient. Conclusions Transurethral holmium laser deroofing of prostatic abscesses ensures successful drainage of the entire abscess cavity. Because we resolved the predisposing conditions of prostatic abscess, such as bladder outlet obstruction and prostatic calcification, by simultaneously conducting HoLEP, there was no recurrence of the prostatic abscesses after surgery. We recommend our method in patients requiring transurethral drainage. PMID:25685303

  16. Holmium laser for multifunctional use in urology

    NASA Astrophysics Data System (ADS)

    Watson, Graham M.; Shroff, Sunil; Thomas, Robert; Kellett, Michael

    1994-05-01

    The holmium laser pulsed at 350 microsecond cuts tissue and fragments calculi. It has been assessed for minimally invasive urological intervention. It is useful for partly excising and partly coagulating tumors, incising strictures and the obstructed PUJ. It partly drill and partly fragments urinary calculi however hard. Other lasers are more effective at any one particular application, but this laser is a useful compromise as a multifunctional device.

  17. Holmium laser lithotripsy of bladder calculi

    NASA Astrophysics Data System (ADS)

    Beaghler, Marc A.; Poon, Michael W.

    1998-07-01

    Although the overall incidence of bladder calculi has been decreasing, it is still a significant disease affecting adults and children. Prior treatment options have included open cystolitholapaxy, blind lithotripsy, extracorporeal shock wave lithotripsy, and visual lithotripsy with ultrasonic or electrohydraulic probes. The holmium laser has been found to be extremely effective in the treatment of upper tract calculi. This technology has also been applied to the treatment of bladder calculi. We report our experience with the holmium laser in the treatment of bladder calculi. Twenty- five patients over a year and a half had their bladder calculi treated with the Holmium laser. This study was retrospective in nature. Patient demographics, stone burden, and intraoperative and post-operative complications were noted. The mean stone burden was 31 mm with a range of 10 to 60 mm. Preoperative diagnosis was made with either an ultrasound, plain film of the abdomen or intravenous pyelogram. Cystoscopy was then performed to confirm the presence and determine the size of the stone. The patients were then taken to the operating room and given a regional or general anesthetic. A rigid cystoscope was placed into the bladder and the bladder stone was then vaporized using the holmium laser. Remaining fragments were washed out. Adjunctive procedures were performed on 10 patients. These included transurethral resection of the prostate, transurethral incision of the prostate, optic internal urethrotomy, and incision of ureteroceles. No major complications occurred and all patients were rendered stone free. We conclude that the Holmium laser is an effective and safe modality for the treatment of bladder calculi. It was able to vaporize all bladder calculi and provides a single modality of treating other associated genitourinary pathology.

  18. Holmium: YAG laser resection of the prostate.

    PubMed

    Bukala, B; Denstedt, J D

    1999-04-01

    The holmium laser is a relatively new multipurpose medical laser that recently became available for use in urology. There has been considerable interest in this device, as it seems to combine the cutting properties of the carbon dioxide laser with the coagulating properties of the neodymium:YAG laser, making it particularly appealing for many surgical applications. The last decade has seen enthusiasm for the use of laser energy for the treatment of benign prostatic hyperplasia. In this article, we review the technique of Ho:YAG laser resection of the prostate, including the essential equipment and perioperative patient care. PMID:10360503

  19. Holmium fibre laser with record quantum efficiency

    SciTech Connect

    Kurkov, Andrei S; Sholokhov, E M; Tsvetkov, V B; Marakulin, A V; Minashina, L A; Medvedkov, O I; Kosolapov, A F

    2011-06-30

    We report holmium-doped fibre lasers with a Ho{sup 3+} concentration of 1.6 x 10{sup 19} cm{sup -3} and lasing wavelengths of 2.02, 2.05, 2.07 and 2.1 {mu}m at a pump wavelength of 1.15 {mu}m. The slope efficiency of the lasers has been measured. The maximum efficiency, 0.455, has been obtained at a lasing wavelength of 2.05 {mu}m. The laser efficiency is influenced by both the optical loss in the wing of a vibrational absorption band of silica and active-ion clustering. (lasers)

  20. Percutaneous holmium laser fulguration of calyceal diverticula.

    PubMed

    Alwaal, Amjad; Azhar, Raed A; Andonian, Sero

    2012-01-01

    Introduction. Calyceal diverticular stones are uncommon findings that represent a challenge in their treatment, due to the technical difficulty in accessing the diverticulum, and the high risk of their recurrence. Current percutaneous technique for calyceal diverticular stones involves establishing a renal access, clearing the stone, and fulguration of the diverticular lining with a roller-ball cautery electrode using hypotonic irrigation solution such as sterile water or glycine solution which may be associated with the absorption of hypotonic fluids with its inherent electrolyte disturbances. Case Report. In this paper, we present for the first time percutaneous holmium laser fulguration of calyceal diverticula in 2 patients using normal saline. Their immediate postoperative sodium was unchanged and their follow-up imaging showed absence of stones. Both patients remain asymptomatic at 30 months post-operatively. Conclusion. This demonstrates that holmium laser is a safe alternative method to fulgurate the calyceal diverticulum after clearing the stone percutaneously. PMID:22606636

  1. Percutaneous laser disc decompression with the holmium: YAG laser.

    PubMed

    Casper, G D; Hartman, V L; Mullins, L L

    1995-06-01

    This article discusses the evolution of the percutaneous laser disc decompression (PLDD) method using a holmium:YAG laser. Advantages of using this wavelength and several techniques for its use in PLDD are reviewed. The article also discusses the current devices and delivery systems available for this application. PMID:10150646

  2. Holmium laser resection of the prostate.

    PubMed

    Matsuoka, K; Iida, S; Tomiyasu, K; Shimada, A; Suekane, S; Noda, S

    1998-06-01

    A total of 35 patients with benign prostatic hyperplasia (BPH) were treated with the Ho: YAG laser using a new technique termed holmium laser resection of the prostate or HoLRP. The laser energy was applied directly to prostatic tissue exclusively through the use of a standard 550 micron end-firing fiber. A high-powered holmium laser was used and was set at 2.4 J per pulse at 25 pulses per second for an average power of 60 W. The mean preoperative AUA Symptom Score was 24. Postoperatively, the score dropped to 10.9, 8.2, 5.2, and 4.6 at 1 week, 1 month, 3 months, and 6 months, respectively. The peak urine flow rate improved from 6.3 mL/sec preoperatively to 15.1, 15.3 and 16 mL/sec at 1 week, 1 month, 3 months, and 6 months. A foley catheter was removed within 24 hours of completion of the operation in 31 patients (89%), and voiding was improved. The HoLRP technique was bloodless, and the short-term results were satisfactory. Most importantly, the defect produced by HoLRP is identical to that of a conventional transurethral resection. These initial results demonstrate that HoLRP is a useful surgical alternative in the treatment of patients with obstructive BPH. PMID:9658303

  3. Perspectives of holmium laser resection of the prostate: cutting effects with the holmium:YAG laser

    NASA Astrophysics Data System (ADS)

    Eichenauer, Rolf H.; Droege, Gerit; Brinkmann, Ralf; Neuss, Malte; Gafumbegete, Evariste; Jocham, Dieter

    1998-07-01

    Laser prostatectomy shows an improvement in peak urinary flow rates, in post-void residual urine volumes and also a symptomatic improvement when compared to the transurethral resection of the prostate (TUR-P). Time to achieve symptomatic improvement is delayed with many established laser procedures compared to standard resection. However, this disadvantage can be solved with a new resection technique using a pulsed holmium laser. Nevertheless, this advanced technique shows a few problems in a first clinical trial. Besides this clinical study, in vitro experiments were carried out in order to determine the optimal irradiation parameters with respect to resection rate, incision/ablation quality and handling. Prostate tissue of radical prostatectomies and chicken breast as model were irradiated with a pulsed holmium-laser in vitro with different laser parameters using a bare fiber in contact to tissue. The incision quality (depths and coagulation/vaporization effects) was analyzed with regard to pulse energy (speed of incision, angle of incision) and fiber diameter. Fast flash photography was performed to analyze thermo-mechanical side-effects. Fast flash photography reveals cavitation bubble up to 7 mm length in water and dissections in tissue. The ablation rate increases proportional to the laser pulse energy. The Holmium Laser Resection of the Prostate (HOLRP) in humans with available instrumentation right now shows equieffective results compared to the transurethral resection, no need for transfusion, no transurethral resection syndrome, short time for catheterization. Further technical approvement may significantly improve holmium laser prostate resection. We present a new application system for the laser resection.

  4. Holmium:YAG laser stapedotomy: preliminary evaluation

    NASA Astrophysics Data System (ADS)

    Stubig, Ingrid M.; Reder, Paul A.; Facer, G. W.; Rylander, Henry G.; Welch, Ashley J.

    1993-07-01

    This study investigated the use of a pulsed Holmium:YAG ((lambda) equals 2.09 micrometers ) laser- fiber microsurgical system for laser stapedotomy. This system ablates human stapes bones effectively with minimal thermal damage. The study was designed to determine the effectiveness of the Ho:YAG laser (Schwartz Electro Optics, Inc., Orlando, FL) for stapedotomy and to evaluate temperature changes within the cochlea during the ablation process. Human cadaveric temporal bones were obtained and the stapes portion of the ossicular chain was removed. A 200 micrometers diameter low OH quartz fiber was used to irradiate these stapes bones in an air environment. The laser was pulsed at 2 Hz, 250 microsecond(s) ec pulse width and an irradiance range of 100 - 240 J/cm2 was used to ablate holes in the stapes footplate. The resultant stapedotomies created had smooth 300 micrometers diameter holes with a minimum of circumferential charring. Animal studies in-vivo were carried out in chinchillas to determine the caloric spread within the cochlea. A 0.075 mm Type T thermocouple was placed in the round window. Average temperature change during irradiation of the stapes footplate recorded in the round window was 3.6 degree(s)C. The data suggest that stapedotomy using the Ho:YAG laser can result in a controlled ablation of the stapes footplate with minimal thermal damage to the surrounding stapes. Optical coupling using fiberoptic silica fibers is an ideal method for delivering laser energy to the stapes during stapedotomy.

  5. Laser cooling, trapping, and Rydberg spectroscopy of neutral holmium atoms

    NASA Astrophysics Data System (ADS)

    Hostetter, James Allen

    This thesis focuses on progress towards using ensembles of neutral holmium for use in quantum computing operations. We are particularly interested in using a switchable interaction between neutral atoms, the Rydberg blockade, to implement a universal set of quantum gates in a collective encoding scheme that presents many benefits over quantum computing schemes which rely on physically distinct qubits. We show that holmium is uniquely suited for operations in a collective encoding basis because it has 128 ground hyperfine states, the largest number of any stable, neutral atom. Holmium is a rare earth atom that is very poorly described for our purposes as it has never been cooled and trapped, its spectrum is largely unknown, and it presents several unique experimental challenges related to its complicated atomic structure and short wavelength transitions. We demonstrate important progress towards overcoming these challenges. We produce the first laser cooling and trapping of holmium into a MOT. Because we use a broad cooling transition, our cooling technique does not require the use of a Zeeman slower. Using MOT depletion spectroscopy, we provide precise measurements of holmium's Rydberg states and its ionization potential. Our work continues towards cooling holmium into a dipole trap by calculating holmium's AC polarizability and demonstrating the results of early attempts at an optical dipole trap. We provide details of future upgrades to the experimental apparatus and discuss interesting potential for using holmium in quantum computing using single atoms in a magnetically trapped lattice. This thesis shows several promising indicators for continued work in this field.

  6. Midline Prostatic Cyst Marsupialization Using Holmium Laser.

    PubMed

    Kilinc, Mehmet; Goger, Yunus Emre; Piskin, Mesut; Balasar, Mehmet; Kandemir, Abdulkadir

    2015-01-01

    Many of the prostatic cysts are asymptomatic and only 5% are symptomatic (Hamper et al., 1990; Higashi et al., 1990). These symptoms include pelvic pain, hematospermia, infertility, voiding dysfunction, prostatitis-like syndrome, and painful ejaculation. Treatment of prostatic cysts includes TRUSG guided drainage, endoscopic transurethral resection, and in some cases even open surgery. In the literature, endoscopic interventions use marsupialization of the midline prostatic cyst with transurethral resection (TUR) or transurethral incision with endoscopic urethrotomy (Dik et al., 1996; Terris, 1995). Holmium: YAG laser was employed for the marsupialization of the cyst wall in midline prostatic cyst treatment for the first time in the present study. Symptoms, treatment, and follow-up are presented in this paper. PMID:26101688

  7. Midline Prostatic Cyst Marsupialization Using Holmium Laser

    PubMed Central

    Kilinc, Mehmet; Goger, Yunus Emre; Piskin, Mesut; Balasar, Mehmet; Kandemir, Abdulkadir

    2015-01-01

    Many of the prostatic cysts are asymptomatic and only 5% are symptomatic (Hamper et al., 1990; Higashi et al., 1990). These symptoms include pelvic pain, hematospermia, infertility, voiding dysfunction, prostatitis-like syndrome, and painful ejaculation. Treatment of prostatic cysts includes TRUSG guided drainage, endoscopic transurethral resection, and in some cases even open surgery. In the literature, endoscopic interventions use marsupialization of the midline prostatic cyst with transurethral resection (TUR) or transurethral incision with endoscopic urethrotomy (Dik et al., 1996; Terris, 1995). Holmium: YAG laser was employed for the marsupialization of the cyst wall in midline prostatic cyst treatment for the first time in the present study. Symptoms, treatment, and follow-up are presented in this paper. PMID:26101688

  8. Holmium laser urethrotomy for urethral stricture.

    PubMed

    Hossain, A Z M Z; Khan, S A; Hossain, S; Salam, M A

    2004-08-01

    A prospective cross-sectional study was carried-out in the department of urology, Dhaka Medical College Hospital (DMCH) to evaluate the outcome of Laser urethrotomy for the treatment of urethral stricture. For this purpose, 30 male patients aged 15 to 60 years with short segment anterior urethral stricture (>2cm) were treated by HO:YAG Laser. The energy used for this purpose was 0.8 to 1.5 joules by LISA 80 Watt Holmium Laser machine. All patients were catheterized for less than 24 hours and were followed up for 6 to 12 months postoperatively by uroflowmetry and by retrograde with voiding cystourethrogram 3 monthly. The study revealed that out of 30 patients, 27(90%) showed good flow of urine (Qave>16.0 ml/sec) and adequate caliber urethra in retrograde urethrogram (RGU). Only 3(10%) patients showed narrow stream of urine (Qave<8.0 ml/sec) and recurrent stricture in RGU which were managed by optical internal urethrotomy (OIU) and clean intermittent self catheterization (CISC). The study showed satisfactory results in 90% cases with short term follow up. The study concludes that HO:YAG Laser urethrotomy for the treatment of short segment urethral stricture is highly effective. The study further reveals that the method is simple, safe and thus, it can be considered favorably as a new therapeutic option for the treatment of urethral stricture. However, long term follow up is necessary for making a final comment on this issue. PMID:15813486

  9. Spectral performance of monolithic holmium and thulium lasers

    NASA Technical Reports Server (NTRS)

    Storm, Mark E.

    1991-01-01

    Fabry-Perot resonators have been used to demonstrate single-mode lasing of holmium and neodymium YAG. The previous demonstration in the holmium laser required TE cooling the crystal to -15 C in order to achieve threshold. The present study extends that result, demonstrating +25 C operation in a 1-mm thick plano/plano resonator. The experimental configuration of lasing both the holmium and thulium lasers used a 500-mW diode laser which was collimated, circularized, and focused into a beam radius of 60 microns. The single-frequency lasing spectrum of the holmium laser is shown. By adjusting the mirror reflectivity, the ability to control the laser's wavelength is demonstrated. This laser operated with 11 mW of optical power, a 57-percent slope efficiency, and 120-mW threshold vs absorbed diode power laser for the 60-micron beam radius. The thulium laser operated very efficiently at room temperature, but on seven longitudinal modes. The Tm:TAG laser exhibits typical characteristics of spatial hole burning not seen in the Ho:Tm:YAG for flat/flat resonators.

  10. Hemangioma of the prostatic urethra: holmium laser treatment.

    PubMed

    de León, Javier Ponce; Arce, Jacobo; Gausa, Luís; Villavicencio, Humberto

    2008-01-01

    Urethral hemangiomas are benign vascular tumors that are found in perimontanal prostatic localization and less frequently in the urethra. Although different urethral procedures have been postulated for its treatment, the best results are achieved using lasers. A patient who underwent endoscopic holmium laser treatment for such hemangiomas is presented. Total disappearance of the lesions without any complications was achieved. PMID:18204245

  11. Use of the holmium:YAG laser in urology

    NASA Astrophysics Data System (ADS)

    Mattioli, Stefano

    1997-12-01

    The Holmium-YAG is a versatile laser with multiple soft- tissue applications including tissue incision and vaporization, and pulsed-laser applications such as lithotripsy. At 2140 nanometers, the wavelength is highly absorbed by tissue water. Further, like CO2 laser, the Holmium produces immediate tissue vaporization while minimizing deep thermal damage to surrounding tissues. It is an excellent instrument for endopyelotomy, internal urethrotomy, bladder neck incisions and it can be used to resect the prostate. The Holmium creates an acute TUR defect which gives immediate results like the TURP. More than 50 patients were treated from Jan. 1996 to Jan. 1997 for obstructive symptoms due to benign prostatic hyperplasia, bladder neck stricture, urethral stenosis, and superficial bladder tumors.

  12. Holmium:YAG laser coronary angioplasty in acute myocardial infarction

    NASA Astrophysics Data System (ADS)

    Topaz, On; Luxenberg, Michael; Schumacher, Audrey

    1994-07-01

    Patients who sustain complicated acute myocardial infarction in whom thrombolytic agents either fail or are contraindicated often need mechanical revascularization other than PTCA. In 24 patients with acute infarction complicated by continuous chest pain and ischemia who either received lytics or with contraindication to lytics, a holmium:YAG laser (Eclipse Surgical Technologies, Palo Alto, CA) was utilized for thrombolysis and plaque ablation. Clinical success was achieved in 23/24 patients, with 23 patients (94%) surviving the acute infarction. Holmium:YAG laser is very effective and safe in thrombolysis and revascularization in this complicated clinical setting.

  13. Holmium YAG laser treatment of superficial bladder carcinoma.

    PubMed

    Hossain, M Z; Khan, S A; Salam, M A; Hossain, S; Islam, R

    2005-01-01

    Holmium YAG laser is one of the new modalities of treatment of urinary bladder tumor. Thirty patients of superficial bladder carcinoma were selected from the Urology out patient department of Dhaka Medical College Hospital from January 2004 to July 2004. Among thirty cases, 18 were recurrent and 12 were primary superficial bladder carcinoma. Out of thirty patients, 24 were male and six were female. Patients were treated with Holmium YAG laser under spinal anesthesia. Before resection, cold cup biopsy were taken from the apex and after resection of the tumor, another cold cup biopsy were taken from the base of the tumor. Holmium YAG laser therapy was given with a 550 micron end firing quartz laser fiber through the working element of resectoscope. Small tumors (< 1 cm) were ablated and large tumors (1-4 cm) were resected. The initial laser setting was 0.5 to 0.8 J and 10 Hz. For resection of the tumor, a slightly higher energy of 1 to 1.2 J was used at 10 to 12 Hz. After resection, bleeding vessels were coagulated. The resected tumor was evacuated by Elik's evacuator. All cases were followed for 6 to 12 months by history, physical examination, urine analysis, sonogram and cystoscopy three monthly. Bleeding was minimum during the procedure and no transfusion was required. Complications like obturator jerk, clot retention or perforation were not developed. No recurrence was found during the 6 to 12 months follow up period. The procedure was found safe, effective, and acceptable. The study was conducted to evaluate the initial result of Holmium YAG laser for the treatment of superficial bladder carcinoma. We warrants further studies in this regard. PMID:15695945

  14. Femtosecond laser based enucleation of porcine oocytes for somatic cell nuclear transfer

    NASA Astrophysics Data System (ADS)

    Kütemeyer, K.; Lucas-Hahn, A.; Petersen, B.; Hassel, P.; Lemme, E.; Niemann, H.; Heisterkamp, A.

    2009-07-01

    Cloning of several mammalian species has been achieved by somatic cell nuclear transfer (SCNT) in recent years. However, this method still results in very low efficiencies around 1% which originate from suboptimal culture conditions and highly invasive techniques for oocyte enucleation and injection of the donor cell using micromanipulators. In this paper, we present a new minimal invasive method for oocyte imaging and enucleation based on the application of femtosecond (fs) laser pulses. After imaging of the oocyte with multiphoton microscopy, ultrashort pulses are focused onto the metaphase plate of MII-oocytes in order to ablate the DNA molecules. We show that fs laser based enucleation of porcine oocytes completely inhibits the first mitotic cleavage after parthenogenetic activation while maintaining intact oocyte morphology in most cases. In contrast, control groups without previous irradiation of the metaphase plate are able to develop to the blastocyst stage. Further experiments have to clarify the suitability of fs laser based enucleated oocytes for SCNT.

  15. Treatment of pulmonary diseases with Holmium:YAG laser

    NASA Astrophysics Data System (ADS)

    Zhang, Mei-Jue; Zhu, Jing; Zhang, Hui-Guo; Wang, Fu-Juan; Ke, Lin; Ma, Wei; Luo, Qun-Hua; Zhang, Yue-E.

    1998-11-01

    We report 5 cases of pulmonary disease treated with Holmium:YAG laser through fibrous bronchoscope. 1 inflammatory granuloma was cured after three times of treatment. Compared with conventional methods such as electrocautery and microwave treatment, laser has the merit of good hemostasis effect and quick recovery of the operation area. The other 4 patients who were suffered late lung cancer received 3-7 times of palliative treatment. After the treatment, the tumor tissues become smaller variably, and tact were unobstructed, symptoms of tract- obstructed obviously alleviated. We think that laser treatment has some practical significance in alleviating tract blocking of pulmonary diseases of late stage, and therefore raise the life quality.

  16. Intracorporeal lithotripsy with the holmium:YAG laser

    NASA Astrophysics Data System (ADS)

    Denstedt, John D.; Razvi, Hassan A.; Chun, Samuel S.; Sales, Jack L.

    1995-05-01

    A variety of devices are currently available for intracorporeal stone fragmentation. Recently a new wavelength of laser, the Holmium:YAG, has demonstrated a variety of potential urologic applications including ablation of soft tissue lesions as well as stone fragmentation. This laser has a wavelength of 2100 nm and operates in a pulsed mode. Energy is delivered through a 400 um quartz end-firing fiber. In this presentation we review our clinical experience with the Holmium:YAG laser for the treatment of renal and ureteral calculi. Over a 23 month period, 63 patients underwent 67 procedures. Seven procedures consisted of percutaneous nephrolithotripsy for large or staghorn renal calculi. Sixty procedures were performed for ureteral stones. Procedures for proximal ureteral stones (6) employed a retrograde approach using flexible ureteroscopes (8.5 or 9.8). Stones in the mid ureter (12) and distal ureter (42) were approached transurethrally using a 6.9 rigid ureteroscope. Complete stone fragmentation without the need for additional procedures was achieved in 82% of cases. Treatment failures included 1 stone migration into the renal pelvis during laser activation, 6 patients who had incomplete fragmentation and 3 patients in which laser malfunction precluded complete fragmentation. Stone analysis available in 23 patients revealed calcium oxalate monohydrate (15), calcium oxalate dihydrate (2), cystine (2), uric acid (3) and calcium phosphate (1). A single complication of ureteral perforation occurred when the laser was fired without direct visual guidance. Radiographic follow-up at an average of 16 weeks is available in 22 patients and has identified 2 patients with ureteral strictures that are not believed to be related to laser lithotripsy. In summary, we have found the Holmium:YAG laser to be a reliable and versatile device for intracorporeal lithotripsy. Its safety and efficacy make it a suitable alternative for performing intracorporeal lithotripsy of urinary

  17. Holmium:YAG laser angioplasty: treatment of acute myocardial infarction

    NASA Astrophysics Data System (ADS)

    Topaz, On

    1993-06-01

    We report our clinical experience with a group of 14 patients who presented with acute myocardial infarction. A holmium:YAG laser was applied to the infarct-related artery. This laser emits 250 - 600 mJ per pulse, with a pulse length of 250 microseconds and repetition rate of 5 Hz. Potential benefits of acute thrombolysis by lasers include the absence of systemic lytic state; a shortened thrombus clearing time relative to using thrombolytics; safe removal of the intracoronary thrombus and facilitation of adjunct balloon angioplasty. Potential clinical difficulties include targeting the obstructive clot and plaque, creation of debris and distal emboli and laser-tissue damage. It is conceivable that holmium:YAG laser can be a successful thrombolytic device as its wave length (2.1 microns) coincides with strong water absorption peaks. Since it is common to find an atherosclerotic plaque located under or distal to the thrombotic occlusion, this laser can also be applied for plaque ablation, and the patient presenting with acute myocardial infarction can clearly benefit from the combined function of this laser system.

  18. Experimental studies on the usage possibilities of the holmium laser in cataract surgery

    NASA Astrophysics Data System (ADS)

    Kecik, Tadeusz; Kecik, Dariusz; Kasprzak, Jan; Pratnicki, Antoni; Jankiewicz, Zdzislaw; Zajac, Andrzej

    1996-03-01

    The authors present initial investigations of used holmium laser during experimental cataract surgery. The investigations were performed 'in vitro' and 'in vivo.' The presented results of the experiments show that structure of the lens can be emulsified with the use of the holmium laser.

  19. Combined multiphoton imaging and automated functional enucleation of porcine oocytes using femtosecond laser pulses

    NASA Astrophysics Data System (ADS)

    Kuetemeyer, Kai; Lucas-Hahn, Andrea; Petersen, Bjoern; Lemme, Erika; Hassel, Petra; Niemann, Heiner; Heisterkamp, Alexander

    2010-07-01

    Since the birth of ``Dolly'' as the first mammal cloned from a differentiated cell, somatic cell cloning has been successful in several mammalian species, albeit at low success rates. The highly invasive mechanical enucleation step of a cloning protocol requires sophisticated, expensive equipment and considerable micromanipulation skill. We present a novel noninvasive method for combined oocyte imaging and automated functional enucleation using femtosecond (fs) laser pulses. After three-dimensional imaging of Hoechst-labeled porcine oocytes by multiphoton microscopy, our self-developed software automatically identified the metaphase plate. Subsequent irradiation of the metaphase chromosomes with the very same laser at higher pulse energies in the low-density-plasma regime was used for metaphase plate ablation (functional enucleation). We show that fs laser-based functional enucleation of porcine oocytes completely inhibited the parthenogenetic development without affecting the oocyte morphology. In contrast, nonirradiated oocytes were able to develop parthenogenetically to the blastocyst stage without significant differences to controls. Our results indicate that fs laser systems have great potential for oocyte imaging and functional enucleation and may improve the efficiency of somatic cell cloning.

  20. Femtosecond mode-locked holmium fiber laser pumped by semiconductor disk laser.

    PubMed

    Chamorovskiy, A; Marakulin, A V; Ranta, S; Tavast, M; Rautiainen, J; Leinonen, T; Kurkov, A S; Okhotnikov, O G

    2012-05-01

    We report on a 2085 nm holmium-doped silica fiber laser passively mode-locked by semiconductor saturable absorber mirror and carbon nanotube absorber. The laser, pumped by a 1.16 μm semiconductor disk laser, produces 890 femtosecond pulses with the average power of 46 mW and the repetition rate of 15.7 MHz. PMID:22555700

  1. Laser-assisted hair transplantation: histologic comparison between holmium:YAG and CO2 lasers

    NASA Astrophysics Data System (ADS)

    Chu, Eugene A.; Rabinov, C. Rose; Wong, Brian J.; Krugman, Mark E.

    1999-06-01

    The histological effects of flash-scanned CO2 (λ=10.6μm) and pulsed Holmium:YAG (Ho:YAG, λ=2.12μm) lasers were evaluated in human scalp following the creation of hair transplant recipient channels. Ho:YAG laser irradiation created larger zones of thermal injury adjacent to the laser channels than irradiation with the CO2 laser device. When the two lasers created recipient sites of nearly equal depth, the Holmium:YAG laser caused a larger region of lateral thermal damage (589.30μm) than the CO2 laser (118.07μm). In addition, Holmium:YAG irradiated specimens exhibited fractures or discontinuities beyond the region of clear thermal injury. This shearing effect is consistent with the photoacoustic mechanism of ablation associated with pulsed mid-IR laser irradiation. In contrast, channels created with the CO2 exhibited minimal epithelial disruption and significantly less lateral thermal damage. While the Holmium:YAG laser is a useful tool for ablation soft tissue with minimal char in select applications (sinus surgery, arthroscopic surgery), this study suggests that the use of the CO2 laser for the creation of transplantation recipient channels result in significantly less lateral thermal injury for the laser parameters employed.

  2. Holmium laser lithotripsy for ureteral calculi: an outpatient procedure.

    PubMed

    Yip, K H; Lee, C W; Tam, P C

    1998-06-01

    A retrospective review was conducted to evaluate the efficacy of ureteroscopic lithotripsy using the holmium laser with a semirigid endoscope in a newly established day surgery center. In 1996, 69 consecutive patients (40 male and 29 female) with a mean age of 46.7 (range 21-73) years and ASA status I or II underwent ureteroscopic lithotripsy for their ureteral calculi using the holmium laser (365-micron fiber; power setting 0.5-1.4 J/5 Hz) and 8.5F semirigid ureteroscope in a day surgery setting. Stone features, postoperative pain scores, readmissions, and complications were evaluated. Eighteen upper, 17 middle, and 34 lower ureteral stones were treated, with a mean size measuring 12.1 (5-45) mm. The mean operative time was 61 minutes including the anesthetic time (range 15-150 minutes), and the success rate was 91% (63/69). The complication rate was 10% (7/69) including four unscheduled readmissions (6%). Telephone follow-up on postoperative Day 1 and Day 3 revealed mean pain scores of 2 and 1, respectively (on a 0-10 scale) and an analgesic requirement of 1 tablet of Dologesic (containing 32.5 mg of dextropropoxyphene + 320 mg of paracetamol) four times a day on both days. Ureteroscopic lithotripsy using the holmium laser and a semirigid endoscope is highly successful and well tolerated and carries a low complication rate. It is indicated as an ambulatory and minimally invasive treatment modality in low-risk patients with ureteral stones. PMID:9658294

  3. Buckshot colic: utilizing holmium:yag laser for ureteroscopic removal of a bullet fragment within the proximal ureter.

    PubMed

    Ziegelmann, Matthew; Carrasco, Alonso; Knoedler, John; Krambeck, Amy E

    2016-06-01

    Buckshot colic is a rare phenomenon, presenting as firearm-induced urinary tract obstruction. We present a case of gunshot-induced ureteral obstruction in a 49-year-old male, treated endoscopically with the holmium:YAG (holmium) laser. CT revealed a 1 cm bullet fragment within the left proximal ureter. A percutaneous nephrolithotomy was performed utilizing the holmium laser to fragment the metal into basket-retrievable pieces. At 4 month follow up the patient is without evidence of stricture. To our knowledge, this is the first reported utilization of the holmium laser to treat "buckshot colic". Endoscopy with holmium laser appears a feasible and safe treatment option. PMID:27347630

  4. Office Hysteroscopic Laser Enucleation of Submucous Myomas without Mass Extraction: A Case Series Study

    PubMed Central

    Haimovich, Sergio; López-Yarto, Maite; Urresta Ávila, Julio; Saavedra Tascón, Alejandro; Hernández, José L.; Carreras Collado, Ramón

    2015-01-01

    Background and Objectives. A new two-step hysteroscopic myomectomy carried out in the office setting and without anesthesia was feasible for the excision of submucous myomas. The objective of this study was to assess whether removal of submucous myomas from the uterine cavity after hysteroscopic laser enucleation is necessary. Methods. Between June 2009 and April 2013, all outpatients with symptomatic myomatosis (bleeding, pelvic pain, and infertility) assessed ultrasonographically were eligible to participate in a prospective study. All patients underwent office hysteroscopic enucleation of submucous myomas. Enucleated myomas were left in the uterine cavity. Neither anesthesia nor antibiotic prophylaxis was used. Results. Sixty-one women (mean age: 47.3 years) were included. Regardless of hysteroscopic localization and grading, all myomas were enucleated. The mean (standard deviation, SD) diameter of the myoma as measured by the ultrasound scan was 22.6 (8.5) mm. In 29 cases (47.5%), the diameter of the resected myoma was >20 mm and in 10 cases (16.4%) >30 mm. After a mean follow-up of 68.2 (16.5) days, none of the patients showed a residual myoma inside the uterine cavity. Conclusions. The present results indicate that leaving laser-enucleated submucous myoma in the uterine cavity is a feasible and safe therapeutic option. PMID:26090457

  5. Combination of erbium and holmium laser radiation for tissue ablation

    NASA Astrophysics Data System (ADS)

    Pratisto, Hans S.; Frenz, Martin; Koenz, Flurin; Altermatt, Hans J.; Weber, Heinz P.

    1996-05-01

    Erbium lasers emitting at 2.94 micrometers and holmium lasers emitting at 2.1 micrometers are interesting tools for cutting, drilling, smoothing and welding of water containing tissues. The high absorption coefficient of water at these wavelengths leads to their good ablation efficiency with controlled thermally altered zones around the ablation sites. Combination of pulses with both wavelengths transmitted through one fiber were used to perform incisions in soft tissue and impacts in bone disks. Histological results and scanning electron microscope evaluations reveal the strong influence of the absorption coefficient on tissue effects, especially on the ablation efficiency and the zone of thermally damaged tissue. It is demonstrated that the combination of high ablation rates and deep coagulation zones can be achieved. The results indicate that this laser system can be considered as a first step towards a multi-functional medical instrument.

  6. Effect of the active-ion concentration on the lasing dynamics of holmium fibre lasers

    SciTech Connect

    Kurkov, Andrei S; Sholokhov, E M; Marakulin, A V; Minashina, L A

    2010-12-09

    The lasing dynamics of fibre lasers with a core based on quartz glass doped with holmium ions to concentrations in the range of 10{sup 19}-10{sup 20} cm{sup -3} is investigated. It is shown that fibre lasers with a high concentration of active holmium ions generate pulses, but a decrease in the holmium concentration changes the lasing from pulsed to cw regime. At the same time, a decrease in the active-ion concentration and the corresponding increase in the fibre length in the cavity reduce the lasing efficiency. (lasers)

  7. Effect of active-ion concentration on holmium fibre laser efficiency

    SciTech Connect

    Kurkov, Andrei S; Sholokhov, E M; Marakulin, A V; Minashina, L A

    2010-08-03

    We have measured the fraction of holmium ions that relax nonradiatively to the ground level as a result of interaction at a metastable level in optical fibres with a silica-based core doped with holmium ions to 2 x 10{sup 19} - 2 x 10{sup 20} cm{sup -3}. The percentage of such ions has been shown to depend on the absolute active-ion concentration. The fibres have been used to make a number of 2.05-{mu}m lasers, and their slope efficiency has been measured. The laser efficiency decreases with increasing holmium concentration in the fibres (lasers)

  8. Functional enucleation of porcine oocytes for somatic cell nuclear transfer using femtosecond laser pulses

    NASA Astrophysics Data System (ADS)

    Kuetemeyer, K.; Lucas-Hahn, A.; Petersen, B.; Hassel, P.; Lemme, E.; Niemann, H.; Heisterkamp, A.

    2010-02-01

    Cloning of several mammalian species has been achieved by somatic cell nuclear transfer over the last decade. However, this method still results in very low efficiencies originating from biological and technical aspects. The highly-invasive mechanical enucleation belongs to the technical aspects and requires considerable micromanipulation skill. In this paper, we present a novel non-invasive method for combined oocyte imaging and automated functional enucleation using femtosecond (fs) laser pulses. After three-dimensional imaging of Hoechst-labeled porcine oocytes by multiphoton microscopy, our self-developed software automatically determined the metaphase plate position and shape. Subsequent irradiation of this volume with the very same laser at higher pulse energies in the low-density-plasma regime was used for metaphase plate ablation. We show that functional fs laser-based enucleation of porcine oocytes completely inhibited further embryonic development while maintaining intact oocyte morphology. In contrast, non-irradiated oocytes were able to develop to the blastocyst stage without significant differences to control oocytes. Our results indicate that fs laser systems offer great potential for oocyte imaging and enucleation as a fast, easy to use and reliable tool which may improve the efficiency of somatic cell clone production.

  9. Clinical development of holmium:YAG laser prostatectomy

    NASA Astrophysics Data System (ADS)

    Kabalin, John N.

    1996-05-01

    Holmium:YAG (Ho:YAG) laser vaporization and resection of the prostate offers advantages in immediate tissue removal compared to the Neodymium:YAG (Nd:YAG) laser. Ongoing development of appropriate operative techniques and Ho:YAG laser delivery systems suitable for endoscopic prostate surgery, including side-firing optical delivery fibers, have facilitated this approach. We performed Ho:YAG laser prostatectomy in 20 human subjects, including 2 men treated immediately prior to radical prostatectomy to assess Ho:YAG laser effects in the prostate. A total of 18 men were treated in an initial clinical trial of Ho:YAG prostatectomy. Estimated excess hyperplastic prostate tissue averaged 24 g (range 5 - 50 g). A mean of 129 kj Ho:YAG laser energy was delivered, combined with a mean of 11 kj Nd:YAG energy to provide supplemental coagulation for hemostasis. We have observed no significant perioperative or late complications. No significant intraoperative changes in hematocrit or serum electrolytes were documented. In addition to providing acute removal of obstructing prostate tissue, Ho:YAG laser resection allowed tissue specimen to be obtained for histologic examination. A total of 16 of 18 patients (90%) underwent successful removal of their urinary catheter and voiding trial within 24 hours following surgery. Immediate improvement in voiding, comparable to classic transurethral electrocautery resection of the prostate (TURP), was reported by all patients. Ho:YAG laser resection of the prostate appears to be a viable surgical technique associated with minimal morbidity and immediate improvement in voiding.

  10. Comparison of holmium:YAG and thulium fiber lasers for lithotripsy

    NASA Astrophysics Data System (ADS)

    Blackmon, Richard L.; Irby, Pierce B.; Fried, Nathaniel M.

    2010-02-01

    The Holmium:YAG laser is currently the most common laser lithotripter. However, recent experimental studies have demonstrated that the Thulium fiber laser is also capable of vaporizing urinary stones. The high-temperature water absorption coefficient for the Thulium wavelength (μa = 160 cm-1 at λ = 1908 nm) is significantly greater than for the Holmium wavelength (μa = 28 cm-1 at λ = 2120 nm). We hypothesize that this should translate into more efficient laser lithotripsy using the Thulium fiber laser. This study directly compares stone vaporization rates for Holmium and Thulium fiber lasers. Holmium laser radiation pulsed at 3 Hz with 70 mJ pulse energy and 220 μs pulse duration was delivered through a 100-μm-core silica fiber to human uric acid (UA) and calcium oxalate monohydrate (COM) stones, ex vivo (n = 10 each). Thulium fiber laser radiation pulsed at 10 Hz with 70 mJ pulse energy and 1 ms pulse duration was also delivered through a 100-μm fiber for the same sets of 10 stones. For same number of pulses and total energy (126 J) delivered to each stone, mass loss averaged 2.4 +/- 0.6 mg (UA) and 0.7 +/- 0.2 mg (COM) for Holmium laser and 12.6 +/- 2.5 mg (UA) and 6.8 +/- 1.7 (COM) for Thulium fiber laser. UA and COM stone vaporization rates for Thulium fiber laser averaged 5-10 times higher than for Holmium laser at 70 mJ pulse energies. With further development, the Thulium fiber laser may represent an alternative to the conventional Holmium laser for more efficient laser lithotripsy.

  11. Holmium laser use in the treatment of selected dry eye syndrome complications

    NASA Astrophysics Data System (ADS)

    Kecik, Dariusz; Kecik, Tadeusz; Kasprzak, Jan; Kecik, Mariusz

    1996-03-01

    The authors present initial results of treatment selected complications of dry eye syndrome with holmium laser. The lacrimal puncta obliteration and coagulation of the corneal ulcer surface were done.

  12. Thulium laser enucleation of the prostate is a safe and a highly effective modality for the treatment of benign prostatic hyperplasia - Our experience of 236 patients

    PubMed Central

    Ketan, P. Vartak; Prashant, H. Salvi

    2016-01-01

    Context: Thulium LASER is fast emerging as a safe and effective modality for benign prostatic hyperplasia (BPH). Still, compared to holmium laser transurethral enucleation of the prostate (HoLEP) the number of institutes all over the world using Thulium LASER are limited. This is our effort to bring the statistical facts about the safety and effectivity of Thulium LASER. Aims: To study the efficacy of thulium laser enucleation of the prostate (ThuLEP). Settings and Design: All patients in the stipulated period were documented for all parameters and were evaluated. The results were tabulated. Subjects and Materials: (1) Two hundred and thirty-six patients with symptomatic BPH were treated with ThuLEP between March 2010 and September 2014 at our institute by a single surgeon. (2) The inclusion criteria were maximum urinary flow rate (Qmax) <15 ml/s, International Prostate Symptoms Score (IPSS) >15 or acute retention of urine with the failure of catheter trial or Acute retention of urine with prior history of severe bladder outlet obstruction. (3) Patients evaluated by: Digital rectal examination, uroflowmetry, IPSS, prostate-specific antigen (PSA), blood and urine routine tests, abdominal usage with trains rectal ultrasonography (TRUS), TRUS guided biopsies. Statistical Analysis Used: Not used. Results: (1) ThuLEP was a highly effective procedure as compared to all other procedures like HOLEP, TURP in terms of catheterization time, hospital stay, and drop in hemoglobin (Hb). (2) Catheterization time: 25.22 h (224 patients within 24 h and 12 patients within 48 h). (3) Hospital stay: 24–36 h 218 patients (92.3%), 36–48 h 18 patients (7.6%). (4) Drop in Hb: 0.8 ± 0.42 g/dl. (5) Average operative time: 56.91 min. Conclusions: Thulium LASER is a safe and highly effective LASER in terms of blood loss, speed of tissue resection, drop in serum PSA, and versatility of prostatic resection. PMID:26834407

  13. Efficient holmium:yttrium lithium fluoride laser longitudinally pumped by a semiconductor laser array

    NASA Technical Reports Server (NTRS)

    Hemmati, H.

    1987-01-01

    Optical pumping of a holmium:yttrium lithium floride (Ho:YLF) crystal with a 790-nm continuous-wave diode-laser array has generated 56 mW of 2.1-micron laser radiation with an optical-to-optical conversion slope efficiency of 33 percent while the crystal temperature is held at 77 K. The lasing threshold occurs at 7 mW of input power, and laser operation continues up to a crystal temperature of 124 K.

  14. Non-radiative decay of holmium-doped laser materials

    NASA Astrophysics Data System (ADS)

    Bowman, Steven R.; O'Connor, Shawn; Condon, Nicholas J.; Friebele, E. Joseph; Kim, Woohong; Shaw, B.; Quimby, R. S.

    2013-03-01

    Anti-Stokes fluorescence cooling has been demonstrated in a number rare earth doped materials. Ytterbium doped oxides and fluorides, such as ZBLAN, YLF, and YAG, were the first materials to exhibit cooling.1,2,3 These materials were originally developed as laser gain media and fluorescence cooling was eventually incorporated into the 1μm lasers to reduce detrimental thermal loading.4 Anti-Stokes cooling can offset quantum defect heating allowing laser power to be scaled to very high average powers. Since the early work in ytterbium, fluorescence cooling has been demonstrated in both erbium and thulium doped materials.5,6 These materials were also initially developed as lasing media and their fluorescence cooling could be used to increase laser powers at 1.5μm and 2.0μm. In this study we examine the radiative efficiency of holmium and ask the question, "Can anti-Stokes fluorescence cooling be extended beyond 2μm?"

  15. Holmium:YAG laser in dentistry: photoconditioning of dentinal surfaces

    NASA Astrophysics Data System (ADS)

    Holt, Raleigh A.; Nordquist, Robert E.

    1994-09-01

    This in vitro study was undertaken to determine energy levels necessary to produce tubule closure and surface smoothing on dentinal surfaces of human teeth and their resultant temperature increases within the pulpal canals with the Holmium:YAG laser. An optimal working spot size and even absorption pattern were produced by defocusing the laser beam and evaluated by images produced on light exposed and developed photographic paper. The surface effects on dentin were examined by scanning electron microscopy. A thermocouple was positioned in the canals of fresh dissected dog jaws and attached to a recorder which produced a graph of the temperature changes. The in vitro research model for intrapulpal temperatures changes was verified by comparing premortem and postmortem temperature readings. The same protocol was used to evaluate temperature changes in fresh human extracted teeth. In vivo histological studies were conducted to evaluate the effects of HO:YAG laser energy on pulpal tissues. The results of these studies indicate the HO:YAG laser at a wavelength of 2.12 microns can be safely and effectively used for photoconditioning of the dentinal surfaces of teeth in clinical conditions.

  16. Laser angioplasty with lensed fibers and a holmium:YAG laser in iliac artery occlusions

    NASA Astrophysics Data System (ADS)

    White, Christopher J.; Ramee, Stephen R.; Mesa, Juan E.; Collins, Tyrone J.; Kotmel, Robert; Godfrey, Maureen A.

    1991-05-01

    Holmium-YAG (2.1 (mu) ) laser recanalization was attempted in 10 totally occluded miniature swine iliac arteries using a lensed fiber delivery system. The iliac artery occlusions were created in a Yucatan miniature swine model of atherosclerosis by means of a high cholesterol diet and balloon endothelial denudation. In order to increase the spot size, a spherical silica lens was attached to the distal end of a 300 micrometers core diameter silica optical fiber. The holmium-YAG laser was operated in the free-running mode with 250 microsecond(s) ec pulses at 4 Hz. The energy delivered was 225 mJ per pulse for the 1.0 mm lensed fiber and 200 mJ per pulse for the 1.3 mm lensed fiber. Laser energy was delivered in 2 to 5 second bursts. Successful recanalization was achieved in all 10 arteries attempted without perforation of the arterial wall. The average length of the occlusions was 5.0 +/- 1.8 cm. Following successful laser recanalization significant stenoses (>50%) remained in all of the arteries as judged by angiography. In conclusion, the lensed fibers coupled to the pulsed holmium-YAG laser were safe and effective in recanalizing these difficult lesions in relatively straight iliac arteries. There is potential clinical utility for this system as an adjunct to balloon angioplasty in patients with lesions which are unable to be crossed with guidewires.

  17. Proximal fiber tip damage during Holmium:YAG and thulium fiber laser ablation of kidney stones

    NASA Astrophysics Data System (ADS)

    Wilson, Christopher R.; Hardy, Luke A.; Irby, Pierce B.; Fried, Nathaniel M.

    2016-02-01

    The Thulium fiber laser (TFL) is being studied as an alternative to Holmium:YAG laser for lithotripsy. TFL beam originates within an 18-μm-core thulium doped silica fiber, and its near single mode, Gaussian beam profile enables transmission of higher laser power through smaller fibers than possible during Holmium laser lithotripsy. This study examines whether TFL beam profile also reduces proximal fiber tip damage compared to Holmium laser multimodal beam. TFL beam at wavelength of 1908 nm was coupled into 105-μm-core silica fibers, with 35-mJ energy, 500-μs pulse duration, and pulse rates of 50-500 Hz. For each pulse rate, 500,000 pulses were delivered. Magnified images of proximal fiber surfaces were taken before and after each trial. For comparison, 20 single-use, 270-μm-core fibers were collected after clinical Holmium laser lithotripsy procedures using standard settings (600 mJ, 350 μs, 6 Hz). Total laser energy, number of laser pulses, and laser irradiation time were recorded, and fibers were rated for damage. For TFL studies, output power was stable, and no proximal fiber damage was observed after delivery of 500,000 pulses at settings up to 35 mJ, 500 Hz, and 17.5 W average power. In contrast, confocal microscopy images of fiber tips after Holmium lithotripsy showed proximal fiber tip degradation in all 20 fibers. The proximal fiber tip of a 105-μm-core fiber transmitted 17.5 W of TFL power without degradation, compared to degradation of 270-μm-core fibers after transmission of 3.6 W of Holmium laser power. The smaller and more uniform TFL beam profile may improve fiber lifetime, and potentially reduce costs for the surgical disposables as well.

  18. Safety and efficacy of holmium:YAG laser lithotripsy in patients with bleeding diatheses

    NASA Astrophysics Data System (ADS)

    Watterson, James D.; Girvan, Andrew R.; Cook, Anthony J.; Beiko, Darren T.; Nott, Linda; Auge, Brian K.; Preminger, Glenn M.; Denstedt, John D.

    2003-06-01

    Purpose: To assess the safety and efficacy of ureteroscopy and holmium:YAG (yttrium-aluminum-garnet) laser lithotripsy in the treatment of upper urinary tract calculi in patients with known and uncorrected bleeding diatheses. Materials and Methods: A retrospective chart review from 2 tertiary stone centers was performed to identify patients with known bleeding diatheses who were treated with holmium:YAG laser lithotripsy for upper urinary tract calculi. Twenty-five patients with 29 upper urinary tract calculi were treated with ureteroscopic holmium laser lithotripsy. Bleeding diatheses identified were coumadin administration for various conditions (17), liver dysfunction (3), thrombocytopenia (4), and von Willebrand's disease (1). Mean international normalized ratio (INR), platelet count and bleeding time were 2.3, 50 x 109/L, and > 16 minutes, for patients receiving coumadin or with liver dysfunction, thrombocytopenia, or von Willebrand's disease, respectively. Results: Overall, the stone-free rate was 96% (27/28) and 29 of 30 procedures were completed successfully without significant complication. One patient who was treated concomitantly with electrohydraulic lithotripsy (EHL) had a significant retroperitoneal hemorrhage that required blood transfusion. Conclusions: Treatment of upper tract urinary calculi in patients with uncorrected bleeding diatheses can be safely performed using contemporary small caliber ureteroscopes and holmium laser as the sole modality of lithotripsy. Ureteroscopic holmium laser lithotripsy without preoperative correction of hemostatic parameters limits the risk of thromboembolic complications and costs associated with an extended hospital stay. Avoidance of the use of EHL is crucial in reducing bleeding complications in this cohort of patients.

  19. Spectroscopic properties, energy transfer dynamics, and laser performance of thulium-holmium doped laser systems

    SciTech Connect

    Kalisky, Y.; Rotman, S.R.; Boulon, G.; Pedrini, C.; Brenier, A.

    1994-12-31

    Spectroscopic studies using laser induced fluorescence and numerical modeling of energy transfer and back transfer mechanism are reported in Er:Tm:Ho:YLF, Cr:Tm:Ho:YAG and Cr:Tm:YAG laser crystals at various temperatures (10 K-300 K). Direct energy transfer from Tm{sup 3+} excited states to Ho{sup 3+} {sup 5}I{sub 7} emitting level was observed and analyzed both in YAG and YLF. Further analysis of Cr{sup 3+} and Tm{sup 3+} time-dependent emission curves indicate a strong correlation of chromium-thulium pairs. Pulsed operation of holmium laser at high temperature will be presented.

  20. Histological evaluation of coagulation foci produced in the human lens with a holmium laser

    NASA Astrophysics Data System (ADS)

    Kecik, Dariusz; Kecik, Tadeusz; Pratnicki, Antoni; Kasprzak, Jan; Kecik, Mariusz

    1997-10-01

    We present the results of histological evaluation of human lenses treated with the holmium laser. The lenses, extracted at the time of extracapsular surgery for cataract, were placed in containers filled with Ringer's solution. After treatment with laser-emitted radiation they were histologically evaluated. The formation of crater-like defects was found in the material studied.

  1. Combination of fiber-guided pulsed erbium and holmium laser radiation for tissue ablation under water

    NASA Astrophysics Data System (ADS)

    Pratisto, Hans; Frenz, Martin; Ith, Michael; Altermatt, Hans J.; Jansen, E. Duco; Weber, Heinz P.

    1996-07-01

    Because of the high absorption of near-infrared laser radiation in biological tissue, erbium lasers and holmium lasers emitting at 3 and 2 mu m, respectively, have been proven to have optimal qualities for cutting or welding and coagulating tissue. To combine the advantages of both wavelengths, we realized a multiwavelength laser system by simultaneously guiding erbium and holmium laser radiation by means of a single zirconium fluoride (ZrF4) fiber. Laser-induced channel formation in water and poly(acrylamide) gel was investigated by the use of a time-resolved flash-photography setup, while pressure transients were recorded simultaneously with a needle hydrophone. The shapes and depths of vapor channels produced in water and in a submerged gel after single erbium and after combination erbium-holmium radiation delivered by means of a 400- mu m ZrF4 fiber were measured. Transmission measurements were performed to determine the amount of pulse energy available for tissue ablation. The effects of laser wavelength and the delay time between pulses of different wavelengths on the photomechanical and photothermal responses of meniscal tissue were evaluated in vitro by the use of histology. It was observed that the use of a short (200- mu s, 100-mJ) holmium laser pulse as a prepulse to generate a vapor bubble through which the ablating erbium laser pulse can be transmitted (delay time, 100 mu s) increases the cutting depth in meniscus from 450 to 1120 mu m as compared with the depth following a single erbium pulse. The results indicate that a combination of erbium and holmium laser radiation precisely and efficiently cuts tissue under water with 20-50- mu m collateral tissue damage. wave, cavitation, channel formation, infrared-fiber-delivery system, tissue damage, cartilage.

  2. Holmium:YAG laser-assisted otolaryngologic surgery: Lahey Clinic experience

    NASA Astrophysics Data System (ADS)

    Shapshay, Stanley M.; Rebeiz, Elie E.; Pankratov, Michail M.

    1993-07-01

    The Holmium:YAG laser was used to assist in 36 rhinologic procedures including surgery for chronic sinus disease, chronic dacryocystitis, recurrent choanal stenosis, and a sphenoid sinus mucocele. There were no laser related complications. The laser permitted controlled ablation of bone and soft tissue in all cases with satisfactory results. The Ho:YAG laser can be used in otolaryngology to assist in cases where surgical access is difficult or when controlled, precise bone and soft tissue ablation is necessary.

  3. Are Histological Findings of Thulium Laser Vapo-Enucleation Versus Transurethral Resection of the Prostate Comparable?

    PubMed

    Carmignani, Luca; Macchi, Alberto; Ratti, Dario; Finkelberg, Elisabetta; Casellato, Stefano; Bozzini, Giorgio; Maruccia, Serena; Marenghi, Carlo; Picozzi, Stefano

    2015-09-01

    We investigated if an adequate histological diagnosis can be made from tissue after Thulium laser vapo-enucleation of the prostate (ThuVEP) and whether it is comparable to transurethral prostate resection (TURP) tissue findings in patients with symptomatic benign prostatic hyperplasia. We analyzed 350 ThuLEP and 100 matched TURP tissue specimens from patients who underwent one of the two procedures between January 2009 and June 2014. Thulium Laser Enucleation of Prostate (ThuVEP) was combined with mechanical morcellation of the resected lobe. Each histological specimen was reviewed by two pathologists. Preoperative prostate ultrasound volume, total serum prostatic specific antigen and postoperative tissue weight were evaluated. Microscopic histological diagnosis was assessed by standard histological techniques and immunohistochemical evaluation. Patients were comparable in terms of age and preoperative total serum prostate specific antigen. Incidental adenocarcinoma and high grade PIN of the prostate were diagnosed in a comparable percent of specimens in the 2 groups (2.5 % in the ThuVEP group versus 3 % in the TURP group). Tissue thermal artifacts induced by the Thulium laser are mostly due to coagulation as that of the conventional monopolar diathermy in TURP. Tissue quality was maintained in the ThuVEP histological specimens. Tissue maintain histological characteristics and proprieties without modification for successive immunoistochemical analysis. The pathologist ability to detect incidental prostate cancer and PIN was maintained even if there is a quoted of vaporized tissue. PMID:25862670

  4. Holmium:YAG laser coronary angioplasty: quantitative angiography and clinical results in a large experience of a single medical center

    NASA Astrophysics Data System (ADS)

    Topaz, On; Luxenberg, Michael; Schumacher, Audrey

    1994-07-01

    Clinical experience with the mid IR holmium:YAG laser in a single medical center (St. Paul Ramsey Medical Center, University of Minnesota Medical School, St. Paul, MN) includes 112 patients who underwent holmium laser coronary angioplasty. Utilizing a unique lasing technique; `pulse and retreat,' we applied this laser to thrombotic and nonthrombotic lesions in patients presenting with unstable angina, stable angina, and acute myocardial infarction. A very high clinical success and very low complication rates were achieved. Holmium:YAG laser is effective and safe therapy for patients with symptomatic coronary artery disease. Unlike excimer lasers, the clinical success, efficacy and safety of holmium laser angioplasty is not compromised when thrombus is present.

  5. Fiber-optic manipulation of urinary stone phantoms using holmium:YAG and thulium fiber lasers

    NASA Astrophysics Data System (ADS)

    Blackmon, Richard L.; Case, Jason R.; Trammell, Susan R.; Irby, Pierce B.; Fried, Nathaniel M.

    2013-02-01

    Fiber-optic attraction of urinary stones during laser lithotripsy may be exploited to manipulate stone fragments inside the urinary tract without mechanical grasping tools, saving the urologist time and space in the ureteroscope working channel. We compare thulium fiber laser (TFL) high pulse rate/low pulse energy operation to conventional holmium:YAG low pulse rate/high pulse energy operation for fiber-optic suctioning of plaster-of-paris (PoP) stone phantoms. A TFL (wavelength of 1908 nm, pulse energy of 35 mJ, pulse duration of 500 μs, and pulse rate of 10 to 350 Hz) and a holmium laser (wavelength of 2120 nm, pulse energy of 35 to 360 mJ, pulse duration of 300 μs, and pulse rate of 20 Hz) were tested using 270-μm-core optical fibers. A peak drag speed of ˜2.5 mm/s was measured for both TFL (35 mJ and 150 to 250 Hz) and holmium laser (210 mJ and 20 Hz). Particle image velocimetry and thermal imaging were used to track water flow for all parameters. Fiber-optic suctioning of urinary stone phantoms is feasible. TFL operation at high pulse rates/low pulse energies is preferable to holmium operation at low pulse rates/high pulse energies for rapid and smooth stone pulling. With further development, this novel technique may be useful for manipulating stone fragments in the urinary tract.

  6. Fiber-optic manipulation of urinary stone phantoms using holmium:YAG and thulium fiber lasers.

    PubMed

    Blackmon, Richard L; Case, Jason R; Trammell, Susan R; Irby, Pierce B; Fried, Nathaniel M

    2013-02-01

    Fiber-optic attraction of urinary stones during laser lithotripsy may be exploited to manipulate stone fragments inside the urinary tract without mechanical grasping tools, saving the urologist time and space in the ureteroscope working channel. We compare thulium fiber laser (TFL) high pulse rate/low pulse energy operation to conventional holmium:YAG low pulse rate/high pulse energy operation for fiber-optic suctioning of plaster-of-paris (PoP) stone phantoms. A TFL (wavelength of 1908 nm, pulse energy of 35 mJ, pulse duration of 500 μs, and pulse rate of 10 to 350 Hz) and a holmium laser (wavelength of 2120 nm, pulse energy of 35 to 360 mJ, pulse duration of 300 μs, and pulse rate of 20 Hz) were tested using 270-μm-core optical fibers. A peak drag speed of ~2.5 mm/s was measured for both TFL (35 mJ and 150 to 250 Hz) and holmium laser (210 mJ and 20 Hz). Particle image velocimetry and thermal imaging were used to track water flow for all parameters. Fiber-optic suctioning of urinary stone phantoms is feasible. TFL operation at high pulse rates/low pulse energies is preferable to holmium operation at low pulse rates/high pulse energies for rapid and smooth stone pulling. With further development, this novel technique may be useful for manipulating stone fragments in the urinary tract. PMID:23377013

  7. Influence of water environment on holmium laser ablation performance for hard tissues.

    PubMed

    Lü, Tao; Xiao, Qing; Li, Zhengjia

    2012-05-01

    This study clarifies the ablation differences in air and in water for hard biological tissues, which are irradiated by fiber-guided long-pulsed holmium lasers. High-speed photography is used to record the dynamic characteristics of ablation plumes and vaporization bubbles induced by pulsed holmium lasers. The ablation morphologies and depth of hard tissues are quantitatively measured by optical coherence microscopy. Explosive vaporization effects in water play a positive role in the contact ablation process and are directly responsible for significant ablation enhancement. Furthermore, water layer depth can also contribute to ablation performance. Under the same laser parameters for fiber-tissue contact ablation in air and water, ablation performances are comparable for a single-laser pulse, but for more laser pulses the ablation performances in water are better than those in air. Comprehensive knowledge of ablation differences under various environments is important, especially in medical procedures that are performed in a liquid environment. PMID:22614434

  8. Effect of holmium and erbium laser action on the human lens: an in-vitro study

    NASA Astrophysics Data System (ADS)

    Kasprzak, Jan; Kecik, Dariusz

    1997-10-01

    We investigated the holmium and erbium lasers operating at the medium IR range, used for cataract surgery. The main advantage of these lasers action on biological structures is total absorption of radiation by superficial layers. During the study of the lens emulsification process we found that the mechanical properties of the lens nucleus were of crucial importance for the rate of emulsification. The soft lenses were fragmented and emulsified after 200-700 pulses, while the hard lens required 5000 or more pulses while complete emulsification was not achieved. The results are promising and show that the holmium and erbium lasers can be used for human lens emulsification during ECCE. For clinical purposes, however, it is necessary to construct a suitable fiberoptic tip to be used in cataract removal. It seems that lasers whose beam is in the medium IR range could be used in many ophthalmic operations.

  9. Mathematical modelling of dispersion-managed thulium/holmium fibre lasers

    SciTech Connect

    Yarutkina, I A; Shtyrina, O V

    2013-11-30

    The mathematical model of a dispersion-managed thulium/holmium fibre laser is described; the results of numerical calculations and their comparison with the experimental data are presented. Qualitative agreement of the results of the mathematical modelling with those of the experiment is obtained. Using the methods of mathematical modelling, the variation in the characteristics of the optical pulses due to the change in the average cavity dispersion is analysed. (control of laser radiation parameters)

  10. A novel one lobe technique of thulium laser enucleation of the prostate: 'All-in-One' technique

    PubMed Central

    Kim, Yeon Joo; Lee, Yoon Hyung; Kwon, Joon Beom; Cho, Sung Ryong

    2015-01-01

    Purpose The thulium laser is the most recently introduced technology for the surgical treatment of benign prostatic hyperplasia (BPH). Until recently, most thulium laser enucleation of the prostate (ThuLEP) was performed by use of the three-lobe technique. We introduce a novel one-lobe enucleation technique for ThuLEP called the "All-in-One" technique. We report our initial experiences here. Materials and Methods From June 2013 to May 2014, a total of 47 patients underwent the All-in-One technique of ThuLEP for symptomatic BPH performed by a single surgeon. All patients were assessed with the International Prostate Symptom Score (IPSS), transrectal ultrasonography, serum prostate-specific antigen (PSA), maximal urine flow rate (Qmax), and postvoid residual urine volume (PVR) before and 1 month after surgery. We reassessed IPSS, Qmax, and PVR 3 months after surgery. To assess the efficacy of the All-in-One technique, we checked the PSA reduction ratio, transitional zone volume reduction ratio, and enucleation failure rate. Results The mean operative time was 82.1±33.3 minutes. The mean enucleation time and morcellation time were 52.7±21.7 minutes and 8.2±7.0 minutes, respectively. The mean resected tissue weight and decrease in hemoglobin were 36.9±24.6 g and 0.4±0.8 g/dL, respectively. All perioperative parameters showed significant improvement (p<0.05). No major complications were observed. The PSA reduction ratio, transitional zone volume reduction ratio, and enucleation failure rate were 0.81, 0.92, and 4.3%, respectively. Conclusions The All-in-One technique of ThuLEP showed efficacy and effectiveness comparable to that of other techniques. We expect that this new technique could reduce the operation time and the bleeding and improve the effectiveness of enucleation. PMID:26568795

  11. Soft-tissue applications of the holmium:YAG laser in urology

    NASA Astrophysics Data System (ADS)

    Denstedt, John D.; Razvi, Hassan A.; Chun, Samuel S.; Sales, Jack L.

    1995-05-01

    The ideal surgical laser for the treatment of soft tissue pathology should possess both ablative and hemostatic abilities. As well, for use in urologic conditions the laser must also be suitable for endoscopic use. The Holmium:YAG laser possesses these qualities and in preliminary clinical use has demonstrated a variety of potential urologic applications. In this study we review our initial experience with the Holmium:YAG laser over a 18 month period. A total of 51 patients underwent 53 procedures for a variety of soft tissue conditions including: bladder tumor ablation (25), incision of ureteral stricture (15), incision of urethral stricture (6), treatment of ureteropelvic junction obstruction (3), incision of bladder neck contracture (2), and ablation of a ureteral tumor (2). Satisfactory hemostasis was achieved in all cases. Procedures were considered successful (no further intervention being required to treat the condition) in 81% of the cases. Two patients with dense bladder neck contractures required electroincision under the same anesthetic for completion of the procedure. A single complication, that of urinary extravasation following incision of a urethral stricture resolved with conservative management. In summary, the Holmium:YAG laser has demonstrated safety and proficiency in the treatment of a variety of urologic soft tissue conditions.

  12. Microscopic analysis of laser-induced proximal fiber tip damage during holmium:YAG and thulium fiber laser lithotripsy

    NASA Astrophysics Data System (ADS)

    Wilson, Christopher R.; Hardy, Luke A.; Irby, Pierce B.; Fried, Nathaniel M.

    2016-04-01

    The thulium fiber laser (TFL) is being studied as an alternative to the standard holmium:YAG laser for lithotripsy. The TFL beam originates within an 18-μm-core thulium-doped silica fiber, and its near single mode, Gaussian beam profile enables transmission of higher laser power through smaller (e.g., 50- to 150-μm core) fibers than possible during holmium laser lithotripsy. This study examines whether the more uniform TFL beam profile also reduces proximal fiber tip damage compared with the holmium laser multimodal beam. Light and confocal microscopy images were taken of the proximal surface of each fiber to inspect for possible laser-induced damage. A TFL beam at a wavelength of 1908 nm was coupled into 105-μm-core silica fibers, with 35-mJ energy, and 500-μs pulse duration, and 100,000 pulses were delivered at each pulse rate setting of 50, 100, 200, 300, and 400 Hz. For comparison, single use, 270-μm-core fibers were collected after clinical holmium laser lithotripsy procedures performed with standard settings (600 mJ, 350 μs, 6 Hz). Total laser energy, number of laser pulses, and laser irradiation time were recorded, and fibers were rated for damage. For TFL studies, output pulse energy and average power were stable, and no proximal fiber damage was observed at settings up to 35 mJ, 400 Hz, and 14 W average power (n=5). In contrast, confocal microscopy images of fiber tips after holmium lithotripsy showed proximal fiber tip degradation, indicated by small ablation craters on the scale of several micrometers in all fibers (n=20). In summary, the proximal fiber tip of a 105-μm-core fiber transmitted up to 14 W of TFL power without degradation, compared to degradation of 270-μm-core fibers after transmission of 3.6 W of holmium laser power. The smaller and more uniform TFL beam profile may improve fiber lifetime, and potentially translate into lower costs for the surgical disposables as well.

  13. Successful treatment of recurrent vesicourethral stricture after radical prostatectomy with holmium laser: report of three cases.

    PubMed

    Hayashi, Tetsuo; Yoshinaga, Atsushi; Ohno, Rena; Ishii, Nobuyuki; Watanabe, Toru; Yamada, Takumi; Kihara, Kazunori

    2005-04-01

    We report three cases with severe anastomotic strictures, which recurred several times after radical prostatectomy despite repeated treatments of urethral dilation, internal urethrotomy and/or transurethral resection. All three cases were finally treated with holmium laser successfully without any intraoperative or postoperative complications after repeated failures of each treatment. There were two specific characteristics in these three cases: the early onset of the stricture and the pinhole opening located on the top (12-o'clock) of the stricture wall. PMID:15948734

  14. Erbium:YAG and holmium:YAG laser root resection of extracted human teeth.

    PubMed

    Komori, T; Yokoyama, K; Matsumoto, Y; Matsumoto, K

    1997-02-01

    Root resection of extracted human teeth was performed using the erbium:YAG (Er:YAG) and holmium:YAG (Ho:YAG) laser to investigate the clinical application of lasers on hard tissue. The CO2 laser and the mechanical drill were also used for comparison. After resection using these technologies, the morphological changes of the cut surface were investigated by optical and scanning electron microscope. Er:YAG laser irradiation produced smooth, clean resected surfaces without signs of thermal damages. Complete obturation of the root canal was maintained after Er:YAG laser irradiation. Ho:YAG laser irradiation, however, produced some signs of thermal damage. Relatively large voids between the gutta-percha and the canal walls were revealed after Ho:YAG laser irradiation. The sealing of the dentinal tubules was not completely attained as stipulated by original conditions of this study. PMID:9467336

  15. Ureteroscopy and holmium:YAG laser lithotripsy: an emerging definitive management strategy for symptomatic ureteral calculi in pregnancy

    NASA Astrophysics Data System (ADS)

    Watterson, James D.; Girvan, Andrew R.; Beiko, Darren T.; Nott, Linda; Wollin, Timothy A.; Razvi, Hassan A.; Denstedt, John D.

    2003-06-01

    Objectives: Symptomatic urolithiasis in pregnancy that does not respond to conservative measures has traditionally been managed with ureteral stent insertion or percutaneous nephrostomy (PCN). Holmium:yttrium-aluminum-garnet (YAG) laser lithotripsy using state-of-the-art ureteroscopes represents an emerging strategy for definitive stone management in pregnancy. The purpose of this study was to review the results of holmium laser lithotripsy in a cohort of patients who presented with symptomatic urolithiasis in pregnancy. Methods: A retrospective analysis was conducted at 2 tertiary stone centers from January 1996 to August 2001 to identify pregnant patients who were treated with ureteroscopic holmium laser lithotripsy for symptomatic urolithiasis or encrusted stents. Eight patients with a total of 10 symptomatic ureteral calculi and 2 encrusted ureteral stents were treated. Mean gestational age at presentation was 22 weeks. Mean stone size was 8.1 mm. Stones were located in the proximal ureter/ureteropelvic junction (UPJ) (3), mid ureter (1), and distal ureter (6). Results: Complete stone fragmentation and/or removal of encrusted ureteral stents were achieved in all patients using the holmium:YAG laser. The overall procedural success rate was 91%. The overall stone-free rate was 89%. No obstetrical or urological complications were encountered. Conclusions: Ureteroscopy and holmium laser lithotripsy can be performed safely in all stages of pregnancy providing definitive management of symptomatic ureteral calculi. The procedure can be done with minimal or no fluoroscopy and avoids the undesirable features of stents or nephrostomy tubes.

  16. [Critical evaluation of indications for the holmium:YAG laser and the neodymium:YAG laser in orthopedic surgery based on an in vitro study].

    PubMed

    Anders, J O; Pietsch, S; Staupendahl, G

    1999-04-01

    This is an in vitro study of the biophysical effects of holmium:YAG and neodymium-YAG lasers that was prompted by the poor clinical results obtained with lumbar percutaneous laser discus decompression (PLDD). In the absence of adequate cooling, ablation of tissue with the holmium:YAG laser causes thermal damage to the surrounding tissues. Utilizing the immediate colour-independent laser coupling effect, the holmium:YAG laser removes soft and hard tissue immediately. The low tissue penetrating power (max. 0.32 mm), together with the use of irrigation, avoids thermal problems, and this laser type with its high pulse energy and frequency is to be recommended for arthroscopic surgery. In contrast, the effects of the neodymium:YAG laser are highly dependent on tissue colour. Using this laser on light-coloured tissue only diffuse warming but no ablation of soft tissue was often seen. The depth of tissue penetration seen in our study was 0.58 mm, but is greatly dependent on the duration of application, and is much larger with long application times. In conclusion, we believe that the neodymium:YAG laser is more suitable for percutaneous intradiscal procedures than the holmium:YAG laser. For arthroscopic surgery, the holmium:YAG laser will be the better choice. The effect of each type of laser depends not only on its physical properties, but also on tissue properties (light or dark-coloured, thermal conductivity) and duration of application. PMID:10379068

  17. Benign Prostatic Hyperplasia Treatment by Transurethral Enucleation of the Prostate Using a 2-μm Laser.

    PubMed

    Guo, He-Qing; Zhou, Gao-Biao; Liu, Hong-Ming; Sun, Bin; Pan, Guang-Xin; Mu, Da-Wei; Yan, Jing-Ming; Xing, Ji-Zhang; Li, Di; Hong, Quan

    2015-12-01

    This study investigates the efficacy of benign prostatic hyperplasia (BPH) treatment by prostate transurethral enucleation using a 2-μm laser. A total of 107 patients with BPH were treated by prostate transurethral enucleation using a RevoLix 2-μm laser surgery system. Bleeding volume, operation time, catheterization time, voiding situation, maximum urinary flow rate, and hospital stay were observed. The mean operation time was 74 min ± 12 min (range 45 to 150 min), the mean follow-up period was 2 to 6 months, the mean catheter time was 5 days, and the mean peak urinary flow rate increased from 6.3 ± 0.6 to 17.5 ± 1.5 mL/s. The International Prostate Symptom Score and quality of life significantly declined (p < 0.01). No significant differences were observed in the hemoglobin and blood electrolytes before and after operation. Prostate transurethral enucleation using a 2-μm laser is safe and efficient for BPH treatment. PMID:27011513

  18. Retrograde flexible ureterorenoscopic holmium-YAG laser lithotripsy: the new gold standard.

    PubMed

    Gould, D L

    1998-03-01

    To demonstrate the efficacy of flexible retrograde ureterorenoscopic holmium-YAG intracorporeal laser lithotripsy for the treatment of renal calculi, a total of 86 patients presenting to our hospital with renal calculi underwent flexible retrograde ureterorenoscopic holmium-YAG intracorporeal laser lithotripsy of their stones, and the data were collected prospectively. As extracorporeal shock wave lithotripsy is not available at our institution, all patients with renal calculi in this study were treated in a retrograde fashion using the Richard Wolf 6.0F semirigid ureteroscope, the 7.5F flexible ureterorenoscope, and the holmium-YAG laser by Coherent Inc. Except for inhospital consults or patients requiring admission secondary to infection, all cases were performed on an ambulatory basis. All renal calculi 3 cm or smaller were approached in a retrograde fashion. Where possible, the stones were initially debulked using the semirigid ureteroscope and the 550-microm fiber followed by the flexible ureterorenoscope in combination with the 360- or 200-microm laser fiber depending on stone position. Stones were fragmented until they were small enough to be removed by hydrocleansing. Using this technique, stone-free success rates for calculi 2.5 cm or smaller after a single treatment, regardless of stone composition or location, are superior to those of extracorporeal shock wave lithotripsy. For calculi between 2.5 and 3 cm, the results also are noted to be superior. We conclude that for calculi larger than 3 cm or for partial staghorn calculi, the treatment of choice appears to be a percutaneous approach. PMID:9568772

  19. Optimization of dosimetry and safety using the holmium laser for urology

    NASA Astrophysics Data System (ADS)

    van Swol, Christiaan F. P.; Verdaasdonck, Rudolf M.; Zeijlemaker, Bram Y. W.; Grimbergen, Matthijs C. M.; Boon, Tom A.

    1998-07-01

    The holmium laser has become accepted as a versatile instrument for urological applications, such as prostate resection, urethrotomy, tumor coagulation and lithotripsy. Presently, more powerful lasers have become available generating pulses up to 4 J at 80 W. The necessity of these high power systems in urology is ambiguous. In this study, the dosimetry as to efficacy and especially safety was investigated for various applications. The holmium laser ((lambda) equals 2.1 micrometer) emits its energy in 350 microsecond pulses which instantly turn water into vapor. Using high-speed photography explosive vapor bubbles with diameters over 10 mm were captured. The mechanical force of these bubbles, effectively fragments stones but may dilate and rupture a small lumen like the ureter. After implosion of the bubble, the energy of vaporization turns into heat. Depending on pulse energy and pulse repetition rate, tissue can be thermally affected up to 5 mm. For soft tissue applications, e.g., urethrotomy, prostatectomy or tumor coagulation, pulse energies of 0.5 - 1.5 J were applied at a high repetition rate (20 - 40 Hz) to provide sufficient coagulative and hemostatic effects. At higher pulse energies, the fiber tip was vibrating vigorously and the tissue was ripped to pieces decreasing hemostasis and visibility. For hard tissue applications, bursts of 0.5 J pulses at 5 Hz, proved to be sufficient to fragment all types of stones (including cystine) in the ureter and the bladder without mechanical or thermal damage to surrounding tissue. At higher settings, targeting the stone was less controlled and effective due to 'jumping' of the fiber tip with resulting mechanical and thermal trauma to the surrounding tissue. The holmium laser can be used effectively to coagulate and cut soft tissue and fragment stones at relatively low energy and power settings, thus minimizing the risk of complications.

  20. Acute and chronic response of meniscal fibrocartilage to holmium:YAG laser irradiation

    NASA Astrophysics Data System (ADS)

    Horan, Patrick J.; Popovic, Neven A.; Islinger, Richard B.; Kuklo, Timothy R.; Dick, Edward J.

    1997-05-01

    The acute and chronic (10 week) histological effects of the holmium:YAG laser during partial meniscectomy in an in vivo rabbit model were investigated. Twenty-four adult male New Zealand rabbits underwent bilateral parapatellar medial knee arthrotomies. In the right knee, a partial medial meniscectomy was done through the avascular zone using a standard surgical blade. In the left knee, an anatomically similar partial medial meniscectomy was performed using a Ho:YAG laser (Coherent, USA). This study indicates that the laser creates two zones of damage in the meniscal fibrocartilage and that the zone of thermal change may act as a barrier to healing. The zone of thermal change which is eventually debrided was thought at the time of surgery to be viable. In the laser cut menisci, the synovium appears to have greater inflammation early and to be equivalent with the scalpel cut after three weeks. At all time periods there appeared more cellular damage in the laser specimens.

  1. Cavitation effect of holmium laser pulse applied to ablation of hard tissue underwater.

    PubMed

    Lü, Tao; Xiao, Qing; Xia, Danqing; Ruan, Kai; Li, Zhengjia

    2010-01-01

    To overcome the inconsecutive drawback of shadow and schlieren photography, the complete dynamics of cavitation bubble oscillation or ablation products induced by a single holmium laser pulse [2.12 microm, 300 micros (FWHM)] transmitted in different core diameter (200, 400, and 600 microm) fibers is recorded by means of high-speed photography. Consecutive images from high-speed cameras can stand for the true and complete process of laser-water or laser-tissue interaction. Both laser pulse energy and fiber diameter determine cavitation bubble size, which further determines acoustic transient amplitudes. Based on the pictures taken by high-speed camera and scanned by an optical coherent microscopy (OCM) system, it is easily seen that the liquid layer at the distal end of the fiber plays an important role during the process of laser-tissue interaction, which can increase ablation efficiency, decrease heat side effects, and reduce cost. PMID:20799845

  2. Percutaneous Endoscopic Holmium Laser Lithotripsy for Management of Complicated Biliary Calculi

    PubMed Central

    Healy, Kelly; Chamsuddin, Abbas; Spivey, James; Martin, Louis; Nieh, Peter

    2009-01-01

    Background and Objectives: Advances in endoscopic techniques have transformed the management of urolithiasis. We sought to evaluate the role of such urological interventions for the treatment of complex biliary calculi. Methods: We conducted a retrospective review of all patients (n=9) undergoing percutaneous holmium laser lithotripsy for complicated biliary calculi over a 4-year period (12/2003 to 12/2007). All previously failed standard techniques include ERCP with sphincterotomy (n=6), PTHC (n=7), or both of these. Access to the biliary system was obtained via an existing percutaneous transhepatic catheter or T-tube tracts. Endoscopic holmium laser lithotripsy was performed via a flexible cystoscope or ureteroscope. Stone clearance was confirmed intra- and postoperatively. A percutaneous transhepatic drain was left indwelling for follow-up imaging. Results: Mean patient age was 65.6 years (range, 38 to 92). Total stone burden ranged from 1.7 cm to 5 cm. All 9 patients had stones located in the CBD, with 2 patients also having additional stones within the hepatic ducts. All 9 patients (100%) were visually stone-free after one endoscopic procedure. No major perioperative complications occurred. Mean length of stay was 2.4 days. At a mean radiological follow-up of 5.4 months (range, 0.5 to 21), no stone recurrence was noted. Conclusions: Percutaneous endoscopic holmium laser lithotripsy is a minimally invasive alternative to open salvage surgery for complex biliary calculi refractory to standard approaches. This treatment is both safe and efficacious. Success depends on a multidisciplinary approach. PMID:19660213

  3. Endoscopic removal of a proximal urethral stent using a holmium laser: Case report and literature review

    PubMed Central

    Botelho, Francisco; Thomas, Anil A.; Miocinovic, Ranko; Angermeier, Kenneth W.

    2012-01-01

    Urethral stents were initially developed for the management of urethral strictures and obstructive voiding disorders in select patients. Urethral stent complications are common and may require stent explantation, which is often quite challenging. We present our experience with endoscopic removal of an encrusted UroLume proximal urethral stent in a 72-year-old male using a holmium laser. The literature on various management options and outcomes for urethral stent removal is reviewed. Endoscopic removal of proximal urethral stents is feasible and safe and should be considered as the primary treatment option in patients requiring stent extraction. PMID:23248530

  4. Sexual outcome of patients undergoing thulium laser enucleation of the prostate for benign prostatic hyperplasia.

    PubMed

    Carmignani, Luca; Bozzini, Giorgio; Macchi, Alberto; Maruccia, Serena; Picozzi, Stefano; Casellato, Stefano

    2015-01-01

    Treatment of patients with lower urinary tract symptoms (LUTS) secondary to benign prostatic hyperplasia (BPH) may affect the quality of sexual function and ejaculation. The effect of new surgical procedures, which are currently available to treat BPH, on erection and ejaculation, has been poorly studied. This study aimed to assess the effect of thulium laser enucleation of the prostate (ThuLEP) on sexual function and retrograde ejaculation in patients with LUTS secondary to BPH. We performed a prospective study in 110 consecutive patients who had undergone ThuLEP to analyze changes in sexual function and urinary symptoms. To evaluate changes in erection and ejaculation, and the effect of urinary symptoms on the quality of life (QoL), five validated questionnaires were used: the ICIQ-MLUTSsex, MSHQ-EjD, International Index of Erectile Function 5, International Prognostic Scoring System (IPSS) questionnaire, and QoL index of the intraclass correlation coefficients. Patients also underwent IPSS and flowmetry to assess the outcome of flow. Patients were evaluated before surgery and 3-6 months after ThuLEP, whereas those with previous abdominal surgery were excluded. The patients' mean age was 67.83 years. Postoperative urinary symptoms improved after surgery. No significant differences in erectile function before and after surgery were observed. As compared with other techniques described in the literature, the percentage of patients with conserved ejaculation increased by 52.7% after ThuLEP. ThuLEP positively affects urinary symptoms and their effect on the QoL of patients as assessed by questionnaire scores. While endoscopic management of BPH (e.g. transurethral resection of the prostate) causes retrograde ejaculation in most patients, those who undergo ThuLEP have conserved ejaculation and erectile function. PMID:25652616

  5. Sexual outcome of patients undergoing thulium laser enucleation of the prostate for benign prostatic hyperplasia

    PubMed Central

    Carmignani, Luca; Bozzini, Giorgio; Macchi, Alberto; Maruccia, Serena; Picozzi, Stefano; Casellato, Stefano

    2015-01-01

    Treatment of patients with lower urinary tract symptoms (LUTS) secondary to benign prostatic hyperplasia (BPH) may affect the quality of sexual function and ejaculation. The effect of new surgical procedures, which are currently available to treat BPH, on erection and ejaculation, has been poorly studied. This study aimed to assess the effect of thulium laser enucleation of the prostate (ThuLEP) on sexual function and retrograde ejaculation in patients with LUTS secondary to BPH. We performed a prospective study in 110 consecutive patients who had undergone ThuLEP to analyze changes in sexual function and urinary symptoms. To evaluate changes in erection and ejaculation, and the effect of urinary symptoms on the quality of life (QoL), five validated questionnaires were used: the ICIQ-MLUTSsex, MSHQ-EjD, International Index of Erectile Function 5, International Prognostic Scoring System (IPSS) questionnaire, and QoL index of the intraclass correlation coefficients. Patients also underwent IPSS and flowmetry to assess the outcome of flow. Patients were evaluated before surgery and 3–6 months after ThuLEP, whereas those with previous abdominal surgery were excluded. The patients’ mean age was 67.83 years. Postoperative urinary symptoms improved after surgery. No significant differences in erectile function before and after surgery were observed. As compared with other techniques described in the literature, the percentage of patients with conserved ejaculation increased by 52.7% after ThuLEP. ThuLEP positively affects urinary symptoms and their effect on the QoL of patients as assessed by questionnaire scores. While endoscopic management of BPH (e.g. transurethral resection of the prostate) causes retrograde ejaculation in most patients, those who undergo ThuLEP have conserved ejaculation and erectile function. PMID:25652616

  6. Influence of pulse duration on erbium and holmium laser ablation under water

    NASA Astrophysics Data System (ADS)

    Ith, Michael; Frenz, Martin; Pratisto, Hans S.; Weber, Heinz P.; Altermatt, Hans J.; Staeubli, Hans U.; Asshauer, Thomas; Delacretaz, Guy P.; Salathe, Rene-Paul; Gerber, Bruno E.

    1995-01-01

    Erbium and Holmium lasers are ideally suited for cutting and drilling biological tissue. This is due to the fact that their wavelengths (Er:YSGG at 2.79 micrometers and Ho:YAG at 2.12 micrometers ) are strongly absorbed in water which is present in all tissues. Combined with an optical fiber these lasers seem to be optimal instruments for endoscopic and/or minimal invasive applications in surgery. In this study we focused our interest on cutting of human meniscus in the knee where, besides a very limited operation field, the standard arthroscopic treatment is performed in a liquid, highly absorbing environment. The bubble formation process, therefore, has to be well understood because it mainly determines relevant aspects of tissue ablation. The influence of the laser parameters in general and the influence of pulse duration in particular are determined in this paper for two different laser wavelengths. The goal was to determine the optimum laser parameters in view of a high ablation efficiency, a high precision and a minimal destruction of the adjacent tissue. To determine the optimum pulse duration for ablating tissue under water and to obtain a better understanding of the channel formation process, transmission and pressure measurements together with video flash photography were performed. Additionally, we determined experimentally the ratio between initial laser pulse energy and energy available for tissue treatment under water. To prove the results obtained, cuts in human meniscus were performed, sectioned and evaluated. The comparison between the results obtained with the Erbium and Holmium laser revealed a strong influence of the absorption coefficients on the tissue effects, especially on the ablation efficiency and on the zone of thermally and mechanically damaged tissue.

  7. Operation of the nose using Nd-YAG and holmium laser

    NASA Astrophysics Data System (ADS)

    Kukwa, Andrzej; Tulibacki, Marek P.; Zajac, Andrzej; Dudziec, Katarzyna

    2000-06-01

    During more than 5 years Nd:YAG and Holmium laser has been used in our ENT Department for the treatment of varies pathological changes. Most of our cases were previously treated many times because of recurrences of the nasal polyps. As a rule the treatment was given in one to three sessions. Each patient was very closely monitored. The time period between the session was 2-4 weeks. The consequent application of laser was dependent on healing process. All adults' patients were treated in local anesthesia using 1,5 percent of Cocaine and 10 percent Xylocaine applied in a spray; no other anesthetics were needed, although in some patients 10 mg Valium was administered before first session of laser application. We do not observe a severe bleeding needed sponge or a nose package. Among advantages we have to concentrate on two: the recurrences of nasal polyps are definitely much rare and patient may appear at work at the same day.

  8. High power operation of cladding pumped holmium-doped silica fibre lasers.

    PubMed

    Hemming, Alexander; Bennetts, Shayne; Simakov, Nikita; Davidson, Alan; Haub, John; Carter, Adrian

    2013-02-25

    We report the highest power operation of a resonantly cladding-pumped, holmium-doped silica fibre laser. The cladding pumped all-glass fibre utilises a fluorine doped glass layer to provide low loss cladding guidance of the 1.95 µm pump radiation. The operation of both single mode and large-mode area fibre lasers was demonstrated, with up to 140 W of output power achieved. A slope efficiency of 59% versus launched pump power was demonstrated. The free running emission was measured to be 2.12-2.15 µm demonstrating the potential of this architecture to address the long wavelength operation of silica based fibre lasers with high efficiency. PMID:23481989

  9. Holmium:YAG laser: effect on pulpal tissues and root surfaces

    NASA Astrophysics Data System (ADS)

    Holt, Raleigh A.; Nordquist, Robert E.

    1996-04-01

    The effects of the Holmium:YAG irradiation on the pulpal tissues and surface topography on root surface dentin in human teeth in vivo were studied. The exposed root surfaces of seventeen pre-immediate denture patients were scaled and root planed with a Gracey 3 - 4 curette apical to the dentinoenamel junction until smooth and hard. The prepared root surfaces of two teeth per patient were exposed with Holmium:YAG laser energy after an application of nonfilled resin/fluoride mixture. The laser exposed areas were below the dentinoenamel junction around one-half of each root surface. The opposing sides of each of the teeth received resin/fluoride but no laser energy. A third tooth was identified as a nontreated control. The HO:YAG at 2.12 microns wavelength with a defocused beam size of 3 mm was used. The amount of laser energy delivered per 3 X 5 mm area was 0.450 (+/- .05) joules with a fluence of 2.66 - 3.30 J/cm2. The teeth were extracted after periods of 45 - 120 days. The specimens were fixed in formalin and prepared for histological examination using hematoxylin and eosin stains. Microscopic evaluation of room surfaces showed increased smoothness on the laser treated sites compared to their opposing non-lased sides. Histological examination of the pulpal tissues exhibited no abnormal changes. No clinical symptoms of pulpal pathology were produced. HO:YAG laser energy proved safe for treating room surfaces of human teeth in vivo under conditions presented in this study.

  10. Experience with endoscopic holmium laser in the pediatric population

    NASA Astrophysics Data System (ADS)

    Merguerian, Paul A.; Reddy, Pramod P.; Barrieras, Diego; Bagli, Darius J.; McLorie, Gordon A.; Khoury, Antoine E.

    1999-06-01

    Introduction: Due to the unavailability of suitable endoscopic instruments, pediatric patients have not benefited fully from the technological advances in the endoscopic management of the upper urinary tract. This limitation may be overcome with the Holmuim:Yttrium-Aluminum-Garnet(Ho:YAG) laser delivered via small instruments. To date, there is no published report on the use of this modality in children. Purpose: We evaluated the indications, efficacy, and complications of endourological Ho:YAG laser surgery in the treatment of pediatric urolithiasis, posterior urethral valves, ureterocele and ureteropelvic junction obstruction. Methods: The patient population included 10 children with renal, ureteral and bladder calculi, 2 children with posterior urethral valves, 2 children with obstructing ureteroceles, 2 children with ureteropelvic junction obstruction and 1 child with a urethral stricture. Access to the lesions was either antegrade via a percutaneous nephrostomy tract or retrograde via the urethra. A solid state Ho:YAG laser with maximum output of 30 watts (New Star lasers, Auburn, CA) was utilized as the energy source. Results: A total of 10 patients underwent laser lithotripsy. The means age of the patients was 9 yrs (5-13 yrs). The average surface area of the calculi as 425.2 mm2 (92-1645 mm2). 8 of the patients required one procedure to render them stone free, one patient had a staghorn calculus filling every calyx of a solitary kidney requiring multiple treatments and one other patient with a staghorn calculus required 2 treatments. There were no complications related to the laser lithotripsy. Two newborn underwent successful ablation of po sterious urethral valves. Two infants underwent incision of obstructing ureteroceles with decompression of the ureterocele on postoperative ultrasound. Two children underwent endypyelotomy for ureteropelvic junction obstruction. One was successful an done required an open procedure to correct the obstruction. One child

  11. Treatment of Parapelvic Cyst by Internal Drainage Technology Using Ureteroscope and Holmium Laser

    PubMed Central

    Zhao, Q; Huang, S; Li, Q; Xu, L; Wei, X; Huang, S; Li, S; Liu, Z

    2015-01-01

    ABSTRACT Background: The aim of parapelvic cyst treatment is to have complete drainage of cyst fluid and prevent its further compression of the kidney and collective system. This study explores the efficacy and safety of surgical approaches with holmium laser ureteroscopic internal drainage in the treatment of parapelvic cyst. Methods: The compression effect of parapelvic cyst on the renal collective system was observed by rigid ureteroscope using retrograde ureteroscopic technology. With direct vision, the cyst wall on the obvious parapelvic compression site was cut. The diameter of the cyst wall cut was about 1 cm. The internal drainage was obtained by double-J tubes. When the cyst was in the inferior pole of kidney or where the rigid ureteroscope could not reach, a flexible ureteroscope was used. Results: In 28 cases of operation, 27 cases were successful. The cyst treatment time was eight to 40 minutes (average 26 minutes). During the operation, no massive haemorrhage, damage of nearby organ and ureter, or other complications happened. Time of follow-up was 10–72 months (average 39 months). The results of follow-up showed that in 22 cases, the cyst disappeared; the diameter of the cyst in four cases was reduced by more than half, and one case recurred. Conclusion: The treatment of parapelvic cyst by internal drainage operation using holmium laser and ureteroscopy was effective. The operation was safe with few complications. PMID:26426175

  12. Posterior Urethral Polyp: First Holmium-YAG Laser Ablation on a 3-Month-Old Infant

    PubMed Central

    Keskin, Ercument; Yapanoglu, Turgut; Adanur, Senol; Ziypak, Tevfik; Altay, Mehmet Sefa; Aksoy, Yılmaz

    2016-01-01

    Abstract Background: Urethral polyps are rare benign pathologies seen in the male posterior urethra, more frequently originating from verumontanum. In this article, we aimed to discuss diagnosis and treatment of a urethral polyp causing hematuria and urinary infection in a 3-month-old male infant. This is the first case in the literature in which a urethral polyp is treated with Holmium yttrium-aluminum-garnet (YAG) laser. Case Presentation: The patient was a 3-month-old male infant, and complains were hematuria and crying during micturition. Ultrasonography and voiding cystourethrogram were used for diagnosis. Urethral polyp was observed on urethrocystoscopy. Ablation was performed with a newborn cystoscope. Conclusion: Urethral polyp can cause hematuria and urinary obstruction and should be considered in the differential diagnosis of pathologies such as posterior urethral valve and cecoureterocele that could cause infravesical obstruction. Holmium-YAG laser is a good choice of treatment with easy application possibilities using a newborn cystoscope, especially for newborns and infants who have thin urethra. PMID:27579428

  13. Endoscopic goniotomy probe for holmium:YAG laser delivery

    NASA Astrophysics Data System (ADS)

    Joos, Karen M.; Shen, Jin-Hui; Ren, Qiushi

    1994-06-01

    Goniotomy is an effective treatment for primary infantile glaucoma. Because a cloudy cornea may prevent a clear view of the anterior chamber angle through the operating microscope, we investigated whether an endoscope can be combined with a cutting laser to perform laser goniotomy in a surgical model of primary infantile glaucoma. The anterior chambers of cadaver procine eyes were deepened with a viscoelastic material. A 300-micron-diameter silica fiber coupled to an Olympus 0.8-mm-diameter flexible fiber optic endoscope entered the anterior chambers through 4-mm corneal incisions. The anterior chamber angles were clearly observed on a videoscreen as the endoscopic fiber optic laser scalpel approached the pectinate ligaments. With the guidance of a He-Ne aiming beam, the anterior chamber angle pectinate ligaments were cut over a 160 degree arc with a pulsed Ho:YAG laser (2.1 micrometers wavelength, 50 mJ, 5 Hz repetition). The specimens were fixed in glutaraldehyde and processed for scanning electron microscopy, or fixed in formalin and processed for light microscopy. The treated area demonstrated incision of the pectinate ligaments with opening of the underlying trabecular meshwork. The edoscopic fiber optic laser scalpel is capable of cutting the pectinate ligaments in a surgical model of primary infantile glaucoma. Therefore, it may be a useful instrument for performing goniotomy when a cloudy cornea in primary infantile glaucoma prevents visualization of the anterior chamber angle with a goniotomy lens.

  14. Evaluation of holmium laser versus cold knife in optical internal urethrotomy for the management of short segment urethral stricture

    PubMed Central

    Jain, Sudhir Kumar; Kaza, Ram Chandra Murthy; Singh, Bipin Kumar

    2014-01-01

    Objectives: Sachse cold knife is conventionally used for optical internal urethrotomy intended to manage urethral strictures and Ho: YAG laser is an alternative to it. The aim of this study was to evaluate the role of urethral stricture treatment outcomes, efficacy, and complications using cold knife and Ho: YAG (Holmium laser) for optical internal urethrotomy Materials and Methods: In this prospective study included, 90 male patients age >18 years, with diagnosis of urethral stricture admitted for internal optical urethrotomy during April 2010 to March 2012. The patients were randomized into two groups containing 45 patients each using computer generated random number. In group A (Holmium group), internal urethrotomy was done with Holmium laser and in group B (Cold knife group) Sachse cold knife was used. Patients were followed up for 6 months after surgery in Out Patient Department on 15, 30 and 180 post-operative days. At each follow up visit physical examination, and uroflowmetry was performed along with noting complaints, if any. Results: The peak flow rates (PFR) were compared between the two groups on each follow up. At 180 days (6 month interval) the difference between mean of PFR for Holmium and Cold knife group was statistically highly significant (P < 0.001). Complications were seen in 12.22% of cases. Conclusion: Both modalities are effective in providing immediate relief to patients with single and short segment (<2 cm long) urethral strictures but more sustained response was attained with Cold knife urethrotomy. PMID:25371611

  15. Holmium laser ablation of cartilage: effects of cavitation bubbles

    NASA Astrophysics Data System (ADS)

    Asshauer, Thomas; Jansen, Thomas; Oberthur, Thorsten; Delacretaz, Guy P.; Gerber, Bruno E.

    1995-05-01

    The ablation of fresh harvested porcine femur patellar groove cartilage by a 2.12 micrometers Cr:Tm:Ho:YAG laser in clinically used irradiation conditions was studied. Laser pulses were delivered via a 600 micrometers diameter fiber in isotonic saline. Ablation was investigated as a function of the angle of incidence of the delivery fiber with respect to the cartilage surface (0-90 degrees) and of radiant exposure. Laser pulses with energies of 0.5, 1.0 and 1.5 J and a duration of 250 microseconds were used. A constant fiber tip-tissue distance of 1 mm was maintained for all experiments. The dynamics of the induced vapor bubble and of the ablation process was monitored by time resolved flash videography with a 1 microseconds illumination. Acoustic transients were measured with a piezoelectric PVDF needle probe hydrophone. Bubble attachment to the cartilage surface during the collapse phase, leading to the direct exposition of the cartilage surface to the maximal pressure generated, was observed in all investigated irradiation conditions. Maximal pressure transients of up to 200 bars (at 1 mm distance from the collapse center) were measured at the bubble collapse at irradiation angles >= 60 degrees. No significant pressure variation was observed in perpendicular irradiation conditions as a function of radiant exposure. A significant reduction of the induced pressure for irradiation angles

  16. Application of 2-um wavelength holmium lasers for treatment of skin diseases

    NASA Astrophysics Data System (ADS)

    Shcherbakov, Ivan A.; Klimov, Igor V.; Tsvetkov, Vladimir B.; Nerobeev, Alexander I.; Sadovnikova, Lija B.; Eliseenko, Vladimir I.

    1994-09-01

    Theoretical and experimental analysis of the efficiency of application of 2 micrometers pulsed holmium laser for cosmetic and plastic surgery and dermatology is carried out. Preliminary experiments were carried out on rats. Solid state 2 micrometers pulsed laser was allowed to operate in free running mode with pulse energy up to 1.5 J and pulse repetition rate up to 5 Hz. To deliver emission to the object a flexible quartz fiber without further focusing of 2.5 m in length and 400 micrometers of the core diameter was used. The effect of the different power density emission on the skin was studied. The second stage was the study of the influence of 2 micrometers emission on human skin. The results of the removal of hemangioma, papilloma, telangiectasia, nevus, nevus acantholytic, xanthelasma palpebral, verruca, chloasma, pigmental spots, tattoos, etc. are presented. Precision, simplicity, efficiency, and the high cosmetic effect of these operations is noted.

  17. Metals fact sheet: Holmium/thulium

    SciTech Connect

    1996-02-01

    This article discusses the geology, exploitation, market, and applications of holmium and thulium. Holmium and thulium are important part in the development of specific laser technologies, x-ray film and high-temperature superconductors.

  18. Laboratory investigation of the efficacy of holmium:YAG laser irradiation in removing intracanal debris

    NASA Astrophysics Data System (ADS)

    Nuebler-Moritz, Michael; Gutknecht, Norbert; Sailer, Hermann F.; Hering, Peter; Prettl, Wilhelm

    1997-05-01

    Current endodontic therapy involves debridement and disinfection of the root canal by means of mechanical instrumentation and chemical irrigation. However, several studies have shown that these techniques fail to achieve complete cleansing. Recently, lasers have been suggested for use within root canals. This study was conducted to determine the efficacy of Holmium:YAG laser irradiation in removing intracanal debris and smear layer. Root canal surfaces of freshly-extracted human teeth were exposed to pulsed Ho:YAG laser radiation. Subsequently, laser induced structural changes were investigated using scanning electron microscopy. Temperature measurements during irradiation were performed by means of thermocouples. The result of this survey give a preliminary indication of the ability of the Ho:YAG laser to improve current endodontic treatment survey give a preliminary indication of the ability of the Ho:YAG laser to improve current endodontic treatment modalities. However, limitations exist with regard to circumscribed and well-quantified irradiation of root canal surfaces, due to the lack of perpendicular delivery of the laser beam. Additional studies will be required to develop suitable optical transmission systems, in order to achieve complete cleansing and to avoid damage to the periradicular tissues, respectively.

  19. Changes in corneal collagen induced by holmium:YAG laser irradiation

    NASA Astrophysics Data System (ADS)

    Timberlake, George T.; Reinke, Martin H.; Miller, Alvin

    1996-05-01

    Holmium:YAG laser thermokeratoplasty corrects hyperopia (farsightedness) by producing small areas of corneal collagen shrinkage that cause the central cornea to bulge outward, increasing optical power. Collagen shrinkage is probably caused by laser-heated corneal water, but details of the shrinkage mechanism are not known. We investigated the shrinkage mechanism by measuring changes in corneal ultrastructure, surface shrinkage, water content, and strength following Ho:YAG laser exposures. Morphological changes in collagen were documented by measurements from electron micrographs. Corneal adhesive strength was determined by measuring tearing force in a plane parallel to the corneal surface. Laser-induced water loss was measured by weighing corneal samples before and after exposure. Corneal surface shrinkage was assessed by photographing the movement of particles on the cornea. Lasered collagen fibrils increased in diameter, lost their orderly arrangement, and appeared `frayed.' The corneal surface contracted toward lasered areas with a maximal shift of approximately 190 micrometers , more than could be explained by a model based on collagen fibril changes. Water loss plays a minor role in corneal shrinkage since corneal samples lost about only about 1.4% of their weight after massive laser exposure. Despite marked changes in collagen structure, corneal adhesive force was unchanged.

  20. Q-switching of a thulium-doped fibre laser using a holmium-doped fibre saturable absorber

    SciTech Connect

    Sadovnikova, Ya E; Kamynin, V A; Kurkov, A S; Medvedkov, O I; Marakulin, A V; Minashina, L A

    2014-01-31

    We have proposed and demonstrated a new passively Q-switched thulium-doped fibre laser configuration. A distinctive feature of this configuration is the use of a heavily holmium-doped fibre for Q-switching. Lasing was obtained at 1.96 μm, with a pulse energy of 3 μJ and pulse duration of 600 ns. The highest pulse repetition rate was 80 kHz. (control of laser radiation parameters)

  1. Risk factors of infectious complications following flexible ureteroscope with a holmium laser: a retrospective study

    PubMed Central

    Fan, Song; Gong, Binbin; Hao, Zongyao; Zhang, Li; Zhou, Jun; Zhang, Yifei; Liang, Chaozhao

    2015-01-01

    Purpose: We aimed to evaluate the effectiveness of flexible ureteroscope for treating kidney stones and the risk factors for infectious complications following flexible ureteroscope (FURS) with a holmium laser. Methods: We retrospectively reviewed the data of 227 patients with kidney stones who underwent flexible ureteroscope with a holmium laser at our hospital from January 2012 to September 2014, including gender, age, comorbidity, urine analysis results, urine culture results, blood test results, stone size, operative duration, and residual stones. Patients with and without infectious complications were assigned to groups A and B, respectively. The dependent variables were postoperative infectious complications, and the risk factors for infectious complications following FURS were assessed using Chi-square tests and multivariate logistic regression analyses. Results: All the surgeries were successfully completed. The total stone-free rate was 81.9% (n = 186), and the incidence of infectious complications after FURS was 8.37% (n = 19). Fifteen patients (6.61%) developed fever postoperatively, 10 patients (4.41%) developed systemic inflammatory response syndrome (SIRS), 6 patients with fever were considered to have SIRS (2.64%), and 2 patients had sepsis (0.88%). Univariate analyses of groups A and B indicated that pyuria, stone size, operative duration, and infectious stones were risk factors for infectious complications after FURS (P < 0.05). Multivariate logistic regression analyses indicated that pyuria (P = 0.017), operative duration (P = 0.026), and infectious stones (P = 0.030) were independently related to infectious complications. Conclusion: Pyuria, operative duration, and infectious stones were risk factors for infectious complications following FURS. Hence, routine urinalysis findings should be carefully considered, particularly the finding of pyuria. PMID:26379932

  2. Percutaneous Transhepatic Endoscopic Holmium Laser Lithotripsy for Intrahepatic and Choledochal Biliary Stones

    SciTech Connect

    Rimon, Uri; Kleinmann, Nir; Bensaid, Paul; Golan, Gil; Garniek, Alexander; Khaitovich, Boris; Winkler, Harry

    2011-12-15

    Purpose: To report our approach for treating complicated biliary calculi by percutaneous transhepatic endoscopic biliary holmium laser lithotripsy (PTBL). Patients and Methods: Twenty-two symptomatic patients (11 men and 11 women, age range 51 to 88 years) with intrahepatic or common bile duct calculi underwent PTBL. Nine patients had undergone previous gastrectomy and small-bowel anastomosis, thus precluding endoscopic retrograde cholangiopancreatography. In the other 13 patients, stone removal attempts by ERCP failed due to failed access or very large calculi. We used a 7.5F flexible ureteroscope and a 200-{mu}m holmium laser fiber by way of a percutaneous transhepatic tract, with graded fluoroscopy, to fragment the calculi with direct vision. Balloon dilatation was added when a stricture was seen. The procedure was performed with the patient under general anaesthesia. A biliary drainage tube was left at the end of the procedure. Results: All stones were completely fragmented and flushed into the small bowel under direct vision except for one patient in whom the procedure was aborted. In 18 patients, 1 session sufficed, and in 3 patients, 2 sessions were needed. In 7 patients, balloon dilatation was performed for benign stricture after Whipple operation (n = 3), for choledochalenteric anastomosis (n = 3), and for recurrent cholangitis (n = 1). Adjunctive 'balloon push' (n = 4) and 'rendezvous' (n = 1) procedures were needed to completely clean the biliary tree. None of these patients needed surgery. Conclusion: Complicated or large biliary calculi can be treated successfully using PTBL. We suggest that this approach should become the first choice of treatment before laparoscopic or open surgery is considered.

  3. Correlation of thermal and mechanical effects of the holmium laser for various clinical applications

    NASA Astrophysics Data System (ADS)

    Grimbergen, Matthijs C. M.; Verdaasdonck, Rudolf M.; van Swol, Christiaan F. P.

    1998-05-01

    The Holmium laser has become established in orthopedic surgery and urology due to its unique combination of mechanical and thermal properties induced by explosive vapor bubbles. In a specialized setup, real-time high-speed and thermal images of dynamic vapor bubbles and thermal relaxation at a water tissue interface were obtained simultaneously. The thermal effects in the tissue model were correlated to the characteristics of the bubbles dependent on pulse energy (0.2 - 4 J), pulse repetition frequency (5 - 40 Hz), distance and angle of fiber delivery system (diameter 365 micrometer) to the tissue surface. Up to a fiber-to-tissue distance of 50% of the radius of the bubble, only a superficial tissue layer was heated. During bubble implosion, the tissue surface was attracted to the fiber, ripping of irregularities, and was effectively cooled by turbulence. In case of hard tissues, the bubble detached from the fiber imploding towards the hard surface. At closer distances (less than 50% of bubble radius), the tissue itself was vaporized resulting in mechanical damage and thermal relaxation into the tissue, especially above repetition rates of 5 Hz. There is a strong correlation between the path length of the free beam within the bubble and the degree of mechanical and thermal damage in the tissue directly irradiated by this beam. During clinical applications the surgeon should be aware of the size of the vapor bubble in relation to the distance and angle with the tissue for safe optimal use of the mechanical and thermal properties of the Holmium laser.

  4. A review of thulium laser vapo-enucleation of the prostate: A novel laser-based strategy for benign prostate enlargement.

    PubMed

    Jones, Patrick; Rai, Bhavan Prasad; Somani, Bhaskar K; Aboumarzouk, Omar M

    2015-09-01

    Thulium laser vapo-enucleation of the prostate is the latest addition to the arsenal of minimally invasive therapies available for the surgical treatment of lower urinary tract symptoms secondary to benign prostate hyperplasia. The potential advantages include smoother vaporisation, a clearer visual field and the option of both continuous-wave and pulsed modes, which also potentiate the haemostatic properties of this endoscopic method. Short-term results show that it yields significant improvements in both subjective and objective outcomes, with a strong safety profile. Large-scale randomised studies with a longer follow-up are warranted to determine the durability of this laser procedure. PMID:26413349

  5. A review of thulium laser vapo-enucleation of the prostate: A novel laser-based strategy for benign prostate enlargement

    PubMed Central

    Jones, Patrick; Rai, Bhavan Prasad; Somani, Bhaskar K.; Aboumarzouk, Omar M.

    2015-01-01

    Thulium laser vapo-enucleation of the prostate is the latest addition to the arsenal of minimally invasive therapies available for the surgical treatment of lower urinary tract symptoms secondary to benign prostate hyperplasia. The potential advantages include smoother vaporisation, a clearer visual field and the option of both continuous-wave and pulsed modes, which also potentiate the haemostatic properties of this endoscopic method. Short-term results show that it yields significant improvements in both subjective and objective outcomes, with a strong safety profile. Large-scale randomised studies with a longer follow-up are warranted to determine the durability of this laser procedure. PMID:26413349

  6. Management of Benign Prostatic Hyperplasia Larger than 100 ml: Simple Open Enucleation Versus Transurethral Laser Prostatectomy.

    PubMed

    Elkoushy, Mohamed A; Elhilali, Mostafa M

    2016-06-01

    Benign prostatic hyperplasia (BPH) is one of the most common causes of lower urinary tract symptoms (LUTS) in aging men. Over the age of 60, more than a half of men have BPH and/or bothersome LUTS. Contemporary guidelines advocate surgery as the standard of care for symptomatic BPH after failure of medical therapy, where the choice of the appropriate surgical procedure depends on the prostate size. Transurethral resection of the prostate (TURP) and simple open prostatectomy (OP) have been considered for decades the reference-standard techniques for men with prostate smaller and larger than 80 ml, respectively. However, both procedures are potentially associated with considerable perioperative morbidity which prompted the introduction of a variety of minimally invasive surgical techniques with comparable long-term outcomes compared to TURP and OP. Nevertheless, the management of prostates larger than 100 ml remains a clinical challenge. Transurethral anatomical enucleation of the prostate utilizing different laser energy represents an excellent alternative concept in transurethral BPH surgery. These procedures gained popularity and demonstrated similar outcomes to OP with the advantages of favorable morbidity profiles and shorter catheter time and hospital stay. Despite the fact that OP remains a viable treatment option for patients with bothersome LUTS secondary to very large prostates, this procedure has been to a large extent replaced by these emerging enucleation techniques. Given the advent of surgical alternatives, the current review presents an evidence-based comparison of the efficacy and safety profile of the currently available transurethral laser techniques with the standard OP for the management of BPH due to adenomas larger than 100 ml. PMID:27048160

  7. Efficacy of Holmium Laser Urethrotomy in Combination with Intralesional Triamcinolone in the Treatment of Anterior Urethral Stricture

    PubMed Central

    Kapoor, Ankur; Ganesamoni, Raguram; Nanjappa, Bhuvanesh; Sharma, Varun; Mete, Uttam K

    2012-01-01

    Purpose To evaluate the outcome of visual internal urethrotomy with a holmium:yttrium-aluminum-garnet laser along with intralesional triamcinolone injection. Materials and Methods Patients with an anterior urethral stricture less than 3 cm in length were evaluated by clinical history, physical examination, uroflowmetry, and retrograde urethrogram preoperatively. All patients were treated with holmium laser urethrotomy and intralesional triamcinolone (80 mg) injection under general or regional anesthesia. An 18 F urethral catheter was placed for 5 days. All patients were followed up for 12 months postoperatively by history, uroflowmetry, and if required, retrograde urethrogram or urethroscopy every 3 months. Results The mean age of the patients was 42.9 years (range, 14 to 70 years). The overall recurrence rate was 24%. The success rate in patients with strictures less than 1 cm in length was 95.8%, whereas that in patients with strictures of 1 to 3 cm in length was 57.7% (p=0.002). The outcome did not depend on age, duration of symptoms, etiology, or location of stricture. Conclusions Holmium laser urethrotomy with intralesional triamcinolone is a safe and effective minimally invasive therapeutic modality for urethral strictures. This procedure has an encouraging success rate, especially in those with stricture segments of less than 1 cm in length. PMID:23060998

  8. Single-frequency, single-polarization holmium-doped ZBLAN fiber laser

    NASA Astrophysics Data System (ADS)

    Zhu, X.; Zong, J.; Miller, A.; Wiersma, K.; Norwood, R. A.; Prasad, N. S.; Chavez-Pirson, A.; Peyghambarian, N.

    2013-02-01

    We present the performance of a single frequency, single-polarization holmium (Ho3+)-doped ZBLAN (ZrF4-BaF2-LaF3- AlF3-NaF) fiber laser at 1200 nm. This distributed Bragg reflector (DBR) fiber laser was developed by splicing a 22 mm long highly Ho3+-doped ZBLAN fiber to a pair of silica fiber Bragg gratings (FBG). The successful fusion splicing of silica fiber to ZBLAN fiber, with their very different melting temperatures, was accomplished by using NP Photonics proprietary splicing technique. The 3 mol% Ho3+-doped ZBLAN fiber had a core diameter of 6.5 μm and a cladding diameter of 125 μm. The threshold of this laser was seen to be about 260 mW, and when the pump power was 520 mW, the output power was about 10 mW. The efficiency of the 1200 nm single-frequency fiber laser, i.e. the ratio of the output power to the launched pump power, was about 3.8%. The linewidth of the 1200 nm single-frequency fiber laser was estimated to be about 100 kHz by comparing the measured frequency noise of the 1200 nm single-frequency fiber laser with that of 1 μm NP Photonics single-frequency fiber lasers whose linewidths have been measured to be in the 1- 10 kHz range. The relative intensity noise of this DBR all-fiber laser was measured to be < 110 dB/Hz at the relaxation oscillation peak and the polarization extinction ratio was measured to be > 19 dB. Due to its low phonon energy and long radiative lifetimes, rare-earth-doped ZBLAN allows various transitions that are typically terminated in silica glass, resulting in ultraviolet, visible, and infrared rare-earth doped ZBLAN lasers. Therefore, our results highlight the exciting prospect that the accessible wavelength range of single-frequency DBR fiber lasers can be expanded significantly by using rare-earth-doped ZBLAN fibers.

  9. Holmium-doped 2.1 μm waveguide chip laser with an output power > 1 W.

    PubMed

    Lancaster, D G; Stevens, V J; Michaud-Belleau, V; Gross, S; Fuerbach, A; Monro, T M

    2015-12-14

    We demonstrate the increasing applicability of compact ultra-fast laser inscribed glass guided-wave lasers and report the highest-power glass waveguide laser with over 1.1 W of output power in monolithic operation in the short-infrared near 2070 nm achieved (51% incident slope efficiency). The holmium doped ZBLAN chip laser is in-band pumped by a 1945 nm thulium fiber laser. When operated in an extended-cavity configuration, over 1 W of output power is realized in a linearly polarized beam. Broad and continuous tunability of the extended-cavity laser is demonstrated from 2004 nm to 2099 nm. Considering its excellent beam quality of M² = 1.08, this laser shows potential as a flexible master oscillator for single frequency and mode-locking applications. PMID:26699055

  10. Kidney stone ablation times and peak saline temperatures during Holmium:YAG and Thulium fiber laser lithotripsy, in vitro, in a ureteral model

    NASA Astrophysics Data System (ADS)

    Hardy, Luke A.; Wilson, Christopher R.; Irby, Pierce B.; Fried, Nathaniel M.

    2015-02-01

    Using a validated in vitro ureter model for laser lithotripsy, the performance of an experimental Thulium fiber laser (TFL) was studied and compared to clinical gold standard Holmium:YAG laser. The Holmium laser (λ = 2120 nm) was operated with standard parameters of 600 mJ, 350 μs, 6 Hz, and 270-μm-core optical fiber. TFL (λ = 1908 nm) was operated with 35 mJ, 500 μs, 150-500 Hz, and 100-μm-core fiber. Urinary stones (60% calcium oxalate monohydrate / 40% calcium phosphate), of uniform mass and diameter (4-5 mm) were laser ablated with fibers through a flexible video-ureteroscope under saline irrigation with flow rates of 22.7 ml/min and 13.7 ml/min for the TFL and Holmium laser, respectively. The temperature 3 mm from tube's center and 1 mm above mesh sieve was measured by a thermocouple and recorded during experiments. Total laser and operation times were recorded once all stone fragments passed through a 1.5-mm sieve. Holmium laser time measured 167 +/- 41 s (n = 12). TFL times measured 111 +/- 49 s, 39 +/- 11 s, and 23 +/- 4 s, for pulse rates of 150, 300, and 500 Hz (n = 12 each). Mean peak saline irrigation temperatures reached 24 +/- 1 °C for Holmium, and 33 +/- 3 °C, 33 +/- 7 °C, and 39 +/- 6 °C, for TFL at pulse rates of 150, 300, and 500 Hz. To avoid thermal buildup and provide a sufficient safety margin, TFL lithotripsy should be performed with pulse rates below 500 Hz and/or increased saline irrigation rates. The TFL rapidly fragmented kidney stones due in part to its high pulse rate, high power density, high average power, and reduced stone retropulsion, and may provide a clinical alternative to the conventional Holmium laser for lithotripsy.

  11. The evaluation of tissue mass loss in the incision line of prostate with benign hyperplasia performed using holmium laser and cutting electrode

    PubMed Central

    Szewczyk, Mariusz; Jesionek–Kupnicka, Dorota; Lipinski, Piotr; Różański, Waldemar

    2014-01-01

    Introduction The aim of this study is to compare the changes in the incision line of prostatic adenoma using a monopolar cutting electrode and holmium laser, as well as the assessment of associated tissue mass and volume loss of benign prostatic hyperplasia (BPH). Material and methods The material used in this study consisted of 74 preparations of prostatic adenoma obtained via open retropubic adenomectomy, with an average volume of 120.7 ml. The material obtained cut in vitro before fixation in formaldehyde. One lobe was cut using holmium laser, the other using a monopolar cutting electrode. After the incision was made, tissue mass and volume loss were evaluated. Thermocoagulation changes in the incision line were examinedunder light microscope. Results In the case of the holmium laser incision, the average tissue mass loss was 1.73 g, tissue volume loss 3.57 ml and the depth of thermocoagulation was 1.17 mm. When the monopolar cutting electrode was used average tissue mass loss was 0.807 g, tissue volume loss 2.48 ml and the depth of thermocoagulation was 0.19 mm. Conclusions Where holmium laser was used, it was observed that the layer of tissue with thermocoagulation changes was deeper than in the case of the monopolar cutting electrode. Moreover, it was noticed that holmium laser caused bigger tissue mass and volume loss than the cutting electrode. PMID:25247088

  12. Effectiveness and Safety of Ureteroscopic Holmium Laser Lithotripsy for Upper Urinary Tract Calculi in Elderly Patients.

    PubMed

    Yoshioka, Takashi; Otsuki, Hideo; Uehara, Shinya; Shimizu, Toshihiro; Murao, Wataru; Fujio, Koji; Fujio, Kei; Wada, Koichiro; Araki, Motoo; Nasu, Yasutomo

    2016-06-01

    Upper urinary tract calculi are common; however, there is no recommended treatment selection for elderly patients. Ureteroscopic holmium laser lithotripsy (URS lithotripsy) is minimally invasive, and it provides a high stone-free rate (SFR) treatment for upper urinary tract calculi. Here, we retrospectively evaluated the surgical outcomes of URS lithotripsy after dividing the 189 cases into 3 groups by patient age: the '<65 group' (<65 years old, n=108), the '65-74 group' (65-74 years old, n=42), and the ' 75 group' ( 75 years old, n=39). The patients' characteristics, stone status, and perioperative outcomes were assessed. The 65-74 group and the 75 group had a significantly higher prevalence of hypertension compared to the<65 group. Compared to the<65 group, the 65-74 group had a significantly higher prevalence of hyperlipidemia, and the 75 group had significantly higher the American Society of Anesthesiologists (ASA) scores. Despite these preoperative risk factors, SFR and postoperative pyelonephritis in the 65-74 group and the 75 group were similar to those of the<65 group. In conclusion, URS lithotripsy is the preferred treatment for upper urinary tract calculi, even for elderly patients who have multiple preoperative risk factors. PMID:27339204

  13. Use of the holmium:YAG laser for percutaneous photothermal ablation of cervical invertebral disks in dogs

    NASA Astrophysics Data System (ADS)

    Rochat, Mark; Henry, George A.; Campbell, Gregory A.; Stair, Ernest L.; Bartels, Kenneth E.; Dickey, Tom

    1999-06-01

    Holmium:YAG laser ablation of thoracolumbar disks in dogs has been shown to be an effective alternative to standard surgical fenestration techniques. Our hypothesis was the Holmium:YAG laser could be equally effective and safe when used to ablate cervical intervertebral disks. Six normal chondrodystrophoid breed dogs were used. A sterile, cleaved, 320 micrometers , low-OH quartz optical fiber was inserted into each needle and the laser activated for 40 s at 2 W mean power and a 15 Hz pulse repetition rate for a total of 80 J. Dogs were observed in pain, neurological deficits, or other complications for 24 weeks. At 24 weeks, dogs were euthanatized and cervical disks collected and placed in 10 percent neutral buffered formalin. Disks were decalcified, sectioned at 5 micrometers , and stained with H and E. No problems were encountered during the procedure except occasional difficulties passing the needle by the shoulder to enter the C6-7 disk space. No complications, including neurologic deficits or pain were observe during the 24 weeks. Histologic examination revealed varying degrees of necrosis and defects created in the nucleus pulposus by laser irradiation. In some instances there was evidence of mild adjacent annular and bony thermal injury. On the basis of these result, the Ho:YAG laser appears to be a safe and efficacious method for ablation of canine cervical disks.

  14. [Experimental liver and kidney surgery with CO2, CO, holmium, and neodym lasers. Cutting effect, hemostasis, histopathology, and healing (author's transl)].

    PubMed

    Karbe, E; Königsmann, G; Beck, R

    1980-01-01

    Various laser devices (CO2, CO, Nd: YAG, and holmium: YAG lasers) have been used on pig livers and on dog kidneys for comparison with conventional surgical instruments (electroscalpel, cryoscalpel, and scalpel). CO2 and CO lasers caused the least tissue damage, followed by the holmium laser; severe damage was caused by the Nd: YAG laser. The order was reverse for coagulative effect. The conventional reference instruments showed a weaker hemostatic effect. Surfaces cut by laser healed in four to eight weeks without complications. Remnants of charred tissue in various quantities could still be detected after eight weeks in all cases where CO2, CO, and Nd: YAG lasers had been used. This obviously did not affect scar formation. PMID:6779065

  15. Holmium YLF amplifier performance and the prospects for multi-Joule energies using diode-laser pumping

    NASA Technical Reports Server (NTRS)

    Storm, Mark E.

    1993-01-01

    Laser studies were performed to examine the amplifier characteristics of holmium-doped yttrium lithium fluoride (YLF) at 300 K. An inversion ratio of 0.37 was reached resulting in a measured small-signal gain coefficient of 0.50/cm. In a flashlamp pumping experiment, an output energy of 240 mJ was achieved for 38.5 mJ of input energy resulting in a large gain of 6.2. An amplifier model was developed for diode laser pumping and adapted to consider this flashlamp-pumped case. There is good agreement between the theory and experiment. Multipass amplifier calculations using the model suggest that the Ho: Tm: YLF laser crystal can support a 12 percent electrical to optical efficiency at 300 K even in the presence of upconversion.

  16. Thulium/holmium-doped fiber laser passively mode locked by black phosphorus nanoplatelets-based saturable absorber.

    PubMed

    Yu, Hao; Zheng, Xin; Yin, Ke; Cheng, Xiang'ai; Jiang, Tian

    2015-12-01

    By coupling black phosphorus (BP) nanoplatelets (NPs) with a fiber-taper evanescent light field, a saturable absorber (SA) based on the BP NPs has been successfully fabricated and used in a thulium/holmium-doped fiber laser as the mode locker. The SA had a modulation depth of ∼9.8% measured at 1.93 μm. A stable mode-locking operation at 1898 nm was achieved with a pulse width of 1.58 ps and a fundamental mode-lock repetition rate of 19.2 MHz. By increasing the pump intensity, phenomena of multi-pulsing operations, including harmonic mode-locked states and soliton bunches, were obtained in the experiment, showing that the BP NPs possess an ultrafast optical response time. This work suggests that the BP NPs-based SA is potentially useful for ultrashort, pulsed laser operations in the eye-safe region of 2 μm. PMID:26836690

  17. Histological changes and wound healing response following noncontact holmium: YAG laser thermal keratoplasty.

    PubMed Central

    Koch, D D

    1996-01-01

    PURPOSE: To evaluate acute histological changes and the induced wound healing response in corneal tissue following noncontact holmium:YAG laser thermal keratoplasty (LTK). METHODS: LTK using 10 pulses and a range of radiant energies was performed on 3 human corneas one day prior ro their removal at penetrating keratoplasty. Rabbit corneas were treated with 10-pulse and 5-pulse LTK and followed for up to 3 months. Tissues were studies with light and transmission electron microscopy and immunohistochemistry. RESULTS: The amount of acute tissue injury increased with increasing pulse radiant energy. In human corneas, changes in the irradiated zones included epithelial cell injury and death loss of fine filamentous structure in Bowman's layer, disruption of stromal lamallae, and keratocyte injury and death. In the rabbit corneas, similar acute changes were noted. By 3 weeks, epithelial hyperplasia and stromal contraction were present. Wound healing in the rabbit corneas included repair of the epithelial attachment complex, keratocyte activation, synthesis of type I collagen, partial restoration of stromal keratan sulfate and type VI collagen, and retrocorneal membrane formation. Compared to 10-pulse treatments, 5-pulse treatments produced less acute tissue injury and had more rapid restoration of normal stromal architecture. CONCLUSION: Noncontact LTK produces acute epithelial and stromal tissue changes and in rabbit corneas stimulates a brisk wound healing response. These changes could contribute to postoperative regression of induced refractive correction. Further work is required to determine if reductions in the magnitude of acute tissue injury and induced wound healing response will enhance the efficacy and stability of LTK. Images FIGURE 1A FIGURE 1B FIGURE 2A FIGURE 2B FIGURE 3A FIGURE 3B FIGURE 4A FIGURE 4B FIGURE 4C FIGURE 4D FIGURE 5A FIGURE 5B FIGURE 5C FIGURE 5D FIGURE 6A FIGURE 6B FIGURE 6C FIGURE 6D FIGURE 7A FIGURE 7B FIGURE 8A FIGURE 8B FIGURE 8C FIGURE

  18. Ex vivo pyelotomy, nephroscopy and holmium laser lithotripsy of a staghorn stone in a donor kidney prior to renal transplant

    PubMed Central

    Janczak, Dariusz; Bolanowska, Barbara; Jankowski, Paweł; Dorobisz, Tadeusz; Dorobisz, Karolina; Chabowski, Mariusz; Janczak, Dawid

    2015-01-01

    This case report presents the diagnostic and treatment procedures of stone removal from the kidney of a 67-year-old donor, the transplantation of the kidney to a 65-year-old recipient, and the postoperative course until the end of hospitalization. Computed tomography performed before collecting the organ showed a staghorn stone in the renal pelvis and lower calyces in the right donor kidney. The stones were removed ex-vivo using a rigid ureteroscope and a holmium laser prior to transplantation. Then the organ was transplanted to the left iliac fossa of a 65-year-old man with end-stage renal failure. The authors think there is a possibility of increasing the kidney pool, by using organs containing large calculi. In such cases stones should be removed before the operation and the patient should be monitored regularly, especially in the first months after the transplant. PMID:26240630

  19. Treatment of Urethral/Bladder Neck Stricture After High-Intensity Focused Ultrasound for Prostate Cancer With Holmium: Yttrium-Aluminium-Garnet Laser

    PubMed Central

    Cho, Won Jin; Kim, Tae Heon; Lee, Hyo Serk; Chung, Jin Woo; Lee, Ha Na

    2013-01-01

    Purpose To evaluate the efficacy and safety of the Holmium: yttrium-aluminium-garnet (YAG) laser for the treatment of urethral/bladder neck strictures after high-intensity focused ultrasound for prostate cancer. Methods Between February 2007 and July 2010, Holmium: YAG laser urethrotomies were performed in eleven patients for bladder neck strictures or prostatic urethral strictures. The laser was used with a 550-µm fiber at 2 J and frequency 30 to 50 Hz. The medical records were retrospectively reviewed for medical history, perioperative and postoperative data, uroflowmetry, International Prostate Symptoms Score/quality of life, and stricture recurrence. Results At a median follow-up of 12.0 months (range, 4 to 35 months), the mean postoperative maximal flow rate and residual volume were improved significantly (P<0.05). The mean postoperative total, voiding and quality of life of international prostate symptom score were improved significantly (P<0.05). Of the 11 patients, 7 patients required one treatment, 4 patients two treatment, and 1 patients three treatment. 2 patients who had a documented urinary incontinence prior to the laser treatment subsequently required artificial urinary sphincter implantation and reported satisfaction without developing any recurrent strictures or artificial urinary sphincter erosion. All patients exhibited well-healed strictures and could void without difficulty. Conclusions Holmium: YAG laser therapy represents a safe, effective and minimally invasive treatment for urethral/bladder neck strictures occurring secondary to high-intensity focused ultrasound for prostate cancer. PMID:23610708

  20. Holmium laser transurethral incision of the prostate: Can prostate size predict the long-term outcome?

    PubMed Central

    Elkoushy, Mohamed A.; Elshal, Ahmed M.; Elhilali, Mostafa M.

    2015-01-01

    Introduction: We determine the impact of prostate size on the long-term outcome of holmium laser transurethral incision of the prostate (Ho-TUIP) for bladder outlet obstruction (BOO) secondary to benign prostate enlargement (BPE). Methods: A retrospective review of prospectively collected data was performed for patients undergoing Ho-TUIP by a single surgeon for patients presenting with lower urinary tract symptoms (LUTS) secondary to BOO. Patients were stratified into 2 groups: Group 1 included patients with prostate ≤30 cc and Group 2 included patients with prostate >30 cc. Demographic, operative and follow-up data were recorded and analyzed. In addition, intraoperative and long-term adverse events were included. Results: In total, 82 patients underwent surgery between March 1998 and March 2013, including 9 (11%) reoperated patients. Only prostate size independently predicted reoperation after Ho-TUIP (adjusted odds ratio [aOR], 95% confidence interval [CI] 7.12 [2.92–9.14], p = 0.01). The receiver operating characteristic (ROC) analysis showed an optimal cutoff value of prostate volume of 29 cc to characterize long-term reoperation after TUIP, with area under the curve (AUC) of 0.96, sensitivity of 89.7 and specificity of 88.9. Group 1 included 51 patients and Group 2 included 31 patients. The international prostate symptoms score (IPSS) and peak flow rate (Qmax) significantly improved in both groups at different follow-up points. At the 12-month follow-up, the percent change in IPSS and Qmax were comparable between both groups. However, after 12 months, the degree of improvement in all voiding parameters was significantly higher in Group 1 (p < 0.001 at all points of follow-up). After a median follow-up of 5.3 years (range: 1–13), both groups had comparable early and late adverse events with significantly higher reoperation rate in Group 2 (3.9% vs. 22.6%, p = 0.02). Overall retrograde ejaculation was detected in 25.6% of sexually active men and it was

  1. Enucleation Procedure Manual.

    ERIC Educational Resources Information Center

    Davis, Kevin; Poston, George

    This manual provides information on the enucleation procedure (removal of the eyes for organ banks). An introductory section focuses on the anatomy of the eye and defines each of the parts. Diagrams of the eye are provided. A list of enucleation materials follows. Other sections present outlines of (1) a sterile procedure; (2) preparation for eye…

  2. Holmium:YAG laser lithotripsy for the management of urolithiasis in small ruminants and pot-bellied pigs

    NASA Astrophysics Data System (ADS)

    Halland, Spring K.; House, John K.; George, Lisle

    2001-05-01

    Obstructive urolithiasis is a common problem in small ruminants and pot-bellied pigs. The most common site of urinary tract obstruction in these species is the urethra. Surgical procedures developed to relieve obstructions, in our experience have been effective in approximately 75% of cases. Urethral stricture is a common complication if the mucosa of the urethra is disrupted. The objective of this project was to evaluate endoscopy guided laser lithotripsy as a therapeutic modality to relieve urethral obstructions in small ruminants and pot-bellied pigs. The study population consisted of patients presented to the Veterinary Medical Teaching Hospital at the University of California Davis with obstructive urolithiasis. Lithotripsy was performed using a Holmium:YAG laser via a 200-micron low water quartz fiber passed through a flexible mini-endoscope. Two types of urinary calculi were managed with this technique, calcium carbonate and calcium hydroxyphosphate. Laser lithotripsy was effective at relieving obstructions caused by both types of calculi when conventional methods had failed. Laser lithotripsy performed via urethral endoscopy is a safe and effective therapeutic modality for management of obstructive urolithiasis in small ruminants and pot-bellied pigs and reduces the risk of post procedural urethral stricture.

  3. Severe postoperative dyspnea caused by neglected massive intraperitoneal fluid collection during laser enucleation and morcellation of the prostate: a case report

    PubMed Central

    Kim, Sung-Hoon; Son, Hyo-Jung; Kim, Jae-Won; Kong, Yu-Gyeong; Hwang, Jai-Hyun

    2016-01-01

    Laser enucleation and morcellation of the prostate is an increasingly used surgical management of benign prostatic hyperplasia. However, it can cause several complications including capsular perforation, ureteral orifice injury, and bladder mucosal morcellation injury. Herein, we report a case of severe postoperative dyspnea caused by neglected massive intraperitoneal fluid collection during laser surgery of the prostate. The patient experienced massive abdominal distension and severe respiratory difficulty after the procedure. Although immediate postoperative cystogram showed no leakage of contrast dye, the computed tomography scan of the abdomen and pelvis showed massive fluid collection in the abdominal pelvic cavity suggesting bladder wall injury. After percutaneous drainage of intraperitoneal fluid, abdominal distention and dyspnea were relieved. PMID:27066210

  4. Critical review of lasers in benign prostatic hyperplasia (BPH).

    PubMed

    Gravas, Stavros; Bachmann, Alexander; Reich, Oliver; Roehrborn, Claus G; Gilling, Peter J; De La Rosette, Jean

    2011-04-01

    Laser treatment of benign prostatic hyperplasia has challenged transurethral resection of the prostate (TURP) due to advances in laser technology, better understanding of tissue-laser interactions and growing clinical experience. • Various lasers have been introduced including neodymium: yttrium aluminium garnet (YAG), holmium (Ho):YAG, potassium titanyl phosphate:YAG, thulium(Tm) and diode laser. Based on the different wave-length dependent laser-prostatic tissue interactions, the main techniques are coagulation, vaporization, resection and enucleation. • The present review aims to help urologists to distinguish and to critically evaluate the role of different laser methods in the treatment by using an evidence-based approach. It also details further evidence for use in specific patient groups (in retention, on anticoagulation) and addresses the issues of cost and learning curve. • Coagulation-based techniques have been abandoned; holmium ablation/resection of the prostate has been superseded by the enucleation technique Ho-laser enucleation of the prostate (HoLEP). The short-term efficacy of the emerging laser treatments such as diode and Tm prostatectomy has been suggested by low quality studies. HoLEP and photoselective vaporization of the prostate (PVP) represent valid clinical alternatives to TURP. HoLEP is the most rigorously analysed laser technique with durable efficacy for any prostate size and low early and late morbidity. PVP has grown in acceptance and popularity but long-term results from high quality studies are pending. PMID:21438974

  5. Sialoendoscopy with and without holmium:YAG laser-assisted lithotripsy in the management of obstructive sialadenitis of major salivary glands.

    PubMed

    Sionis, S; Caria, R A; Trucas, M; Brennan, P A; Puxeddu, R

    2014-01-01

    Obstructive sialadenitis is a major cause of dysfunction of the salivary glands, and increasingly sialoendoscopy is used in both diagnosis and treatment. At present the limit of the endoscopic approach is the size of the stone as only stones of less than 4mm can be removed. Endoscopic laser lithotripsy has the potential to treat many stones larger than this with minimal complications and preservation of a functional salivary gland. The holmium:YAG laser has been widely and safely used in urology, and its use has been recently proposed in salivary lithotripsy for the removal of bigger stones. We describe our experience with sialoendoscopy for stones in the parotid and submandibular glands and assess the feasibility and the efficacy of holmium:YAG laser lithotripsy. We have used the procedure 50 times for 43 patients with obstructive sialadenitis; 31 patients had sialolithiasis, 15 of whom (48%) had stones with diameters between 4 and 15mm (mean 7). Total extraction after fragmentation was possible in 14 of the 15 patients without complications. Intraductal holmium:YAG laser lithotripsy is effective and safe, and allows the treatment of large stones in Stensen's and Wharton's ducts. PMID:24280118

  6. Comparison of holmium:YAG and thulium fiber laser lithotripsy: ablation thresholds, ablation rates, and retropulsion effects

    NASA Astrophysics Data System (ADS)

    Blackmon, Richard L.; Irby, Pierce B.; Fried, Nathaniel M.

    2011-07-01

    The holmium:YAG (Ho:YAG) laser lithotriptor is capable of operating at high pulse energies, but efficient operation is limited to low pulse rates (~10 Hz) during lithotripsy. On the contrary, the thulium fiber laser (TFL) is limited to low pulse energies, but can operate efficiently at high pulse rates (up to 1000 Hz). This study compares stone ablation threshold, ablation rate, and retropulsion for the two different Ho:YAG and TFL operation modes. The TFL (λ = 1908 nm) was operated with pulse energies of 5 to 35 mJ, 500-μs pulse duration, and pulse rates of 10 to 400 Hz. The Ho:YAG laser (λ = 2120 nm) was operated with pulse energies of 30 to 550 mJ, 350-μs pulse duration, and a pulse rate of 10 Hz. Laser energy was delivered through 200- and 270-μm-core optical fibers in contact mode with human calcium oxalate monohydrate (COM) stones for ablation studies and plaster-of-Paris stone phantoms for retropulsion studies. The COM stone ablation threshold for Ho:YAG and TFL measured 82.6 and 20.8 J/cm2, respectively. Stone retropulsion with the Ho:YAG laser linearly increased with pulse energy. Retropulsion with TFL was minimal at pulse rates less than 150 Hz, then rapidly increased at higher pulse rates. For minimal stone retropulsion, Ho:YAG operation at pulse energies less than 175 mJ at 10 Hz and TFL operation at 35 mJ at 100 Hz is recommended, with both lasers producing comparable ablation rates. Further development of a TFL operating with both high pulse energies of 100 to 200 mJ and high pulse rates of 100 to 150 Hz may also provide an alternative to the Ho:YAG laser for higher ablation rates, when retropulsion is not a primary concern.

  7. Comparison of holmium:YAG and thulium fiber laser lithotripsy: ablation thresholds, ablation rates, and retropulsion effects.

    PubMed

    Blackmon, Richard L; Irby, Pierce B; Fried, Nathaniel M

    2011-07-01

    The holmium:YAG (Ho:YAG) laser lithotriptor is capable of operating at high pulse energies, but efficient operation is limited to low pulse rates (∼10 Hz) during lithotripsy. On the contrary, the thulium fiber laser (TFL) is limited to low pulse energies, but can operate efficiently at high pulse rates (up to 1000 Hz). This study compares stone ablation threshold, ablation rate, and retropulsion for the two different Ho:YAG and TFL operation modes. The TFL (λ = 1908 nm) was operated with pulse energies of 5 to 35 mJ, 500-μs pulse duration, and pulse rates of 10 to 400 Hz. The Ho:YAG laser (λ = 2120 nm) was operated with pulse energies of 30 to 550 mJ, 350-μs pulse duration, and a pulse rate of 10 Hz. Laser energy was delivered through 200- and 270-μm-core optical fibers in contact mode with human calcium oxalate monohydrate (COM) stones for ablation studies and plaster-of-Paris stone phantoms for retropulsion studies. The COM stone ablation threshold for Ho:YAG and TFL measured 82.6 and 20.8 J∕cm(2), respectively. Stone retropulsion with the Ho:YAG laser linearly increased with pulse energy. Retropulsion with TFL was minimal at pulse rates less than 150 Hz, then rapidly increased at higher pulse rates. For minimal stone retropulsion, Ho:YAG operation at pulse energies less than 175 mJ at 10 Hz and TFL operation at 35 mJ at 100 Hz is recommended, with both lasers producing comparable ablation rates. Further development of a TFL operating with both high pulse energies of 100 to 200 mJ and high pulse rates of 100 to 150 Hz may also provide an alternative to the Ho:YAG laser for higher ablation rates, when retropulsion is not a primary concern. PMID:21806249

  8. Difficulty in the intravesical morcellation procedure for leiomyoma of the prostate enucleated by HoLEP.

    PubMed

    Shinojima, Toshiaki; Yoshimine, Shunsuke

    2013-01-01

    Leiomyoma of prostate are rare benign neoplasms that are usually diagnosed incidentally through postoperative pathological examination. A 70-year-old man is presented with severe symptoms of lower urinary tract obstruction. Although a digital rectal examination and the prostate-specific antigen level did not suggest malignancy, transrectal ultrasonography showed an unusual homogenous echoic mass measuring 45×37 mm in size in the prostate. A needle biopsy was performed and pathological diagnosis was prostatic leiomyoma. Holmium laser enucleation of prostate (HoLEP) was chosen and performed to resect the tumour. Although the enucleation step presented no problems, the morcellation procedure using a conventional transurethral mechanical morcellator was very difficult owing to the firmness of the tissue. By using a bipolar erectrosurgical loop, fragmentation and removal of tissue was accomplished. This is the first case reported of these rare neoplasms in which HoLEP was offered as a less invasive surgical approach. We emphasise the firmness of the leiomyomatous tissue, which would lead to morcellation failure. PMID:23966460

  9. Difficulty in the intravesical morcellation procedure for leiomyoma of the prostate enucleated by HoLEP

    PubMed Central

    Shinojima, Toshiaki; Yoshimine, Shunsuke

    2013-01-01

    Leiomyoma of prostate are rare benign neoplasms that are usually diagnosed incidentally through postoperative pathological examination. A 70-year-old man is presented with severe symptoms of lower urinary tract obstruction. Although a digital rectal examination and the prostate-specific antigen level did not suggest malignancy, transrectal ultrasonography showed an unusual homogenous echoic mass measuring 45×37 mm in size in the prostate. A needle biopsy was performed and pathological diagnosis was prostatic leiomyoma. Holmium laser enucleation of prostate (HoLEP) was chosen and performed to resect the tumour. Although the enucleation step presented no problems, the morcellation procedure using a conventional transurethral mechanical morcellator was very difficult owing to the firmness of the tissue. By using a bipolar erectrosurgical loop, fragmentation and removal of tissue was accomplished. This is the first case reported of these rare neoplasms in which HoLEP was offered as a less invasive surgical approach. We emphasise the firmness of the leiomyomatous tissue, which would lead to morcellation failure. PMID:23966460

  10. Laser treatment of benign prostate enlargement--which laser for which prostate?

    PubMed

    Rieken, Malte; Bachmann, Alexander

    2014-03-01

    Laser-based prostatectomy for benign prostatic obstruction has emerged over the past decade as a treatment alternative to transurethral resection of the prostate (TURP) and open prostatectomy. These techniques set new standards in minimally invasive surgery and aim to obviate the complications of open surgery while ensuring durability of outcomes. Enucleation, which mimics open prostatectomy in that the whole prostate adenoma is removed, and vaporization, which involves ultra-rapid heating of superficial tissue layers and subsequent ablation, are the most often used surgical techniques in laser prostatectomy. The wavelength and the power output of the laser influence the tissue-laser interactions, which determine the physical properties and the safety profile of the technique. Holmium laser enucleation of the prostate (HoLEP) and GreenLight(™) laser vaporization of the prostate are the two reference techniques for laser prostatectomy, both of which have been shown to be as effective as TURP, while offering advantages in the safety profile in various randomized trials. Thulium laser enucleation of the prostate (ThuLEP) shares similarities with HoLEP and has shown encouraging results. However, more controlled trials with longer follow-up assessment are needed. Diode lasers come in various wavelengths and fibre designs and have been used for vaporization and enucleation, but require high-quality data to support their clinical use. PMID:24595121

  11. Impact of holmium fibre laser radiation (λ = 2.1 μm) on the spinal cord dura mater and adipose tissue

    NASA Astrophysics Data System (ADS)

    Filatova, S. A.; Kamynin, V. A.; Ryabova, A. V.; Loshchenov, V. B.; Zelenkov, P. V.; Zolotovskii, I. O.; Tsvetkov, V. B.; Kurkov, A. S.

    2015-08-01

    The impact of holmium fibre laser radiation on the samples of biologic tissues (dura mater of spinal cord and adipose tissue with interlayers of muscle) is studied. The experimental results are evaluated by the size of carbonisation and coagulation necrosis zones. The experiment shows that in the case of irradiation of the spinal cord dura mater samples the size of carbonisation and coagulation necrosis zones is insignificant. In the adipose tissue the carbonisation zone is also insignificant, but the region of cellular structure disturbance is large. In the muscle tissue the situation is opposite. The cw laser operation provides clinically acceptable degree of destruction in tissue samples with a minimal carbonisation zone.

  12. Different lasers in the treatment of benign prostatic hyperplasia: a network meta-analysis.

    PubMed

    Zhang, Xingming; Shen, Pengfei; He, Qiying; Yin, Xiaoxue; Chen, Zhibin; Gui, Haojun; Shu, Kunpeng; Tang, Qidun; Yang, Yaojing; Pan, Xiuyi; Wang, Jia; Chen, Ni; Zeng, Hao

    2016-01-01

    All available surgical treatments for benign prostatic hyperplasia (BPH) have their individual advantages or disadvantages. However, the lack of head-to-head studies comparing different surgeries makes it unavailable to conduct direct analysis. To compare the efficacy and safety among different lasers and transurethral resection of prostate (TURP) for BPH, randomized controlled trials were searched in MEDLINE, EMBASE, Cochrane library, WHO International Clinical Trial Registration Platform, and Clinical Trial.gov by 2015.5; and the effectiveness-, perioperation- and complication-related outcomes were assessed by network meta-analysis. 36 studies involving 3831 patients were included. Holmium laser through resection and enucleation had the best efficacy in maximum flow rate. Thulium laser through vapo-resection was superior in improving international prostate symptom score and holmium laser through enucleation was the best for post-voiding residual volume improvement. Diode laser through vaporization was the rapidest in removing postoperative indwelling catheter, while TURP was the longest. TURP required the longest hospitalization and thulium laser through vapo-resection was relatively shorter. Holmium and thulium lasers seem to be relatively better in surgical efficacy and safety, so that these two lasers might be preferred in selection of optimal laser surgery. Actually, more large-scale and high quality head-to-head RCTs are suggested to validate the conclusions. PMID:27009501

  13. Different lasers in the treatment of benign prostatic hyperplasia: a network meta-analysis

    PubMed Central

    Zhang, Xingming; Shen, Pengfei; He, Qiying; Yin, Xiaoxue; Chen, Zhibin; Gui, Haojun; Shu, Kunpeng; Tang, Qidun; Yang, Yaojing; Pan, Xiuyi; Wang, Jia; Chen, Ni; Zeng, Hao

    2016-01-01

    All available surgical treatments for benign prostatic hyperplasia (BPH) have their individual advantages or disadvantages. However, the lack of head-to-head studies comparing different surgeries makes it unavailable to conduct direct analysis. To compare the efficacy and safety among different lasers and transurethral resection of prostate (TURP) for BPH, randomized controlled trials were searched in MEDLINE, EMBASE, Cochrane library, WHO International Clinical Trial Registration Platform, and Clinical Trial.gov by 2015.5; and the effectiveness-, perioperation- and complication-related outcomes were assessed by network meta-analysis. 36 studies involving 3831 patients were included. Holmium laser through resection and enucleation had the best efficacy in maximum flow rate. Thulium laser through vapo-resection was superior in improving international prostate symptom score and holmium laser through enucleation was the best for post-voiding residual volume improvement. Diode laser through vaporization was the rapidest in removing postoperative indwelling catheter, while TURP was the longest. TURP required the longest hospitalization and thulium laser through vapo-resection was relatively shorter. Holmium and thulium lasers seem to be relatively better in surgical efficacy and safety, so that these two lasers might be preferred in selection of optimal laser surgery. Actually, more large-scale and high quality head-to-head RCTs are suggested to validate the conclusions. PMID:27009501

  14. A comparison of efficacies of holmium YAG laser, and pneumatic lithotripsy in the endoscopic treatment of ureteral stones

    PubMed Central

    Akdeniz, Ekrem; İrkılata, Lokman; Demirel, Hüseyin Cihan; Saylık, Acun; Bolat, Mustafa Suat; Şahinkaya, Necmettin; Zengin, Mehmet; Atilla, Mustafa Kemal

    2014-01-01

    Objective: We aimed to compare the effectiveness of holmium YAG laser and pneumatic lithotripsy in the treatment of ureteral stones. Material and methods: A total of 216 patients who had established indications of ureteroscopy between November 2011 and June 2012 were included in this study. Patients’ files were retrospectively reviewed by dividing cases as groups that underwent pneumatic (PL) or laser lithotripsy (LL) procedures. Age, sex, stone burden and localization, duration of follow-up, operative times were evaluated. Stone-free rates were evaluated by ureteroscopical examination, postoperative scout films and ultrasonography. Results: Group PL consisted of 109 and group LL of 107 patients. Median age was 43.93±15.94 years in Group PL and 46.15±14.54 years in Group LL. Male to female ratio, stone burden and localization were similar for both groups. Overall success rate was 89.9% in Group PL and 87.9% in Group LL, respectively (p<0.791). With the aid of additional procedures, success rate was 100% for both groups at the end of the first month. Groups were not different as for operative time, rate of insertion of an ureteral catheter and its removal time. Hospitalization period was apparently somewhat shorter in Group LL (p=0.00). Conclusion: Pneumatic lithotripsy can be as efficacious as laser lithotripsy and be used safely in the endoscopic management of ureteral stone. In comparison of both methods, we detected no differences as to operative time, success of operation and the time to removal of the catheter, however, hospitalization period was shorter in Group LL. PMID:26328167

  15. Sialendoscopy with holmium:YAG laser treatment for multiple large sialolithiases of the Wharton duct: a case report and literature review.

    PubMed

    Sun, Yu-Ting; Lee, Kuo-Sheng; Hung, Shih-Han; Su, Chin-Hui

    2014-12-01

    Sialolithiasis is defined as calcified stone(s) in the salivary duct or glands. Submandibular gland sialolithiasis is the most common (80 to 90%), followed by parotid gland sialolithiasis (5 to 15%). The typical clinical presentation is salivary gland swelling after eating. As the swelling persists, symptoms owing to local inflammation, such as pain and trismus, emerge. In severe cases, cellulitis and even abscess formation occur and subsequently lead to salivary gland atrophy or fistula formation if the sialolithiasis remains untreated. The most common treatment is complete excision of the affected gland together with the stone(s). In some cases, intraoral sialolithotomy is performed when the stone is solitary and easily palpable through the oral cavity. Sialendoscopy is increasingly performed because of its minimal invasiveness. The major limitation of endoscopic laser lithotripsy of the salivary glands is the size of the stone. Often, for a stone larger than 4 mm, multiple fragmentations of the stone into small pieces is necessary before the pieces can be removed by wire basket or grasping forceps. Recently, the holmium:YAG laser has been reported as quite effective in removing larger salivary gland stones. However, sialoendoscopic laser lithotripsy is a very time-consuming procedure and in most cases, when there are multiple large stones in a single gland, entire gland excision is recommended. This report describes a male patient diagnosed with multiple large stones in his left submandibular gland who was successfully treated under sialendoscopy with holmium:YAG laser lithotripsy. PMID:25216563

  16. Widely tunable short-infrared thulium and holmium doped fluorozirconate waveguide chip lasers.

    PubMed

    Lancaster, D G; Gross, S; Withford, M J; Monro, T M

    2014-10-20

    We report widely tunable (≈ 260 nm) Tm(3+) and Ho(3+) doped fluorozirconate (ZBLAN) glass waveguide extended cavity lasers with close to diffraction limited beam quality (M(2) ≈ 1.3). The waveguides are based on ultrafast laser inscribed depressed claddings. A Ti:sapphire laser pumped Tm(3+)-doped chip laser continuously tunes from 1725 nm to 1975 nm, and a Tm(3+)-sensitized Tm(3+):Ho(3+) chip laser displays tuning across both ions evidenced by a red enhanced tuning range of 1810 to 2053 nm. We also demonstrate a compact 790 nm diode laser pumped Tm(3+)-doped chip laser which tunes from 1750 nm to 1998 nm at a 14% incident slope efficiency, and a beam quality of M(2) ≈ 1.2 for a large mode-area waveguide with 70 µm core diameter. PMID:25401562

  17. Management of impacted proximal ureteral stone: Extracorporeal shock wave lithotripsy versus ureteroscopy with holmium: YAG laser lithotripsy

    PubMed Central

    Khalil, Mostafa

    2013-01-01

    Objective: Prospective evaluation of the efficacy and safety of the extracorporeal shock wave lithotripsy (SWL) and ureteroscopy with Holmium: YAG laser lithotripsy (URSL) as a primary treatment for impacted stone in the proximal ureter. Patients and Methods: A total of 82 patients with a single impacted stone in the proximal ureter were included in the study. Patients were allocated into two groups according to patient preference for either procedure. The first group included 37 patients who were treated by SWL and the second group included 45 patients treated by URSL. The preoperative data and treatment outcomes of both procedures were compared and analyzed. Results: There was no difference as regards to patient and stone characters between the two groups. There was significantly higher mean session number and re-treatment rate in the SWL group in comparison to URSL group (1.5 ± 0.8 vs. 1.02 ± 0.15 session, and 43.2% vs. 2.2%, respectively). At one month, the stone-free rate of the URSL group was statistically significantly higher than that of the SWL group (80% vs. 67.6%, respectively). The stone-free rate at three months was still higher in the URSL group, but without statistically significant difference (80.2% vs. 78.4%, respectively). There was no statistically significant difference in the rate of complications between the SWL and URSL (24.3% vs. 15.6%, respectively). Conclusion: Both procedures can be used effectively and safely as a primary treatment for impacted stone in the proximal ureter; however, the URSL has a significantly higher initial stone-free rate and lower re-treatment rate. PMID:23798864

  18. Transcranial excision of massive pituitary tumor with low-energy holmium laser

    NASA Astrophysics Data System (ADS)

    Xiong, Wen-Hao; Luo, Qi-Zhong; Li, Shan-Quan; Li, Xiao-Xiong; Dai, Jun; Zhu, Jing; Zhang, Mei-Jue

    1998-11-01

    From May, 1994 to September, 1996 we have operated on 64 cases of brain tumor with Homium Laser, 18 cases of massive pituitary tumor with low energy laser were included. The result are satisfying. Now, we report it to the congress.

  19. Against the motion: Lasers are superfluous for the surgical management of benign prostatic hyperplasia in the developing world.

    PubMed

    Varshney, Anil; Agarwal, Anshuman

    2009-07-01

    Lasers have arrived in a big way for the management of benign prostatic hyperplasia. The most common ones in use are holmium, potassium titanyl phosphate (KTP) and thulium.They remove the prostatic adenoma either by way of enucleation or ablation. Backed by numerous studies that prove their safety, efficacy and durability, lasers score over TURP in several ways. Their use is associated with less blood loss, shorter catheter time and decreased hospital stay. The fluid absorption during laser prostatectomy is negligible and thus makes it safer for use in cardiac patients. Also there is no chance of a transurethral resection syndrome, the incidence of which is approximately 2% with TURP. Due to superior hemostatic capabilities and non interference lasers can be used in patients on anti coagulants, cardiac pacemaker. Another advantage of laser over TURP is its ability to deal with prostates that are larger in size especially holmium laser which has been used to enucleate glands more than 300 g in size thus completely avoiding the need for open prostatectomy. The amount of tissue removed with enucleation is more thus retreatment rates are less than that of TURP. The initial cost of laser is higher but its capability to treat stones, its use in high risk situations, less morbidity, short hospital stay, and durable results make it an attractive option to treat BPH even in the developing world. PMID:19881144

  20. Electron-impact excitation of holmium atoms

    SciTech Connect

    Smirnov, Yu M

    2000-06-30

    The electron-impact excitation of holmium atoms was studied by the method of extended crossing beams. The cross sections and the optical excitation functions were obtained for odd levels of Ho I, including the 22014 cm{sup -1} laser level. Over 99% of the atoms were shown to reside in the ground level prior to collisions with electrons. Also measured were the excitation cross sections for six even levels, which presumably participate in the formation of inversion population in a gas-discharge holmium vapour laser. (laser applications and other topics in quantum electronics)

  1. Holmium laser core through internal urethrotomy with explantation of UroLume stent. An ideal approach for a complicated posterior urethral stricture.

    PubMed

    Gupta, N P; Ansari, M S

    2004-05-01

    Although the UroLume wallstent has been proven effective in the treatment of recurrent urethral stricture, obstruction may recur in some cases. A likely cause of obstruction is hyperplastic tissue reaction, which may necessitate the removal of the stent. The hyperplastic tissue reaction may be severe, resulting in a completely obliterative stricture. Stent removal with a completely obliterative stricture and the stent in situ is a tedious job, as there is no lumen in which to place the laser fiber to cut the stent wires. We report on a patient in whom a UroLume urethral stent was placed one year ago for post-traumatic recurrent bulbomembranous urethral stricture. The stricture recurred in spite of the stent in place and the lumen was finally completely obliterated. A holmium laser was used for core through internal urethrotomy and the explantation of the stent. PMID:15147555

  2. Holmium laser ablation of cartilage: effects of delivery fiber angle of incidence

    NASA Astrophysics Data System (ADS)

    Asshauer, Thomas; Oberthur, Thorsten; Jansen, Thomas; Gerber, Bruno E.; Delacretaz, Guy P.

    1996-01-01

    The effects of 2.12 micrometers Cr:Tm:Ho:YAG laser pulses delivered in isotonic saline solution via an optical fiber system on fresh porcine femur patellar groove cartilage were studied in vitro. Various irradiation geometry, corresponding to angles of 0 - 90 degree(s) of the delivering fiber with respect to the cartilage surface, have been investigated. A laser pulse energies of 1.0 J with a pulse duration of 250 microsecond(s) (FWHM) was used. The dynamics of the induced transient vapor bubbles and the ablation process were monitored by time resolved flash videography techniques. Acoustic transients of up to 200 bars induced by bubble collapses were measured by a calibrated piezoelectric needle probe hydrophone. Histological assessment of the irradiated cartilage samples was performed using azan and Safranin-O stains. The extent of the area of altered cartilage cells is larger than the zone of tissue matrix damage. The predominant mechanism of tissue damage is thermal rather than acousto-mechanical. Cartilage treatment at an angle of incidence of 30 degree(s) reduces significantly the overall damage as compared to 60 degree(s) or 90 degree(s) irradiation.

  3. Evidence of the efficacy and safety of the thulium laser in the treatment of men with benign prostatic obstruction

    PubMed Central

    Barbalat, Yana; Velez, Marissa C.; Sayegh, Christopher I.; Chung, Doreen E.

    2016-01-01

    In 2005, the high power thulium laser was introduced for the surgical treatment of benign prostatic obstruction. It has several properties that confer theoretical advantages over other lasers used for the same indication, such as technical versatility and a relatively small zone of thermal damage. Studies using the 70–150 W thulium laser systems demonstrate good efficacy of these procedures with low morbidity and few complications even in higher risk patients. Different techniques have been employed to treat the prostate with this technology, including enucleation, vapoenucleation, vaporization and resection. Comparative studies have been published comparing thulium laser prostatectomy to monopolar transurethral resection of prostate (TURP), bipolar TURP and holmium laser enucleation of prostate (HoLEP). In this review we discuss the current literature on the safety and efficacy of various thulium techniques for the treatment of benign prostatic hyperplasia and examine comparative studies. PMID:27247628

  4. Evidence of the efficacy and safety of the thulium laser in the treatment of men with benign prostatic obstruction.

    PubMed

    Barbalat, Yana; Velez, Marissa C; Sayegh, Christopher I; Chung, Doreen E

    2016-06-01

    In 2005, the high power thulium laser was introduced for the surgical treatment of benign prostatic obstruction. It has several properties that confer theoretical advantages over other lasers used for the same indication, such as technical versatility and a relatively small zone of thermal damage. Studies using the 70-150 W thulium laser systems demonstrate good efficacy of these procedures with low morbidity and few complications even in higher risk patients. Different techniques have been employed to treat the prostate with this technology, including enucleation, vapoenucleation, vaporization and resection. Comparative studies have been published comparing thulium laser prostatectomy to monopolar transurethral resection of prostate (TURP), bipolar TURP and holmium laser enucleation of prostate (HoLEP). In this review we discuss the current literature on the safety and efficacy of various thulium techniques for the treatment of benign prostatic hyperplasia and examine comparative studies. PMID:27247628

  5. Modular flexible ureteroscopy and holmium laser lithotripsy for the treatment of renal and proximal ureteral calculi: A single-surgeon experience of 382 cases

    PubMed Central

    YAN, ZEJUN; XIE, GUOHAI; YUAN, HESHENG; CHENG, YUE

    2015-01-01

    To determine the safety and efficacy of modular flexible ureteroscopy and holmium laser lithotripsy for the treatment of renal and proximal ureteral calculi, a retrospective chart review of a single surgeon's 3-year modular flexible ureteroscopy experience was performed. All of the patients were treated with modular flexible ureteroscopy and holmium laser lithotripsy by a single surgeon. Stone-free status was defined as no fragments or a single fragment ≤4 mm in diameter at the 3-month follow-up. The procedure number, operative time, stone-free rates, repeat usage of the multilumen catheter, and perioperative complications were documented. The present study included 215 male patients and 167 female patients, with an average age of 48.5±13.7 years (range, 17–84 years). The mean stone size was 11.5±4.1 mm (range, 4–28 mm), and the mean total stone burden was 17.5±5.7 mm (range 15–46 mm). A total of 305 patients (79.8%) had a stone burden ≤20 mm, and 77 patients (20.2%) had a stone burden >20 mm. The mean number of primary procedures was 1.3±0.2 (range, 1–3). The stone-free rate following the first and the second procedure was 73.4 and 86.9%, respectively. The mean postoperative hospital stay was 3.1±1.2 days (range, 2–6 days). The highest clearance rates were observed for proximal ureteral stones (100%) and renal pelvic stones (88.7%), whereas the lowest clearance rates were observed for lower calyx stones (76.7%) and multiple calyx stones (77.8%). The higher the initial stone burden, the lower the postoperative stone-free rate (≤20 vs. >20 mm; 89.8 vs. 75.3%). The overall complication rate was 8.1%. The results of the present study suggest that modular flexible ureteroscopy with holmium laser lithotripsy may be considered the primary method for the treatment of renal and proximal ureteral calculi in select patients, due to its acceptable efficacy, low morbidity, and relatively low maintenance costs. PMID:26622508

  6. AB178. Holmium laser resection of the distal ureter and bladder cuff during radical nephroureterectomy for patients with pelvis or ureteral cancer

    PubMed Central

    Ge, Yongchao

    2016-01-01

    Objective To explore the feasibility of transurethral resection for the distal ureter and bladder cuff in radical nephroureterectomy for the treatment of upper urinary tract urothelial carcinoma (UUT-UC). Methods A total of 76 patients with renal pelvic carcinoma or upper tract urothelial carcinoma during July 2003 to December 2011 were retrospective analyzed. All patients were divided into two groups according to doctor’s suggestion and their wishes. Thirty-six patients of them received excision of the distal ureter and bladder cuff by transurethral Holmium laser (cystoscopy group) combined with open nephroureterectomy, and 40 patients of them underwent open surgery (open surgery group).The operation time, postoperative activity time, and postoperative hospital stay in the two groups were compared. Results All operations were completed successfully in both groups. Compared with Open Surgery Group, the operation time [(177.2±36.9) vs. (229.6±28.1) min, t=−7.004, P=0.000], postoperative activity time [(2.7±0.7) vs. (4.1±1.0) d, t=−6.802, P=0.000] and hospital stay [(6.9±1.0) vs. (8.6±1.5) d, t=−5.448, P=0.000] of cystoscopy group were shorter. No recurrence or metastasis was observed from a follow-up of 6–120 months (median=32 months) in the two groups. Conclusions Transurethral surgery is superior to traditional open surgery in trauma degree and postoperative recovery time. Transurethral Holmium laser resection of the distal ureter and bladder cuff is a minimally invasive and safety technique in the nephroureterectomy for the treatment of UTUC.

  7. [History of laser in BPH therapy].

    PubMed

    Grande, Marco; Facchini, Francesco; Moretti, Matteo; Larosa, Michelangelo; Leone, Marco; Ziglioli, Francesco; Pozzoli, Gian Luigi; Frattini, Antonio

    2014-01-01

    Laser technology has been used in the treatment of BPH for more than 15-20 years in order to challenge transurethral resection of the prostate. The aim of this review article is to analyze the evolution of laser in BPH therapy, from early coagulative techniques - progressively abandoned for their elevated postoperative morbidity and unfavorable outcomes - to the newer techniques of vaporization, resection and enucleation of the prostate. A better comprehension of tissue-laser interactions, the improvement of laser technology and a growing clinical experience have lead to the development of different laser systems (Holmium, KTP, Thulium laser) that challenge TURP. Today, HoLEP and, secondarily, PVP are the laser techniques supported by more clinical evidences and represent valid alternatives to TURP. PMID:24665033

  8. Impressive Performance: New Disposable Digital Ureteroscope Allows for Extreme Lower Pole Access and Use of 365 μm Holmium Laser Fiber

    PubMed Central

    Kelly, Emily Fell

    2016-01-01

    Abstract Background: Since the development of the first flexible ureteroscope, in 1964, technological advances in image quality, flexibility, and deflection have led to the development of the first single-use digital flexible ureteroscope, LithoVue™ (Boston Scientific, Marlborough, MA). With respect to reusable fiber-optic and now digital ureteroscopes, there is an initial capital cost of several thousand dollars (USD) as well as, controversy regarding durability, the cost of repairs and the burdensome reprocessing steps of ureteroscopy. The single-use LithoVue eliminates the need for costly repairs, the occurrence of unpredictable performance, and procedural delays. Renal stones located in the lower pole of the kidney can be extremely challenging as extreme deflections of greater than 160° are difficult to maintain and are often further compromised when using stone treatment tools, such as laser fibers and baskets. This case describes an initial use of the LithoVue digital disposable ureteroscope in the effective treatment of lower pole calculi using a 365 μm holmium laser fiber. Case Report: A 35-year-old female, with a medical history significant for chronic bacteriuria, and recurrent symptomatic culture proven urinary tract infections, underwent localization studies. Retrograde ureteropyelography demonstrated two calcifications adjoining, measuring a total of 1.4 cm, overlying the left renal shadow. Urine aspirated yielded clinically significant, >100,000, Escherichia coli and Streptococcus anginosus bacteriuria, which was felt to be originating from the left lower calix. This case used the newly FDA-approved LithoVue flexible disposable ureteroscope. The two stones were seen using the ureteroscope passed through an ureteral access sheath in the lower pole calix. A 365 μm holmium laser fiber was inserted into the ureteroscope and advanced toward the stones. There was no loss of deflection as the ureteroscope performed reproducibly. The laser was used

  9. Holmium:YAG (λ=2120nm) vs. Thulium fiber laser (λ=1908nm) ablation of kidney stones: thresholds, rates, and retropulsion

    NASA Astrophysics Data System (ADS)

    Blackmon, Richard L.; Irby, Pierce B.; Fried, Nathaniel M.

    2011-03-01

    The Holmium:YAG (Ho:YAG) laser lithotriptor is capable of operating at high pulse energies, but its efficient operation is limited to relatively low pulse rates (~10 Hz) during lithotripsy. On the contrary, the Thulium Fiber Laser (TFL) is limited to low pulse energies, but can operate at very high pulse rates (up to 1000 Hz). This study compares stone ablation threshold, ablation rate, and retropulsion effects for different Ho:YAG and TFL operation modes. The TFL (λ=1908 nm) was operated with pulse energies of 5-35 mJ, 500-μs pulse duration, and pulse rates of 10-400 Hz. The Ho:YAG laser (λ=2120 nm) was operated with pulse energies of 30-550 mJ, 350-μs pulse duration, and pulse rate of 10 Hz. Laser energy was delivered through small-core (200-270-μm) optical fibers in contact mode with human calcium oxalate monohydrate (COM) stones for ablation studies and plaster-of-Paris stone phantoms for retropulsion studies. The COM stone ablation threshold for Ho:YAG and TFL measured 82.6 J/cm2and 20.8 J/cm2, respectively. Stone retropulsion with Ho:YAG laser increased linearly with pulse energy. Retropulsion with TFL was minimal at pulse rates < 150 Hz, then rapidly increased at higher pulse rates. For minimal stone retropulsion, Ho:YAG operation at pulse energies < 175 mJ at 10 Hz, and TFL operation at 35 mJ at 100 Hz is recommended, with both lasers producing comparable ablation rates. Further development of a TFL operating with both high pulse energies (e.g. 100-200 mJ) and high pulse rates (100-150 Hz) may also provide higher ablation rates, when retropulsion is not the primary concern.

  10. Low-power holmium:YAG laser urethrotomy for urethral stricture disease: comparison of outcomes with the cold-knife technique.

    PubMed

    Atak, Mustafa; Tokgöz, Hüsnü; Akduman, Bülent; Erol, Bülent; Dönmez, Ibrahim; Hancı, Volkan; Türksoy, Ozlem; Mungan, Necmettin Aydın

    2011-11-01

    In this prospective randomized clinical trial, we aimed to evaluate the safety and efficacy of endourethrotomy with holmium:yttrium-aluminium-garnet (HO:YAG) laser and compare the outcomes with the conventional cold-knife urethrotomy. Fifty-one male patients with single, iatrogenic, annular strictures of the urethra were randomly divided into two groups; 21 patients who underwent direct-vision endoscopic urethrotomy with Ho:YAG laser (15 W; 1,200-1,400 mJ; 8-12 Hz) at 12 o'clock position (laser group) and 30 patients who underwent direct-vision endoscopic urethrotomy with cold-knife incision at 12 o'clock position (cold-knife group). The results obtained were analyzed and compared at 3 months, 6 months, 9 months, and 12 months postoperatively by clinical evaluation, uroflowmetry, and retrograde urethrographies. Variables were compared among groups using Fisher's exact and Mann Whitney U tests. There were no differences between two groups in terms of patient age, preoperative Qmax value, stricture location, and length. Operative time was shorter in laser group (16.4 ± 8.04 minutes) when compared with cold-knife group (23.8 ± 5.47 minutes) (p<0.001). Recurrence-free rate at 3 months was similar between two groups (p=0.122). However, recurrence-free rates at 6 months, 9 months, and 12 months were significantly higher in laser group when compared with cold-knife group (p values were 0.045, 0.027, and 0.04, respectively). No intra- or postoperative complications were encountered. Use of Ho:YAG laser in the management of urethral stricture disease is a safe and effective method. In addition, it provides shorter operative time and lower recurrence rate when compared with the conventional technique. PMID:22005159

  11. Efficacy and safety profile of a novel technique, ThuLEP (Thulium laser enucleation of the prostate) for the treatment of benign prostate hypertrophy. Our experience on 148 patients

    PubMed Central

    2012-01-01

    Background Over the past years laser technology has played a predominant role in prostate surgery, for the treatment of benign prostate hypertrophy (BPH). Various laser devices have been introduced in clinical practice, showing good results in terms of complications and urodynamic outcomes efficacy compared with TURP and Open Prostatectomy. In this study we describe the efficacy and the safety profile of a novel laser technique, ThuLEP (Thulium Laser Enucleation of Prostate) that permits a complete anatomical endoscopic enucleation of prostatic adenoma independently to prostate size. Methods 148 patients with a mean age of 68.2 years were enrolled between September 2009 and March 2012 (36 months), and treated for BPH with ThuLEP. Every patient was evaluated at base line according to: Digital Rectal Examination (DRE), prostate volume, Post-Voided volume (PVR), International Prostate Symptoms Score (I-PSS), International Index of Erectile Function-5 (IIEF-5), Quality of Life (QoL), PSA values, urine analysis and urine culture, uroflowmetry. The same evaluation was conducted after a 12 month follow-up. ThuLEP was performed by 2 expert surgeons. Results Our data showed a better post-operative outcome in terms of catheter removal, blood loss, TURP syndrome, clot retention and residual tissue compared to large series of TURP and OP. Only 1.3% of patients had bladder wall injury during morcellation. I-PSS, Qmax, Prostate Volume, QoL and PVR showed a highly significant improvement at 12 month follow-up in comparison to preoperative assessment. Conclusion ThuLEP represent an innovative option in patients with BPH. It is a size independent surgical endoscopic technique and it can be considered the real alternative, at this time, to TURP and even more to Open Prostatectomy for large prostate, with a complete removal of adenoma and with a low complication rate. PMID:23173611

  12. New techniques for laser prostatectomy: an update

    PubMed Central

    Chung, Doreen E.; Te, Alexis E.

    2009-01-01

    Traditionally, the gold standard for treatment of BPH has been the electrocautery-based TransUrethral Resection of the Prostate (TURP). However, the number of laser techniques being performed is rapidly increasing. Potential advantages of laser therapy over traditional TURP include decreased morbidity and shorter hospital stay. There are several techniques for laser prostatectomy that continue to evolve. The main competing techniques are currently the Holmium Laser Enucleation of the Prostate (HoLEP) and the 80W 532nm laser prostatectomy. The HoLEP, using the Holmium:YAG laser, has been shown to have clinical results similar to TURP and is suitable for patients on anticoagulation as well as those with large prostates. Disadvantages of this technique are the high learning curve and requirement of a morcellator. When used to treat BPH, studies have demonstrated that, like the HoLEP, the 80W KTP laser is safe and effective in patients with large prostates and in those taking oral anticoagulation. Several studies have compared these two techniques to TURP. Frequently reported advantages of the HoLEP over the 80W laser prostatectomy are the availability after the procedure of a pathology specimen and ability to remove a higher percentage of prostate tissue during resection. However, the transurethral laser enucleation of the prostate addresses these concerns and has shown to have durable outcomes at 2-year follow-up. Two new laser systems and techniques, the thulium laser and the 980nm laser, have emerged recently. However, clinical data from these procedures are in their infancy and large long-term studies are required. PMID:21789057

  13. Inductively coupled plasma-emission spectroscopy and atomic absorption for the use of elemental analysis of a root canal after lasing with a holmium:YAG laser.

    PubMed

    Deutsch, Allan S; Cohen, Brett I; Musikant, Barry Lee

    2003-06-01

    It has been reported in the literature that after lasing dentin the dentin surface has a glassy or globular appearance. Many authors believe this to be recrystallized hydroxyapatite. The purpose of this elemental analysis was to see if any of the silica fiber optic was melted and deposited as these globular structures on the canal wall. Two teeth were used. One was hand-instrumented with files and used as the control, the other was lased with a holmium:YAG laser. A 245-micro low OH- fiber was used with a power setting of 0.75 W, 5 Hz, 94.2 J, and 1134 V to lase the root. The roots were microanalyzed for oxygen, phosphorus, silicon, nitrogen, hydrogen, calcium, and carbon. The percentages for all elements tested were the same for both teeth. Therefore, there was no silicon deposited onto the canal wall of the tooth that was lased. It is concluded that the low OH- silica fiber optic was not melted and deposited onto the dentinal canal wall. PMID:12814225

  14. A prospective, randomized comparison of a 1940 nm and a 2013 nm thulium: yttrium–aluminum–garnet laser device for Thulium VapoEnucleation of the prostate (ThuVEP): First results

    PubMed Central

    Tiburtius, Christian; Gross, Andreas J.; Netsch, Christopher

    2015-01-01

    Introduction: We report the early postoperative results of the first prospective, randomized comparison of two commercially available thulium lasers with different wavelengths for the treatment of benign prostatic obstruction (BPO). Materials and Methods: From January to June 2013, 80 consecutive patients were randomized for Thulium VapoEnucleation of the prostate (ThuVEP) with a 2013 nm (RevoLix®) (n = 39) or a 1940 nm (Vela®XL) (n = 41) thulium laser. Preoperative status, surgical details and the immediate outcome were recorded for each patient. The perioperative complications were assessed and classified according to the modified Clavien classification system. Results: Median operation time, resected tissue, percentage of resected tissue, catheter time, overall operation efficiency and Hb loss differed nonsignificantly between both devices (P > 0.05). At discharge, the median maximum urinary flow rate and postvoiding residual (PVR) urine improved significantly in both groups (P < 0.001). The PVR was lower in the 1940 nm ThuVEP group (P ≤ 0.034). Perioperative complications occurred in 18 (22.5%) patients (Clavien 1: 12.5%; Clavien 2: 5%, Clavien 3b: 2.5%, Clavien 4a: 2.5%), with no differences between the groups (P = 0.5). Conclusions: The 1940 nm and the 2013 nm thulium lasers are both safe and effective for the treatment of BPO with ThuVEP. Both lasers give equivalent and satisfactory immediate micturition improvement with low perioperative morbidity. PMID:25624576

  15. A comparative study of diode laser and plasmakinetic in transurethral enucleation of the prostate for treating large volume benign prostatic hyperplasia: a randomized clinical trial with 12-month follow-up.

    PubMed

    Wu, Gang; Hong, Zhe; Li, Chao; Bian, Cuidong; Huang, Shengsong; Wu, Denglong

    2016-05-01

    The objective of this study is to compare the efficacy and safety of diode laser enucleation of the prostate (DiLEP) with plasmakinetic enucleation of the prostate (PKEP) for symptomatic benign prostatic hyperplasia (BPH) patients with large prostate (volume > 80 ml). From January 2013 to June 2014, 80 consecutive patients were randomized treated with DiLEP (n = 40) or PKEP (n = 40). Perioperative and postoperative outcome data were assessed during a 1-year follow-up. There were no significant preoperative differences between the two surgical groups. The mean prostate volumes in the DiLEP and PKEP groups were 98.6 and 93.3 ml, respectively. DiLEP was equivalent to PKEP in improvement in International Prostate Symptom Score (IPSS), quality of life scores, and maximum flow rate. Compared with PKEP, patients treated with DiLEP showed a lower risk of blood loss (P < 0.01), shorter bladder irrigation and catheterization times (P < 0.01), as well as shorter hospital stays (P < 0.01). Moreover, the DiLEP group was significantly superior to bipolar plasmakinetic group in the irritative symptoms. However, the operation time of the DiLEP group was longer than that of PKEP group (P = 0.02). Both DiLEP and PKEP are safe and effective methods for the treatment of BPH in large prostates (volume > 80 ml). Compared with PKEP, DiLEP provides a decreased risk of hemorrhage, reduced bladder irrigation, and catheterization times, as well as shorter hospital stays. PMID:26822403

  16. Efficacy of holmium laser urethrotomy and intralesional injection of Santosh PGI tetra-inject (Triamcinolone, Mitomycin C, Hyaluronidase and N-acetyl cysteine) on the outcome of urethral strictures

    PubMed Central

    Kishore, Lalit; Sharma, Aditya Prakash; Garg, Nitin; Singh, Shrawan Kumar

    2015-01-01

    Introduction To study the efficacy of holmium laser urethrotomy with intralesional injection of Santosh PGI tetra-inject (Triamcinolone, Mitomycin C, Hyaluronidase and N-acetyl cysteine) in the treatment of urethral strictures. Material and methods A total of 50 patients with symptomatic urethral stricture were evaluated by clinical history, physical examination, uroflowmetry and retrograde urethrogram preoperatively. All patients were treated with holmium laser urethrotomy, followed by injection of tetra-inject at the urethrotomy site. Tetra-inject was prepared by diluting acombination of 40 mg Triamcinolone, 2 mg Mitomycin, 3000 UHyaluronidase and 600 mg N-acetyl cysteine in 5–10 ml of saline, according to the stricture length. An indwelling 18 Fr silicone catheter was left in place for 7–10 days.All patients were followed-up for 6-18 months postoperatively by history, uroflowmetry, and if required, retrograde urethrogram and micturating urethrogram every 3 months. Results 41 (82%) patients had asuccessful outcome,whereas 9 (18%) had recurrences during a follow-up ranging from 6–18 months. In <1 cm length strictures, the success rate was 100%, while in 1–3 cm and >3 cm lengthsthe success rates were 81.2% and 66.7% respectively. This modality, thus, has an encouraging success rate, especially in those with short segment urethral strictures (<3 cm). Conclusions Holmium laser urethrotomy with intralesional injection ofSantosh PGI tetra-inject (Triamcinolone, Mitomycin C, Hyaluronidase, N-acetyl cysteine) is a safe and effective minimally-invasive therapeutic modality for short segment urethral strictures. PMID:26855803

  17. Effect of power settings versus temperature change at the root surface when using multiple fiber sizes with a Holmium YAG laser while enlarging a root canal.

    PubMed

    Cohen, B I; Deutsch, A S; Musikant, B L; Pagnillo, M K

    1998-12-01

    The aim of this study was to determine if there is an increase in temperature at the root surface as the canal is enlarged when using a Holmium:YAG laser. An increase might be expected because, as the canal is enlarged, there is less dentin between the canal walls and the outer cementum surface of the root to absorb the heat. Sixty single-rooted human teeth were randomly assigned to 1 of 3 groups according to laser power settings: 0.50, 0.75, and 1.00 W. Each tooth in each power group was subjected to lasing using fiber sizes of 140, 245, 355, and 410 microns. The dependent variables in these analyses included: (a) change in temperature, measured with T-type thermocouples placed 2 mm from the coronal and apical ends of the root; (b) depth of laser in the tooth; (c) depth that a conventional fiber could be inserted after lasing; and (d) tooth physical dimensions. ANOVA for coronal temperature showed no interaction between fibers and power settings. Repeated-measures ANOVA for apical temperature showed a significant difference between fibers, but not between power settings. No interaction between fibers and power settings was observed. For the depth of tooth during lasing (how far the fiberoptic guide penetrated into the tooth), no interaction between fibers and power settings was observed. Pairwise contrasts revealed that all fibers were different from one another, with depth decreasing as fiber size increased. Depth files could be inserted that showed the depth significantly decreased as file size increased from 50 through 70. ANOVAs illustrated that there were no significant differences between power settings for any of the five tooth physical dimensions. All temperature differences observed apically and coronally were between 0 degree to 10 degrees C, with the majority (> 98%) being between 0 degree to 5 degrees C. After lasing with the 410-micron fiber, the root canals were widened to at least 45 or 50 K-files (450 or 500 microns). However, by using a 410-micron

  18. A comparative study to analyze the efficacy and safety of flexible ureteroscopy combined with holmium laser lithotripsy for residual calculi after percutaneous nephrolithotripsy

    PubMed Central

    Xu, Gang; Wen, Jiaming; Li, Zhongyi; Zhang, Zhewei; Gong, Xiuqing; Chen, Jimin; Du, Chuanjun

    2015-01-01

    A certain proportion of patients with initial Percutaneous nephrolithotripsy (PCNL) management require ancillary procedures to increase the stone-free rate. In this study, we aim to analyze the efficacy and safety of flexible ureteroscopy combined with holmium laser lithotripsy (F-UL) for treatment of residual calculi after PCNL by comparison with extracorporeal shockwave lithotripsy (SWL). Total of 96 patients with residual renal calculi (4 mm to 20 mm) after PCNL was enrolled from May 2010 to March 2013. They were randomly divided into two groups: US Group: patients were treated with F-UL; SWL Group: patients were treated with SWL. Follow-up was made one month and three months after treatment. The mean residual stone size after PCNL was 12.4 ± 4.3 mm in US group compared with 11.9 ± 4.5 in SWL group. The stone-free rate was 84.7% one month after surgical procedure in US group, this rate increased to 91.3% in the third months, while the stone-free rate in SWL group is 64.6% one month after treatment and 72.9% in the third month. For residual stone in lower calyx, the stone-free rate three month after treatment was 90.4% in US group compared to 65.2% in SWL group (P < 0.05). The overall complication rate was low in both groups, no severe complication was found. Both F-UL and SWL are safe and effective methods for residual calculi after PCNL, without severe complications. F-UL provided significantly higher stone-free rate compared with SWL, especially for low-pole calculi. PMID:26064375

  19. Electronically tunable thulium-holmium mode-locked fiber laser for the 1700-1800 nm wavelength band.

    PubMed

    Noronen, Teppo; Okhotnikov, Oleg; Gumenyuk, Regina

    2016-06-27

    We demonstrate a widely tunable, mode-locked fiber laser capable of producing sub-picosecond pulses between 1705 and 1805 nm. The 100 nm tuning range is achieved by using intracavity acousto-optic tunable filter. The laser delivers highly stable pulses via self-starting hybrid mode-locking triggered by frequency-shifting and nonlinear polarization evolution. PMID:27410623

  20. Holmium laser use in debridement of stable labral lesions: two-year experience in initial 50 patients

    NASA Astrophysics Data System (ADS)

    Dew, Douglas K.; Risch, E. David

    1994-09-01

    The purpose of this study is to determine the laser related complication rate for shoulder arthroscopy in the initial clinical experience of 50 patients, and to identify potential advantages of laser use in shoulder arthroscopy. Fifty patients spanning ages 25 to 87 were treated. Surgical debridement was selective and conservative creating a smooth post resection rim. In those that included rotator cuff tears, in addition to arthroscopic debridement, a mini arthrotomy and open acromioplasty were performed. Changes in arthroscopic technique due to laser use included no arthroscopic pump use and use of the shaver only when the fiber could not be easily seen with severe synovitis. We found that the hyper-vascular synovium did not need to be resected last, it could be resected at any point during the procedure. Four hundred and 600 micron fiberoptics were used as well as 20 watts average power. Technical advantage of the laser was felt to be the size of the instrument probe and the availability of excellent hemostasis. Complications include one case of arthroscope damage and one case with a broken fiber tip which was removed with a grasper. Long term follow up of these patients is now underway.

  1. Effects of holmium:YAG laser on equine articular cartilage and subchondral bone adjacent to traumatic lesions

    NASA Astrophysics Data System (ADS)

    Collier, Michael A.; Haugland, L. Mark; Bellamy, Janine; Johnson, Lanny L.; Rohrer, Michael D.; Walls, Robert C.; Bartels, Kenneth E.

    1994-09-01

    The effects of Ho:YAG laser energy on articular cartilage and subchondral bone adjacent to traumatically created cartilage lesions in a continuous weight-bearing model were investigated. The 2.1 micrometers wavelength was delivered in hand-controlled contact and near-contact hard tissue arthroscopic surgery in a saline medium. Bilateral arthroscopy was performed on normal antebrachiocarpal and intercarpal joints of four adult horses. One-hundred twenty traumatic lesions were created on three weight-bearing articular surfaces with a knife, curette, or a motorized burr. Depths of the lesions were partial and full thickness. Configurations of the lesions were lacerations, scrapes, and craters. Left limbs were used as controls. Right limb lesions were treated with various intensities of laser energy. Animals were sacrificed at intervals of 1, 3, and 8 weeks. Gross microscopic anatomy was documented, and tissue sections were subjected to blind review by a pathologist. Mankin grading for cellularity and proteoglycan content was used to qualitatively evaluate cartilage response. Cartilage adjacent to all lesions exposed to laser energy had better cellularity and proteoglycan content than corresponding controls by Mankin grading.

  2. Flexible ureterorenoscopy (F-URS) with holmium laser versus extracorporeal shock wave lithotripsy (ESWL) for treatment of renal stone <2 cm: a meta-analysis.

    PubMed

    Mi, Yuanyuan; Ren, Kewei; Pan, Haiyan; Zhu, Lijie; Wu, Sheng; You, Xiaoming; Shao, Hongbao; Dai, Feng; Peng, Tao; Qin, Feng; Wang, Jian; Huang, Yi

    2016-08-01

    The objective of the study was to systematically review the efficacy and safety of flexible ureterorenoscopy (F-URS) with holmium laser versus extracorporeal shock wave lithotripsy (ESWL) for the treatment of renal stone <2 cm. A systematic literature review was performed in April 2015 using the PubMed, Embase, Web of Science and the Chinese Biomedical Literature (CNKI and Wanfang) databases to identify relevant studies. All clinical trials were retrieved and their included references investigated. Two reviewers independently assessed the quality of all included studies, and the eligible studies were included and analyzed using the RevMan 5.3 software. Six prospective randomized comparison trials and eight retrospective comparison trials were included, involving a total of 2348 patients. For renal stone 1-2 cm, F-URS technique provided a significantly higher stone-free rate (SFR) [weighted mean difference (WMD) = 2.35, 95 % confidence interval (CI) 1.65-3.34, P < 0.00001], lower auxiliary procedure rate (APR) [odds ratio (OR) 0.33, 95 % CI 0.22-0.50, P < 0.00001] and lower retreatment rate (RR) (OR 0.07, 95 % CI 0.01-0.37, P = 0.002). Similar results were found in the lower pole stone for 1-2 cm subgroup. For renal stone <1 cm, F-URS technique also showed a significantly higher SFR than ESWL (WMD = 2.13, 95 % CI 1.13-4.00, P = 0.02). F-URS is associated with higher SFR, lower APR and RR than ESWL. F-URS is a safe and effective procedure. It can successfully treat patients with stones for 1-2 cm, especially for lower pole stone, without increasing complications, operative time and hospital stay. F-URS can be used as an alternative treatment to ESWL in selected cases with larger renal stones. However, further randomized trials are needed to confirm these findings. PMID:26530230

  3. Holmium-doped fibre amplifier operating at 2.1 μm

    SciTech Connect

    Kamynin, V A; Antipov, S O; Kurkov, A S; Baranikov, A V

    2014-02-28

    A small-signal holmium-doped fibre amplifier is demonstrated. The seed source is a cw holmium-doped fibre laser whose output power is modulated by an electro-optical modulator. The maximum gain reached (wavelength, 2.1 μm; power, 0.25 mW; pulse duration, 100 ns; pulse repetition rate, 1 μs) is 28.5 dB. (lasers)

  4. Development of high-power holmium-doped fibre amplifiers

    NASA Astrophysics Data System (ADS)

    Hemming, Alexander; Simakov, Nikita; Davidson, Alan; Oermann, Michael; Corena, Len; Stepanov, Dmitrii; Carmody, Neil; Haub, John; Swain, Robert; Carter, Adrian

    2014-03-01

    Resonantly pumped holmium fibre lasers present a range of opportunities for the development of novel fibre laser and amplifier devices due to the availability of mature, efficient high power thulium fibre pump lasers. In this paper we describe the operation of a large mode area holmium-doped fibre amplifier. The master-oscillator is an all-fibre linearly polarised, core pumped single mode laser operating at 27 W at 2.11 μm. This laser was amplified in a large mode area fibre producing up to 265 W of output power. This system is the first demonstration of a resonantly pumped holmiumdoped fibre amplifier. It is also the highest power fibre amplifier that is capable of operating in an atmospheric transmission window <2.05 μm. This monolithic all-fibre system is able to address a wide range of remote sensing, scientific, medical and defence applications.

  5. A Review of Laser Treatment for Symptomatic BPH (Benign Prostatic Hyperplasia).

    PubMed

    Nair, Shiva Madhwan; Pimentel, Marie Adrianne; Gilling, Peter John

    2016-06-01

    Benign prostatic hyperplasia (BPH) is the predominant cause of bladder outflow obstruction and is associated with significant morbidity. Surgical removal of adenoma has been a key treatment principle for alleviation of obstruction. Lasers have been used as an alternative to transurethral resection of the prostate (TURP), due to the higher complications of the latter procedure, since the early 1990s. Early generations of lasers utilized coagulative and ablative techniques to dis-obstruct the bladder. Ablative techniques have remained popular with the resurgence of 532-nm vaporization (commonly known as GreenLight). Enucleation techniques especially with the holmium laser have shown durable efficacy in randomized controlled trials whilst new modalities such as thulium still require long-term data. This review examines the most common types of laser technology used in BPH surgery, with a focus on efficacy and side effect profile. PMID:27053186

  6. Calcium Signaling Is Required for Erythroid Enucleation

    PubMed Central

    Russell, Sarah M.; Humbert, Patrick O.

    2016-01-01

    Although erythroid enucleation, the property of erythroblasts to expel their nucleus, has been known for 7ore than a century, surprisingly little is known regarding the molecular mechanisms governing this unique developmental process. Here we show that similar to cytokinesis, nuclear extrusion requires intracellular calcium signaling and signal transduction through the calmodulin (CaM) pathway. However, in contrast to cytokinesis we found that orthochromatic erythroblasts require uptake of extracellular calcium to enucleate. Together these functional studies highlight a critical role for calcium signaling in the regulation of erythroid enucleation. PMID:26731108

  7. Calcium Signaling Is Required for Erythroid Enucleation.

    PubMed

    Wölwer, Christina B; Pase, Luke B; Russell, Sarah M; Humbert, Patrick O

    2016-01-01

    Although erythroid enucleation, the property of erythroblasts to expel their nucleus, has been known for 7ore than a century, surprisingly little is known regarding the molecular mechanisms governing this unique developmental process. Here we show that similar to cytokinesis, nuclear extrusion requires intracellular calcium signaling and signal transduction through the calmodulin (CaM) pathway. However, in contrast to cytokinesis we found that orthochromatic erythroblasts require uptake of extracellular calcium to enucleate. Together these functional studies highlight a critical role for calcium signaling in the regulation of erythroid enucleation. PMID:26731108

  8. Investigation and visualization of scleral channels created with femtosecond laser in enucleated human eyes using 3D optical coherence tomography images

    NASA Astrophysics Data System (ADS)

    Chaudhary, Gautam; Rao, Bin; Chai, Dongyul; Chen, Zhongping; Juhasz, Tibor

    2007-02-01

    We used optical coherence tomography (OCT) for non-invasive imaging of the anterior segment of the eye for investigating partial-thickness scleral channels created with a femtosecond laser. Glaucoma is associated with elevated intraocular pressure (IOP) due to reduced outflow facility in the eye. A partial-thickness aqueous humor (AH) drainage channel in the sclera was created with 1.7-μm wavelength femtosecond laser pulses to reduce IOP by increasing the outflow facility, as a solution to retard the progression of glaucoma. It is hypothesized that the precise dimensions and predetermined location of the channel would provide a controlled increase of the outflow rate resulting in IOP reduction. Therefore, it is significant to create the channel at the exact location with predefined dimensions. The aim of this research has two aspects. First, as the drainage channel is subsurface, it is a challenging task to determine its precise location, shape and dimensions, and it becomes very important to investigate the channel attributes after the laser treatment without disturbing the internal anterior structures. Second, to provide a non-invasive, image-based verification that extremely accurate and non-scarring AH drainage channel can be created with femtosecond laser. Partial-thickness scleral channels created in five human cadaver eyes were investigated non-invasively with a 1310-nm time-domain OCT imaging system. Three-dimensional (3D) OCT image stacks of the triangular cornea-sclera junction, also known as anterior chamber angle, were acquired for image-based analysis and visualization. The volumetric cutting-plane approach allowed reconstruction of images at any cross-sectional position in the entire 3D volume of tissue, making it a valuable tool for exploring and evaluating the location, shape and dimension of the channel from all directions. As a two-dimensional image-based methodology, an image-processing pipeline was implemented to enhance the channel features to

  9. Best laser for prostatectomy in the year 2013

    PubMed Central

    Maheshwari, Pankaj N; Joshi, Nitin; Maheshwari, Reeta P

    2013-01-01

    Lasers have come a long way in the management of benign prostatic hyperplasia. Over last nearly two decades, various different lasers have been utilized for prostatectomy. Neodymium: yttrium-aluminum-garnet laser that started this journey, is no longer used for prostatectomy. Holmium laser can achieve transurethral enucleation of the prostatic adenoma producing a fossa that can be compared with the fossa after Freyer's prostatectomy. Green light laser has a short learning curve, is nearly blood-less with good immediate results. Thulium laser is a faster cutting laser while diode laser is a portable laser device. Often laser prostatectomy is considered as a replacement for the standard transurethral resection of prostate (TURP). To be comparable, laser should reduce or avoid the immediate and long-term complications of TURP, especially bleeding and need for blood transfusion. It should also be safe in the ever increasing patient population on antiplatelet and anticoagulant drugs. We need to take stock of the situation and identify, which among the present day lasers has stood the test of time. A review of the literature was performed to see if any of these lasers could be called the “best laser for prostatectomy in 2013.” PMID:24082446

  10. Enucleation in psychosis associated with aqueductal stenosis.

    PubMed

    Mancinelli, Iginia; Pompili, Maurizio; Scapati, Francesco; Lazanio, Simone; Kotzalidis, Giorgio D; Tatarelli, Roberto

    2004-03-01

    Reports of self-enucleation are frequent in medical literature, but cases of enucleation towards another are rare. We report the case of a man, 20 years of age, who suffered from psychosis with hydrocephalus and aqueductal stenosis that required a forensic psychiatric investigation to ascertain whether he was of unsound mind when he assaulted and enucleated the right eye of an officer and led to the surgical enucleation of the victim's left eye. Based on his clinical interviews and hospitalization record, we conclude that at the time of the assault, he was suffering from a delusional disorder with religious and demonic content, visual and auditory hallucinations, illusion phenomena, delusional interpretations, imaginative elements, a feeling of terror, and command hallucinations that compelled him to perform the act of aggression. PMID:15027561

  11. The role of lasers in modern urology

    PubMed Central

    Dołowy, Łukasz; Dembowski, Janusz; Zdrojowy, Romuald; Kołodziej, Anna

    2015-01-01

    Introduction The functioning of modern urological departments and the high level of service they provide is possible through, among other things, the use of modern laser techniques. Material and methods Open operations have been replaced by minimally invasive procedures, and classical surgical tools by advanced lasers. The search for new applications with lasers began as technology developed. Among many devices available, holmium, diode and thulium lasers are currently the most popular. Results Depending on the wavelength, the absorption by water and hemoglobin and the depth of penetration, lasers can be used for coagulation, vaporization and enucleation. In many centres, after all the possibilities of pharmacological treatment have been exhausted, lasers are used as the primary treatment for patients with benign prostatic hyperplasia, with therapeutic results that are better than those obtained through open or endoscopic operations. The use of lasers in the treatment of urolithiasis, urinary strictures and bladder tumours has made treatment of older patients with multiple comorbidities safe, without further necessity to modify the anticoagulant drug treatment. Laser procedures are additionally less invasive, reduce hospitalization time and enable a shorter bladder catheterization time, sometimes even eliminating the need for bladder catherterization completely. Such procedures are also characterized by more stable outcomes and a lower number of reoperations. Conclusions There are also indications that with the increased competition among laser manufacturers, decreased purchase and maintenance costs, and increased operational safety, laser equipment will become mandatory and indispensable asset in all urology wards. PMID:26251737

  12. High-power frequency comb in the range of 2-2.15  μm based on a holmium fiber amplifier seeded by wavelength-shifted Raman solitons from an erbium-fiber laser.

    PubMed

    Coluccelli, Nicola; Cassinerio, Marco; Gambetta, Alessio; Laporta, Paolo; Galzerano, Gianluca

    2014-03-15

    We demonstrate a room-temperature high-power frequency comb source covering the spectral region from 2 to 2.15 μm. The source is based on a femtosecond erbium-fiber laser operating at 1.55 μm with a repetition rate of 250 MHz, wavelength-shifted up to 2.06 μm by the solitonic Raman effect, seeding a large-mode-area holmium (Ho) fiber amplifier pumped by a thulium (Tm) fiber laser emitting at 1.94 μm. The frequency comb has an integrated power of 2 W, with overall power fluctuations as low as 0.3%. The beatnote between the comb and a high-spectral-purity, single-frequency Tm-Ho laser has a linewidth of 32 kHz over 1 ms observation time, with a signal-to-noise ratio in excess of 30 dB. PMID:24690863

  13. Resonance ionization of holmium for ion implantation in microcalorimeters

    NASA Astrophysics Data System (ADS)

    Schneider, F.; Chrysalidis, K.; Dorrer, H.; Düllmann, Ch. E.; Eberhardt, K.; Haas, R.; Kieck, T.; Mokry, C.; Naubereit, P.; Schmidt, S.; Wendt, K.

    2016-06-01

    The determination of the electron neutrino mass by calorimetric measurement of the 163 Ho electron capture spectrum requires ultra-pure samples. Several collaborations, like ECHo or HOLMES, intend to employ microcalorimeters into which 163 Ho is implanted as an ion beam. This makes a selective and additionally very efficient ion source for holmium mandatory. For this purpose, laser resonance ionization of stable holmium 165 Ho was studied, using a three step excitation scheme driven by pulsed Ti:sapphire lasers. Five measurements with sample sizes of 1014 and 1015 atoms were performed for the efficiency investigation. In average, an excellent ionization efficiency of 32(5) % could be shown, demonstrating the suitability for ion beam implantation.

  14. Magnetic structure of holmium

    NASA Astrophysics Data System (ADS)

    Pechan, M. J.; Stassis, C.

    1984-03-01

    The magnetic structure of high purity single crystals of holmium has been studied by neutron diffraction techniques. Although the general characteristics of the magnetic structure have been found to agree with earlier measurements, some discrepancies have been resolved and new features have been observed. The magnetic form factor has been measured and compared with relativistic atomic calculations. The low temperature structure (T<20 K) is that of a conical ferromagnet with wave vector (1/6)(2π/c) along the c axis. The basal plane moment is 9.7 μB and the c-axis ferromagnetic component is 1.6 μB at T=6 K. Bunching of the basal plane moments around the easy hexagonal direction has been observed below T=50 K. Evidence for asphericity in the magnetization density is presented and discussed. The wave vector of the basal plane modulation decreases monotonically with temperature in general accordance with the Elliott-Wedgewood theory. Several inflection points were observed, however, which correspond to commensurability with the chemical lattice. The measured temperature dependence of the c- and a-axis lattice constants shows significant magnetostriction. The possibility of a c-axis modulated moment is discussed.

  15. Enucleation versus plaque irradiation for choroidal melanoma

    SciTech Connect

    Straatsma, B.R.; Fine, S.L.; Earle, J.D.; Hawkins, B.S.; Diener-West, M.; McLaughlin, J.A.

    1988-07-01

    The Collaborative Ocular Melanoma Study (COMS) is an international, multicenter-controlled study. The organization includes an Executive Committee, Steering Committee, 6 Central Units, 32 Clinical Centers, and a Data and Safety Monitoring Committee. Scientifically, the COMS consists of (1) a randomized trial of patients with medium choroidal melanoma treated with enucleation versus iodine-125 plaque irradiation, (2) a randomized trial of patients with large choroidal melanoma treated with enucleation versus preenucleation external beam irradiation and enucleation, and (3) a prospective observational study of patients with small choroidal melanoma to determine whether a randomized trial of treatment is appropriate. In design and conduct of the COMS, special consideration is given to biostatistics and sample size considerations, iodine-125 plaque irradiation of choroidal melanoma, and coordinated ocular melanoma research. Recruitment is in progress. However, the pool of eligible patients is limited and the COMS needs the continued support and cooperation of ophthalmologists throughout the United States and Canada.

  16. Magneto-optical trapping of holmium atoms

    NASA Astrophysics Data System (ADS)

    Miao, J.; Hostetter, J.; Stratis, G.; Saffman, M.

    2014-04-01

    We demonstrate sub-Doppler laser cooling and magneto-optical trapping of the rare-earth element holmium. Atoms are loaded from an atomic beam source and captured in six-beam σ+-σ- molasses using a strong J =15/2↔J=17/2 cycling transition at λ =410.5 nm. Due to the small difference in hyperfine splittings and Landé g factors in the lower and upper levels of the cooling transition the MOT is self-repumped without additional repump light, and deep sub-Doppler cooling is achieved with the magnetic trap turned on. We measure the leakage out of the cycling transition to metastable states and find a branching ratio <10-5, which is adequate for state-resolved measurements on hyperfine encoded qubits.

  17. Enucleation for Treating Rodent Ocular Disease

    PubMed Central

    Wilding, Laura A; Uchihashi, Mayu; Bergin, Ingrid L; Nowland, Megan H

    2015-01-01

    Our standard of care for rodent corneal lesions previously included treatment of the primary lesion, application of topical NSAIDs, and systemic NSAIDs in severe cases. When intensive medical management was unsuccessful, animals were euthanized, leading to premature loss of valuable genetically modified animals and those on long-term studies. We investigated enucleation surgery as a treatment for 15 cases of rodent corneal disease that did not respond to medical management. Enucleation was performed under isoflurane anesthesia and involved removal of the globe, extensive hemostasis, and packing the orbital space with absorbable gelatin sponge. The lid margins were closed by tarsorrhaphy and tissue glue. Analgesia was provided by using buprenorphine preoperatively and carprofen chew tabs postoperatively. To date, we have a 100% success rate with this procedure (n = 20; 15 clinically affected rodents [2 rats, 13 mice], 5 healthy controls), which included a 60-d follow-up period. The single complication involved dehiscence of the tarsorrhaphy site and was repaired by trimming the lid margins to provide fresh tissue for closure. Histologic examination at both 1 and 3 mo after surgery revealed no evidence of infection of the enucleation site. Enucleation in rodents is a straightforward procedure that represents a refinement to our current standard of care for rodents, does not cause significant inflammation of remaining periocular structures, and has reduced the number of animals euthanized prior to study endpoint because of severe ocular lesions. PMID:26045460

  18. Current Laser Treatments for Benign Prostatic Hyperplasia

    PubMed Central

    Son, Hwancheol; Song, Sang Hoon

    2010-01-01

    The latest technical improvements in the surgical armamentarium are remarkable. In particular, advancements in the urologic field are so exceptional that we could observe the flare-up of robot-assisted laparoscopic radical prostatectomy for prostate cancer and laser prostatectomy for benign prostatic hyperplasia (BPH). Photoselective vaporization of the prostate (PVP) and holmium laser prostatectomy are the most generalized options for laser surgery of BPH, and both modalities have shown good postoperative results. In comparison to transurethral prostatectomy (TURP), they showed similar efficacy and a much lower complication rate in randomized prospective clinical trials. Even in cases of large prostates, laser prostatectomy showed comparable efficacy and safety profiles compared to open prostatectomy. From a technical point of view, PVP is considered to be an easier technique for the urologist to master. Furthermore, patients can be safely followed up in an outpatient clinic. Holmium laser enucleation of the prostate (HoLEP) mimics open prostatectomy because the adenomatous tissue is peeled off the surgical capsule in both procedures. Therefore, HoLEP shows notable volume reduction of the prostate similar to open prostatectomy with fewer blood transfusions, shorter hospital stay, and cost reduction regardless of prostate size. Outcomes of laser prostatectomy for BPH are encouraging but sometimes are unbalanced because safety and feasibility studies were reported mainly for PVP, whereas long-term data are mostly available for HoLEP. We need longer-term randomized clinical data to identify the reoperation rate of PVP and to determine which procedure is the ideal alternative to TURP and open prostatectomy for each patient. PMID:21165192

  19. Special optical fibers doped with nanocrystalline holmium-yttrium titanates (HoxY1-x)2Ti2O7 for fiber-lasers

    NASA Astrophysics Data System (ADS)

    Mrázek, Jan; Kašík, Ivan; Boháček, Jan; Proboštová, Jana; Aubrecht, Jan; Podrazký, Ondřej; Cajzl, Jakub; Honzátko, Pavel

    2015-05-01

    The paper deals with the preparation and characterization of the silica optical fibers doped with nanocrystalline holmium-yttrium titanates (HoxY1-x)2Ti2O7 with optimized luminescence properties. The sol-gel approach was employed to prepare colloidal solution of (HoxY1-x)2Ti2O7 precursors. The concentration of Ho3+ ions in the compounds was varied up to x=0.4. Prepared sols were calcined at 1000 °C forming xerogels which were characterized by X-ray diffraction to confirm their structure. The xerogels were analyzed by the mean of steady-state luminescence technique to optimize the concentration of Ho3+ ions in the compound. The most intensive emission at 2050 nm was observed for the compound (Ho5Y95)2Ti2O7. Sol of the corresponding composition was soaked into the porous silica frit deposed inside the silica substrate tube which was collapsed into preform and drawn into optical fiber. Single mode optical fiber with the core diameter 12 μm and outer diameter 125 μm was prepared. Numerical aperture of prepared fiber was 0.16. The concentration of Ho3+ ions in the fiber core was 0.03 at %. Background attenuation of prepared fiber at 850 nm was smaller than 0.5 dBṡm-1.

  20. High-power and highly efficient diode-cladding-pumped holmium-doped fluoride fiber laser operating at 2.94 microm.

    PubMed

    Jackson, Stuart D

    2009-08-01

    A high-power diode-cladding-pumped Ho(3+), Pr(3+)-doped fluoride glass fiber laser is demonstrated. The laser produced a maximum output power of 2.5 W at a slope efficiency of 32% using diode lasers emitting at 1,150 nm. The long-emission wavelength of 2.94 microm measured at maximum pump power, which is particularly suited to medical applications, indicates that tailoring of the proportion of Pr(3+) ions can provide specific emission wavelengths while providing sufficient de-excitation of the lower laser level. PMID:19649086

  1. Relaxation oscillations of the radiation from a 2-{mu}m holmium laser with a Cr,Tm,Ho : YSGG crystal

    SciTech Connect

    Alpat'ev, A N; Smirnov, Valerii A; Shcherbakov, Ivan A

    1998-02-28

    Analytic expressions for the parameters of relaxation oscillations in a cw 2-{mu}m, Cr,Tm,Ho : YSGG crystal laser are derived and analysed. They are compared quantitatively with the corresponding parameters of a 2-{mu}m Cr,Tm : YSGG crystal laser. Significant differences are found between the damping decrements. The experimental and theoretical results are compared and the different operational dynamics of the Ho{sup 3+} and Tm{sup 3+} ion lasers explained. (control of laser radiation parameters)

  2. Suppression of optical damage at 532 nm in Holmium doped congruent lithium niobate.

    PubMed

    Barnes, Eftihia; O'Connell, Nathan H; Balli, Nicolas R; Pokhrel, Madhab; Movsesyan, Anush; Kokanyan, Edvard; Sardar, Dhiraj K

    2014-10-20

    Optical damage experiments were carried out in a series of Holmium doped congruent lithium niobate (Ho:cLN) crystals as a function of dopant concentration and laser intensity. The light induced beam distortion was recorded with a camera and a detector under the pseudo-Z-scan configuration. At 532 nm, strong suppression of the optical damage was observed for the 0.94 mol. % doped crystal. Increased resistance to optical damage was also observed at 488 nm. The suppression of the optical damage is predominantly attributed to the reduction of the Nb antisites due to the holmium doping. PMID:25401654

  3. Gain and energy storage in holmium YLF

    NASA Technical Reports Server (NTRS)

    Storm, Mark E.; Deyst, John P.

    1991-01-01

    It is demonstrated that Q-switched holmium lasers are capable of high-gain and high-energy operation at 300 K. Small-signal gain coefficients of 0.50 and 0.12/cm have been measured in YLF and YAG, respectively. Small-signal gains of 0.50/cm are comparable to those achievable in Nd:YAG and are not typical of low-gain materials. This large gain in the Ho:YLF material is made possible by operating the amplifier in the ground state depletion mode. The amplifier performance data and associated analysis presented demonstrate that efficient energy storage is possible with very high excited state ion densities of the Ho 5I7 upper laser level. This is an important result since upconversion can limit the 5I7 population. Although upconversion was still present in this experiment, it was possible to achieve efficient energy storage, demonstrating that the problem is manageable even at high excitation densities in YLF.

  4. Efficient holmium-doped fluoride fiber laser emitting 2.1 µm and blue upconversion fluorescence upon excitation at 2 µm.

    PubMed

    Guhur, A; Jackson, S D

    2010-09-13

    We demonstrate a highly efficient and high power Ho(3+)-doped fluoride glass fiber laser that is resonantly pumped with a Tm(3+)-doped silicate glass fiber laser operating at 2.051 µm. The laser operates at 2080 nm and generated 6.66 W at a slope efficiency of 72%. We observe strong visible upconversion fluorescence centered at a variety of wavelengths including 491 nm which results from three sequential energy transfer upconversion processes; the fluorescence to pump energy ratio for this emission is one the largest reported to date. PMID:20940907

  5. Effects of simultaneously fiber transmitted erbium and holmium radiation on the interaction with highly absorbing media

    NASA Astrophysics Data System (ADS)

    Frenz, Martin; Pratisto, Hans S.; Ith, Michael; Koenz, Flurin; Weber, Heinz P.

    1995-05-01

    Erbium and Holmium lasers have both been shown to be suitable for orthopedic surgery performed under water. Erbium lasers emitting in the 3 micrometers wavelength region corresponding to the maximum water absorption peak effectively ablated biological tissues with high precision and minimal thermal damage. Holmium laser radiation at 2 micrometers , due to a lower absorption coefficient, is characterized by a greater extent of thermal damage leading to hemostasis. To combine the special advantages of each system we simultaneously coupled their radiation into a zirconium fluoride fiber (ZrF4) which was protected with a quartz fiber tip. Pressure measurements performed in the liquid using a piezo electrical transducer, transmission measurements and video flash lamp schlieren imaging of the laser induced vapor bubble were used in order to determine optimum laser parameters. The cutting efficiency of the Erbium laser is drastically improved when a low energy Holmium laser pulse is additionally used which is just able to open a vapor channel through which the Erbium laser pulse can be transmitted. The dynamics of the channel formation, geometry and life time are measured as a function of the delay time between the two different laser pulses and the pulse energy applied. The combination of 2 micrometers and 3 micrometers radiation seems to be an ideal instrument for tissue treatment.

  6. Holmium-doped Lu2O3, Y2O3, and Sc2O3 for lasers above 2.1 μm.

    PubMed

    Koopmann, Philipp; Lamrini, Samir; Scholle, Karsten; Schäfer, Michael; Fuhrberg, Peter; Huber, Günter

    2013-02-11

    Efficient room-temperature laser operation was obtained in the wavelength range from 2117 nm to 2134 nm with Ho:Lu(2)O(3) and Ho:Y(2)O(3) as the active materials. With an FBG-stabilized Tm-doped fiber laser as the pump source, the maximum slope efficiency and output power of the Ho:Y(2)O(3) laser were 63% and 18.8 W, respectively. With Ho:Lu(2)O(3) the respective values were 76% and 25.2 W. With Ho:Sc(2)O(3) as the active material the accessible wavelength range could be expanded to 2158 nm in a diode-pumped setup. PMID:23481849

  7. [Testicular epidermoid cyst: orchiectomy or enucleation resection?].

    PubMed

    Heidenreich, A; Zumbé, J; Vorreuther, R; Klotz, T; Vietsch, H; Engelmann, U H

    1996-01-01

    Our experience with 18 patients with simple epidermoid cysts of the testis is reported. In each patient the tumour was enucleated completely and two biopsies of the adjacent parenchyma were obtained for exclusion of associated germ cell cancer, scars or carcinoma in situ. There was no evidence of malignancy in any of the biopsy specimens. Preoperative evaluation included physical examination, testicular sonography, and determination of AFP and hCG serum levels. Although epidermoid cyst can be strongly suspected on sonography the ultrasound appearance is not specific, and inguinal testicular exploration was required in these patients. In 1 patient multiple epidermoid cysts of the right testis were associated with an adult teratoma containing embryonal carcinoma and choriocarcinoma of the left testis; no similar case has been described in the literature. On the basis of our results and experience we consider tumour enucleation and biopsy of the adjacent parenchyma to be adequate treatment for benign epidermoid cyst. The world literature concerning organ-sparing surgery in testicular epidermoid cyst is reviewed. PMID:8851841

  8. Comparison of the clinical efficacy and safety of retroperitoneal laparoscopic ureterolithotomy and ureteroscopic holmium laser lithotripsy in the treatment of obstructive upper ureteral calculi with concurrent urinary tract infections.

    PubMed

    Jiang, Jun-Tao; Li, Wei-Guo; Zhu, Yi-Ping; Sun, Wen-Lan; Zhao, Wei; Ruan, Yuan; Zhong, Chen; Wood, Kristofer; Wei, Hai-Bin; Xia, Shu-Jie; Sun, Xiao-Wen

    2016-07-01

    The aim of this study is to compare the clinical efficacy and safety of retroperitoneal laparoscopic ureterolithotomy (RPLU) and ureteroscopic holmium laser lithotripsy (UHLL) as two minimally invasive procedures in managing obstructive upper ureteral calculi with concurrent urinary tract infections (UTI). The retrospective study included 189 patients who underwent unilateral obstructive upper ureteral stones with concurrent UTI from January 2007 to November 2014 at our institution. Patients received RPLU (81 cases) or UHLL (108 cases). All patients received preoperative anti-infection treatment (indwelling ureteral stent and/or preoperative antibiotics). Collected data, including sex, age, stone size, success rate, operation duration, post-operation hospitalization time, and post-operation complications, were compared. All patients were followed up for more than 6 months after surgeries, and no ureterostenosis occurred. The study included 189 patients, 41 (21.7 %) females and 148 (78.3 %) males with a medium age of 52 years (range 22-81 years). All surgeries were successfully performed without conversion to open surgery. Stone size in the RPLU group was larger than that of the UHLL group (16.1 ± 1.4 vs. 10.4 ± 1.6 mm, P = 0.012). Operative duration (P = 0.009) and hospitalization time (P < 0.001) in the UHLL group were significantly shorter than those in the RPLU group, whereas stone clearance rate was significantly higher in the RPLU group (100 vs. 88.9 %, P = 0.002). Of note, postoperative fever was more common in patients treated with UHLL (15 cases) versus RPLU (4 cases) (13.9 vs. 4.9 %, P = 0.043). Moreover, in the UHLL group, three patients without a preoperative indwelling ureteral stent were complicated with sepsis, which was not seen in RPLU group. In our study, the safety and stone clearance rate of RPLU are better than those of UHLL in the treatment of unilateral upper ureteric calculi with concurrent UTI

  9. Erythroblast enucleation is a dynein-dependent process.

    PubMed

    Kobayashi, Isuzu; Ubukawa, Kumi; Sugawara, Kotomi; Asanuma, Ken; Guo, Yong-Mei; Yamashita, Junsuke; Takahashi, Naoto; Sawada, Kenichi; Nunomura, Wataru

    2016-04-01

    Mammalian erythroblasts undergo enucleation through a process thought to be similar to cytokinesis. Microtubule-organizing centers (MTOCs) mediate organization of the mitotic spindle apparatus that separates the chromosomes during mitosis and are known to be crucial for proper cytokinesis. However, the role of MTOCs in erythroblast enucleation remains unknown. We therefore investigated the effect of various MTOC inhibitors on cytokinesis and enucleation using human colony-forming units-erythroid (CFU-Es) and mature erythroblasts generated from purified CD34(+) cells. We found that erythro-9-[3-(2-hydroxynonyl)]adenine (EHNA), a dynein inhibitor, and monastrol, a kinesin Eg5 inhibitor, as well as various inhibitors of MTOC regulators, including ON-01910 (Plk-1), MLN8237 (aurora A), hesperadin (aurora B), and LY294002 (PI3K), all inhibited CFU-E cytokinesis. Among these inhibitors, however, only EHNA blocked enucleation. Moreover, terminally differentiated erythroblasts expressed only dynein; little or none of the other tested proteins was detected. Over the course of the terminal differentiation of human erythroblasts, the fraction of cells with nuclei at the cell center declined, whereas the fraction of polarized cells, with nuclei shifted to a position near the plasma membrane, increased. Dynein inhibition impaired nuclear polarization, thereby blocking enucleation. These data indicate that dynein plays an essential role not only in cytokinesis but also in enucleation. We therefore conclude that human erythroblast enucleation is a process largely independent of MTOCs, but dependent on dynein. PMID:26724640

  10. Energy upconversion in holmium doped lead-germano-tellurite glass

    SciTech Connect

    Kamma, Indumathi; Reddy, B. Rami

    2010-06-15

    Holmium doped lead-germano-tellurite glass was prepared by the melt quenching technique. The Judd-Ofelt intensity parameters were estimated as {Omega}{sub 2}=7.6x10{sup -20}, {Omega}{sub 4}=12.9x10{sup -20}, and {Omega}{sub 6}=2.5x10{sup -20} cm{sup 2}. Radiative transition probabilities and lifetimes were also determined for some of the levels. Room temperature upconversion emissions have been observed from Ho{sup 3+} at 497 nm under 532 nm laser excitation, and at 557 and 668 nm under 762 nm laser excitation. The upconversion emission mechanisms were found to be due to a step wise excitation process. Upconversion emission intensity enhanced in a heat treated glass.

  11. Unsuccessful Self-Enucleation in a Schizophrenic Patient

    PubMed Central

    Noy Achiron, Romi; Paul, Michael; Achiron, Asaf

    2014-01-01

    Self-enucleation is a very unusual form of self-mutilation directly linked to mental illness. In this case we present a 26-year-old schizophrenic patient who attempted to enucleate his eye with a rollerball pen. Antipsychotic therapy and emergency surgery saved the patient eye and emphasize the importance of quick response and good collaboration between psychiatric and ophthalmic teams. PMID:25328735

  12. Space-resolved density diagnostic of a highly ionized holmium ([ital Z]=67) laser-produced plasma from 3[ital d][sup 10]4[ital l]-3[ital d][sup 10]4[ital l][prime] Cu I--like lines

    SciTech Connect

    Mandelbaum, P.; Behar, E. ); Seely, J.F.; Feldman, U.; Brown, C.M. ); Hammel, B.A.; Back, C.A.; Lee, R.W.; Kania, D.R. ); Bar-Shalom, A. )

    1994-06-01

    A space-resolved electron density diagnostic of a holmium laser-produced plasma has been performed using the intensity ratios of Cu I--like 3[ital d][sup 10]4[ital l]-3[ital d][sup 10]4[ital l][prime] lines. The atomic theoretical model of the Cu I--like ion included the 3[ital d][sup 10][ital nl] levels with [ital n]=4,5 and [ital l]=[ital s],[ital p],[ital d],[ital f]. The effect of line absorption at high electron densities is discussed and the atomic data obtained with the HULLAC computer code are compared with previously published data.

  13. On-chip enucleation of an oocyte by untethered microrobots

    NASA Astrophysics Data System (ADS)

    Ichikawa, Akihiko; Sakuma, Shinya; Sugita, Masakuni; Shoda, Tatsuro; Tamakoshi, Takahiro; Akagi, Satoshi; Arai, Fumihito

    2014-09-01

    We propose a novel on-chip enucleation of an oocyte with zona pellucida by using a combination of untethered microrobots. To achieve enucleation within the closed space of a microfluidic chip, two microrobots, a microknife and a microgripper were integrated into the microfluidic chip. These microrobots were actuated by an external magnetic force produced by permanent magnets placed on the robotic stage. The tip of the microknife was designed by considering the biological geometric feature of an oocyte, i.e. the oocyte has a polar body in maturation stage II. Moreover, the microknife was fabricated by using grayscale lithography, which allows fabrication of three-dimensional microstructures. The microgripper has a gripping function that is independent of the driving mechanism. On-chip enucleation was demonstrated, and the enucleated oocytes are spherical, indicating that the cell membrane of the oocytes remained intact. To confirm successful enucleation using this method, we investigated the viability of oocytes after enucleation. The results show that the production rate, i.e. the ratio between the number of oocytes that reach the blastocyst stage and the number of bovine oocytes after nucleus transfer, is 100%. The technique will contribute to complex cell manipulation such as cell surgery in lab-on-a-chip devices.

  14. Prostate resection - minimally invasive

    MedlinePlus

    Laser prostatectomy; Transurethral needle ablation; TUNA; Transurethral incision; TUIP; Holmium laser enucleation of the prostate; HoLep; Interstitial laser coagulation; ILC; Photoselective vaporization of the prostate; PVP; Transurethral ...

  15. Spectrum of the holmium atom arising from bombardment of a tantalum surface by holmium ions

    SciTech Connect

    Vasileva, E.K.; Morozov, S.N.

    1986-12-01

    The ion--photon emission spectrum of holmium has been recorded and investigated. It is shown that the appearance of so-called continuous radiation (CR) is due to excitation of the lower triplet system of terms.

  16. Obliterated urethra: holmium:yttrium-aluminum-garnet cut-to-light with urolume stenting.

    PubMed

    Monga, M; Gordon, Z; Alexandrescu, B

    2001-12-01

    Antegrade-retrograde urethrotomy, or the cut-to-light procedure, performed for obliterated urethra is associated with a high rate of recurrence of urethra] stricture. With the goal of reducing the stricture recurrence rate, we performed a modified cut-to-light procedure using a holmium:yttrium-aluminum-garnet laser and UroLume stenting in a 76-year-old man with urethral obliteration. PMID:11763485

  17. New, efficient, room temperature mid-infrared laser at 3.9 mu m in holmium:barium yttrium fluoride and visible praseodymium:lithium yttrium fluoride laser for holography

    NASA Astrophysics Data System (ADS)

    Tabirian, Anna Murazian

    This dissertation describes a series of experiments and theoretical studies, which led to the development of two new solid state laser systems: efficient, room temperature mid-infrared solid state laser at 3.9 μm in Ho 3+ doped BaY2F8 and visible Pr:LiYF4 laser at 640 mn for holography. The 3.9 μm laser wavelength matches the peak of mid-IR atmospheric transmission window, which makes it very important for multiple applications such as remote sensing, imaging, IR countermeasures, eye-safe lidars and environmental agent detection. We present the results of spectroscopic evaluations and numerical modeling of energy transfer processes between rare earth ions of Ho3+ doped in two host laser materials: BaY2F8 and LiYF 4. The 3.9 μm laser is based on transition with upper laser lifetime considerably shorter than lower level lifetime, which in general leads to self-terminating laser action in the cw mode or at high repetition rates. Therefore, three different pumping and lasing schemes, that could allow overcoming these limitations have been suggested and studied. First, cascade laser action at 1.4 μm and 3.9 μm was achieved with low thresholds and near-theoretical quantum efficiency in Ho3+ doped BaY2F8 pumped at 532 nm by a Q- switched frequency doubled Nd:YAG laser. Next, the feasibility of achieving 3.9 μm laser with cw resonant cascade pumping at 750 mn by a Ti:Sapphire laser was studied. New energy transfer process, such as upconversion from terminal level of the 3.9 μm laser was observed in high concentration Ho3+ doped BaY2F 8. Finally, we proposed to use high-energy flashlamp pumped tunable Cr:LiSAF laser operating in long pulse regime for the direct pumping of the upper level of the 3.9 μm laser. Pulsed laser oscillation at 3.9 μm is demonstrated in Ho3+ doped BaY2F8 with low threshold of 3 mJ and a slope efficiency of 14.5% with maximal energy of 30 mJ. The second part of the thesis describes the design and the development of the visible Pr:LiYF4 laser

  18. Management of large prostatic adenoma: Lasers versus bipolar transurethral resection of prostate.

    PubMed

    Gupta, Narmada P; Nayyar, Rishi

    2013-07-01

    Transurethral resection of prostate (TURP) has long been the most commonly performed surgical procedure for the management of benign prostate enlargement (BPE), but has several associated limitations. Over the years, laser techniques have developed as major contenders as alternative therapies for BPE. However, simultaneously, TURP has also flourished and with relatively recent development of resection in saline (bipolar TURP), the tussle between laser techniques and TURP has further gained momentum. A systematic search was performed on Medline using the various Medical subject headings related to the surgical management of BPE including TURP, bipolar, lasers, holmium laser enucleation of prostate (HoLEP), photo-selective vaporization of prostate (PVP), etc., All articles types including meta-analysis randomized controlled trials, review articles, guidelines from various urological associations, single center studies from 2002 onward were considered for review. Bipolar TURP, HoLEP, and PVP provide equivalent outcomes for large prostate adenoma (<60 g). For extremely large glands (<150 g), HoLEP is a very efficacious endoscopic alternative to open prostatectomy and has proven long-term results over more than a decade. Bipolar TURP and PVP are attractive with a minimal learning curves and equivalent short term durability. Surgical management of large prostate should be individualized based upon patient's comorbidities and surgeon's expertise. PMID:24082445

  19. Management of large prostatic adenoma: Lasers versus bipolar transurethral resection of prostate

    PubMed Central

    Gupta, Narmada P; Nayyar, Rishi

    2013-01-01

    Transurethral resection of prostate (TURP) has long been the most commonly performed surgical procedure for the management of benign prostate enlargement (BPE), but has several associated limitations. Over the years, laser techniques have developed as major contenders as alternative therapies for BPE. However, simultaneously, TURP has also flourished and with relatively recent development of resection in saline (bipolar TURP), the tussle between laser techniques and TURP has further gained momentum. A systematic search was performed on Medline using the various Medical subject headings related to the surgical management of BPE including TURP, bipolar, lasers, holmium laser enucleation of prostate (HoLEP), photo-selective vaporization of prostate (PVP), etc., All articles types including meta-analysis randomized controlled trials, review articles, guidelines from various urological associations, single center studies from 2002 onward were considered for review. Bipolar TURP, HoLEP, and PVP provide equivalent outcomes for large prostate adenoma (<60 g). For extremely large glands (<150 g), HoLEP is a very efficacious endoscopic alternative to open prostatectomy and has proven long-term results over more than a decade. Bipolar TURP and PVP are attractive with a minimal learning curves and equivalent short term durability. Surgical management of large prostate should be individualized based upon patient's comorbidities and surgeon's expertise. PMID:24082445

  20. Risk factors for endophthalmitis requiring evisceration or enucleation

    PubMed Central

    Lu, Xuehui; Ng, Danny Siu-Chun; Zheng, Kangkeng; Peng, Kun; Jin, Chuang; Xia, Honghe; Chen, Weiqi; Chen, Haoyu

    2016-01-01

    Endophthalmitis has devastating sequelae resulting in blindness and even loss of eyeball. Although the prognosis of endophthalmitis has much improved with the advances of antibiotics and vitreoretinal surgery, of the number of patients that required evisceration or enucleation is still significant. We retrospectively reviewed the charts of 210 eyes of 210 patients with endophthalmitis andcompared the group that required evisceration or enucleation with those that received salvaging therapies. Regression analysis was used to identify the risk factors for evisceration or enucleation. Thirty eyes (14.3%) underwent enucleation or evisceration. The group of eviscerated or enucleated eyes were older (58.7 vs. 42.2 years, p < 0.001), had more women (56.7% vs. 22.2%, p = 0.003), had poorer initial visual acuity (2.79 vs. 2.10 LogMAR, p < 0.001), and had longer duration before intervention (18.03 vs. 5.74 days, p = 0.031). The most common primary indications for endophthalmitis were infections from corneal ulcer (50.0% vs. 4.4%, p < 0.001) andfrom endogenous source (23.3% vs. 5.6%, p < 0.001). Less common indications were trauma (26.7% vs. 67.8%, p < 0.001) and postoperative (6.7% vs. 22.2%, p = 0.049) endophthalmitis. After adjusting for confounding factors, corneal ulcer-related endophthalmitis, endogenous endophthalmitis and initial visual acuity were the independent risk factors for evisceration or enucleation. PMID:27302573

  1. Psychological Reactions and Persistent Facial Pain following Enucleation

    PubMed Central

    2014-01-01

    Background. Enucleation is a psychologically and physically traumatic event associated with chronic pain. It would be desirable to better predict which patients will have pain after surgery. Methods. A cross-sectional postal questionnaire study of adults undergoing enucleation captured the demographic details, Pain Quality Assessment Scale (PQAS), Pain Catastrophizing Scale (PCS), and the Facial Pain Assessment questionnaire. Patients were classified as suffering from chronic pain if they reported a pain score of >1 out of 10 on the numerical pain score (NRS). Results. Seventeen of 60 adults participated in the study. 47% of patients reported chronic pain (mean pain score = 1.4 ± 0.7, n = 17); 25% experienced pain daily. No difference in age, surgical side, reason for surgery, or the duration of time since the surgery was noted. All patients had low PQAS scores and 50% of individuals with persistent pain were concerned about their facial appearance. There was no significant difference in the level of catastrophization noted in patients with or without pain or between the subgroups (rumination, magnification, or helplessness). Conclusions. Although persistent pain following enucleation affected a significant number of patients, the pain intensity was mild. Enucleation influenced the physical perception some individuals had of themselves. PMID:24864208

  2. The risk of enucleation after proton beam irradiation of uveal melanoma

    SciTech Connect

    Egan, K.M.; Gragoudas, E.S.; Seddon, J.M.; Glynn, R.J.; Munzenreider, J.E.; Goitein, M.; Verhey, L.; Urie, M.; Koehler, A. )

    1989-09-01

    Enucleation after proton beam irradiation of uveal melanomas occurred in 64 (6.4%) of 994 eyes with a median follow-up time of 2.7 years. The median time between irradiation and enucleation in the 64 enucleated eyes was 13 months. The probability of retaining the eye was 95 and 90%, 2 and 5 years postirradiation, respectively. Three percent of eyes were enucleated during posttreatment year 1, and the yearly rate was 1% by the fourth year. No patient had enucleation later than 5 1/2 years posttreatment. The complication most likely to result in enucleation was neovascular glaucoma although this was frequently managed without enucleation. Other common reasons for enucleation were documented or suspected tumor growth and complete retinal detachment with associated loss of vision. The leading risk factors for enucleation were anterior tumor margin involving the ciliary body, tumor height greater than 8 mm, and proximity of the tumor to the fovea. Based on the presence or absence of these factors, 5-year eye retention rates were 99, 92, and 76% for low-, moderate-, and high-risk groups, respectively. Thus, the probability of eye retention after proton beam irradiation is high even among those at greatest risk of enucleation.

  3. Cobalt-60 plaque radiotherapy vs enucleation for posterior uveal melanoma

    SciTech Connect

    Augsburger, J.J.; Gamel, J.W.; Lauritzen, K.; Brady, L.W. )

    1990-05-15

    We compared the survival of 302 patients with a primary choroidal or ciliary body melanoma treated by cobalt-60 plaque radiotherapy between 1976 and 1982 with the survival of 134 patients treated by enucleation during the same period. Tumor size, location of the anterior margin of the tumor, and patient age at the time of treatment were identified as simultaneous significant clinical variables for predicting melanoma-specific mortality by multivariate Cox proportional hazards modeling. We computed a prognostic index for each patient based on this model and found that patients in the enucleation group had slightly higher values of this index than did patients in the cobalt-60 plaque radiotherapy group. Risk ratios for the treatment effect computed from a Cox model incorporating prognostic index and the treatment variable were found to be approximately equal to 1, both for analysis of melanoma-specific mortality and total mortality. These results indicate that when one controls for differences in prognostic index between the groups, cobalt-60 plaque therapy and enucleation are essentially equivalent in their effect on survival.

  4. Phylogenic insights into the enucleation of erythroblasts in human.

    PubMed

    Nunomura, Wataru

    2016-07-01

    Two key questions remain unanswered in the erythropoiesis field: Why and how do erythroblasts enucleate in mammalian species? Recent studies have unveiled the roles of various molecules, cytoskeletal proteins, motor proteins, vesicle transport, signaling pathways, lipid rafts and actomyosin ring contraction in the enucleation process. However, few reports provide insights into the fitness benefit for mammalian species of having anucleate erythrocytes. Herein, we discuss the biological significance of enucleation of human erythroblasts based on our recent results and on evolutionary considerations related to the biology of hemoglobin and the comparative biochemistry of erythrocyte membrane cytoskeletal proteins, such as protein 4.1R. We specifically focus on the Mesozoic era, a geological period during which dinosaurs and the ancestors of mammalian species coexisted. Approximately 200 million years ago, at the beginning of this era, the earth's atmosphere was hypoxic. Interestingly, animals adopted different respiration systems to adapt to this hypoxic environment. Recent studies using state-of-the-art technologies have shown that dinosaurs might have had nucleated erythrocytes. After dinosaurs became extinct about 65.5 million years ago, their respiration system was maintained by birds. We propose a new adaptive theory that establishes a correlation between evolution towards nucleated or anucleate erythrocytes depending on organism respiration systems during the Mesozoic era. PMID:27498741

  5. Enucleation: a possible mechanism of cancer cell death

    PubMed Central

    Paunescu, Virgil; Bojin, Florina M; Gavriliuc, Oana I; Taculescu, Elena A; Ianos, Robert; Ordodi, Valentin L; Iman, Vlad F; Tatu, Calin A

    2014-01-01

    There are few major morphologies of cell death that have been described so far: apoptosis (type I), cell death associated with autophagy (type II), necrosis (type III) and anchorage-dependent mechanisms—anoikis. Here, we show for the first time a possibly novel mechanism inducing tumour cell death under in vitro conditions—enucleation. We pursued the influence of colloidal suspensions of Fe3O4 nanoparticles on tumour cell lines (SK-BR-3 and MCF-7 breast cancer cell lines) grown according to standard cell culture protocols. Magnetite nanoparticles were prepared by combustion synthesis and double layer coated with oleic acid. Scanning and transmission electron microscopy revealed that tumour cells developed a network of intracytoplasmic stress fibres, which induce extrusion of nuclei, and enucleated cells die. Normal adult mesenchymal stem cells, used as control, did not exhibit the same behaviour. Intact nuclei were found in culture supernatant of tumour cells, and were visualized by immunofluorescence. Enucleation as a potential mechanism of tumour cell death might open new horizons in cancer biology research and development of therapeutic agents capable of exploiting this behaviour. PMID:24629135

  6. Sequential transurethral enucleation of the prostate and laparoscopic bladder diverticulectomy.

    PubMed

    Yu, Yang; Guan, Sheng; Shen, Chen; Yang, Bo

    2016-08-01

    Transurethral endoscopic technique and standard laparoscopic technique are surgical options for the management of benign prostatic hyperplasia (BPH) associated with urinary bladder diverticuli (UBD). In this article, we report laparoscopic diverticulectomy (LD) and transurethral plasmakinetic enucleation of the prostate (TUEP) in the same patient sequentially. To the best of our knowledge, this is the first case report of LD combined with TUEP. An 82-year-old patient with benign prostatic hyperplasia and two secondary large bladder diverticuli underwent sequential TUEP and LD. After completion of the TUEP procedure, the detached adenoma was pushed into the bladder as a whole. Then laparoscopic transperitoneal extravesical diverticulectomy assisted by cystoscopic transillumination was performed immediately, and the enucleated prostate was removed via the neck of the diverticulum. The enucleation time and diverticulectomy time was 18 minutes and 108 minutes, respectively. The catheter was removed on the tenth postoperative day. Transurethral endoscopic surgery combined with LD is a good choice in treating BPH and UBD in one session. But the combined procedure is time-consuming, especially for fragmentation of the prostate. TUEP can greatly reduce the operative time of the combined procedure. PMID:27249185

  7. Self-enucleation: forget Freud and Oedipus, it's all about untreated psychosis.

    PubMed

    Large, Matthew Michael; Nielssen, Olav B

    2012-08-01

    Self-enucleation is a rare but serious ophthalmological and psychiatric emergency. It has traditionally been considered to be the result of psycho-sexual conflicts, including those arising from Freud's Oedipal complex and Christian religious teaching. However, an analysis of published case reports suggests that self-enucleation is a result of psychotic illnesses such as schizophrenia. Early treatment with antipsychotic medication in the case of unilateral or threatened self-enucleation might prevent some cases of blindness. PMID:22373824

  8. Histologic comparison of needle, holmium:YAG, and erbium:YAG endoscopic goniotomy

    NASA Astrophysics Data System (ADS)

    Joos, Karen M.; Shen, Jin-Hui; Rivera, Brian K.; Hernandez, Eleut; Shetlar, Debra J.

    1995-05-01

    An endoscope allows visualization of the anterior chamber angle in porcine eyes despite the presence of cloudy corneas. The pectinate ligaments in the anterior chamber angle are a surgical model for primary infantile glaucoma. This study investigated the histologic results, one month after treating the anterior chamber angle with a goniotomy needle, the holmium:YAG laser, or the erbium:YAG laser coupled to a small endoscope. The anterior chambers were deepened with a viscoelastic material in one-month-old anesthetized pigs. An Olympus 0.8 mm diameter flexible endoscope was externally coupled to a 23 gauge needle or a 300 micron diameter fiber. The angle was treated for 120 degrees by one of the three methods, and the probe was removed. During the acute study, all three methods cut the pectinate ligaments. The histologic findings one month after healing demonstrated minimal surrounding tissue damage following goniotomy with a needle and the most surrounding tissue damage following treatment with the holmium:YAG laser.

  9. The laser in urology

    NASA Astrophysics Data System (ADS)

    Hofstetter, Alfons G.

    2002-10-01

    Laser is an acronym for a physical principle and means: Light Amplification by stimulated Emission of Radiation. This principle offers a lot of tissue/light effects caused by the parameters: power density/time and the special qualities of the laser light. Nowadays for diagnosis and therapy following lasers are used in urology: Krypton- and Dye-lasers as well as the Neodymium-YAG- (nd:YAG-), Holmium-YAG (Ho:YAG-), Diode-, Argon- and the CO2-lasers.

  10. Soliton Thulium-Doped Fiber Laser With Carbon Nanotube Saturable Absorber

    PubMed Central

    Kieu, K.; Wise, F. W.

    2011-01-01

    We report stabilization of a thulium–holmium codoped fiber soliton laser with a saturable absorber based on carbon nanotubes. The laser generates transform-limited 750-fs pulses with 0.5-nJ energy. PMID:21731403

  11. Soliton Thulium-Doped Fiber Laser With Carbon Nanotube Saturable Absorber.

    PubMed

    Kieu, K; Wise, F W

    2009-02-01

    We report stabilization of a thulium-holmium codoped fiber soliton laser with a saturable absorber based on carbon nanotubes. The laser generates transform-limited 750-fs pulses with 0.5-nJ energy. PMID:21731403

  12. Quantum state control of trapped Holmium atoms

    NASA Astrophysics Data System (ADS)

    Hostetter, James; Yip, Christopher; Milner, William; Booth, Donald; Collett, Jeffrey; Saffman, Mark

    2016-05-01

    Neutral Holmium with its large number of hyperfine ground states provides a promising approach for collective encoding of a multi-qubit register. A prerequisite for collective encoding is the ability to prepare different states in the 128 state hyperfine ground manifold. We report progress towards optical pumping and control of the hyperfine Zeeman state of trapped Ho atoms. Atoms are transferred from a 410.5 nm MOT into a 455 nm optical dipole trap. The atoms can be optically pumped using light driving the ground 6s2 , F = 11 to 6 s 6 p ,F' = 11 transition together with a F = 10 to F' = 11 repumper. Microwave fields are then used to drive transitions to hyperfine levels with 4 <= F <= 11 . Work supported by NSF award PHY-1404357.

  13. The construction of cloned Sika deer embryos (Cervus nippon hortulorum) by demecolcine auxiliary enucleation.

    PubMed

    Yin, Y; Mei, M; Zhang, D; Zhang, S; Fan, A; Zhou, H; Li, Z

    2014-02-01

    The objective of our study was to establish the feasibility of experimental protocols for cloning sika deer. We performed auxiliary enucleation to improve the efficiency of nuclear transfer operation by optimizing the demecolcine concentration to induce cytoplasmic protrusions in the sika deer oocytes. In the present study,we had studied the impact of different demecolcine concentrations on cytoplasmic protrusions and enucleation rates. We determined that 95.9% of the sika deer oocytes formed cytoplasmic protrusions when treated for 1 h with 0.8 μg/ml demecolcine. The lowest observed rate of protrusion was 19.3% after overnight treatment with demecolcine. When the oocytes aged or had a poor cumulus expansion, they exhibited a significant decrease in the ability to form cytoplasmic protrusions. The rates of enucleation (94.9% vs 85.8%, p < 0.05), cell fusion (84.6% vs 70.1%, p < 0.05) and blastocyst formation (15.4% vs 10.9%, p < 0.05) using demecolcine auxiliary enucleation were significantly higher than those after blind enucleation. These results demonstrated that sika deer oocytes could be enucleated quickly and effectively using demecolcine auxiliary enucleation, which could enhance the enucleation rate, cell fusion rate and blastocyst rate of cloned embryos in vitro. PMID:24138424

  14. Compact Ho:YLF Laser

    NASA Technical Reports Server (NTRS)

    Hemmati, H.

    1988-01-01

    Longitudinal pumping by laser diodes increases efficiency. Improved holmium:yttrium lithium fluoride laser radiates as much as 56 mW of power at wavelength of 2.1 micrometer. New Ho:YLF laser more compact and efficient than older, more powerful devices of this type. Compact, efficient Ho:YLF laser based on recent successes in use of diode lasers to pump other types of solid-state lasers.

  15. Endoscope-Assisted Enucleation of Mandibular Odontogenic Keratocyst Tumors.

    PubMed

    Romano, Antonio; Orabona, Giovanni D A; Abbate, Vincenzo; Maglitto, Fabio; Solari, Domenico; Iaconetta, Giorgio; Califano, Luigi

    2016-09-01

    The keratocyst odontogenic tumor (KCOT) represents a rare and benign but locally aggressive developmental cystic lesion usually affecting the posterior aspect of the mandible bone, the treatment of which has always been raising debate, since Philipsen first described it as a distinct pathological entity in 1956.Recent studies have proposed the use of endoscope-assisted surgical technique, due to the possibility given by the endoscope of improving the effectiveness of the treatment of these lesions thanks to a better visualization of operative field and though a better understanding of the pathology. In this article, we would like to present our experience with the endoscope-assisted treatment of KCOT of the posterior region of the mandible.From April 2000 to April 2012, 32 patients treated for KCOT were enrolled in our retrospective study: patients were divided in 2 groups according to the type of treatment, that is, 18 were treated with traditional enucleation surgery (TES), and 14 patients underwent endoscopic assisted enucleation surgery (EES).Fischer exact test and Kaplan-Meier curves were used to compare the outcomes between the 2 focusing on the recurrence and complication rates. In the TES group, patients we found a higher recurrence rate (39%) and higher postoperative complication rate at 5-year follow-up.Our data suggested, though, that EES seems to be a feasible alternative for the treatment of posterior mandibular KCOT. Further studies and larger series are needed to confirm these results. PMID:27607111

  16. Laser arthroscopy of the temporomandibular joint.

    PubMed

    Gerard, N; Hendler, B H

    1995-04-01

    Laser surgery is very different than traditional surgery. The clinician must be familiar with the physical properties of the laser to use this instrument safely and properly. Various lasers are available for use in oral and maxillofacial surgery and dentistry, namely the carbon dioxide laser, the neodymium:yttrium-aluminum-garnet laser, and the holmium: yttrium-aluminum-garnet laser (Ho:YAG). Only the Ho:YAG laser has been used with effectiveness in temporomandibular joint arthroscopic surgery. PMID:8935004

  17. Unsuspected Ganglioneuroma of the Choroid Diagnosed after Enucleation

    PubMed Central

    Mbagwu, Michael; Rahmani, Bahram; Srivastava, Arth; Burrowes, Delilah; Bryar, Paul J.

    2015-01-01

    We report a case of an unsuspected ganglioneuroma of the choroid in a patient with neurofibromatosis type 1. A 5-year-old girl presented from an outside institution with right proptosis and glaucoma since birth. Magnetic resonance imaging was obtained and showed a cavernous sinus mass extending into the right orbit and multiple orbital lesions. Additionally, increased signal in the posterior globe of the right eye was noted, but its etiology was unclear at the time. She was lost to follow-up for 3 years and later returned with a blind painful eye. Enucleation was performed, and histopathology was significant for diffuse choroidal ganglioneuroma and advanced glaucoma. We report the atypical history, examination findings, and histopathology to support the diagnosis. PMID:27171204

  18. Enucleation and development of cluster headache: a retrospective study

    PubMed Central

    Sörös, Peter; Vo, Oanh; Gerding, Heinrich; Husstedt, Ingo W; Evers, Stefan

    2005-01-01

    Background Cluster headache (CH) is a neurovascular, primary headache disorder. There are, however, several case reports about patients whose CH started shortly after a structural brain disease or trauma. Motivated by a patient who developed CH 3 weeks after the removal of an eye and by similar case reports, we tested the hypothesis that the removal of an eye is a risk factor for CH. Methods A detailed headache questionnaire was filled out by 112 patients on average 8 years after enucleation or evisceration of an eye. Results While 21 % of these patients experienced previously unknown headaches after the removal of an eye, no patient fulfilled the diagnostic criteria for CH. Conclusion Our data does not suggest that the removal of an eye is a major risk factor for the development of CH. PMID:15784136

  19. The eyeball killer: serial killings with postmortem globe enucleation.

    PubMed

    Coyle, Julie; Ross, Karen F; Barnard, Jeffrey J; Peacock, Elizabeth; Linch, Charles A; Prahlow, Joseph A

    2015-05-01

    Although serial killings are relatively rare, they can be the cause of a great deal of anxiety while the killer remains at-large. Despite the fact that the motivations for serial killings are typically quite complex, the psychological analysis of a serial killer can provide valuable insight into how and why certain individuals become serial killers. Such knowledge may be instrumental in preventing future serial killings or in solving ongoing cases. In certain serial killings, the various incidents have a variety of similar features. Identification of similarities between separate homicidal incidents is necessary to recognize that a serial killer may be actively killing. In this report, the authors present a group of serial killings involving three prostitutes who were shot to death over a 3-month period. Scene and autopsy findings, including the unusual finding of postmortem enucleation of the eyes, led investigators to recognize the serial nature of the homicides. PMID:25682709

  20. Symptomatic subserosal gastric lipoma successfully treated with enucleation

    PubMed Central

    Krasniqi, Avdyl Selmon; Hoxha, Faton Tatil; Bicaj, Besnik Xhafer; Hashani, Shemsedin Isuf; Hasimja, Shpresa Mehmet; Kelmendi, Sadik Mal; Gashi-Luci, Lumturije Hasan

    2008-01-01

    Gastric lipomas are rare tumors, accounting for 2%-3% of all benign gastric tumors. They are of submucosal or extremely rare subserosal origin. Although most gastric lipomas are usually detected incidentally, they can cause abdominal pain, dyspeptic disorders, obstruction, invagination, and hemorrhages. Subserosal gastric lipomas are rarely symptomatic. There is no report on treatment of subserosal gastric lipomas in the English literature. We present a case of a 50-year-old male with symptomatic subserosal gastric lipoma which was successfully managed with removal, enucleation of lipoma, explorative gastrotomy and edge resection for histology check of gastric wall. The incidence of gastric lipoma, advanced diagnostic possibilities and their role in treatment modalities are discussed. PMID:18855998

  1. Delayed stimulated afterglow from holmium ions in crystals with coactivators

    SciTech Connect

    Petrov, M.V.; Tkachuk, A.M.

    1980-12-01

    Delayed stimulated afterglow from holmium ions in ..cap alpha beta..-SrF/sub 2/-YF/sub 3/ crystals was observed and investigated. This took the form of several series of emission spikes separated by dark intervals after the action of a single pump pulse. The effect is attributed to some features of the mechanism for population of the upper active level of the lasing holmium ion in the presence of sensitizer ions. It is found that in order to observe the effect, the system must incorporate a metastable level from which energy transfer to the active level provides an independent ''additional pumping'' system for the holmium ions acting over times much longer than the pump pulse duration.

  2. Effect of the method of enucleation on the prognosis of choroidal melanoma.

    PubMed Central

    Migdal, C

    1983-01-01

    The prognosis following treatment of uveal melanomata depends not only on factors such as cell type and degree of mitotic activity, size and location of the tumour, and the age of the patient, but also on the method of enucleation, as surgical manipulation of the neoplasm may potentiate the shedding of malignant cells into the blood stream. One hundred and thirty-one patients treated by different methods of enucleation were reviewed and the mortality patterns assessed. The numbers of deaths over the first 5 years differed significantly between the different groups. A specific method of enucleation used for tumour-containing eyes is described and its importance emphasised. Images PMID:6849859

  3. Attempted auto-enucleation in two incarcerated young men with psychosis

    PubMed Central

    Reichstein, David; Esmaili, Neda; Wells, Timothy; Kim, Judy E.

    2014-01-01

    Auto-enucleation is a sign of untreated psychosis. We describe two patients who presented with attempted auto-enucleation while being incarcerated. This is an observation two-case series of two young men who suffered untreated psychosis while being incarcerated. These young men showed severe self-inflicted ocular trauma during episodes of untreated psychosis. Injuries included orbital bone fracture and dehiscence of the lateral rectus in one patient and severe retinal hemorrhage and partial optic nerve avulsion in the second patient. Auto-enucleation is a severe symptom of untreated psychosis. This urgent finding can occur in a jail setting in which psychiatric care may be minimal. PMID:25892940

  4. Attempted auto-enucleation in two incarcerated young men with psychosis.

    PubMed

    Reichstein, David; Esmaili, Neda; Wells, Timothy; Kim, Judy E

    2015-01-01

    Auto-enucleation is a sign of untreated psychosis. We describe two patients who presented with attempted auto-enucleation while being incarcerated. This is an observation two-case series of two young men who suffered untreated psychosis while being incarcerated. These young men showed severe self-inflicted ocular trauma during episodes of untreated psychosis. Injuries included orbital bone fracture and dehiscence of the lateral rectus in one patient and severe retinal hemorrhage and partial optic nerve avulsion in the second patient. Auto-enucleation is a severe symptom of untreated psychosis. This urgent finding can occur in a jail setting in which psychiatric care may be minimal. PMID:25892940

  5. High gain holmium-doped fibre amplifiers.

    PubMed

    Simakov, Nikita; Li, Zhihong; Jung, Yongmin; Daniel, Jae M O; Barua, Pranabesh; Shardlow, Peter C; Liang, Sijing; Sahu, Jayanta K; Hemming, Alexander; Clarkson, W Andrew; Alam, Shaif-Ul; Richardson, David J

    2016-06-27

    We investigate the operation of holmium-doped fibre amplifiers (HDFAs) in the 2.1 µm spectral region. For the first time we demonstrate a diode-pumped HDFA. This amplifier provides a peak gain of 25 dB at 2040 nm with a 15 dB gain window spanning the wavelength range 2030 - 2100 nm with an external noise figure (NF) of 4-6 dB. We also compare the operation of HDFAs when pumped at 1950 nm and 2008 nm. The 1950 nm pumped HDFA provides 41 dB peak gain at 2060 nm with 15 dB of gain spanning the wavelength range 2050 - 2120 nm and an external NF of 7-10 dB. By pumping at the longer wavelength of 2008 nm the gain bandwidth of the amplifier is shifted to longer wavelengths and using this architecture a HDFA was demonstrated with a peak gain of 39 dB at 2090 nm and 15 dB of gain spanning the wavelength range 2050 - 2150 nm. The external NF over this wavelength range was 8-14 dB. PMID:27410557

  6. Decompression, enucleation, and implant placement in the management of a large dentigerous cyst.

    PubMed

    Cakarer, Sirmahan; Selvi, Firat; Isler, Sabri Cemil; Keskin, Cengizhan

    2011-05-01

    The dentigerous cyst is a developmental odontogenic cyst, accounting for 10% of all cysts of the jaws. The treatment options are decompression, marsupialization, or enucleation regarding the features of the lesions. In this article, a case of a 17-year-old adolescent girl having a large mandibular dentigerous cyst associated with an unerupted third molar is presented. The treatment is composed of decompression for 6 months and enucleation. Decompression and enucleation are a predictable choice in the treatment of large cysts. Radiologic evaluation is mandatory to decide for the appropriate time for the removal of the decompression stents, the enucleation time, and also for the evaluation of the adequate new bone formation for implant placement. The present case emphasizes the success of a conservative approach in the management of a large dentigerous cyst in a young patient and also the maintenance of the new bone formation without using any graft materials for the placement of dental implants. PMID:21558915

  7. Prosthetic rehabilitation of an ocular defect with post-enucleation socket syndrome: A case report

    PubMed Central

    Amornvit, Pokpong; Rokaya, Dinesh; Shrestha, Binit; Srithavaj, Theerathavaj

    2014-01-01

    Ocular trauma can be caused by road traffic accidents, falls, assaults, or work-related accidents. Enucleation is often indicated after ocular injury or for the treatment of intraocular tumors, severe ocular infections, and painful blind eyes. Rehabilitation of an enucleated socket without an intraocular implant or with an inappropriately sized implant can result in superior sulcus deepening, enophthalmos, ptosis, ectropion, and lower lid laxity, which are collectively known as post-enucleation socket syndrome. This clinical report describes the rehabilitation of post-enucleation socket syndrome with a modified ocular prosthesis. Modifications to the ocular prosthesis were performed to correct the ptosis, superior sulcus deepening, and enophthalmos. The rehabilitation procedure produced satisfactory results. PMID:24526826

  8. Mouse model of brachytherapy in consort with enucleation for treatment of malignant intraocular melanoma

    SciTech Connect

    Niederkorn, J.; Sanborn, G.E.; Scarbrough, E.E. )

    1990-06-01

    The efficacy of brachytherapy in the treatment and prevention of metastasis of intraocular melanoma was investigated in a mouse model. A highly metastatic subline of B16 melanoma was transplanted into the anterior segment of C57BL/6 mice and allowed to grow. Brachytherapy was delivered by means of miniature iodine 125 seeds implanted in shallow subcutaneous pockets of the upper eyelid margin of these mice, and 25 Gy of radiation was delivered between days 12 and 14. This brachytherapy reduced both the tumor volume and the number of mitotic figures per high-power field compared with irradiated controls. In a second experiment, 25 Gy of brachytherapy was delivered before enucleation, straddling enucleation, and after enucleation; there was a significant reduction in metastasis when radiation was delivered prior to enucleation. This model may be useful in conducting further studies involving brachytherapy with 125I plaque implants.

  9. Prosthetic rehabilitation of an ocular defect with post-enucleation socket syndrome: A case report.

    PubMed

    Amornvit, Pokpong; Rokaya, Dinesh; Shrestha, Binit; Srithavaj, Theerathavaj

    2014-01-01

    Ocular trauma can be caused by road traffic accidents, falls, assaults, or work-related accidents. Enucleation is often indicated after ocular injury or for the treatment of intraocular tumors, severe ocular infections, and painful blind eyes. Rehabilitation of an enucleated socket without an intraocular implant or with an inappropriately sized implant can result in superior sulcus deepening, enophthalmos, ptosis, ectropion, and lower lid laxity, which are collectively known as post-enucleation socket syndrome. This clinical report describes the rehabilitation of post-enucleation socket syndrome with a modified ocular prosthesis. Modifications to the ocular prosthesis were performed to correct the ptosis, superior sulcus deepening, and enophthalmos. The rehabilitation procedure produced satisfactory results. PMID:24526826

  10. Sub-100 fs passively mode-locked holmium-doped fiber oscillator operating at 2.06 μm

    NASA Astrophysics Data System (ADS)

    Li, Peng; Ruehl, Axel; Grosse-Wortmann, Uwe; Hartl, Ingmar

    2015-03-01

    We demonstrate a simple and compact Holmium-doped fiber (HDF) femtosecond oscillator with 35 MHz repetition rate. The oscillator is pumped by a Tm-doped fiber laser. A dispersion compensating fiber was utilized to set the net-intracavity dispersion to zero at 2.06 μm. The output pulses had an maximum average power of 40 mW and 160 fs FWHM pulse duration. To further shorten the pulse duration, we implemented a nonlinear compressor consisting of a solid core highly nonlinear fiber (HNLF) for SPM broadening and single mode fiber (SMF) for pulse compression. Sub-100 fs pulses were achieved.

  11. Solvent extraction studies of holmium with acidic extractants

    SciTech Connect

    Gaikwad, A.G.; Damodaran, A.D. )

    1993-03-01

    Liquid-liquid extraction studies of holmium with 2-ethylhexyl phosphoric acid mono-2-ethylhexyl ester, naphthenic, and Versatic 10 acids have been carried out. The nature of the extracted species and the extraction equilibrium constants of these systems have been determined from aqueous nitrate solution. The extraction mechanism and complexation models have been proposed. 11 refs., 8 figs.

  12. Synthesis, characterization, and neutron activation of holmium metallofullerenes

    SciTech Connect

    Cagle, D.W.; Thrash, T.P.; Wilson, L.J.; Alford, M.; Chibante, L.P.F.; Ehrhardt, G.J.

    1996-08-28

    Isolation of the first macroscopic quantities of endohedral holmium metallofullerenes (principally Ho@C{sub 82}, Ho{sub 2}@C{sub 82}, and Ho{sub 3}@C{sub 82} by LD-TOF mass spectrometry) has been accomplished by carbon-arc and preparative HPLC methodologies. The detailed procedure for production and isolation of the metallofullerenes includes a new technique whereby holmium-impregnated electrodes are prepared simply by soaking porous graphite rods in an ethanolic solution of Ho(NO{sub 3}){sub 3}.xH{sub 2}O. Monoisotopic {sup 165}Ho offers a unique combination of advantages for neutron-activation studies of metallofullerenes, and purified samples containing {sup 165}Ho@C{sub 82}, {sup 165}Ho{sub 2}@C{sub 82}, and {sup 165}Ho{sub 3}@C{sub 82} have been activated by high-flux neutron irradiation ({Phi} = 4 x 10{sup 13}n cm{sup -2} s{sup -1}) to generate {sup 166}Ho metallofullerenes, which undergo {beta}{sup -} decay to produce stable {sup 166}Er. Chemical workup of the irradiated samples, followed by re-irradiation, has been used to demonstrate that observed decomposition of holmium metallofullerenes is due mainly to `fast` neutron damage rather than to holmium atom nuclear recoil (E{sub max} = 200 eV). This implies that metallofullerene damage can be minimized by using neutron fluxes with the highest possible thermal component. 60 refs., 4 figs.

  13. Discovery of dysprosium, holmium, erbium, thulium, and ytterbium isotopes

    SciTech Connect

    Fry, C.; Thoennessen, M.

    2013-09-15

    Currently, thirty-one dysprosium, thirty-two holmium, thirty-two erbium, thirty-three thulium, and thirty-one ytterbium isotopes have been observed and the discovery of these isotopes is described here. For each isotope a brief synopsis of the first refereed publication, including the production and identification method, is presented.

  14. Endometrial laser ablation in rabbits: A comparative study of three laser types

    SciTech Connect

    Rosenberg, C.; Tadir, Y.; Braslavsky, D.; Fisch, B.; Karni, Z.; Ovadia, J. )

    1990-01-01

    Endometrial laser ablation is one of the alternatives to hysterectomy in cases of intractable uterine bleeding. It is currently performed using the Nd:YAG laser at 1.06 microns. The aim of this study was to compare the tissue effect of three types of laser irradiation (Nd:YAG laser at 1.06 and 1.32 microns and holmium laser at 2.12 microns) on the rabbit endometrium. Crater formation, coagulation necrosis, and muscle necrosis were evaluated at the time of ablation, as well as at 1 week and 4 weeks postablation. The results were assessed by determining the depth and width of the affected portion in the uterine wall (lumen to serosa). It was shown that Nd:YAG laser at 1.32 microns caused more generalized and extended effects as compared with the other laser types examined. Endometrial regeneration was faster after ablation by the Nd:YAG laser at 1.06 microns and the holmium laser than by the Nd:YAG laser at 1.32 microns. The widest range of ablation energy (defined as that causing ablation without muscle damage) was achieved by applying the holmium laser. Further evaluation of the holmium laser for this indication is recommended.

  15. In vitro analysis of laser meniscectomy.

    PubMed

    Vangsness, C T; Akl, Y; Nelson, S J; Liaw, L H; Smith, C F; Marshall, G J

    1995-01-01

    Partial meniscectomies were performed on 32 fresh human meniscal autopsy specimens. The following laser systems were tested: carbon dioxide (CO2), neodymium:yttrium aluminum garnet (Nd:YAG), potassium titanyl phosphate (KTP), holmium:YAG (Ho:YAG), and excimer. Meniscectomies with these lasers were compared with scalpel, mechanical, and electrocautery meniscectomies. Lasers were applied to specimens in and out of normal saline. Routine hematoxylin and eosin and sirius red sections were prepared for each specimen, and the depths of thermal changes were analyzed. Scanning electron microscopy was used to visualize the meniscectomy interface. Among these specimens, the scalpel and mechanical meniscectomies showed the least extension of cellular changes (range, 10-15 nm). The excimer laser caused the least tissue changes of the lasers tested. Tissue changes were less extensive with the pulsed CO2 laser than with the holmium:YAG, neodymium:YAG, and KTP lasers. Scanning electron microscopy showed that use of the scalpel meniscectomy resulted in the smoothest meniscectomy edge, followed by use of the excimer, CO2, holmium:YAG, neodymium:YAG, and KTP lasers. The most surface disruption occurred with electrocautery. Meniscectomies under saline required more energy and took longer in each case, with the holmium:YAG, neodymium:YAG, and CO2 laser cutting the best. Saline meniscectomies showed less thermal change. The CO2 and KTP lasers cut best in air. PMID:7641441

  16. Increased cortical surface area and gyrification following long-term survival from early monocular enucleation

    PubMed Central

    Kelly, Krista R.; DeSimone, Kevin D.; Gallie, Brenda L.; Steeves, Jennifer K.E.

    2014-01-01

    Purpose Retinoblastoma is typically diagnosed before 5 years of age and is often treated by enucleation (surgical removal) of the cancerous eye. Here, we sought to characterize morphological changes of the cortex following long-term survival from early monocular enucleation. Methods Nine adults with early right-eye enucleation (≤48 months of age) due to retinoblastoma were compared to 18 binocularly intact controls. Surface area, cortical thickness, and gyrification estimates were obtained from T1 weighted images and group differences were examined. Results Early monocular enucleation was associated with increased surface area and/or gyrification in visual (i.e., V1, inferior temporal), auditory (i.e., supramarginal), and multisensory (i.e., superior temporal, inferior parietal, superior parietal) cortices compared with controls. Visual cortex increases were restricted to the right hemisphere contralateral to the remaining eye, consistent with previous subcortical data showing asymmetrical lateral geniculate nucleus volume following early monocular enucleation. Conclusions Altered morphological development of visual, auditory, and multisensory regions occurs subsequent to long-time survival from early eye loss. PMID:25610793

  17. Efficiency of disc ablation with lasers of various wavelengths.

    PubMed

    Choy, D S; Altman, P; Trokel, S L

    1995-06-01

    In testing the CO2 lasers in CW and pulse mode, the erbium:YAG, the Nd:YAG 1318 microns and 1064 microns, the argon, the holmium:YAG, and the excimer, we found the greatest efficiency in the CO2 CW and pulse mode, and the lowest efficiency in the argon. Data with the holmium:YAG were unreliable because of the early generation laser tested. The Nd:YAG was second only to the CO2 laser, and because the latter has no waveguide, we deemed the Nd:YAG the laser of choice for PLDD. PMID:10150639

  18. Standard thermodynamic functions and Gibbs energy of holmium tungstenates

    SciTech Connect

    Nadiradze, A.A.; Gvelesiani, G.G.; Abashidze, T.D.; Makharadze, I.A.

    1986-12-01

    The Gibbs free energy of meta- and normal holmium tungstenates was studied by the emf method with the solid oxygen-ion electrolyte. The standard values of the entropy and enthalpy of formation of holmium tungstenates Ho/sub 6/WO/sub 12/, Ho/sub 10/W/sub 2/O/sub 21/, Ho/sub 14/W/sub 4/O/sub 33/, Ho/sub 2/WO/sub 6/, and Ho/sub 2/(WO/sub 4/)/sub 3/ were calculated. Three-term equations for the Gibbs energy of formation of the indicated tungstenates from the oxides for a wide temperature range were constructed. It was shown that the values of the standard atomic entropies and enthalpies of formation of these compounds decrease as their WO/sub 3/ content increases.

  19. Hard and fragile holmium-based bulk metallic glasses

    SciTech Connect

    Luo, Q.; Zhao, D.Q.; Pan, M.X.; Wang, R.J.; Wang, W.H.

    2006-05-01

    A family of holmium-based bulk metallic glasses (BMGs) with high glass-forming ability is obtained. The Ho-based BMGs exhibit much larger elastic moduli and high thermal stability in contrast to other known rare-earth (RE)-based BMGs. In particular, the BMGs show a large value of fragility. It is expected that the hard RE-based glasses with high glass-forming ability and fragile behaviors make them the appropriate candidate for glass transition study.

  20. Tunable frequency stabilized diode-laser-pumped Tm,Ho:YLiF4 laser at room temperature

    NASA Technical Reports Server (NTRS)

    Mcguckin, Brendan T.; Menzies, Robert T.; Esproles, Carlos

    1993-01-01

    A diode-laser-pumped single-frequency thulium holmium yttrium lithium fluoride laser that exhibits a closed-loop stability of a few megahertz and a continuous single-mode tuning range of 800 MHz is described. The laser output power is 25 mW, and is tunable over about 8/cm at 25 C.

  1. Enucleation vs cobalt plaque radiotherapy for malignant melanomas of the choroid and ciliary body

    SciTech Connect

    Augsburger, J.J.; Gamel, J.W.; Sardi, V.F.; Greenberg, R.A.; Shields, J.A.; Brady, L.W.

    1986-05-01

    Clinical risk factors were assessed prospectively in a nonrandomized concurrent observational study of 237 patients with posterior uveal malignant melanoma. One hundred forty of these patients were treated with enucleation, and 97 underwent cobalt plaque radiotherapy. Tumor size and location of the anterior tumor margin proved to be the most significant clinical risk factors for death from metastatic melanoma. When Cox proportional hazards modeling was used to adjust for recognized intergroup differences in risk factors, the effect of therapy (enucleation vs cobalt plaque radiotherapy) on survival time was not statistically significant. We discuss the implications of this study for a randomized clinical trial of enucleation vs cobalt plaque therapy or comparable forms of irradiation.

  2. Standard Enucleation with Aluminium Oxide Implant (Bioceramic) Covered with Patient's Sclera

    PubMed Central

    Zigiotti, Gian Luigi; Cavarretta, Sonia; Morara, Mariachiara; Nam, Sang Min; Ranno, Stefano; Pichi, Francesco; Lembo, Andrea; Lupo, Stefano; Nucci, Paolo; Meduri, Alessandro

    2012-01-01

    Purpose. We describe in our study a modified standard enucleation, using sclera harvested from the enucleated eye to cover the prosthesis in order to insert a large porous implant and to reduce postoperative complication rates in a phthisis globe. Methods. We perform initially a standard enucleation. The porous implant (Bioceramic) is then covered only partially by the patient's sclera. The implant is inserted in the posterior Tenon's space with the scleral covering looking at front. All patients were followed at least for twelve months (average followup 16 months). Results. We performed nineteen primary procedures (19 patients, 19 eyes, x M; x F) and secondary, to fill the orbital cavity in patients already operated by standard evisceration (7 patients, 7 eyes). There were no cases of implant extrusion. The orbital volume was well reintegrated. Conclusion. Our procedure was safe and effective. All patients had a good cosmetic result after final prosthetic fitting and we also achieved good prothesis mobility. PMID:22654614

  3. Video Assisted Thoracoscopic Surgical Enucleation of a Giant Esophageal Leiomyoma Presenting with Persistent Cough

    PubMed Central

    Mujawar, Parvez; Pawar, Tushar; Chavan, Rahulkumar Narayan

    2016-01-01

    Esophageal leiomyoma is a relatively rare tumor of esophagus but it is the most common benign neoplasm of the esophagus. Small esophageal leiomyoma can be observed but larger ones and those producing symptoms should be excised. As observed for other esophageal tumors, dysphagia is its main symptom. Traditionally, open thoracotomy and enucleation are its main treatment but in the last few years video assisted thoracoscopic surgical (VATS) enucleation is gaining recognition with proven advantages of minimally invasive surgery. Herein we present our experience with patient presenting with cough rather than dysphagia as a main symptom, who was diagnosed to be having giant esophageal leiomyoma. VATS guided enucleation was accomplished successfully. Size of lesion was 16 × 4 × 3 cm. Postoperative recovery was uneventful and patient is not having any signs of recurrence, after three years during follow-up period. PMID:26977331

  4. Enucleation of Eye Using Finger Following Cannabis Consumption: A Case Report

    PubMed Central

    Sabahi, Abdol Reza; Amini-Ranjbar, Zahra; Sharifi, Ali; Kheradmand, Ali

    2014-01-01

    Background Enucleation is a topic discussed in psychiatry which is a self-injury matter. Enucleation is observed as psychotic disorder due to substance abuse. In people with mental disorders who also have substance use leading to hallucinations and delusions, unusual eye evacuation were reported. In most cases, enucleation was done using sharp tools. Case Report This report describes a man suffering from psychosis after consuming hashish and has attempted to evacuate his eyes with his finger. Discussion Given the increasing prevalence of hashish use by young people, and false beliefs about the use of hashish in order to withdraw other substances, preventive methods and education for young and vulnerable people are suggested. PMID:25140221

  5. Rapid Changes in Cortical and Subcortical Brain Regions after Early Bilateral Enucleation in the Mouse

    PubMed Central

    Huffman, Kelly J.

    2015-01-01

    Functional sensory and motor areas in the developing mammalian neocortex are formed through a complex interaction of cortically intrinsic mechanisms, such as gene expression, and cortically extrinsic mechanisms such as those mediated by thalamic input from the senses. Both intrinsic and extrinsic mechanisms are believed to be involved in cortical patterning and the establishment of areal boundaries in early development; however, the nature of the interaction between intrinsic and extrinsic processes is not well understood. In a previous study, we used a perinatal bilateral enucleation mouse model to test some aspects of this interaction by reweighting sensory input to the developing cortex. Visual deprivation at birth resulted in a shift of intraneocortical connections (INCs) that aligned with ectopic ephrin A5 expression in the same location ten days later at postnatal day (P) 10. A prevailing question remained: Does visual deprivation first induce a change in gene expression, followed by a shift in INCs, or vice versa? In the present study, we address this question by investigating the neuroanatomy and patterns of gene expression in post-natal day (P) 1 and 4 mice following bilateral enucleation at birth. Our results demonstrate a rapid reduction in dorsal lateral geniculate nucleus (dLGN) size and ephrin A5 gene expression 24-hours post-enucleation, with more profound effects apparent at P4. The reduced nuclear size and diminished gene expression mirrors subtle changes in ephrin A5 expression evident in P1 and P4 enucleated neocortex, 11 and 8 days prior to natural eye opening, respectively. Somatosensory and visual INCs were indistinguishable between P1 and P4 mice bilaterally enucleated at birth, indicating that perinatal bilateral enucleation initiates a rapid change in gene expression (within one day) followed by an alteration of sensory INCs later on (second postnatal week). With these results, we gain a deeper understanding of how gene expression and

  6. The structure of rare earth thin films: holmium and gadolinium on yttrium

    NASA Astrophysics Data System (ADS)

    Bentall, M. J.; Cowley, R. A.; Ward, R. C. C.; Wells, M. R.; Stunault, A.

    2003-11-01

    Single-crystal holmium and gadolinium layers have been grown on yttrium substrates using the molecular beam epitaxy technique and their structures investigated using high resolution x-ray scattering. The experiments were performed using a Philips MRD diffractometer in Oxford, and with the XMaS facility at the ESRF. Holmium layers with a thickness below T_{\\mathrm {c}}'=115\

  7. Optical materials for space based laser systems

    NASA Technical Reports Server (NTRS)

    Buoncristiani, A. M.; Armagan, G.; Byvik, C. E.; Albin, S.

    1989-01-01

    The design features and performance characteristics of a sensitized holmium laser applicable to differential lidar and Doppler windshear measurements are presented, giving attention to the optimal choice of sensitizing/activating dopant ions. This development of a 2-micron region eye-safe laser, where holmium is sensitized by either hulium or erbium, has called for interionic energy transfer processes whose rate will not result in gain-switched pulses that are excessively long for atmospheric lidar and Doppler windshear detection. The application of diamond films for optical component hardening is noted.

  8. Uveal Melanoma Recurrence After Fractionated Proton Beam Therapy: Comparison of Survival in Patients Treated With Reirradiation or With Enucleation

    SciTech Connect

    Marucci, Laura; Ancukiewicz, Marek; Lane, Anne Marie; Collier, John M.; Gragoudas, Evangelos S.; Munzenrider, John E.

    2011-03-01

    Purpose: To retrospectively compare survival in recurrent uveal melanoma, between patients treated by enucleation or by a second course of fractionated proton beam therapy (PBT). Methods and Materials: Tumor recurrence was documented in 73 patients treated with PBT for uveal melanoma. Of the patients, 31 received a second course of PBT and 42 underwent enucleation. The mean patient age was 56 and 61 years for those undergoing enucleation and those undergoing reirradiation, respectively. Both primary and recurrent tumors were larger in patients undergoing enucleation. Tumor location and the presence or absence of ciliary body involvement did not differ significantly between the groups. The median follow-up after enucleation and after re-treatment was 79 and 59 months, respectively. Cumulative rates of outcomes and differences in rates between the reirradiated and enucleation groups were calculated by the Cox proportional hazards model and the log-rank test, respectively. Results: The median survival duration in the enucleated and reirradiated groups was 42 and 90 months, respectively. The median time free of metastases was 38 months in enucleated patients and 97 months in reirradiated patients. At 5 years after enucleation and after reirradiation, the probability of overall survival was 36% and 63%, respectively (p = 0.040, log-rank test); the probability of freedom from metastases was 31% and 66%, respectively (p = 0.028, log-rank test). These differences persisted after adjustment for recurrent tumor largest diameter and volume at the time of reirradiation or enucleation. Conclusions: This retrospective analysis suggests that survival in reirradiated patients is not compromised by administration of a second course of PBT for recurrent uveal melanoma.

  9. Use of demineralized bone as an osteoinductive orbital enucleation implant in the rabbit.

    PubMed

    Sires, B S; Geggel, H S; Heffernan, J T; Crane, R D; Holds, J B

    1993-06-01

    Implanted allogeneic demineralized bone particles (DBP) may be transformed into endochondral bone by inductive or conductive new bone formation. Using a rabbit model, enucleation or evisceration was performed, and DBP was implanted into the socket. Histology confirmed endochondral bone formation in both groups. A morphologic difference existed between enucleation and evisceration: compact bone was produced following evisceration, and cancellous bony spheres were formed following enucleation. Serial quantitative computed tomography (qCT) was performed to monitor mineral density and proved to be an ideal technique to monitor bone mineralization noninvasively in the postoperative orbit. Bone mineral density (BMD, mg/ml) increased approximately 300% in DBP implanted orbits when compared to controls at 6 weeks. The ideal mass/volume ratio of DBP to socket volume was 400 mg/ml. The rapidly formed bone is well vascularized and creates a stable integrated orbital implant, following enucleation and evisceration surgery. DBP implantation into the central orbit results in inductive bone formation with interesting potential in socket and orbit reconstruction. PMID:8323902

  10. Chromatin Condensation and Enucleation in Red Blood Cells: An Open Question.

    PubMed

    Baron, Margaret H; Barminko, Jeffrey

    2016-03-01

    Differentiating erythroid cells undergo dramatic changes in morphology, with reduction in cell size, chromatin and nuclear condensation, and enucleation. In this issue of Developmental Cell, Zhao et al. (2016) show that these events are associated with the formation of transient, recurring nuclear openings and selective histone release mediated by caspase-3. PMID:26954541

  11. Enucleation is Better for a Giant Hemangioma Proximal to the Hepatic Portal Vascular Structures.

    PubMed

    Wu, Chuan-Xing; Bao, Wan-Yuan; Zhu, Feng

    2016-08-01

    The aim of this study is to compare the effect of liver enucleation with resection of a giant hemangioma proximal to the hepatic portal vascular structures. From 2008 to 2014, 53 patients with giant hemangiomas proximal to the hepatic portal vascular structures underwent surgery in our hospital by the same surgical team. The indications for surgery included a tumor size greater than 8 cm, a middle size greater than 4 cm but with abdominal pain, a rapidly increased tumor size with uncertain malignancy, or tumor rupture. Thirty-two patients (60 %) had pain only, 15 (29 %) had pain with tumor growth, 5 patients (9 %) had an uncertain diagnosis, and 1 patient (2 %) had tumor rupture. Enucleation was performed in 31 patients and liver resection was performed in 22 patients. There were no significant differences in the size of the hemangioma (13.9 ± 3.1 vs 12.3 ± 5.5 cm; P > 0.05), preoperative liver function tests, hemoglobin levels, and platelet counts between the enucleation and resection groups. The mean intraoperative blood loss was significantly less in the enucleation group compared with the resection group (350.9 ± 89.8 vs 988 ± 91.7 mL; P < 0.01), and the enucleation group had a significantly shorter mean operative time (1.7 ± 0.4 vs 2.9 ± 0.9 h; P < 0.01) and significantly shorter duration of hospital stay (9.6 ± 4.2 vs 14.7 ± 3.7 days; P < 0.05). Five patients in the resection group and only 1 patient in the enucleation group had major postoperative complications. Compared to liver resection, enucleation is safer and faster for liver hemangiomas proximal to the hepatic portal vascular structures and is associated with fewer complications. PMID:27574349

  12. Re3+ : YAG laser ceramics: synthesis, optical properties and laser characteristics

    NASA Astrophysics Data System (ADS)

    Bagayev, S. N.; Osipov, V. V.; Vatnik, S. M.; Shitov, V. A.; Shteinberg, I. Sh; Vedin, I. A.; Kurbatov, P. F.; Luk'yashin, K. E.; Maksimov, R. N.; Solomonov, V. I.; Tverdokhleb, P. E.

    2015-05-01

    Highly transparent yttrium aluminium garnet ceramics doped with holmium or ytterbium or neodymium are synthesised. The ceramics were made of a mixture of nanopowders synthesised by laser ablation. The structural and spectral characteristics of ceramics are studied. In the samples with holmium Ho3+ and neodymium Nd3+ ions, lasing was achieved with a slope efficiency of 40% and 35.3%, respectively; the maximum laser power exceeded 4 W. The internal absorption and scattering losses for 1% Nd : YAG ceramics are estimated to be 1.6 × 10-2 cm-1.

  13. Drug metabolism: Comparison of biodistribution profile of holmium in three different compositions in healthy Wistar rats.

    PubMed

    Cerqueira-Coutinho, Cristal; Vidal, Lluis Pascual; Pinto, Suyene Rocha; Santos-Oliveira, Ralph

    2016-06-01

    Radioisotope holmium is a candidate to be used in cancer treatment and diagnosis. There are different holmium salts and they present distinct solubility and consequently different biodistribution profiles. In this work, we aimed to evaluate the biodistribution profiles of two holmium salts (chloride and sulfate) and holmium nanoparticles (oxide) through an in vivo biodistribution assay using animal model. Samples were labeled with technetium-99m and administered in Wistar rats by retro-orbital route. Holmium chloride is highly soluble in water and it was quickly filtered by the kidneys while holmium sulfate that presents lower solubility in water was mainly found in the liver and the spleen. However, both the salts showed a similar biodistribution profile. On the other hand, holmium oxide showed a very different biodistribution profile since it seemed to interact with all organs. Due to its particle size range (approximately 100nm) it was not intensively filtered by the kidneys being found in high quantities in many organs, for this reason its use as a nanoradiopharmaceutical could be promising in the oncology field. PMID:26986812

  14. The studies on the aromaticity of fullerenes and their holmium endohedral compounds.

    PubMed

    Tan, Bisheng; Peng, Rufang; Li, Hongbo; Wang, Bing; Jin, Bo; Chu, Shijin; Long, Xinping

    2011-02-01

    Density functional theory BLYP/DNP was employed to optimize a series of fullerenes and their holmium endohedral compounds, including C(20), Ho@C(20), Ho(3+)@C(20), C(60), Ho@C(60), Ho(3+)@C(60),C(70), Ho@C(70), Ho(3+)@C(70) C(78), Ho@C(78), Ho(3+)@C(78), C(82),Ho@C(82) and Ho(3+)@C(82). DFT semi core pseudospot approximation was taken into consideration in the calculations of the element holmium because of its particular electronic structure. Fullerenes and their holmium endohedral compounds' aromaticity were studied in terms of structural criteria, energetic criteria, and reactivity criteria. The results indicate that the aromaticity of fullerenes was reduced when a holmium atom was introduced into the carbon cage, and the endohedral fullerenes' reactive activity enhance; but the aromaticity of the carbon cage increased when a Ho(3+) cation was encapsulated into a fullerene. Calculations of aromaticity and stability indicate that two paths can lead to the similar aim of preparing holmium endohedral fullerenes; that is, they can form from either a holmium atom or a holmium cation (Ho(3+)) reacting with fullerenes, respectively, and the latter is more favorable. PMID:20443036

  15. Identification of a Murine Erythroblast Subpopulation Enriched in Enucleating Events by Multi-spectral Imaging Flow Cytometry

    PubMed Central

    Konstantinidis, Diamantis G.; Pushkaran, Suvarnamala; Giger, Katie; Manganaris, Stefanos; Zheng, Yi; Kalfa, Theodosia A.

    2014-01-01

    Erythropoiesis in mammals concludes with the dramatic process of enucleation that results in reticulocyte formation. The mechanism of enucleation has not yet been fully elucidated. A common problem encountered when studying the localization of key proteins and structures within enucleating erythroblasts by microscopy is the difficulty to observe a sufficient number of cells undergoing enucleation. We have developed a novel analysis protocol using multiparameter high-speed cell imaging in flow (Multi-Spectral Imaging Flow Cytometry), a method that combines immunofluorescent microscopy with flow cytometry, in order to identify efficiently a significant number of enucleating events, that allows to obtain measurements and perform statistical analysis. We first describe here two in vitro erythropoiesis culture methods used in order to synchronize murine erythroblasts and increase the probability of capturing enucleation at the time of evaluation. Then, we describe in detail the staining of erythroblasts after fixation and permeabilization in order to study the localization of intracellular proteins or lipid rafts during enucleation by multi-spectral imaging flow cytometry. Along with size and DNA/Ter119 staining which are used to identify the orthochromatic erythroblasts, we utilize the parameters “aspect ratio” of a cell in the bright-field channel that aids in the recognition of elongated cells and “delta centroid XY Ter119/Draq5” that allows the identification of cellular events in which the center of Ter119 staining (nascent reticulocyte) is far apart from the center of Draq5 staining (nucleus undergoing extrusion), thus indicating a cell about to enucleate. The subset of the orthochromatic erythroblast population with high delta centroid and low aspect ratio is highly enriched in enucleating cells. PMID:24962543

  16. Role of temperature in the theoretical analysis of holmium pnictides

    NASA Astrophysics Data System (ADS)

    Bhardwaj, Purvee; Singh, Sadhna

    2016-01-01

    The high-pressure structural phase transition and associated properties of holmium pnictides (HoX; X = P, As, Sb and Bi) have been investigated in the present work. The Realistic Interaction Potential Approach (RIPA) including the effect of temperature has been applied. The occurrence of first order phase transition is evidenced from a sudden collapse in volume. These compounds transform from B1 to B2 structure under high pressure. The high temperature and pressure behaviour of elastic constants and bulk modulus are also reported. Our results are in general in good agreement with experimental and other theoretical results where available, and provide predictions where they are unavailable.

  17. Lasers in the management of calcified urinary tract stents

    NASA Astrophysics Data System (ADS)

    Nseyo, Unyime O.; Tunuguntla, Hari S. G. R.; Crone, Michael

    2003-06-01

    Indwelling double J ureteral stents are used for internal urinary diversion for ureteral obstruction and post-surgical drainage of the upper urinary tract. Stent calcification is a serious complication especially in those with forgotten stents. In a retrospective review of 16 patients (10 male and 6 female) we found holmium laser to be highly effective in the management of calcified stents. Encrustations/calcifications were noted on the distal end of the sent in 6 patiens (37.5%), middle and distal portions in 2 patients (12.5%), along the entire length of the stent in 3 patients (18.75%), lower portion of the stent in 4 patients (25%) and at the upper and lower ends of the stent in one patient (6.25%). Cystolitholapaxy, retrograde ureteroscopy (URS) with holmium: YAG (yttrium-aluminum-garnet) laser intracorporeal lithotripsy, percutaneous nephrostolithotomy (PNL) and antegrade URS with holmium: YAG laser intracorporeal lithotripsy were effectively performed without intraoperative complications. Lithotripsy became necessary before stent removal in 11 patients (68.75%). Holmium laser lithotripsy was useful in managing 7 patients (43.75%), and shockwave lithotripsy (SWL) in 6 patients (37.5%). In two patients (12.5%) both holmium and SWL were used before the stent can be removed.

  18. Holmium Nitrate Complexation with Tri-n-butyl Phosphate in Supercritical Carbon Dioxide

    SciTech Connect

    Robert V. Fox; R. Duane Ball; Peter de B. Harrington; Harry W. Rollins; Chien M. Wai

    2005-12-01

    Holmium nitrate pentahydrate was reacted with tri-n-butyl phosphate in supercritical carbon dioxide at 308 K. The products of the complexation reaction were measured under supercritical fluid conditions using UV-vis spectroscopy. The solubility of the metal complexes in the supercritical fluid phase was measured. The mole-ratio titration method was used to determine the stoichiometry of the soluble complexes. Conditional extraction coefficients were calculated from spectral data using least-squares regression and hard-equilibria models. Data indicate that the holmium nitrate-tributyl phosphate system forms 1:2 and 1:4 holmium-tributyl phosphate complexes.

  19. Single frequency fiber laser at 2.05 μm based on Ho-doped germanate glass fiber

    NASA Astrophysics Data System (ADS)

    Wu, Jianfeng; Yao, Zhidong; Zong, Jie; Chavez-Pirson, Arturo; Peyghambarian, Nasser; Yu, Jirong

    2009-02-01

    A single frequency fiber laser operating near 2 micron with over 50 mW output power has been demonstrated by using a short piece of newly developed single mode holmium-doped germanate glass fiber. Laser from 2004 nm to 2083 nm was demonstrated from a short Ho-doped fiber laser cavity. A heavily thulium-doped germanate fiber was used as an in-band pump source for the holmium-doped fiber laser. The single frequency fiber laser can be thermally tuned.

  20. Dielectric and conducting behaviour of polycrystalline holmium octa-molybdate

    NASA Astrophysics Data System (ADS)

    Want, Basharat; Zahoor Ahmad, Bhat; Bhat, Bilal Hamid

    2014-09-01

    Polycrystalline holmium octa-molybdate spherulites have been obtained by using gel diffusion technique and characterized by different physio-chemical techniques. The surfaces of these spherulites are composed of nano-rod with an average diameter of about 80 nm. At room temperature the initial crystal structure is triclinic, space group P1. Thermal studies suggested a phase transition occurring in holmium octa-molybdate crystals at about 793 K. The electrical properties of the system have been studied as a function of frequency and temperature in the ranges of 20 Hz-3 MHz and 290-570 K, respectively. A giant dielectric constant and two loss peaks have been observed in the permittivity formalism. The conducting behaviour of the material is also discussed. The conductivity was found to be 1572 μ Ω-1 m-1 at room temperature and 3 MHz frequency. The conductivity of the polycrystalline material was attributed to the fact that it arises due to the migration of defects on the oxygen sub-lattice. Impedance studies were also performed in the frequency domain to infer the bulk and grain boundary contributions to the overall electric response of the material. The electrical responses have been attributed to the grain, grain-boundary, and interfacial effects.

  1. Composition and method of treatment of arthritis and related diseases with holmium-166 radionuclides

    SciTech Connect

    Lieberman, E.; Bordoni, M.E.; Thornton, A.K.

    1991-10-29

    This patent describes a radioactive composition for the treatment of arthritis. It comprises a suspension containing particles having a minimum size of one micron, the suspension including particles containing holmium-166.

  2. Ki-67 immunostaining in uveal melanoma. The effect of pre-enucleation radiotherapy

    SciTech Connect

    Mooy, C.M.; de Jong, P.T.; Van der Kwast, T.H.; Mulder, P.G.; Jager, M.J.; Ruiter, D.J. )

    1990-10-01

    The reactivity of 33 choroidal and ciliary body melanomas with monoclonal antibody Ki-67, which recognizes a proliferation associated nuclear antigen, has been assessed and compared with clinicopathologic parameters. In 23 cases, 8 Gy irradiation was given 2 days before enucleation. Nonirradiated melanomas had a significantly higher proliferation rate as defined by staining with monoclonal antibody Ki-67 as compared with irradiated tumors (P = 0.007). Similarly, a strong relationship was found between pre-enucleation irradiation and low mitotic activity (P = 0.001). There was no significant correlation between the presence of Ki-67-positive nuclei and histologic classification, largest tumor diameter, localization of the tumor, age, sex, scleral invasion, pigmentation, and lymphocytic infiltration. The relevance of Ki-67 immunohistochemistry for the assessment of the life prognosis of patients with uveal melanoma has to be studied prospectively.

  3. Bilateral self-enucleation in acute transient psychotic disorder: the influence of sociocultural factors on psychopathology.

    PubMed

    Harish, Thippeswamy; Chawan, Namdev; Rajkumar, Ravi Philip; Chaturvedi, Santosh Kumar

    2012-07-01

    Self-inflicted eye injuries are rare but a devastating consequence of a serious mental disorder. Bilateral self-enucleation also known as oedipism has been documented in ancient texts and myths. Various biologic, psychologic, and social theories have been put forward to explain this rare phenomenon. In this report, we describe a case of oedipism, which highlights the influence of sociocultural factors on the psychopathology in acute transient psychotic disorder. PMID:21864835

  4. Periumbilical fat auto-graft associated to a porous orbital implant for socket reconstruction after enucleation.

    PubMed

    Medel, Ramon; Alonso, Tirso; Pelaez, Francisco; Vasquez, LuzMaria

    2016-08-01

    Having to remove the sclera, fat and the optic nerve in patients undergoing an enucleation, translates in a larger volume that needs to be replaced to achieve good motility and aesthetic results. Using a 20 or 22 mm implant can only partially replace the removed volume. We report the results of our enucleation technique, which includes the use of a porous orbital implant combined with a primary fat graft to replace a higher percentage of the removed volume to achieve a better cosmetic outcome and to avoid implant related complications in high risk patients. Prospective, non-randomized study of enucleated patients for whom porous orbital implantation was performed with anterior placement of a fat auto-graft. The development of implant extrusion or exposure was recorded as well as the presence of conjunctival wound dehiscence and infection. Orbital volume was clinically and radiologically evaluated as well. Twenty-eight patients were included, with a postop follow-up of at least 6 months (6-79 months). No cases of migration or extrusion were found. One case of a large exposure resolved completely. All MRI demonstrated proper implant-graft integration and vascularisation. The aesthetic result and the symmetry were very adequate, with Hertel differences of less than 2 mm in all cases and good motility range. The fat graft is well tolerated, showing low incidence of implant-related complications whilst maintaining good volume and motility. PMID:27322024

  5. Impediments to eye transplantation: ocular viability following optic-nerve transection or enucleation

    PubMed Central

    Ellenberg, D; Shi, J; Jain, S; Chang, J-H; Ripps, H; Brady, S; Melhem, E R; Lakkis, F; Adamis, A; Chen, D-F; Ellis-Behnke, R; Langer, R S; Strittmatter, S M; Azar, D T

    2010-01-01

    Maintenance of ocular viability is one of the major impediments to successful whole-eye transplantation. This review provides a comprehensive understanding of the current literature to help guide future studies in order to overcome this hurdle. A systematic multistage review of published literature was performed. Three specific questions were addressed: (1) Is recovery of visual function following eye transplantation greater in cold-blooded vertebrates when compared with mammals? (2) Is outer retina function following enucleation and reperfusion improved compared with enucleation alone? (3) Following optic-nerve transection, is there a correlation between retinal ganglion cell (RGC) survival and either time after transection or proximity of the transection to the globe? In a majority of the studies performed in the literature, recovery of visual function can occur after whole-eye transplantation in cold-blooded vertebrates. Following enucleation (and reperfusion), outer retinal function is maintained from 4 to 9 h. RGC survival following optic-nerve transection is inversely related to both the time since transection and the proximity of transection to the globe. Lastly, neurotrophins can increase RGC survival following optic-nerve transection. This review of the literature suggests that the use of a donor eye is feasible for whole-eye transplantation. PMID:19286686

  6. Three histopathological types of retinoblastoma and their relation to heredity and age of enucleation.

    PubMed Central

    Moll, A C; Koten, J W; Lindenmayer, D A; Everse, L A; Tan, K E; Hamburg, A; Faber, J A; Den Otter, W

    1996-01-01

    The histopathology of 61 eyes was studied with special attention to the morphology of the retina adjacent to the main tumour. Three retinal types were distinguished. Retina type 1 (RT-1, 28 specimens) contained a single tumour that was sharply demarcated from surrounding normal retina. In retina type 2 (RT-2, 29 specimens) large parts of the retina were affected and the main tumour mass gradually blended with the adjacent pathological retina. Retina type 3 (RT-3, four specimens) was characterised by a retina almost entirely affected by diffuse tumour growth. RT-1 correlated significantly with early enucleation (0-3 years) both in hereditary and non-hereditary cases. RT-2 was seen in eyes enucleated later (2-5 years). The progressing tumour may release growth factors in the intraocular space that stimulate the cells of the adjacent retina and lead to multiple new primary tumours in the adjacent retinal area. RT-3 was only present in non-hereditary cases with late enucleation (at 2-5 years). Hereditary retinoblastoma cases are usually detected early. Therefore in hereditary cases RT-1 is significantly more common than RT-2. In 25 eyes of the 44 patients with unilateral sporadic retinoblastoma, multifocal tumours of the retina were observed. Such cases should not mistakenly be classified as hereditary cases on the basis of the histological pattern of multifocality of the tumour process. Images PMID:8950672

  7. Iron dose-dependent differentiation and enucleation of human erythroblasts in serum-free medium.

    PubMed

    Byrnes, Colleen; Lee, Y Terry; Meier, Emily R; Rabel, Antoinette; Sacks, David B; Miller, Jeffery L

    2016-02-01

    Improvements in ex vivo generation of enucleated red blood cells are being sought for erythroid biology research, toward the ultimate goal of erythrocyte engineering for clinical use. Based upon the high levels of iron-saturated transferrin in plasma serum, it was hypothesized that terminal differentiation in serum-free media may be highly dependent on the concentration of iron. Here adult human CD34(+) cells were cultured in a serum-free medium containing dosed levels of iron-saturated transferrin (holo-Tf, 0.1-1.0 mg/ml). Iron in the culture medium was reduced, but not depleted, with erythroblast differentiation into haemoglobinized cells. At the lowest holo-Tf dose (0.1 mg/ml), terminal differentiation was significantly reduced and the majority of the cells underwent apoptotic death. Cell survival, differentiation and enucleation were enhanced as the holo-Tf dose increased. These data suggest that adequate holo-Tf dosing is critical for terminal differentiation and enucleation of human erythroblasts generated ex vivo in serum-free culture conditions. Published 2013. This article is a US Government work and is in the public domain in the USA. PMID:23606586

  8. Lasers.

    ERIC Educational Resources Information Center

    Schewe, Phillip F.

    1981-01-01

    Examines the nature of laser light. Topics include: (1) production and characteristics of laser light; (2) nine types of lasers; (3) five laser techniques including holography; (4) laser spectroscopy; and (5) laser fusion and other applications. (SK)

  9. Effects of neonatal enucleation on the functional organization of the superior colliculus in the golden hamster.

    PubMed Central

    Rhoades, R W

    1980-01-01

    1. The responses of visual, auditory and somatosensory superior collicular neurones were investigated using extracellular single unit recording techniques in hamsters which were subjected to the removal of one eye on the day of birth. 2. Neonatal enucleation resulted in a marked increase in the region of the colliculus from which visual neurones activated by stimulation of the ipsilateral eye could be recorded. In most cases the visuotopic representation in the colliculus ipsilateral to the remaining eye mirrored that observed in the contralateral tectum along both the rostrocaudal and mediolateral axes: in both colliculi temporal retina projected rostrally and inferior retina medially. In some animals, however, there appeared to be a dual mapping of the remaining eye onto the ipsilateral tectum. In these hamsters the central portion of the visual field was represented twice along the rostrocaudal axis of colliculus. 3. No changes in the topography of the somatosensory and auditory representations in the tectum were observed following neonatal enucleation. 4. The laminar distribution of visual neurones in the ipsilateral colliculus was markedly altered in the neonatally enucleated hamsters. Very few exclusively visual units were encountered in the layers ventral to the stratum opticum and almost all of the visual cells recorded in the ipsilateral colliculus were isolated within 150 microM of the tectal surface. 5. In the posterior half of the ipsilateral tectum a large number of extravisually responsive cells were encountered in the stratum griseum superficiale and stratum opticum. This was not the case in the colliculus contralateral to the remaining eye, nor has it ever been observed in normal hamsters. 6. Recordings from animals subjected to both neonatal enucleation and acute bilateral removal of somatosensory and auditory cortex indicated that the projections from these areas to the colliculus were not essential to the observed changes in laminar organization

  10. Characterization of a Ho:Tm:Cr:YAG laser with a Cr:GSAG laser as pumping source

    NASA Technical Reports Server (NTRS)

    Henderson, George W.

    1989-01-01

    Rare earth lasers were in existance since the first laser was developed. The primary lasing elements for the class of lasers in the infrared was neodymium and chromium. However, the need for eye safe lasers in the mid-infrared range has prompted an enormous amount of research to the use of other elements. Holmium was investigated extensively as the source of infrared radiation for atmospheric research as well as medical research. The results and procedure are briefly discussed.

  11. Thulium fiber laser damage to Nitinol stone baskets

    NASA Astrophysics Data System (ADS)

    Wilson, Christopher R.; Hardy, Luke A.; Irby, Pierce B.; Fried, Nathaniel M.

    2015-02-01

    Our laboratory is studying the experimental Thulium fiber laser (TFL) as an alternative lithotripter to clinical gold standard Holmium:YAG laser. Safety studies characterizing undesirable Holmium laser-induced damage to Nitinol stone baskets have been previously reported. Similarly, this study characterizes TFL induced stone basket damage. A TFL beam with pulse energy of 35 mJ, pulse duration of 500 μs, and pulse rates of 50-500 Hz was delivered through 100-μm-core optical fibers, to a standard 1.9-Fr Nitinol stone basket wire. Stone basket damage was graded as a function of pulse rate, number of pulses, and working distance. Nitinol wire damage decreased with working distance and was non-existent at distances greater than 1.0 mm. In contact mode, 500 pulses delivered at pulse rates >= 200 Hz (<= 2.5 s) were sufficient to cut Nitinol wires. The Thulium fiber laser, operated in low pulse energy and high pulse rate mode, may provide a greater safety margin than standard Holmium laser for lithotripsy, as evidenced by shorter non-contact working distances for stone basket damage than previously reported with Holmium laser.

  12. Wilbrand's knee of the primate optic chiasm is an artefact of monocular enucleation.

    PubMed Central

    Horton, J C

    1997-01-01

    PURPOSE: The anterior chiasmal syndrome consists of a temporal hemianopia or complete visual field loss in one eye, plus a superior temporal hemianopia in the other eye. The superior temporal hemianopia in the other eye is thought to result from injury to Wilbrand's Knee of the optic chiasm. Wilbrand's Knee is a loop of decussating fibers which detours into the contralateral optic nerve before entering the optic tract. I studied the organization of fibers in the optic chiasm of monkeys and humans to verify the existence of Wilbrand's Knee and to elucidate further the pattern of visual field loss seen from lesions of the sellar region. METHODS: The primary optic pathway was labelled in monkeys by injection of [3H] proline into one eye, followed by autoradiography. There were 8 intact Rhesus monkeys and 3 intact squirrel monkeys. In addition, the optic pathway was studied in the Rhesus monkey 6 months and 4 years after monocular enucleation. The optic chiasm was also examined using myelin stains in specimens obtained post-mortem from 3 patients. The patients had lost 1 eye 5 months, 2 years, and 28 years prior to their deaths. Finally, clinical observations were recorded in 3 patients with the anterior chiasmal syndrome. RESULTS: In normal Rhesus and squirrel monkeys, optic nerve fibers crossed the optic chiasm without entering the contralateral optic nerve. After short-term monocular enucleation, fibers from the normal optic nerve were drawn closer to the entry zone of the degenerating optic nerve, but Wilbrand's Knee was still absent. After long-term enucleation, a typical Wilbrand's Knee was induced to form. In the human, Wilbrand's Knee was absent 5 months after monocular enucleation, but emerged in the two cases involving long-term enucleation, in a fashion analogous to the monkey. The case reports describe 3 patients with variants of the anterior chiasmal syndrome from parasellar tumors. CONCLUSIONS: Wilbrand's Knee does not exist in the normal primate optic

  13. The combined effects of unilateral enucleation and rearing in a 'dim' red light on synapse-to-neuron ratios in the rat visual cortex.

    PubMed Central

    Bedi, K S

    1989-01-01

    One day old rats had their right eyes removed and together with non-enucleated controls were raised in either 'light' or 'dark' (red light) conditions from birth until 39 days of age. This resulted in four groups of animals: light-reared enucleated, light-reared non-enucleated, dark-reared enucleated and dark-reared non-enucleated. All animals were killed by intracardiac perfusion with 2.5% sodium cacodylate-buffered glutaraldehyde at 39 days of age. Pieces of visual cortex (Area 17) from both right and left cerebral hemispheres of each animal were dissected out and processed for electron microscopy. Stereological procedures were used to estimate the synapse-to-neuron ratios in Layers II-III of these cortices. Light-reared non-enucleated rats had about 16,000 synapses per neuron in both right and left visual cortices. Rearing non-enucleated rats in the dark reduced this value to about 11,500. The synapse-to-neuron ratio of unilaterally enucleated rats raised in the light was not significantly different from that observed in light-reared non-enucleated rats. Combined dark-rearing and unilateral enucleation did reduce the synapse-to-neuron ratio but not to any greater extent than did dark-rearing alone. However, there was a suggestion of a differential effect between the right and left cortices in these enucleated, dark-reared animals. These results demonstrate the importance of light stimulation for the normal development of interneuronal connectivity of the visual cortex. They also show that the effects of unilateral enucleation for the visual cortex are not as great as those previously observed for the superior colliculi in the same animals, at least as far as synapse-to-neuron ratios are concerned. Images Fig. 1 Fig. 2 PMID:2630542

  14. Advanced Unilateral Retinoblastoma: The Impact of Ophthalmic Artery Chemosurgery on Enucleation Rate and Patient Survival at MSKCC

    PubMed Central

    Abramson, David H.; Fabius, Armida W. M.; Issa, Reda; Francis, Jasmine H.; Marr, Brian P.; Dunkel, Ira J.; Gobin, Y. Pierre

    2015-01-01

    Purpose To report on the influence of ophthalmic artery chemosurgery (OAC) on enucleation rates, ocular and patient survival from metastasis and impact on practice patterns at Memorial Sloan Kettering for children with advanced intraocular unilateral retinoblastoma. Patients and Methods Single-center retrospective review of all unilateral retinoblastoma patients with advanced intraocular retinoblastoma treated at MSKCC between our introduction of OAC (May 2006) and December 2014. End points were ocular survival, patient survival from metastases and enucleation rates. Results 156 eyes of 156 retinoblastoma patients were included. Primary enucleation rates have progressively decreased from a rate of >95% before OAC to 66.7% in the first year of OAC use to the present rate of 7.4%. The percent of patients receiving OAC has progressively increased from 33.3% in 2006 to 92.6% in 2014. Overall, ocular survival was significantly better in eyes treated with OAC in the years 2010–2014 compared to 2006–2009 (p = 0.023, 92.7% vs 68.0% ocular survival at 48 months). There have been no metastatic deaths in the OAC group but two patients treated with primary enucleation have died of metastatic disease. Conclusion OAC was introduced in 2006 and its impact on patient management is profound. Enucleation rates have decreased from over 95% to less than 10%. Our ocular survival rate has also significantly and progressively improved since May 2006. Despite treating more advanced eyes rather then enucleating them patient survival has not been compromised (there have been no metastatic deaths in the OAC group). In our institution, enucleation is no longer the most common treatment for advanced unilateral retinoblastoma. PMID:26709699

  15. Strain differences of the effect of enucleation and anophthalmia on the size and growth of sensory cortices in mice.

    PubMed

    Massé, Ian O; Guillemette, Sonia; Laramée, Marie-Eve; Bronchti, Gilles; Boire, Denis

    2014-11-01

    Anophthalmia is a condition in which the eye does not develop from the early embryonic period. Early blindness induces cross-modal plastic modifications in the brain such as auditory and haptic activations of the visual cortex and also leads to a greater solicitation of the somatosensory and auditory cortices. The visual cortex is activated by auditory stimuli in anophthalmic mice and activity is known to alter the growth pattern of the cerebral cortex. The size of the primary visual, auditory and somatosensory cortices and of the corresponding specific sensory thalamic nuclei were measured in intact and enucleated C57Bl/6J mice and in ZRDCT anophthalmic mice (ZRDCT/An) to evaluate the contribution of cross-modal activity on the growth of the cerebral cortex. In addition, the size of these structures were compared in intact, enucleated and anophthalmic fourth generation backcrossed hybrid C57Bl/6J×ZRDCT/An mice to parse out the effects of mouse strains and of the different visual deprivations. The visual cortex was smaller in the anophthalmic ZRDCT/An than in the intact and enucleated C57Bl/6J mice. Also the auditory cortex was larger and the somatosensory cortex smaller in the ZRDCT/An than in the intact and enucleated C57Bl/6J mice. The size differences of sensory cortices between the enucleated and anophthalmic mice were no longer present in the hybrid mice, showing specific genetic differences between C57Bl/6J and ZRDCT mice. The post natal size increase of the visual cortex was less in the enucleated than in the anophthalmic and intact hybrid mice. This suggests differences in the activity of the visual cortex between enucleated and anophthalmic mice and that early in-utero spontaneous neural activity in the visual system contributes to the shaping of functional properties of cortical networks. PMID:25242615

  16. Arthroscopic shoulder surgery with three different laser systems: an evaluation of laser applications.

    PubMed

    Vangsness, C T; Smith, C F

    1995-12-01

    Twelve cadaveric shoulder arthroscopies were performed to evaluate the use of lasers as an adjunctive tool in arthroscopic shoulder surgery. The three most common lasers historically used in orthopedic surgery were examined: Holmium:YAG, Neodymium:YAG, and the CO2. The following parameters were evaluated for each laser system: (1) ease of use of the laser system and handpiece; (2) ability to excise and trim bursae, synovium, ligament, tendon, bone, and articular cartilage; and (3) ability to contract ligaments and capsule by heat transfer. None of these lasers efficiently cut bone, whereas all three systems readily debrided the soft tissues around the shoulder. The free-beam Ho:YAG and CO2 systems heat contracted soft tissues with more control than the contact Nd:YAG. The fiberoptic delivery system of the Neodymium:YAG and Holmium:YAG laser performed well in the saline arthroscopy, and the CO2 delivery system was cumbersome. Overall, the CO2 system removed tissue better than the others, but its difficult use favored the Holmium laser as the best overall current laser system for shoulder arthroscopy. PMID:8679031

  17. Chemically induced enucleation of activated bovine oocytes: chromatin and microtubule organization and production of viable cytoplasts.

    PubMed

    Saraiva, Naiara Zoccal; Oliveira, Clara Slade; Leal, Cláudia Lima Verde; de Lima, Marina Ragagnin; Del Collado, Maite; Vantini, Roberta; Monteiro, Fabio Morato; Niciura, Simone Cristina Méo; Garcia, Joaquim Mansano

    2015-12-01

    As the standard enucleation method in mammalian nuclear transfer is invasive and damaging to cytoplast spatial organization, alternative procedures have been developed over recent years. Among these techniques, chemically induced enucleation (IE) is especially interesting because it does not employ ultraviolet light and reduces the amount of cytoplasm eliminated during the procedure. The objective of this study was to optimize the culture conditions with demecolcine of pre-activated bovine oocytes for chemically IE, and to evaluate nuclear and microtubule organization in cytoplasts obtained by this technique and their viability. In the first experiment, a negative effect on oocyte activation was verified when demecolcine was added at the beginning of the process, reducing activation rates by approximately 30%. This effect was not observed when demecolcine was added to the medium after 1.5 h of activation. In the second experiment, although a reduction in the number of microtubules was observed in most oocytes, these structures did not disappear completely during assessment. Approximately 50% of treated oocytes presented microtubule reduction at the end of the evaluation period, while 23% of oocytes were observed to exhibit the complete disappearance of these structures and 28% exhibited visible microtubules. These findings indicated the lack of immediate microtubule repolymerization after culture in demecolcine-free medium, a fact that may negatively influence embryonic development. However, cleavage rates of 63.6-70.0% and blastocyst yield of 15.5-24.2% were obtained in the final experiment, without significant differences between techniques, indicating that chemically induced enucleation produces normal embryos. PMID:25318529

  18. Effects of dexmedetomidine for retrobulbar anesthesia in orbital ball implants after enucleation surgery

    PubMed Central

    Ye, Weidi; Hu, Zhiyong; Jin, Xiuming; Wang, Pei

    2015-01-01

    Background: Dexmedetomidine (DEX) can prolong the duration of local anesthetics, but the use of retrobulbar DEX has not been fully elucidated. This study was designed to determine the effects of adding DEX to lidocaine-bupivacaine for retrobulbar block in orbital ball implants after enucleation surgery. Materials and Methods: A total of 200 patients of both sexes aged 30–60 years of American Society of Anesthesiologists I and II, scheduled for orbital ball implants after enucleation surgery, were enrolled for the study. Patients were randomly assigned into one of the two groups: Control (n = 100) received lidocaine-bupivacaine retrobulbar block, DEX (n = 100) received lidocaine-bupivacaine plus 1 ug/kg DEX retrobulbar block. Hemodynamic data, duration of motor and sensory blocks, pain by visual analog scale, bispectral index (BIS), side effects, consumption of dezocine as a rescue analgesic, patient and surgeon satisfaction were recorded. Results: Duration of analgesia was prolonged in the DEX, compared with the control group ([258.35 ± 66.82 min] as [130.75 ± 29.52 min], [P < 0.05]). The median number of postoperative analgesic requests per patient during the first 24 h was decreased in the DEX group (P < 0.05). In the first 24 postoperative hours, DEX group consumed significantly less dezocine (P < 0.05). BIS values and mean arterial pressure remained lower in the DEX group, but within the safe range (P < 0.05). The side effect profile was similar between the two groups. Patients and surgeon satisfaction were higher in the DEX group (P < 0.05). Demographic characteristics were comparable in both groups (P > 0.05). Conclusion: Retrobulbar DEX reduces consumption of rescue analgesic, prolonged the duration of retrobulbar block, improved postoperative pain, provided better sedation effects, and increased patient and surgeon satisfaction after orbital ball implants after enucleation surgery. PMID:26632125

  19. Worldwide Enucleation Techniques and Materials for Treatment of Retinoblastoma: An International Survey

    PubMed Central

    Mourits, Daphne L.; Hartong, Dyonne T.; Bosscha, Machteld I.; Kloos, Roel J. H. M.; Moll, Annette C.

    2015-01-01

    Purpose To investigate the current practice of enucleation with or without orbital implant for retinoblastoma in countries across the world. Methods A digital survey identifying operation techniques and material used for orbital implants after enucleation in patients with retinoblastoma. Results We received a response of 58 surgeons in 32 different countries. A primary artificial implant is routinely inserted by 42 (72.4%) surgeons. Ten (17.2%) surgeons leave the socket empty, three (5.2%) decide per case. Other surgeons insert a dermis fat graft as a standard primary implant (n=1), or fill the socket in a standard secondary procedure (n=2; one uses dermis fat grafts and one artificial implants). The choice for porous implants was more frequent than for non-porous implants: 27 (58.7%) and 15 (32.6%), respectively. Both porous and non-porous implant types are used by 4 (8.7%) surgeons. Twenty-five surgeons (54.3%) insert bare implants, 11 (23.9%) use separate wrappings, eight (17.4%) use implants with prefab wrapping and two insert implants with and without wrapping depending on type of implant. Attachment of the muscles to the wrapping or implant (at various locations) is done by 31 (53.4%) surgeons. Eleven (19.0%) use a myoconjunctival technique, nine (15.5%) suture the muscles to each other and seven (12.1%) do not reattach the muscles. Measures to improve volume are implant exchange at an older age (n=4), the use of Restylane SQ (n=1) and osmotic expanders (n=1). Pegging is done by two surgeons. Conclusion No (worldwide) consensus exists about the use of material and techniques for enucleation for the treatment of retinoblastoma. Considerations for the use of different techniques are discussed. PMID:25767872

  20. [Enzyme histochemical examinations of the visual system of the adult rat following unilateral enucleation].

    PubMed

    Leibnitz, L; Bär, B

    1979-01-01

    12 adult white lab-rats were enucleated and after a survival period of 1, 3, 7 and 30 days the activities of GABA-T, GDH, LDH, SDH and GPDH were demonstrated histochemically in the Tractus opticus (To), Corpus geniculatum laterale, pars dorsalis (CGLd) et ventralis (CGLv), Colliculus superior (Cs) and Nucleus olivaris praetectalis (Nop). Since the ipsi- and contralateral grisea are always in the same tissue section the enzyme activities can be quantitatively compared by visual impression without a greater mistake. In To enucleation caused a hypertrophy of astrocytes together with an increase of the activities of GABA-T, GDH, LDH, and GPDH in these cells. The reactions indicate a more intensive metabolism in connection with the myelin degradation. In CGLd, CGLv, Cs and Nop following enucleation there appeared contralaterally a graded loss in the activities of GDH, LDH, GPDH, and GABA-T; only SDH scarely changed its activity. The fastest and strongest reaction was found in Cs and Nop, while CGLd and CGLv reacted later and to a less degree. In CGLv the enzyme reaction was limited to the lateral part of the nucleus. As diminution of activity is caused by degeneration of the retinal terminals the effected enzymes must be localised in cytoplasma and mitochondria of these terminals. Taking into account findings from literature the following is concluded from the time patterns, the degree of diminution of the enzyme activities and the relation of retinal to extraretinal terminals in the individual nuclei: GABA probably acts as a transmitter in interneurons of CGLd, Cs, and Nop. Glutamate is a transmitter in Cs and Nop. PMID:121134

  1. Transendoscopic soft-tissue laser ablation in the equine upper respiratory tract

    NASA Astrophysics Data System (ADS)

    Bartels, K. E.; MacAllister, C. G.; Dickey, D. T.; Schafer, S. A.; Nordquist, R. E.

    1997-05-01

    Transendoscopic application of Nd:YAG laser energy for treatment of partial upper respiratory obstruction in the horse has been practiced for the last 12 years in both contact and non-contact modes. Endoscopic laser ablation has been limited to wavelengths transmitted through flexible optical fibers. Devices used for this purpose have been primarily the Nd:YAG (1064 nm), KTP (532 nm), holmium (2100 nm), and diode (805 nm) lasers. Few investigations have focused on use of the holmium or diode lasers. Objectives of this study were to evaluate use of fiber-deliverable laser wavelengths provided by newer, more portable, user-friendly, solid-state diode and holmium lasers for ablation of laryngeal tissues of the equine upper respiratory tract. In addition, information on efficacy and dosimetry for both the contact and non-contact modes was obtained using an in vitro cadaveric model. Preliminary conclusions based on histologic evaluation and scanning electron microscopy revealed that diode laser energy has the ability to penetrate laryngeal tissue easily and deeply with minimal collateral coagulation, but is sensitive to tissue color. Holmium laser energy can be used to incise laryngeal tissue easily in contact mode with moderate collateral damage, and absorption does not seem dependent on tissue color.

  2. Stress relaxation and cartilage shaping under laser radiation

    NASA Astrophysics Data System (ADS)

    Sobol, Emil N.; Sviridov, Alexander P.; Bagratashvili, Victor N.; Omelchenko, Alexander I.; Ovchinnikov, Yuriy M.; Shekhter, Anatoliy B.; Downes, S.; Howdle, Steven; Jones, Nicholas; Lowe, J.

    1996-05-01

    The problem of a purposeful change of the shape of cartilage is of great importance for otolaryngology, orthopaedics, and plastic surgery. In 1992 we have found a possibility of controlled shaping of cartilage under moderate laser heating. This paper presents new results in studies of that phenomenon. We have measured temperature and stress in a tissue undergoing to irradiation with a Holmium laser. Study of cartilage structure allowed us to find conditions for laser shaping without pronounced alterations in the structure of matrix.

  3. A simple technique for hemostasis control after enucleation of deep located liver tumors or after liver trauma.

    PubMed

    Machado, Marcel A; Surjan, Rodrigo C; Basseres, Tiago; Makdissi, Fábio F

    2016-01-01

    Modern liver techniques allowed the development of segment-based anatomical liver resections. Nevertheless, there is still a place for nonanatomical liver resections. However, in some cases, there is a need for enucleation of deep located liver tumors. The main problem with enucleation of a liver tumor deeply located in the middle of the liver is the control of bleeding resulting from the rupture of small or medium vessels. The authors describe a simple way to control the bleeding without the use of any special instrument or material. This technique can also be used to control bleeding from penetrating liver injury. PMID:26846270

  4. Telelap Alf-X-Assisted Laparoscopy for Ovarian Cyst Enucleation: Report of the First 10 Cases.

    PubMed

    Gueli Alletti, Salvatore; Rossitto, Cristiano; Fanfani, Francesco; Fagotti, Anna; Costantini, Barbara; Gidaro, Stefano; Monterossi, Giorgia; Selvaggi, Luigi; Scambia, Giovanni

    2015-01-01

    This prospective single-institutional clinical trial sought to assess the safety and feasibility of laparoscopic benign ovarian cyst enucleation with a novel robotic-assisted laparoscopic system. Here we report a series of 10 patients treated using the Telelap ALF-X system in the first clinical application on patients at the Division of Gynecologic Oncology, Catholic University of the Sacred Heart of Rome. The primary inclusion criterion was the presence of monolateral ovarian cyst without a preoperative assessment suspicious for malignancy. Intraoperative data, including docking time, operative time, estimated blood loss, intraoperative and perioperative complications, and conversion to either standard laparoscopy or laparotomy, were collected. The cysts were removed with an ovary-sparing technique with respect to conservative surgical principles. The median operative time was 46.3 minutes, and patients without postoperative complications were discharged at 1 or 2 days after the procedure. Telelap ALF-X laparoscopic enucleation of benign ovarian cysts with an ovary-sparing technique is feasible, safe, and effective; however, more clinical data are needed to determine whether this approach can offer any other benefits over other minimally invasive surgical techniques. PMID:25987523

  5. A technique for evisceration as an alternative to enucleation in birds of prey: 19 cases.

    PubMed

    Murray, Maureen; Pizzirani, Stefano; Tseng, Florina

    2013-06-01

    Ocular trauma is common in birds of prey presented to wildlife clinics and rehabilitation centers. Enucleation is the procedure most commonly described for treatment of end-stage ocular disease or chronically painful eyes in birds; however, there are several disadvantages and risks to this procedure. While evisceration has been suggested as an alternative, it has not been described for multiple cases or with long-term follow-up data in birds of prey. This report details an evisceration technique performed in 5 captive birds of prey of 4 different species (1 eastern screech owl [Megascops asio], 1 great horned owl [Bubo virginianus], 2 red-tailed hawks [Buteo jamaicensis], and 1 bald eagle [Haliaeetus leucocephalus]) with long-term follow-up information. In addition, this report describes 14 cases of free-living owls of 3 different species (1 great horned owl, 4 barred owls [Strix varia], and 9 eastern screech owls) on which this technique was performed from 2004 to 2011 and which were subsequently released to the wild. Because of the limited risk of complications and the less-severe disruption of facial symmetry, which may be particularly important in owls that are candidates for release to the wild, evisceration should be considered over enucleation in birds of prey that require surgical intervention for the management of severe sequelae to ocular trauma. PMID:23971220

  6. In situ non-ischemic enucleation of multilocular cystic renal cell carcinoma using a microwave coagulator.

    PubMed

    Kagebayashi, Y; Hirao, Y; Samma, S; Fukui, Y; Hirohashi, R

    1995-11-01

    A case of multilocular cystic renal cell carcinoma is reported, in which nephron-sparing surgery was done using microwave tissue coagulation. A 37-year-old man was referred to our outpatient clinic for a multilocular cystic tumor, 4.5 cm in diameter, in the middle-lower portion of the right kidney, which was detected by ultrasound during a health checkup. The patient had been found to have the same cystic mass on a CT done during another health checkup 1.5 years before. The tumor showed no growth during the 1.5-year period. With a diagnosis of multilocular cystic renal cell carcinoma, T2N0M0, in situ non-ischemic tumor enucleation was done using a microwave tissue coagulator (Microtaze, Heiwa Electronics Industry Inc., Tokyo). Operation time was 150 minutes and blood loss was 135 cc. The histological diagnosis was renal cell carcinoma, T2N0M0V0, cystic type, clear cell subtype, grade 1. Diagnostic imaging done postoperatively showed no sign of damage to renal function. In this report, the characteristics of multilocular cystic renal carcinoma are reviewed from the literature, and the advantages of nephron-sparing surgery for this type of renal tumor are discussed. In addition, an operative technique of tumor enucleation used in this case and the characteristics of Microtaze are introduced. PMID:8749956

  7. Hereditary Spherocytosis and Hereditary Elliptocytosis: Aberrant Protein Sorting during Erythroblast Enucleation

    SciTech Connect

    Salomao, Marcela; Chen, Ke; Villalobos, Jonathan; Mohandas, Narla; An, Xiuli; Chasis, Joel Anne

    2010-02-08

    During erythroblast enucleation, membrane proteins distribute between extruded nuclei and reticulocytes. In hereditary spherocytosis (HS) and hereditary elliptocytosis (HE), deficiencies of membrane proteins, in addition to those encoded by the mutant gene, occur. Elliptocytes, resulting from protein 4.1R gene mutations, lack not only 4.1R but also glycophorin C, which links the cytoskeleton and bilayer. In HS resulting from ankyrin-1 mutations, band 3, Rh-associated antigen, and glycophorin A are deficient. The current study was undertaken to explore whether aberrant protein sorting, during enucleation, creates these membrane-spanning protein deficiencies. We found that although glycophorin C sorts to reticulocytes normally, it distributes to nuclei in 4.1R-deficient HE cells. Further, glycophorin A and Rh-associated antigen, which normally partition predominantly to reticulocytes, distribute to both nuclei and reticulocytes in an ankyrin-1-deficient murine model of HS. We conclude that aberrant protein sorting is one mechanistic basis for protein deficiencies in HE and HS.

  8. Thermal Properties of Holmium-Implanted Gold Films

    NASA Astrophysics Data System (ADS)

    Prasai, K.; Alves, E.; Bagliani, D.; Yanardag, S. Basak; Biasotti, M.; Galeazzi, M.; Gatti, F.; Gomes, M. Ribeiro; Rocha, J.; Uprety, Y.

    2014-09-01

    The effective mass of the electron neutrino can be probed by studying the Ho electron capture decay with cryogenic microcalorimeters. The goal is to perform a calorimetric experiment, where all the energy released in the decay is measured except for the kinetic energy of the neutrino. To achieve such a goal, multiple approaches are being investigated to enclose the radioactive source in a microcalorimeter absorber without affecting the thermal properties of the absorber material. One such approach is to implant the radioactive isotope into a gold absorber, as gold is successfully used in similar applications. We measured the heat capacity of gold films, implanted with various concentrations of holmium and erbium (a byproduct of the Ho fabrication), in the temperature range 70-300 mK. Our results show that the specific heat capacity of the films is not affected by the implant, making this a viable option for a future experiment. We also verified that the implant does not affect the crystal structure of the gold film.

  9. Single crystal growth and characterization of holmium tartrate trihydrate

    NASA Astrophysics Data System (ADS)

    Want, Basharat; Ahmad, Farooq; Kotru, P. N.

    2007-02-01

    The growth of holmium tartrate trihydrate (HTT) single crystals is achieved in organic (agar-agar) as well as in inorganic (silica) gels by single gel diffusion method. Results of the study on nucleation kinetics of crystals grown in silica gel are described. The crystals exhibit the morphological form of a tetragonal dipyramidal class with {0 0 1} and {1 1 1} as dominant faces. Elemental and thermogravimetric analysis (TGA) supplemented by energy dispersive analysis of X-rays (EDAX) support the suggested chemical formula of the grown crystals to be [Ho (C 4H 4O 6) (C 4H 5O 6)·3H 2O]. Single crystal X-ray diffraction (XRD) studies indicate that the crystals belong to tetragonal system with the cell parameters a=5.97 Å, c=36.09 Å, bearing the space group P4 1. Fourier transform infrared (FT-IR) spectroscopic study indicates the presence of tartrate ligands and suggests that one of the tartrate ions is singly ionized. TGA suggests that the material is thermally stable up to 220 °C.

  10. Magnetic field-dependent spin structures of nanocrystalline holmium

    PubMed Central

    Szary, Philipp; Kaiser, Daniel; Bick, Jens-Peter; Lott, Dieter; Heinemann, André; Dewhurst, Charles; Birringer, Rainer; Michels, Andreas

    2016-01-01

    The results are reported of magnetic field-dependent neutron diffraction experiments on polycrystalline inert-gas condensed holmium with a nanometre crystallite size (D = 33 nm). At T = 50 K, no evidence is found for the existence of helifan(3/2) or helifan(2) structures for the nanocrystalline sample, in contrast with results reported in the literature for the single crystal. Instead, when the applied field H is increased, the helix pattern transforms progressively, most likely into a fan structure. It is the component of H which acts on the basal-plane spins of a given nanocrystallite that drives the disappearance of the helix; for nanocrystalline Ho, this field is about 1.3 T, and it is related to a characteristic kink in the virgin magnetization curve. For a coarse-grained Ho sample, concomitant with the destruction of the helix phase, the emergence of an unusual angular anisotropy (streak pattern) and the appearance of novel spin structures are observed. PMID:27047307

  11. An architecture for quantum computation with magnetically trapped Holmium atoms

    NASA Astrophysics Data System (ADS)

    Saffman, Mark; Hostetter, James; Booth, Donald; Collett, Jeffrey

    2016-05-01

    Outstanding challenges for scalable neutral atom quantum computation include correction of atom loss due to collisions with untrapped background gas, reduction of crosstalk during state preparation and measurement due to scattering of near resonant light, and the need to improve quantum gate fidelity. We present a scalable architecture based on loading single Holmium atoms into an array of Ioffe-Pritchard traps. The traps are formed by grids of superconducting wires giving a trap array with 40 μm period, suitable for entanglement via long range Rydberg gates. The states | F = 5 , M = 5 > and | F = 7 , M = 7 > provide a magic trapping condition at a low field of 3.5 G for long coherence time qubit encoding. The F = 11 level will be used for state preparation and measurement. The availability of different states for encoding, gate operations, and measurement, spectroscopically isolates the different operations and will prevent crosstalk to neighboring qubits. Operation in a cryogenic environment with ultra low pressure will increase atom lifetime and Rydberg gate fidelity by reduction of blackbody induced Rydberg decay. We will present a complete description of the architecture including estimates of achievable performance metrics. Work supported by NSF award PHY-1404357.

  12. Laser and spectral properties of Cr, Tm, Ho:YAG at 2.1 microns

    NASA Astrophysics Data System (ADS)

    Bowman, Steven R.; Tucker, J. E.; Searles, Stuart K.; Feldman, Barry J.; Winings, M. J.; Auyeung, Raymond C. Y.

    1991-09-01

    The authors study the loss process in a uniformly pumped amplifier experiment. The impact of the loss mechanism on laser performance is discussed and its dependence on excited state density is considered. An extensive set of measurements was performed on flashlamp pumped YAG crystals doped with chromium, thulium, and holmium. Near-room-temperature laser operation on the 2.1 micron holmium transitions was characterized using a frequency selective resonator. Small signal gain and stored energy lifetimes were analyzed to determine the strength and dependence of loss mechanisms. The analysis of the thermal lensing experiments demonstrated a high degree of excess heat generation in this material.

  13. Urologic laser types and instrumentation.

    PubMed

    Natalin, Ricardo A; Phillips, Courtney K; Clayman, Ralph V; Landman, Jaime

    2008-11-01

    Though the primary role of lasers in urology has always been in the treatment of urolithiasis, there are several other indications for their use. There are many different types of lasers currently available, each with unique properties conducive to treating certain disorders. As such, it is critical that today's urologist understands each laser's characteristics in order to optimize patient selection and treatment. The lasers which are primarily used in urologic applications include the carbon dioxide (CO2) laser; the Neodymium:Yttrium-Aluminum-Garnet (Nd:YAG); the Potassium Titanyl Phosphate (KTP) laser and the Holmium:YAG (Ho:YAG) laser. This review focuses on the unique characteristics of each of these lasers as well as the instrumentation needed utilize and deploy these tools in the urinary tract. PMID:19140577

  14. Laparoscopic simple prostatectomy.

    PubMed

    Blew, Brian D M; Fazio, Luke M; Pace, Kenneth; D'A Honey, R John

    2005-12-01

    Classically, surgical options for very large prostate glands, not amenable to transurethral resection, include suprapubic or retropubic simple prostatectomy and Holmium laser enucleation of the prostate (HoLEP). We present a case managed with a laparoscopic simple prostatectomy. Technical considerations are discussed as well as possible advantages of this approach including decreased blood loss, faster patient recovery and improved visualization. PMID:16401375

  15. Laser purification of ultradispersed diamond in aqueous solution

    SciTech Connect

    Dolgaev, Sergei I; Kirichenko, N A; Lubnin, Evgenii N; Simakin, Aleksandr V; Shafeev, Georgii A; Kulevskii, L A

    2004-09-30

    The effect of pulsed radiation from a 2.92-{mu}m, 130-ns Cr{sup 3+}:Yb{sup 3+}:Ho{sup 3+}:YSGG holmium laser and a 510-nm, 20-ns copper vapour laser on an aqueous suspension of ultradispersed diamond is studied. X-ray photoelectron spectroscopy and electron energy loss spectroscopy revealed that exposure of the suspension to holmium laser radiation reduces the concentration of nondiamond carbon impurity in it. This is due to the dissolution of carbon impurity in supercritical aqueous solution, caused by radiation absorption. Dissolution of the nondiamond fraction may serve as an indicator of the solution being in the supercritical state as a result of laser irradiation of liquids. This process can be used for efficient purification of ultradispersed diamonds. (laser applications and other topics in quantum electronics)

  16. Concomitant Laparoendoscopic Single-Site Surgery for Vesicolithotomy and Finger-Assisted Single-Port Transvesical Enucleation of the Prostate

    PubMed Central

    Lee, Joo Yong; Kang, Dong Hyuk; Chung, Jae Hoon; Jo, Jung Ki

    2011-01-01

    Transurethral resection of the prostate is the most common surgery for benign prostatic hyperplasia. However, it doesn't work best for men with very large prostate and bladder stones. Herein we report our initial experience with concomitant laparoendoscopic single-site surgery and finger-assisted single-port transvesical enucleation of the prostate for the treatment of the condition. PMID:22259738

  17. Thulium fiber laser lithotripsy in an in vitro ureter model.

    PubMed

    Hardy, Luke A; Wilson, Christopher R; Irby, Pierce B; Fried, Nathaniel M

    2014-12-01

    Using a validated in vitro ureter model for laser lithotripsy, the performance of an experimental thulium fiber laser (TFL) was studied and compared to the clinical gold standard holmium:YAG laser. The holmium laser (λ = 2120 nm) was operated with standard parameters of 600 mJ, 350 μs, 6 Hz, and 270-μm-core optical fiber. The TFL (λ=1908 nm) was operated with 35 mJ, 500 μs, 150 to 500 Hz, and a 100-μm-core fiber. Urinary stones (60% calcium oxalate monohydrate/40% calcium phosphate) of uniform mass and diameter (4 to 5 mm) were laser ablated with fibers through a flexible video-ureteroscope under saline irrigation with flow rates of 22.7 and 13.7 ml/ min for the TFL and holmium laser, respectively. The temperature 3 mm from the tube's center and 1 mm above the mesh sieve was measured by a thermocouple and recorded throughout each experiment for both lasers. Total laser and operation times were recorded once all stone fragments passed through a 1.5-mm sieve. The holmium laser time measured 167±41 s (n=12). TFL times measured 111±49, 39±11, and 23±4 s, for pulse rates of 150, 300, and 500 Hz, respectively (n=12 each). Mean peak saline irrigation temperatures reached 24±1°C for holmium, and 33±3°C, 33±7°C, and 39±6°C, for TFL at pulse rates of 150, 300, and 500 Hz, respectively. To avoid thermal buildup and provide a sufficient safety margin, TFL lithotripsy should be performed with pulse rates below 500 Hz and/or increased saline irrigation rates. The TFL rapidly fragmented kidney stones due in part to its high pulse rate, high power density, high average power, and observation of reduced stone retropulsion and may provide a clinical alternative to the conventional holmium laser for lithotripsy. PMID:25518001

  18. Thulium fiber laser lithotripsy in an in vitro ureter model

    NASA Astrophysics Data System (ADS)

    Hardy, Luke A.; Wilson, Christopher R.; Irby, Pierce B.; Fried, Nathaniel M.

    2014-12-01

    Using a validated in vitro ureter model for laser lithotripsy, the performance of an experimental thulium fiber laser (TFL) was studied and compared to the clinical gold standard holmium:YAG laser. The holmium laser (λ=2120 nm) was operated with standard parameters of 600 mJ, 350 μs, 6 Hz, and 270-μm-core optical fiber. The TFL (λ=1908 nm) was operated with 35 mJ, 500 μs, 150 to 500 Hz, and a 100-μm-core fiber. Urinary stones (60% calcium oxalate monohydrate/40% calcium phosphate) of uniform mass and diameter (4 to 5 mm) were laser ablated with fibers through a flexible video-ureteroscope under saline irrigation with flow rates of 22.7 and 13.7 ml/min for the TFL and holmium laser, respectively. The temperature 3 mm from the tube's center and 1 mm above the mesh sieve was measured by a thermocouple and recorded throughout each experiment for both lasers. Total laser and operation times were recorded once all stone fragments passed through a 1.5-mm sieve. The holmium laser time measured 167±41 s (n=12). TFL times measured 111±49, 39±11, and 23±4 s, for pulse rates of 150, 300, and 500 Hz, respectively (n=12 each). Mean peak saline irrigation temperatures reached 24±1°C for holmium, and 33±3°C, 33±7°C, and 39±6°C, for TFL at pulse rates of 150, 300, and 500 Hz, respectively. To avoid thermal buildup and provide a sufficient safety margin, TFL lithotripsy should be performed with pulse rates below 500 Hz and/or increased saline irrigation rates. The TFL rapidly fragmented kidney stones due in part to its high pulse rate, high power density, high average power, and observation of reduced stone retropulsion and may provide a clinical alternative to the conventional holmium laser for lithotripsy.

  19. Measurement of cross sections for charge pickup by relativistic holmium ions on heavy targets

    SciTech Connect

    Westphal, A.J.; Guiru, J.; Price, P.B. Nuclear Science Division, Lawrence Berkeley Laboratory, Berkeley, California )

    1991-10-01

    We have measured the cross section for nuclear charge pickup by relativistic holmium on several targets of larger atomic number than have been studied previously. We find that although measurements made with most of the targets are consistent with a peripheral geometric scaling, one target, silver, shows an anomalously high cross section.

  20. Preparation and complex characterization of silica holmium sol-gel monoliths.

    PubMed

    Cacaina, D; Areva, S; Laaksonen, H; Simon, S; Ylänen, H

    2011-01-01

    Amorphous, sol-gel derived SiO(2) are known to biocompatible and bioresorbable materials. Biodegradable and inert materials containing radioactive isotopes have potential application as delivery vehicles of the beta radiation to the cancer tumors inside the body. Incorporation of holmium in the sol-gel derived SiO(2) could lead to the formation of a biodegradable material which could be used as carrier biomaterial for the radiation of radioactive holmium to the various cancer sites. The homogeneity of the prepared sol-gel silica holmium monoliths was investigated by Back Scattered Electron Imaging of Scanning Electron Microscope equipped with Energy Dispersive X-ray Analysis, X-ray Induced Photoelectron Spectroscopy and Nuclear Magnetic Resonance Spectroscopy. The biodegradation of the monoliths was investigated in Simulated Body Fluid and TRIS (Trizma pre-set Crystals) solution. The results show that by suitable tailoring of the sol-gel processing parameters holmium can be homogeneously incorporated in the silica matrix with a controlled biodegradation rate. PMID:21132520

  1. Chiral holmium complex-catalyzed Diels-Alder reaction of silyloxyvinylindoles: stereoselective synthesis of hydrocarbazoles.

    PubMed

    Harada, Shinji; Morikawa, Takahiro; Nishida, Atsushi

    2013-10-18

    The catalytic and asymmetric cycloaddition between 3-[1-(silyloxy)vinyl]indoles and electron-deficient olefins gave substituted hydrocarbazoles in up to 99% yield and 94% ee. This reaction was catalyzed by a novel chiral holmium(III) complex. Alkylation of the cycloadduct gave a tricyclic compound with four continuous chiral centers, one of which was a quaternary carbon. PMID:24079531

  2. Early Development of Cloned Bovine Embryos Produced from Oocytes Enucleated by Fluorescence Metaphase II Imaging Using a Conventional Halogen-Lamp Microscope

    PubMed Central

    Iwamoto, Daisaku; Yamagata, Kazuo; Kishi, Masao; Hayashi-Takanaka, Yoko; Kimura, Hiroshi; Wakayama, Teruhiko

    2015-01-01

    Abstract Enucleation of a recipient oocyte is one of the key processes in the procedure of somatic cell nuclear transfer (SCNT). However, especially in bovine species, lipid droplets spreading in the ooplasm hamper identification and enucleation of metaphase II (MII) chromosomes, and thereby the success rate of the cloning remains low. In this study we used a new experimental system that enables fluorescent observation of chromosomes in living oocytes without any damage. We succeeded in visualizing and removing the MII chromosome in matured bovine oocytes. This experimental system consists of injecting fluorescence-labeled antibody conjugates that bind to chromosomes and fluorescent observation using a conventional halogen-lamp microscope. The cleavage rates and blastocyst rates of bovine embryos following in vitro fertilization (IVF) decreased as the concentration of the antibody increased (p<0.05). The enucleation rate of the conventional method (blind enucleation) was 86%, whereas all oocytes injected with the antibody conjugates were enucleated successfully. Fusion rates and developmental rates of SCNT embryos produced with the enucleated oocytes were the same as those of the blind enucleation group (p>0.05). For the production of SCNT embryos, the new system can be used as a reliable predictor of the location of metaphase plates in opaque oocytes, such as those in ruminant animals. PMID:25826723

  3. Early development of cloned bovine embryos produced from oocytes enucleated by fluorescence metaphase II imaging using a conventional halogen-lamp microscope.

    PubMed

    Iwamoto, Daisaku; Yamagata, Kazuo; Kishi, Masao; Hayashi-Takanaka, Yoko; Kimura, Hiroshi; Wakayama, Teruhiko; Saeki, Kazuhiro

    2015-04-01

    Enucleation of a recipient oocyte is one of the key processes in the procedure of somatic cell nuclear transfer (SCNT). However, especially in bovine species, lipid droplets spreading in the ooplasm hamper identification and enucleation of metaphase II (MII) chromosomes, and thereby the success rate of the cloning remains low. In this study we used a new experimental system that enables fluorescent observation of chromosomes in living oocytes without any damage. We succeeded in visualizing and removing the MII chromosome in matured bovine oocytes. This experimental system consists of injecting fluorescence-labeled antibody conjugates that bind to chromosomes and fluorescent observation using a conventional halogen-lamp microscope. The cleavage rates and blastocyst rates of bovine embryos following in vitro fertilization (IVF) decreased as the concentration of the antibody increased (p<0.05). The enucleation rate of the conventional method (blind enucleation) was 86%, whereas all oocytes injected with the antibody conjugates were enucleated successfully. Fusion rates and developmental rates of SCNT embryos produced with the enucleated oocytes were the same as those of the blind enucleation group (p>0.05). For the production of SCNT embryos, the new system can be used as a reliable predictor of the location of metaphase plates in opaque oocytes, such as those in ruminant animals. PMID:25826723

  4. Sub-100  fs passively mode-locked holmium-doped fiber oscillator operating at 2.06  μm.

    PubMed

    Li, Peng; Ruehl, Axel; Grosse-Wortmann, Uwe; Hartl, Ingmar

    2014-12-15

    We demonstrate a simple and compact Holmium-doped fiber femtosecond oscillator, in-band pumped by a commercial Tm-doped fiber laser. The oscillator operates in the dispersion managed soliton regime at net zero intracavity dispersion and delivers >1  nJ pulse energy at 35 MHz repetition rate. The pulse duration directly at the oscillator output is 160 fs FWHM, close to the Fourier-limit of 145 fs FWHM. Using an additional nonlinear compressor stage, sub-100 fs FWHM pulse durations could be achieved. The nonlinear fiber compressor is implemented by a solid core highly nonlinear fiber for spectral broadening and a single mode fiber for pulse compression. PMID:25503015

  5. A case of a benign cementoblastoma treated by enucleation and apicoectomy.

    PubMed

    Gulses, Aydin; Bayar, Gurkan Rasit; Aydin, Cumhur; Sencimen, Metin

    2012-01-01

    Cementoblastoma is a rare, benign, odontogenic neoplasm of ectomesenchymal origin, representing less than 6% of all odontogenic tumors. Despite its well-known typical features, there are still controversies regarding the management of the condition. This article presents the case of a benign cementoblastoma in a 17-year-old girl. The lesion was typical and associated with the mandibular right first molar. Endodontic treatment of the involved tooth, enucleation of the cementoblastoma, and apicoectomy of the affected roots were performed. Removal of the tumor while preserving the associated tooth resulted in normal osseous healing and no evidence of recurrence after one year. Based on the findings of the current report, it can be suggested that, in properly selected cases, it is possible to remove cementoblastomas that affect molars without extracting the involved teeth. PMID:23220315

  6. Aqueous Angiography–Mediated Guidance of Trabecular Bypass Improves Angiographic Outflow in Human Enucleated Eyes

    PubMed Central

    Huang, Alex S.; Saraswathy, Sindhu; Dastiridou, Anna; Begian, Alan; Mohindroo, Chirayu; Tan, James C. H.; Francis, Brian A.; Hinton, David R.; Weinreb, Robert N.

    2016-01-01

    Purpose To assess the ability of trabecular micro-bypass stents to improve aqueous humor outflow (AHO) in regions initially devoid of AHO as assessed by aqueous angiography. Methods Enucleated human eyes (14 total from 7 males and 3 females [ages 52–84]) were obtained from an eye bank within 48 hours of death. Eyes were oriented by inferior oblique insertion, and aqueous angiography was performed with indocyanine green (ICG; 0.4%) or fluorescein (2.5%) at 10 mm Hg. With an angiographer, infrared and fluorescent images were acquired. Concurrent anterior segment optical coherence tomography (OCT) was performed, and fixable fluorescent dextrans were introduced into the eye for histologic analysis of angiographically positive and negative areas. Experimentally, some eyes (n = 11) first received ICG aqueous angiography to determine angiographic patterns. These eyes then underwent trabecular micro-bypass sham or stent placement in regions initially devoid of angiographic signal. This was followed by fluorescein aqueous angiography to query the effects. Results Aqueous angiography in human eyes yielded high-quality images with segmental patterns. Distally, angiographically positive but not negative areas demonstrated intrascleral lumens on OCT images. Aqueous angiography with fluorescent dextrans led to their trapping in AHO pathways. Trabecular bypass but not sham in regions initially devoid of ICG aqueous angiography led to increased aqueous angiography as assessed by fluorescein (P = 0.043). Conclusions Using sequential aqueous angiography in an enucleated human eye model system, regions initially without angiographic flow or signal could be recruited for AHO using a trabecular bypass stent. PMID:27588614

  7. Visual system plasticity in mammals: the story of monocular enucleation-induced vision loss

    PubMed Central

    Nys, Julie; Scheyltjens, Isabelle; Arckens, Lutgarde

    2015-01-01

    The groundbreaking work of Hubel and Wiesel in the 1960’s on ocular dominance plasticity instigated many studies of the visual system of mammals, enriching our understanding of how the development of its structure and function depends on high quality visual input through both eyes. These studies have mainly employed lid suturing, dark rearing and eye patching applied to different species to reduce or impair visual input, and have created extensive knowledge on binocular vision. However, not all aspects and types of plasticity in the visual cortex have been covered in full detail. In that regard, a more drastic deprivation method like enucleation, leading to complete vision loss appears useful as it has more widespread effects on the afferent visual pathway and even on non-visual brain regions. One-eyed vision due to monocular enucleation (ME) profoundly affects the contralateral retinorecipient subcortical and cortical structures thereby creating a powerful means to investigate cortical plasticity phenomena in which binocular competition has no vote.In this review, we will present current knowledge about the specific application of ME as an experimental tool to study visual and cross-modal brain plasticity and compare early postnatal stages up into adulthood. The structural and physiological consequences of this type of extensive sensory loss as documented and studied in several animal species and human patients will be discussed. We will summarize how ME studies have been instrumental to our current understanding of the differentiation of sensory systems and how the structure and function of cortical circuits in mammals are shaped in response to such an extensive alteration in experience. In conclusion, we will highlight future perspectives and the clinical relevance of adding ME to the list of more longstanding deprivation models in visual system research. PMID:25972788

  8. Thulium fiber laser damage to the ureter

    NASA Astrophysics Data System (ADS)

    Wilson, Christopher R.; Hardy, Luke A.; Irby, Pierce B.; Fried, Nathaniel M.

    2015-07-01

    Our laboratory is studying experimental thulium fiber laser (TFL) as a potential alternative lithotripter to the clinical gold standard Holmium:YAG laser. Safety studies characterizing undesirable Holmium laser-induced damage to ureter tissue have been previously reported. Similarly, this study characterizes TFL induced ureter and stone basket damage. A TFL beam with pulse energy of 35 mJ, pulse duration of 500 μs, and pulse rates of 150-500 Hz was delivered through a 100-μm-core, low-OH, silica optical fiber to the porcine ureter wall, in vitro. Ureter perforation times were measured and gross, histological, and optical coherence tomography images of the ablation zone were acquired. TFL operation at 150, 300, and 500 Hz produced mean ureter perforation times of 7.9, 3.8, and 1.8 s, respectively. Collateral damage averaged 510, 370, and 310 μm. TFL mean perforation time exceeded 1 s at each setting, which is a greater safety margin than previously reported during Holmium laser ureter perforation studies.

  9. Transient cavitation and acoustic emission produced by different laser lithotripters.

    PubMed

    Zhong, P; Tong, H L; Cocks, F H; Pearle, M S; Preminger, G M

    1998-08-01

    Transient cavitation and shockwave generation produced by pulsed-dye and holmium:YAG laser lithotripters were studied using high-speed photography and acoustic emission measurements. In addition, stone phantoms were used to compare the fragmentation efficiency of various laser and electrohydraulic lithotripters. The pulsed-dye laser, with a wavelength (504 nm) strongly absorbed by most stone materials but not by water, and a short pulse duration of approximately 1 microsec, induces plasma formation on the surface of the target calculi. Subsequently, the rapid expansion of the plasma forms a cavitation bubble, which expands spherically to a maximum size and then collapses violently, leading to strong shockwave generation and microjet impingement, which comprises the primary mechanism for stone fragmentation with short-pulse lasers. In contrast, the holmium laser, with a wavelength (2100 nm) most strongly absorbed by water as well as by all stone materials and a long pulse duration of 250 to 350 microsec, produces an elongated, pear-shaped cavitation bubble at the tip of the optical fiber that forms a vapor channel to conduct the ensuing laser energy to the target stone (Moss effect). The expansion and subsequent collapse of the elongated bubble is asymmetric, resulting in weak shockwave generation and microjet impingement. Thus, stone fragmentation in holmium laser lithotripsy is caused primarily by thermal ablation (drilling effect). PMID:9726407

  10. Comparative analysis of the optical spectra of the holmium atom excited by electron impact and ionic bombardment

    SciTech Connect

    Vasileva, E.K.; Morozov, S.N.; Ryskin, B.V.

    1988-02-01

    A comparative analysis of the optical spectra of holmium excited by electron impact and ionic bombardment is given. It is shown that under ionic bombardment, the probability of excitation of screened transitions is significantly higher than under electron impact.

  11. Percutaneous laser discectomy of cervical discs: preliminary clinical results.

    PubMed

    Siebert, W

    1995-06-01

    Thirty-one patients with herniated cervical discs were treated with PLDD from 1991 to 1993. In 1990, a few of these patients were treated with the Nd:YAG laser with no complications. Since 1991 we have used the holmium:YAG laser; 28 of the 31 patients experienced pain relief in a 6-week follow-up. PLDD for the cervical discs is a viable therapy. PMID:10150647

  12. Use of lasers in orthopedic surgery: current concepts.

    PubMed

    Abelow, S P

    1993-05-01

    A surgical laser is a new, multipurpose tool that can cut, coagulate, and vaporize tissues. It utilizes a low profile handpiece that allows easy access to tight places and small joints. The holmium laser at 2.1 microns wavelength is gaining wide acceptance among orthopedic surgeons as a useful arthroscopic surgical tool. It has a minimal amount of thermal necrosis and is able to cut and ablate tissues with great ease. Current investigation with laser tissue--agglutination and tissue welding--may make it possible to repair torn tissues with laser energy. The future will bring minimally invasive and minimally damaging laser orthopedic surgery. PMID:8327382

  13. HO:LULF and HO:LULF Laser Materials

    NASA Technical Reports Server (NTRS)

    Barnes, Norman P. (Inventor); Morrison, Clyde A. (Inventor); Filer, Elizabeth D. (Inventor); Jani, Mahendra G. (Inventor); Murray, Keith E. (Inventor); Lockard, George E. (Inventor)

    1998-01-01

    A laser host material LULF (LuLiF4) is doped with holmium (Ho) and thulium (Tm) to produce a new laser material that is capable of laser light production in the vicinity of 2 microns. The material provides an advantage in efficiency over conventional Ho lasers because the LULF host material allows for decreased threshold and upconversion over such hosts as YAG and YLF. The addition of Tm allows for pumping by commonly available GaAlAs laser diodes. For use with flashlamp pumping, erbium (Er) may be added as an additional dopant. For further upconversion reduction, the Tm can be eliminated and the Ho can be directly pumped.

  14. Shifts in Developmental Timing, and Not Increased Levels of Experience-Dependent Neuronal Activity, Promote Barrel Expansion in the Primary Somatosensory Cortex of Rats Enucleated at Birth

    PubMed Central

    Fetter-Pruneda, Ingrid; Ibarrarán-Viniegra, Ana Sofía; Martínez-Martínez, Eduardo; Sandoval-Velasco, Marcela; Uribe-Figueroa, Laura; Padilla-Cortés, Patricia; Mercado-Célis, Gabriela; Gutiérrez-Ospina, Gabriel

    2013-01-01

    Birth-enucleated rodents display enlarged representations of whiskers (i.e., barrels of the posteromedial subfield) in the primary somatosensory cortex. Although the historical view maintains that barrel expansion is due to incremental increases in neuronal activity along the trigeminal pathway during postnatal development, recent evidence obtained in experimental models of intramodal plasticity challenges this view. Here, we re-evaluate the role of experience-dependent neuronal activity on barrel expansion in birth-enucleated rats by combining various anatomical methods and sensory deprivation paradigms. We show that barrels in birth-enucleated rats were already enlarged by the end of the first week of life and had levels of metabolic activity comparable to those in control rats at different ages. Dewhiskering after the postnatal period of barrel formation did not prevent barrel expansion in adult, birth-enucleated rats. Further, dark rearing and enucleation after barrel formation did not lead to expanded barrels in adult brains. Because incremental increases of somatosensory experience did not promote barrel expansion in birth-enucleated rats, we explored whether shifts of the developmental timing could better explain barrel expansion during the first week of life. Accordingly, birth-enucleated rats show earlier formation of barrels, accelerated growth of somatosensory thalamocortical afferents, and an earlier H4 deacetylation. Interestingly, when H4 deacetylation was prevented with a histone deacetylases inhibitor (valproic acid), barrel specification timing returned to normal and barrel expansion did not occur. Thus, we provide evidence supporting that shifts in developmental timing modulated through epigenetic mechanisms, and not increased levels of experience dependent neuronal activity, promote barrel expansion in the primary somatosensory cortex of rats enucleated at birth. PMID:23372796

  15. Ureteropyeloscopy and homium: YAG laser lithotripsy for treatment of ureteral calculi (report of 356 cases)

    NASA Astrophysics Data System (ADS)

    Wu, Zhong; Din, Qiang; Jiang, Hao-wen; Zen, Jing-cun; Yu, Jiang; Zhang, Yuanfang

    2005-07-01

    Objective: To evaluate the efficacy and safety of holmium YAG laser lithotripsy for the treatment of ureteral calculi. Methods: A total of 356 patients underwent ureteropyeloscopic lithotripsy using holmium YAG laser with a semirigid uretesopyeloscope, 93 upper, 135 middle, and 128 lower ureteral stones were treated. Results: The overall successful fragmentation rate for all ureteral stones in a single session achieved 98% (349/356). The successful fragmentation rate stratified by stone location was 95% 88/93 in the upper ureter, 99% (134/135) in the mid ureter , and 99%(127/128) in the distal ureter. 12 cases with bilateral ureteral stones which caused acute renal failure and anuria were treated rapidly and effectively by the holmium YAG laser lithotripsy. No complications such as perforation and severe trauma were encountered during the operations. 2 weeks 17months (with an average of 6.8 month ) follow up postoperatively revealed that the overall stone-free rate was 98%(343/349) and no ureteral stenosis was found. Conclusions Holmium YAG laser lithotripsy is a highly effective, minimally invasive and safe therapy for ureteral calculi. It is indicated as a first choice of treatment for patients with ureteral calculi, especially for the ones with mid- lower levels of ureteral calculi.

  16. Detection of Mycobacterium tuberculosis with nested polymerase chain reaction analysis in enucleated eye ball in Eales' disease.

    PubMed

    Verma, Aditya; Biswas, Jyotirmay; Dhanurekha, L; Gayathri, R; Lily Therese, K

    2016-06-01

    Nested polymerase chain reaction (nPCR) was performed on enucleated eyeball for detection of Mycobacterium tuberculosis (M. tb) genome in a patient with Eales' disease. PCR analysis in all previous studies has been done mainly using aqueous, vitreous and epiretinal membranes from these patients. Paraffin wax embedded tissue section of the enucleated eyeball was analyzed by histopathology and nPCR targeting MPB64 gene and IS6110 region of M. tb genome. Lymphocytic infiltration was seen in the vitreous, iris and the retinal tissue. Ziehl Neelsen stain was negative for acid fast bacilli. Caseation necrosis was not seen in any section. Agarose gel electrophoretogram showed positive results with 200 bp specific amplified product targeting MPB64 gene, whereas nPCR targeting IS6110 region was negative. Since biopsy proven M. tb is extremely difficult in ocular tissues due to extensive necrosis, the nPCR technique aided in the diagnosis. PMID:26499903

  17. Malignant melanoma of the eye: treatment of posterior uveal lesions by Co-60 plaque radiotherapy versus enucleation

    SciTech Connect

    Markoe, A.M.; Brady, L.W. Jr.; Shields, J.A.; Augsburger, J.J.; Micaily, B.; Damsker, J.I.; Day, J.L.; Gamel, J.W.

    1985-09-01

    Survival rates and visual acuity of 100 patients treated for posterior uveal malignant melanoma by cobalt-60 plaque radiotherapy were compared with 150 patients treated by enucleation for the same disease. Life-table comparisons of the entire group showed significant differences in survival rates, with plaque radiotherapy patients appearing to fare better. However, when patients with small or medium tumors were compared, only slight differences were seen, implying that criteria used to select patients for treatment may affect interpretation. The two groups were also compared using the Cox proportional hazards model, which predicts survival based on the impact of clinical variables. In this analysis, the survival rates of the plaque radiotherapy group were no worse than those of the enucleation group. The advantage of conservative therapy lies in the potential to preserve useful vision over a considerable time.

  18. Enucleation of large keratocystic odontogenic tumor at mandible via unilateral sagittal split osteotomy: a report of three cases

    PubMed Central

    Lee, Hyeong-Geun; Rhee, Seung-Hyun; Noh, Chung-Ah

    2015-01-01

    Keratocystic odontogenic tumor (KCOT) is a common benign tumor of osseous lesions in dental and maxillofacial practice. We describe three cases of large KCOT located in the posterior part of the mandible extending to the angle and ramus region, which were enucleated via sagittal split osteotomy (SSO) of the mandible. There are cases in which a conventional enucleation procedure does not ensure complete excision of the entire lesion without damage to vital structures like the inferior alveolar nerve. In such cases, a SSO approach could be a better choice than conventional methods. The purpose of this article is to describe our experience using unilateral mandibular SSO for removal of a KCOT from the mandible. PMID:26339581

  19. Ghrelin and obestatin inhibit enucleation-induced adrenocortical proliferation in the rat.

    PubMed

    Rucinski, Marcin; Trejter, Marcin; Ziolkowska, Agnieszka; Tyczewska, Marianna; Malendowicz, Ludwik K

    2010-05-01

    Studies involving the role of ghrelin (GHREL) in regulating the proliferative activity of various cell types have obtained variable results depending primarily on the experimental model applied. It was recently reported that neither GHREL nor obestatin (OBS) affected the proliferative activity of cultured rat adrenocortical cells. In view of the conflicting results, we investigated the effects of GHREL and OBS on the proliferative activity of rat adrenocortical cells in a model of bilateral enucleation-induced adrenocortical regeneration in the rat. Rats were sacrificed 5 or 8 days after surgery. Twenty-four hours before being sacrificed, the appropriate groups were infused with 3 nmol GHREL or OBS/100 g. The mitotic index was assessed using the stachmokinetic method with vincristine. In comparison with intact rats, expression levels of ppGHREL, BAX, JUN-B and JUN-C genes were notably higher in regenerating adrenals, and neither GHREL nor OBS infusion affected these levels. Expression levels of the GHS-R, GPR39v2 and FOS genes were affected neither by adrenal enucleation nor GHREL or OBS infusion. Expression of only two studied genes, GPR39v1 and EGR1, was regulated by OBS. In the regenerating adrenal glands, GPR39v1 and EGR1 mRNA levels were higher than the levels in intact animals. GHREL infusion had no effect while OBS infusion notably stimulated GPR39v1 mRNA levels in the regenerating adrenal gland and evoked an opposite effect on EGR1 mRNA. OBS administration resulted in a potent decrease in the mitotic index of the studied cells, an effect found at both days 5 and 8 of the experiment. GHREL exerted a similar effect only at day 5 of adrenocortical regeneration. Neither GHREL nor OBS had an effect on blood aldosterone concentrations. GHREL infusion lowered plasma corticosterone concentration at day 5 but not 8 of the experiment, while OBS administration was ineffective. Thus, this study is the first to demonstrate that, in vivo, both GHREL and OBS inhibit the

  20. In vivo cerebral incorporation of radiolabeled fatty acids after acute unilateral orbital enucleation in adult hooded Long-Evans rats

    SciTech Connect

    Wakabayashi, S.; Freed, L.M.; Bell, J.M.; Rapoport, S.I.

    1994-03-01

    We examined effects of acute unilateral enucleation on incorporation from blood of intravenously injected unsaturated [1-{sup 14}C]arachidonic acid ([{sup 14}C]AA) and [1-{sup 14}C]docosahexaenoic acid ([{sup 14}C]DHA), and of saturated [9,10-{sup 3}H]palmitic acid ([{sup 3}H]PA), into visual and nonvisual brain areas of awake adult Long-Evans hooded rats. Regional cerebral metabolic rate for glucose (rCMR{sub glc}) values also were assessed with 2-deoxy-D-[1-{sup 14}C]glucose ([{sup 14}C]DG). One day after unilateral enucleation, an awake rat was placed in a brightly lit visual stimulation box with black and white striped walls, and a radiolabeled fatty acid was infused for 5 min or [{sup 14}C]DG was injected as a bolus. [{sup 14}C]DG also was injected in a group of rats kept in the dark for 4 h. Fifteen minutes after starting an infusion of a radiolabeled fatty acid, or 45 min after injecting [{sup 14}C]DG, the rat was killed and the brain was prepared for quantitative autoradiography. Incorporation coefficients k* of fatty acids, or rCMR{sub glc} values, were calculated in homologous brain regions contralateral and ipsilateral to enucleation. As compared with ipsilateral regions, rCMR{sub glc} was reduced significantly (by as much as -39%) in contralateral visual areas, including the superior colliculus, lateral geniculate body, and layers I, IV, and V of the primary (striate) and secondary (association, extrastriate) visual cortices. These results indicate that enucleation acutely reduces neuronal activity in contralateral visual areas of the awake rat and that the reductions are coupled to reduced incorporation of unsaturated fatty acids into sn-2 regions of phosphatidylcholine, phosphatidylinositol, and phosphatidylethanolamine. Reduced fatty acid incorporation likely reflects reduced activity of phospholipases A{sub 2} and/or phospholipase C. 65 refs., 5 figs., 5 tabs.

  1. Results of the treatment of keratocystic odontogenic tumours using enucleation and treatment of the residual bony defect with Carnoy's solution.

    PubMed

    Leung, Y Y; Lau, S L; Tsoi, K Y Y; Ma, H L; Ng, C L

    2016-09-01

    This retrospective study aimed to investigate the recurrence rate of keratocystic odontogenic tumours (KCOTs) treated by enucleation and the application of Carnoy's solution, and to assess the surgical morbidities associated with this treatment. KCOTs treated using a standard protocol of enucleation and the application of Carnoy's solution between 1990 and 2013 were evaluated. One hundred and five KCOTS in 105 patients (54 male, 51 female) were analysed. The mean follow-up period was 86.6 months (range 24-313 months). The recurrence rate was 11.4%. A postoperative inferior alveolar nerve neurosensory deficit occurred in 30.1% of the mandibular cases, with 16% of these being permanent. The postoperative infection and fracture rates were 1.9% and 0.9%, respectively. Younger age, multilocular KCOTs, larger tumour size, and longer antero-posterior lesion length on the radiograph were found to be risk factors for recurrence. It is concluded that enucleation and the application of Carnoy's solution to treat KCOTs results in a relatively low recurrence rate and a low rate of surgical morbidities. PMID:26922497

  2. Ankyrin and band 3 differentially affect expression of membrane glycoproteins but are not required for erythroblast enucleation

    SciTech Connect

    Ji, Peng; Lodish, Harvey F.

    2012-01-27

    Highlights: Black-Right-Pointing-Pointer Ankyrin and band 3 are not required for erythroblasts enucleation. Black-Right-Pointing-Pointer Loss of ankyrin does not affect erythroid membrane glycoprotein expression. Black-Right-Pointing-Pointer Loss of band 3 influences erythroid membrane glycoprotein expression. -- Abstract: During late stages of mammalian erythropoiesis the nucleus undergoes chromatin condensation, migration to the plasma membrane, and extrusion from the cytoplasm surrounded by a segment of plasma membrane. Since nuclear condensation occurs in all vertebrates, mammalian erythroid membrane and cytoskeleton proteins were implicated as playing important roles in mediating the movement and extrusion of the nucleus. Here we use erythroid ankyrin deficient and band 3 knockout mouse models to show that band 3, but not ankyrin, plays an important role in regulating the level of erythroid cell membrane proteins, as evidenced by decreased cell surface expression of glycophorin A in band 3 knockout mice. However, neither band 3 nor ankyrin are required for enucleation. These results demonstrate that mammalian erythroblast enucleation does not depend on the membrane integrity generated by the ankyrin-band 3 complex.

  3. Enucleation-induced rat adrenal gland regeneration: expression profile of selected genes involved in control of adrenocortical cell proliferation.

    PubMed

    Tyczewska, Marianna; Rucinski, Marcin; Ziolkowska, Agnieszka; Szyszka, Marta; Trejter, Marcin; Hochol-Molenda, Anna; Nowak, Krzysztof W; Malendowicz, Ludwik K

    2014-01-01

    Enucleation-induced adrenal regeneration is a highly controlled process; however, only some elements involved in this process have been recognized. Therefore, we performed studies on regenerating rat adrenals. Microarray RNA analysis and QPCR revealed that enucleation resulted in a rapid elevation of expression of genes involved in response to wounding, defense response, and in immunological processes. Factors encoded by these genes obscure possible priming effects of various cytokines on initiation of regeneration. In regenerating adrenals we identified over 100 up- or downregulated genes involved in adrenocortical cell proliferation. The changes were most significant at days 2-3 after enucleation and their number decreased during regeneration. For example, expression analysis revealed a notable upregulation of the growth arrest gene, Gadd45, only 24 hours after surgery while expression of cyclin B1 and Cdk1 genes was notably elevated between days 1-8 of regeneration. These changes were accompanied by changes in expression levels of numerous growth factors and immediate-early transcription factors genes. Despite notable differences in mechanisms of adrenal and liver regeneration, in regenerating adrenals we identified genes, the expression of which is well recognized in regenerating liver. Thus, it seems legitimate to suggest that, in the rat, the general model of liver and adrenal regeneration demonstrate some degree of similarity. PMID:25431590

  4. Enucleation-Induced Rat Adrenal Gland Regeneration: Expression Profile of Selected Genes Involved in Control of Adrenocortical Cell Proliferation

    PubMed Central

    Tyczewska, Marianna; Rucinski, Marcin; Ziolkowska, Agnieszka; Szyszka, Marta; Trejter, Marcin; Hochol-Molenda, Anna; Nowak, Krzysztof W.; Malendowicz, Ludwik K.

    2014-01-01

    Enucleation-induced adrenal regeneration is a highly controlled process; however, only some elements involved in this process have been recognized. Therefore, we performed studies on regenerating rat adrenals. Microarray RNA analysis and QPCR revealed that enucleation resulted in a rapid elevation of expression of genes involved in response to wounding, defense response, and in immunological processes. Factors encoded by these genes obscure possible priming effects of various cytokines on initiation of regeneration. In regenerating adrenals we identified over 100 up- or downregulated genes involved in adrenocortical cell proliferation. The changes were most significant at days 2-3 after enucleation and their number decreased during regeneration. For example, expression analysis revealed a notable upregulation of the growth arrest gene, Gadd45, only 24 hours after surgery while expression of cyclin B1 and Cdk1 genes was notably elevated between days 1–8 of regeneration. These changes were accompanied by changes in expression levels of numerous growth factors and immediate-early transcription factors genes. Despite notable differences in mechanisms of adrenal and liver regeneration, in regenerating adrenals we identified genes, the expression of which is well recognized in regenerating liver. Thus, it seems legitimate to suggest that, in the rat, the general model of liver and adrenal regeneration demonstrate some degree of similarity. PMID:25431590

  5. Solubility product and thermodynamic functions for the holmium trifluoride - water system

    SciTech Connect

    Menon, M.P.; James, J.; Hill, T.L. )

    1988-01-01

    The total solubility, free ion concentrations in saturated solutions, solubility products and thermodynamic functions for the dissolution of holmium trifluoride hemihydrate together with the stability constants for the holmium mono- and diflouride complexes are reported in this paper. Conductometric and potentiometric methods were used to measure the solubilities for comparison of the results obtained therefrom. Our values for pK{sub SO}, the thermodynamic solubility product in terms of free ion concentrations of both ions, obtained from both methods are in agreement with one of the reported values. There are no values reported in the literature for the thermodynamic constants for the dissolution process to be compared with except for entropy change. Our values for the stability constants, measured by a simplified procedure, do not agree with those reported by previous authors.

  6. Thermal properties of holmium-implanted gold films for a neutrino mass experiment with cryogenic microcalorimeters.

    PubMed

    Prasai, K; Alves, E; Bagliani, D; Basak Yanardag, S; Biasotti, M; Galeazzi, M; Gatti, F; Ribeiro Gomes, M; Rocha, J; Uprety, Y

    2013-08-01

    In a microcalorimetric neutrino mass experiment using the radioactive decay of (163)Ho, the radioactive material must be fully embedded in the microcalorimeter absorber. One option that is being investigated is to implant the radioactive isotope into a gold absorber, as gold is successfully used in other applications. However, knowing the thermal properties at the working temperature of microcalorimeters is critical for choosing the absorber material and for optimizing the detector performance. In particular, it is paramount to understand if implanting the radioactive material in gold changes its heat capacity. We used a bolometric technique to measure the heat capacity of gold films, implanted with various concentrations of holmium and erbium (a byproduct of the (163)Ho fabrication), in the temperature range 70 mK-300 mK. Our results show that the specific heat capacity of the gold films is not affected by the implant, making this a viable option for a future microcalorimeter holmium experiment. PMID:24007077

  7. Thermal properties of holmium-implanted gold films for a neutrino mass experiment with cryogenic microcalorimeters

    SciTech Connect

    Prasai, K.; Yanardag, S. Basak; Galeazzi, M.; Uprety, Y.; Alves, E.; Rocha, J.; Bagliani, D.; Biasotti, M.; Gatti, F.; Gomes, M. Ribeiro

    2013-08-15

    In a microcalorimetric neutrino mass experiment using the radioactive decay of {sup 163}Ho, the radioactive material must be fully embedded in the microcalorimeter absorber. One option that is being investigated is to implant the radioactive isotope into a gold absorber, as gold is successfully used in other applications. However, knowing the thermal properties at the working temperature of microcalorimeters is critical for choosing the absorber material and for optimizing the detector performance. In particular, it is paramount to understand if implanting the radioactive material in gold changes its heat capacity. We used a bolometric technique to measure the heat capacity of gold films, implanted with various concentrations of holmium and erbium (a byproduct of the {sup 163}Ho fabrication), in the temperature range 70 mK–300 mK. Our results show that the specific heat capacity of the gold films is not affected by the implant, making this a viable option for a future microcalorimeter holmium experiment.

  8. Medium-energy ion-scattering study of strained holmium silicide nanoislands grown on silicon (100)

    NASA Astrophysics Data System (ADS)

    Wood, T. J.; Eames, C.; Bonet, C.; Reakes, M. B.; Noakes, T. C. Q.; Bailey, P.; Tear, S. P.

    2008-07-01

    We have used medium-energy ion scattering (MEIS) to quantitatively analyze the structure of holmium silicide islands grown on the Si(100) surface. Structure fitting to the experimental data unambiguously shows that the tetragonal silicide phase is present and not the hexagonal phase, which is associated with the growth of nanowires at submonolayer coverages. Islands formed with a lower holmium coverage of 3 ML are also shown to be tetragonal, which suggests that the hexagonal structure is not a low coverage precursor to the growth of the tetragonal phase. MEIS simulations of large nanoislands, which include the effects of lateral strain relief, have been performed and these compare well with the experimental data.

  9. Quantitative Monte Carlo-based holmium-166 SPECT reconstruction

    SciTech Connect

    Elschot, Mattijs; Smits, Maarten L. J.; Nijsen, Johannes F. W.; Lam, Marnix G. E. H.; Zonnenberg, Bernard A.; Bosch, Maurice A. A. J. van den; Jong, Hugo W. A. M. de; Viergever, Max A.

    2013-11-15

    Purpose: Quantitative imaging of the radionuclide distribution is of increasing interest for microsphere radioembolization (RE) of liver malignancies, to aid treatment planning and dosimetry. For this purpose, holmium-166 ({sup 166}Ho) microspheres have been developed, which can be visualized with a gamma camera. The objective of this work is to develop and evaluate a new reconstruction method for quantitative {sup 166}Ho SPECT, including Monte Carlo-based modeling of photon contributions from the full energy spectrum.Methods: A fast Monte Carlo (MC) simulator was developed for simulation of {sup 166}Ho projection images and incorporated in a statistical reconstruction algorithm (SPECT-fMC). Photon scatter and attenuation for all photons sampled from the full {sup 166}Ho energy spectrum were modeled during reconstruction by Monte Carlo simulations. The energy- and distance-dependent collimator-detector response was modeled using precalculated convolution kernels. Phantom experiments were performed to quantitatively evaluate image contrast, image noise, count errors, and activity recovery coefficients (ARCs) of SPECT-fMC in comparison with those of an energy window-based method for correction of down-scattered high-energy photons (SPECT-DSW) and a previously presented hybrid method that combines MC simulation of photopeak scatter with energy window-based estimation of down-scattered high-energy contributions (SPECT-ppMC+DSW). Additionally, the impact of SPECT-fMC on whole-body recovered activities (A{sup est}) and estimated radiation absorbed doses was evaluated using clinical SPECT data of six {sup 166}Ho RE patients.Results: At the same noise level, SPECT-fMC images showed substantially higher contrast than SPECT-DSW and SPECT-ppMC+DSW in spheres ≥17 mm in diameter. The count error was reduced from 29% (SPECT-DSW) and 25% (SPECT-ppMC+DSW) to 12% (SPECT-fMC). ARCs in five spherical volumes of 1.96–106.21 ml were improved from 32%–63% (SPECT-DSW) and 50%–80

  10. Separation of carrier-free holmium-166 from neutron-irradiated dysprosium targets

    SciTech Connect

    Dadachova, E.; Lambrecht, R.M.; Hetherington, E.L. ); Mirzadeh, S.; Knapp, F.F. Jr. )

    1994-12-01

    Holmium-166 ([sup 166]Ho, t[sub 1/2] = 26.4 h) is utilized in radiotherapeutic applications such as radioimmunospecific pharmaceuticals, bone marrow ablation, and radiation synovectomy. High specific activity [sup 166]Ho can be obtained from the decay of dysprosium-166 ([sup 166]Dy, t[sub 1/2] = 81.5 h). Dysprosium-166 is produced by the [sup 164]Dy[n,[gamma

  11. Neuromedin-U stimulates enucleation-induced adrenocortical regeneration in the rat.

    PubMed

    Trejter, Marcin; Neri, Giuliano; Rucinski, Marcin; Majchrzak, Mariola; Nussdorfer, Gastone G; Malendowicz, Ludwik K

    2008-06-01

    Neuromedin-U (NMU) is a brain-gut peptide, which has been previously found to stimulate hypothalamic-pituitary-adrenal axis in the rat. Enucleation-induced adrenal regeneration in rats with contralateral adrenalectomy is a well-established model of adrenal growth, that not only depends on the compensatory ACTH hypersecretion, but is also modulated by several regulatory peptides. Hence, we investigated whether NMU may be included in this group of bioactive molecules. Reverse transcription-polymerase chain reaction and immunocytochemistry showed that regenerating rat adrenocortical cells at days 5 and 8 after surgery express the NMU receptor NMUR1 as mRNA and protein. NMU8 administration to rats bearing regenerating adrenals markedly raised the plasma concentration of corticosterone and notably enhanced proliferative activity of adrenocortical cells. ACTH blood level was unchanged at day 5 and significantly decreased at day 8. The conclusion is drawn that NMU stimulates regeneration of rat adrenal cortex, via a mechanism independent of pituitary ACTH and involving the activation of NMUR1 located on adrenocortical cells. PMID:18506360

  12. Orbital and Subcutaneous Emphysema Following Enucleation and Respiratory Distress in a Japanese Chin.

    PubMed

    Gornik, Kara R; Pirie, Christopher G; Alario, Anthony F

    2015-01-01

    A 7 yr old, neutered male Japanese chin presented to the Cummings School of Veterinary Medicine at Tufts University (CSVMTU) for evaluation of chronic unilateral orbital swelling that worsened following an episode of respiratory distress. The left eye had been enucleated 5 yr previously. Intermittent mild-to-moderate left orbital swelling had been noted by the owner since the initial surgery. Examination demonstrated a moderate-to-severe, soft, fluctuant swelling involving the left orbit with erythema of the overlying skin. Crepitus was noted over the occipital tuberosity. Computed tomography revealed a large volume of gas involving the left orbit. The gas extended caudally within the subcutaneous tissues to both hemimandibles, dorsal to the cranium, and partially surrounded the cranial neck. The presence of a mucosa-lined, air-filled space with a patent nasolacrimal duct was noted on orbital exploration. The lining was removed and the duct closed. Histopathology confirmed the presence of an epithelial lining. No recurrence of the swelling was observed on examination 8 wk after surgery. This is the first report documenting acute worsening of orbital swelling following an episode of respiratory distress. This case highlights the importance of addressing the nasolacrimal duct while performing an enculeation in a brachycephalic dog. PMID:26535462

  13. Cavitation bubble dynamics during thulium fiber laser lithotripsy

    NASA Astrophysics Data System (ADS)

    Hardy, Luke A.; Kennedy, Joshua D.; Wilson, Christopher R.; Irby, Pierce B.; Fried, Nathaniel M.

    2016-02-01

    The Thulium fiber laser (TFL) is being explored for lithotripsy. TFL parameters differ from standard Holmium:YAG laser in several ways, including smaller fiber delivery, more strongly absorbed wavelength, low pulse energy/high pulse rate operation, and more uniform temporal pulse structure. High speed imaging of cavitation bubbles was performed at 105,000 fps and 10 μm spatial resolution to determine influence of these laser parameters on bubble formation. TFL was operated at 1908 nm with pulse energies of 5-75 mJ, and pulse durations of 200-1000 μs, delivered through 100-μm-core fiber. Cavitation bubble dynamics using Holmium laser at 2100 nm with pulse energies of 200-1000 mJ and pulse duration of 350 μs was studied, for comparison. A single, 500 μs TFL pulse produced a bubble stream extending 1090 +/- 110 μm from fiber tip, and maximum bubble diameters averaged 590 +/- 20 μm (n=4). These observations are consistent with previous studies which reported TFL ablation stallout at working distances < 1.0 mm. TFL bubble dimensions were five times smaller than for Holmium laser due to lower pulse energy, higher water absorption coefficient, and smaller fiber diameter used.

  14. In vivo cerebral incorporation of radiolabeled fatty acids after acute unilateral orbital enucleation in adult hooded Long-Evans rats.

    PubMed

    Wakabayashi, S; Freed, L M; Bell, J M; Rapoport, S I

    1994-03-01

    We examined effects of acute unilateral enucleation on incorporation from blood of intravenously injected unsaturated [1-14C]arachidonic acid ([14C]AA) and [1-14C]docosahexaenoic acid ([14C]DHA), and of saturated [9,10-3H]palmitic acid ([3H]PA), into visual and nonvisual brain areas of awake adult Long-Evans hooded rats. Regional cerebral metabolic rate for glucose (rCMRglc) values also were assessed with 2-deoxy-D-[1-14C]glucose ([14C]DG). One day after unilateral enucleation, an awake rat was placed in a brightly lit visual stimulation box with black and white striped walls, and a radiolabeled fatty acid was infused for 5 min or [14C]DG was injected as a bolus. [14C]DG also was injected in a group of rats kept in the dark for 4 h. Fifteen minutes after starting an infusion of a radiolabeled fatty acid, or 45 min after injecting [14C]DG, the rat was killed and the brain was prepared for quantitative autoradiography. Incorporation coefficients k* of fatty acids, or rCMRglc values, were calculated in homologous brain regions contralateral and ipsilateral to enucleation. As compared with ipsilateral regions, rCMRglc was reduced significantly (by as much as -39%) in contralateral visual areas, including the superior colliculus, lateral geniculate body, and layers I, IV, and V of the primary (striate) and secondary (association, extrastriate) visual cortices. Enucleation did not affect incorporation of [3H]PA into contralateral visual regions, but reduced incorporation of [14C]AA and of [14C]DHA by -18.5 to -2.1%. Percent reductions were correlated with percent reductions in rCMRglc in most but not all regions. No effects were noted at any of nine non-visual structures that were examined. These results indicate that enucleation acutely reduces neuronal activity in contralateral visual areas of the awake rat and that the reductions are coupled to reduced incorporation of unsaturated fatty acids into sn-2 regions of phosphatidylcholine, phosphatidylinositol, and

  15. Selective determination of the holmium in rare earth mixtures by second derivative spectrophotometry with 2-isobutylformyl-1,3-dione-indan and octylphenol poly-(ethyleneglycol)ether

    SciTech Connect

    Wang Naixing; Si Zhikun; Jiang Wei

    1996-09-01

    In this paper the absorption spectra of 4f electron transitions of the system of holmium with 2-isobutylformyl-1,3-dione-indan and TX-100 have been studied by normal and derivative spectrophotometry. The molar absorptivities are 98 (at 450 nm) and 21 (at 460 nm) 1 {center_dot} mol{sup -1} {center_dot} cm{sup -1}, respectively. The use of the second derivative spectra, eliminates the interference by other lanthanides and improves the sensitivity for holmium determination. The derivative molar absorptivity is 558 1 {center_dot} mol{sup -1} {center_dot} cm{sup -1}. The calibration graph was linear up to 25{mu}g/ml of holmium. The relative standard deviation evaluated from ten independent determinations of 8.0 {mu}g/ml holmium is 1.0%. The detection limit, obtained from the sensitivity of the calibration graph and for 3 S{sub b} (S{sub b} = standard deviation of a blank without holmium, n = 11), was found to be 0.31 {mu}g/ml of holmium. The quantification limit, obtained for 10 S{sub b}, was 1.0 {mu}g/ml of holmium. A method has been developed for determining holmium in a mixture of lanthanides by means of the second derivative spectra and the analytical results obtained are satisfactory.

  16. Improving Lifetime of Quasi-CW Laser Diode Arrays for Pumping 2-Micron Solid State Lasers

    NASA Technical Reports Server (NTRS)

    Amzajerdian, Farzin; Meadows, Byron L.; Baker, Nathaniel R.; Barnes, Bruce W.; Singh, Upendra N.; Kavaya, Michael J.

    2007-01-01

    Operating high power laser diode arrays in long pulse regime of about 1 msec, which is required for pumping 2-micron thulium and holmium-based lasers, greatly limits their useful lifetime. This paper describes performance of laser diode arrays operating in long pulse mode and presents experimental data on the active region temperature and pulse-to-pulse thermal cycling that are the primary cause of their premature failure and rapid degradation. This paper will then offer a viable approach for determining the optimum design and operational parameters leading to the maximum attainable lifetime.

  17. Efficient energy extraction from a diode-pumped Q-switched Tm,Ho:YLiF4 laser

    NASA Technical Reports Server (NTRS)

    Mcguckin, B. T.; Menzies, R. T.; Hemmati, H.

    1991-01-01

    The operation of a diode-laser pumped thulium, holmium yttrium-lithium-fluoride laser (Tm,Ho:YLF) in Q-switched mode is reported. Output energies of 200 microjoules in pulses of 22 ns duration are recorded at Q-switch frequencies commensurate with an effective upper laser level lifetime of 6 ms. This lifetime is appreciably longer than that observed in other hosts permitting stored energy extraction of 64 percent, close to the projected maximum performance from these materials.

  18. Frequency Swept Diode-pumped Single Frequency TM,Ho:YLiF Laser for spaceborne Doppler Lidar

    NASA Technical Reports Server (NTRS)

    McGuckin, B. T.; Menzies, R. T.; Esproles, C.

    1993-01-01

    Optical heterodyne experiments involving the photomixing of two single frequency, deode-pumped thulium holmium yttrium lithium flouride lasers are described. Operated in external frquency stabilization loops, the lasers exhibit 1MHz short term stability, and are photomixed and offset-locked at 140 MHz. Summation of sine wave modulation onto the PZT control voltage on one laser results in frequency swept operation over a continuous tuning range of 160 MHz.

  19. Globin synthesis in hybrid cells constructed by transplantation of dormant avian erythrocyte nuclei into enucleated fibroblasts.

    PubMed Central

    Bruno, J; Reich, N; Lucas, J J

    1981-01-01

    The polypeptides synthesized by mature embryonic erythrocytes prepared from the peripheral blood of 14- to 15-day-old chicken embryos were analyzed by two-dimensional gel electrophoresis. Fewer than 200 species of polypeptides were detected; the major polypeptides made at this time were identified as the alpha A-, alpha D-, and beta-globin chains. The dormant erythrocyte nuclei were next reactivated to transcriptional competence by transplantation into enucleated mouse or chicken embryo fibroblasts, with frequencies of cytoplast renucleation of about 50 and 90%, respectively. Since large numbers of hybrid cells could be constructed, a biochemical analysis was possible. Electrophoretic analysis of the [35S]methionine-labeled polypeptides made in the hybrid cell types showed that polypeptides having the mobilities of only two (alpha A and alpha D) of the three major adult globin chains were made as major constituents of the hybrid cells. However, analysis of 14C-amino acid-labeled polypeptides revealed that a beta-like polypeptide that lacked methionine was also synthesized in large amounts. This polypeptide was tentatively identified as the early embryonic globin species rho. Globin synthesis was detected as early as 3 h after nuclear transplantation and as late as 18 h, the last time measured in these experiments. It appeared that globin polypeptides made at very early times were translated at least partially from chicken messenger ribonucleic acid introduced into the hybrid cells during fusion, whereas those made at later times were translated primarily from newly synthesized globin messenger ribonucleic acid. The potential usefulness of this hybrid cell system in analyzing mechanisms regulating globin gene expression is discussed. Images PMID:7346715

  20. Fibre laser component technology for 2-micron laser systems

    NASA Astrophysics Data System (ADS)

    Stevens, G.; Robertson, A.

    2014-05-01

    We report on recent developments in fibre laser component technology for use in 2-micron laser systems. A range of `building block' components has been built to allow novel fibre laser architectures that exploit the advantages of fibre lasers based on Thulium and Holmium active fibres. Fibre lasers operating around 2-microns are becoming widely used in an increasing number of applications, which is driving the need for components that can operate reliably at high powers and also integrate easily with other components. To that end, we have designed and built a range of fused fibre, acousto-optic and magneto-optic devices that can be readily integrated into a range of novel fibre laser systems. Research has been carried out into improving fused fibre technology for components operating at 2um wavelengths. Side-coupled feed through combiners have been developed with signal losses as low as 0.02dB and kilowatt level end-coupled pump couplers. Alongside this a range of taps, splitters and WDMs have been developed which allows for the implementation of a variety of laser architectures. Optical isolators based on new Faraday materials have been developed, providing over 30dB isolation, low insertion loss and 30W power handling in a fibre-in, fibre-out version. New cell designs and materials for Acousto-Optic devices have been researched leading to the development of fibre-coupled Acousto-Optic Modulators (AOM) and allows for the realisation of all fibre Thulium and Holmium Q-switched and pulsed fibre lasers. Novel Acousto-Optic Tunable Filters (AOTF) designs have been realised to produce narrow resolution AOTFs and zero-shift AOTFs.

  1. Spontaneous Bone Regeneration After Enucleation of Large Jaw Cysts: A Digital Radiographic Analysis of 44 Consecutive Cases

    PubMed Central

    Chacko, Rabin; Paul, Arun; Arvind

    2015-01-01

    Purpose This study evaluated the healing in cystic defect of the jaw to substantiate our understanding of spontaneous bone healing after enucleation of jaw cysts subjectively and with analysis of digital postoperative panoramic radiographs. Materials and Methods Fourty four consecutive patients reporting to the Department of Dental and Oral Surgery, during the period between 2008-2012 having maxillary and mandibular cysts treated by either surgical enucleation or by marsupialization followed by enucleation were evaluated for subsequent bone formation at the site of cystectomy defect by subjective clinical examination along with digital radiographic examination. Postoperative clinical and radiographic examinations were performed at 6,9,12, and 24 months. Bone regeneration was evaluated by reduction of the size of residual cavities at the cystectomy defect using digital orthopantomogram. Results Out of 44 patients 15 patients completed two years of follow-up with all the patients having 6 months follow-up. The maximum size of the cystic pathology was 150.40mm and minimum of 14.73mm at the time of presentation (average size of 58.16mm). Twenty patients were diagnosed with odontogenic keratocyst, with one patient having multiple OKC associated with Gorlin Goltz Syndrome, 17 patients had dentigerous cyst, 5 had Radicular cyst; solitary bone cyst and globulomaxillary cyst formed one each. Uneventful healing and spontaneous filling of the residual cavities were obtained in all cases. The digital analysis of the postoperative radiographs showed mean values of reduction in size of the residual cavity of 25.85% after 6 months, 57.13% after 9 months, 81.03% after one year and 100% after two year. Conclusion Spontaneous bone regeneration can occur after surgical removal of jaw cysts without the aid of any graft materials even in large cystic cavity sufficiently surrounded by enough bony walls. This simplifies the surgical procedure, decreases the overall cost of surgery, and

  2. Carprofen provides better post-operative analgesia than tramadol in dogs after enucleation: A randomized, masked clinical trial

    PubMed Central

    Delgado, Cherlene; Bentley, Ellison; Hetzel, Scott; Smith, Lesley J

    2015-01-01

    Objective To compare analgesia provided by carprofen or tramadol in dogs after enucleation. Design Randomized, masked trial Animals Forty-three dogs Procedures Client-owned dogs admitted for routine enucleation were randomly assigned to receive either carprofen or tramadol orally 2 hours prior to surgery and 12 hours after the first dose. Dogs were scored for pain at baseline, and postoperatively at 0.25, 0.5, 1, 2, 4, 6, 8, 24, and 30 hours after extubation. Dogs received identical premedication and inhalation anesthesia regimens, including premedication with hydromorphone. If the total pain score was ≥9, if there was a score ≥ 3 in any one category, or if the visual analog scale score (VAS) was ≥35 combined with a palpation score of >0, rescue analgesia (hydromorphone) was administered and treatment failure was recorded. Characteristics between groups were compared with a Student’s t-test and Fisher’s exact test. The incidence of rescue was compared between groups using a log rank test. Pain scores and VAS scores between groups were compared using repeated measures ANOVA. Results There was no difference in age (p=0.493), gender (p=0.366) or baseline pain scores (p=0.288) between groups. Significantly more dogs receiving tramadol required rescue analgesia (6/21) compared to dogs receiving carprofen (1/22; p=0.035). Pain and VAS scores decreased linearly over time (p=0.038, p<0.001, respectively). There were no significant differences in pain (p=0.915) or VAS scores (p=0.372) between groups at any time point (dogs were excluded from analysis after rescue). Conclusions and Clinical Relevance This study suggests that carprofen, with opioid premedication, provides more effective post-operative analgesia than tramadol in dogs undergoing enucleation. PMID:25459482

  3. Congenital Anophthalmia and Binocular Neonatal Enucleation Differently Affect the Proteome of Primary and Secondary Visual Cortices in Mice

    PubMed Central

    Smolders, Katrien; Hu, Tjing-Tjing; Bronchti, Gilles; Boire, Denis; Arckens, Lutgarde

    2016-01-01

    In blind individuals, visually deprived occipital areas are activated by non-visual stimuli. The extent of this cross-modal activation depends on the age at onset of blindness. Cross-modal inputs have access to several anatomical pathways to reactivate deprived visual areas. Ectopic cross-modal subcortical connections have been shown in anophthalmic animals but not in animals deprived of sight at a later age. Direct and indirect cross-modal cortical connections toward visual areas could also be involved, yet the number of neurons implicated is similar between blind mice and sighted controls. Changes at the axon terminal, dendritic spine or synaptic level are therefore expected upon loss of visual inputs. Here, the proteome of V1, V2M and V2L from P0-enucleated, anophthalmic and sighted mice, sharing a common genetic background (C57BL/6J x ZRDCT/An), was investigated by 2-D DIGE and Western analyses to identify molecular adaptations to enucleation and/or anophthalmia. Few proteins were differentially expressed in enucleated or anophthalmic mice in comparison to sighted mice. The loss of sight affected three pathways: metabolism, synaptic transmission and morphogenesis. Most changes were detected in V1, followed by V2M. Overall, cross-modal adaptations could be promoted in both models of early blindness but not through the exact same molecular strategy. A lower metabolic activity observed in visual areas of blind mice suggests that even if cross-modal inputs reactivate visual areas, they could remain suboptimally processed. PMID:27410964

  4. Prosthetic Rehabilitation Following Socket Reconstruction with Blair-Brown Graft and Conformer Therapy for Management of Severe Post-Enucleation Socket Syndrome--A Clinical Report.

    PubMed

    Aggarwal, Himanshi; Singh, Saumyendra V; Kumar, Pradeep; Kumar Singh, Arun

    2015-06-01

    One of the most common tumors of the eye diagnosed in childhood is retinoblastoma, which mandates enucleation with adjunctive chemotherapy and radiotherapy to save the patient's life. The most common late enucleation complication is post-enucleation socket syndrome (PESS), which poses a management dilemma for the prosthodontist and surgeon, along with being a major esthetic concern for the patient. The reconstruction of such sockets is complex. The purpose of this clinical report is to describe the rehabilitation of such a pediatric patient with severe PESS. The patient was successfully rehabilitated by presurgical conformer therapy, socket reconstruction surgery with non-meshed intermediate split thickness skin graft (STSG)/Blair-Brown graft, and postsurgical conformer stent. This was followed by fabrication of a custom ocular prosthesis, to achieve favorable functional, physical, and psychological effects. PMID:25231188

  5. Development of inter-family nuclear transplant embryos by transplanting the nuclei from the loach blastulae into the non-enucleated zebrafish eggs

    NASA Astrophysics Data System (ADS)

    Li, Li; Zhang, Shicui; Yuan, Jinduo; Li, Hongyan

    2003-03-01

    The developmental fate of the pronuclei in recombined embryos obtained by transplanting the donor nuclei into the non-enucleated eggs remains controversial in the case of fish. In the present study, the nuclei from the loach blastulae were transplanted into non-enucleated zebrafish eggs, the resulting 9 inter-family nuclear transplant embryos developed to larval stages. Although the development timing of the nuclear transplants resembled that of zebrafish, chromosome examination revealed that most of the recombined embryos were diploids with karyotype characteristic of loach, which was also proved by RAPD analysis. Moreover, 3 out of the 9 larval fish formed barb rudiments specific to loach. It was therefore concluded that the nuclear transplant larval fish were inter-family nucleo-cytoplasmic hybrids; and that only the donor nuclei were involved in the development of the nuclear transplant embryos, while the pronuclei in the non-enucleated eggs were likely automatically eliminated during the development.

  6. Fertility and Pregnancy Outcome after Myoma Enucleation by Minilaparotomy under Microsurgical Conditions in Pronounced Uterus Myomatosus

    PubMed Central

    Floss, K.; Garcia-Rocha, G.-J.; Kundu, S.; von Kaisenberg, C. S.; Hillemanns, P.; Schippert, C.

    2015-01-01

    Introduction: Besides the typical complaints and symptoms, myomas can cause sterility, infertility and complications during pregnancy. Laparoscopic interventions reach their limits with regard to organ preservation and the simultaneous desire to have children in the removal of multiple and larger intramural myoma nodes. The aim of this study is to examine fertility status and pregnancy outcome after myoma removal by minilaparotomy (skin incision maximal 8 cm) in women with pronounced uterus myomatosus. Materials and Methods: This retrospective study makes use of the data from 160 patients with an average age of 34.6 years. Factors analysed include number, size and localisation of the myomas, complaints due to the myoma, pre- and postoperative gravidity, mode of delivery, and complications of birth. Results: Indications for organ-sparing myoma enucleation were the desire to have children (72.5 %), bleeding disorders (60 %) and pressure discomfort (36.5 %). On average 4.95 (SD ± 0.41), maximally 46 myomas were removed. The largest myoma had a diameter of 6.64 cm (SD ± 2.74). 82.5 % of the patients had transmural myomas, in 17.5 % the uterine cavity was inadvertently opened. On average the operating time was 163 minutes (SD ± 45.47), the blood loss 1.59 g/dL (SD ± 0.955). 60.3 % of the patients with the desire to have children became pregnant postoperatively. 75.3 % of the pregnancies were on average carried through to the 38th week (28.4 % vaginal deliveries, 71.6 % Caesarean sections). In the postoperative period there was one case of uterine rupture in the vicinity of a previous scar. Discussion: By means of the microsurgical “mini-laparotomy” even extensive myomatous uterine changes can, in the majority of cases, be operated in an organ-sparing manner with retention of the ability to conceive and to carry a pregnancy through to maturity of the infant. The risk for a postoperative uterine rupture in a subsequent pregnancy and

  7. Holmium-lipiodol-alginate microspheres for fluoroscopy-guided embolotherapy and multimodality imaging.

    PubMed

    Oerlemans, Chris; Seevinck, Peter R; Smits, Maarten L; Hennink, Wim E; Bakker, Chris J G; van den Bosch, Maurice A A J; Nijsen, J Frank W

    2015-03-30

    Embolotherapy is a minimally invasive transcatheter technique aiming at reduction or complete obstruction of the blood flow by infusion of micro-sized particles in order to induce tumor regression. A major drawback of the current commercially available and clinically used microspheres is that they cannot be detected in vivo with medical imaging techniques, impeding intra- and post-procedural feedback. It can be expected that real-time monitoring of microsphere infusion and post-procedural imaging will result in better predictability and higher efficacy of the treatment. In this study, a novel microsphere formulation has been developed that can be visualized with fluoroscopy, X-ray computed tomography (CT) and magnetic resonance imaging (MRI). The microspheres were prepared with the JetCutter technique and consist of alginate (matrix-forming polymer), holmium (cross-linking and MRI contrast agent), lipiodol (radiopaque contrast agent) and Pluronic F-68 (surfactant). The mean size (±SEM) of the hydrated holmium-lipiodol-alginate microspheres (Ho-lip-ams) was 570±12 μm with a holmium content of 0.38±0.01% (w/w). Stability studies showed that the microspheres remained intact during incubation for two weeks in fetal calf serum (FCS) at 37 °C. The inclusion of lipiodol in the microspheres rendered excellent visualization capabilities for fluoroscopy and CT, whereas the holmium ions, which keep the alginate network together, also allow MR imaging. In this study it was shown that single sphere detection was possible by fluoroscopy, CT and MRI. The Ho-lip-ams were visualized in real-time, during infusion in a porcine kidney using fluoroscopy, and post-procedural, the deposition of the microspheres was examined with fluoroscopy, (cone beam rotational) CT and MRI. The different imaging modalities showed similar deposition patterns of the microspheres within the organ. The combination of intra-procedural visualization, multimodality imaging for patient follow-up and the

  8. Dissolution in a supercritical liquid as a mechanism of laser ablation of sapphire

    SciTech Connect

    Dolgaev, Sergei I; Karasev, M E; Kulevskii, L A; Simakin, Aleksandr V; Shafeev, Georgii A

    2001-07-31

    The laser ablation of sapphire is studied by irradiating its interface with water and aqueous solutions of KOH, KCl and Na{sub 2}CO{sub 3} by 2.92-{mu}m 130-ns holmium laser pulses. The ablation rate depends on the concentration and type of the dissolved substance. The highest ablation rate is 2.5{mu}m per pulse for a laser fluence of 120 J cm{sup -2}. The ablation of sapphire is attributed to its dissolution in water or in aqueous solutions in the supercritical state. (interaction of laser radiation with matter. laser plasma)

  9. Rat Blastocysts from Nuclear Injection and Time-Lagged Enucleation and Their Commitment to Embryonic Stem Cells.

    PubMed

    Hara, Hiromasa; Goto, Teppei; Takizawa, Akiko; Sanbo, Makoto; Jacob, Howard J; Kobayashi, Toshihiro; Nakauchi, Hiromitsu; Hochi, Shinichi; Hirabayashi, Masumi

    2016-04-01

    Pronucleus-like vesicle formation following premature chromosome condensation (PCC) of the donor cell nucleus is the key event for successful generation of cloned rodents by nuclear transplantation (NT). However in rat cloning, this change is difficult to induce in enucleated recipient oocytes because of their inability to maintain maturation-promoting factor levels. In this study, intact oocytes retrieved from nuclear-visualized H2B-tdTomato knock-in rats were injected with Venus-labeled cell nuclei. Because the incidence of PCC under MG-132 treatment significantly increased with the culture period (0%, 10.8%, 36.8%, and 87.5% at 0, 0.5, 1, and 2 h postinjection, respectively), the metaphase plate of the oocyte was removed 1-2 h after the nuclear injection. The NT-derived rat zygotes (n = 748) were activated with ionomycin/cycloheximide and transferred into temporal host mothers, resulting in the harvest of three blastocysts (0.4%) with Venus fluorescence. Two blastocysts were examined for their potential to commit to NT-derived embryonic stem cells (ntESCs). One ntESC line was established successfully and found to be competent in terms of karyotype, stem cell marker expression, and pluripotency. In conclusion, time-lagged enucleation of visualized oocyte nuclei allows the PCC incidence of donor nuclei and generation of NT blastocysts, and the blastocysts can commit to germline-competent ntESCs. PMID:26990947

  10. Mechanism of laser-induced stress relaxation in cartilage

    NASA Astrophysics Data System (ADS)

    Sobol, Emil N.; Sviridov, Alexander P.; Omelchenko, Alexander I.; Bagratashvili, Victor N.; Bagratashvili, Nodar V.; Popov, Vladimir K.

    1997-06-01

    The paper presents theoretical and experimental results allowing to discuss and understand the mechanism of stress relaxation and reshaping of cartilage under laser radiation. A carbon dioxide and a Holmium laser was used for treatment of rabbits and human cartilage. We measured temperature, stress, amplitude of oscillation by free and forced vibration, internal friction, and light scattering in the course of laser irradiation. Using experimental data and theoretical modeling of heat and mass transfer in cartilaginous tissue we estimated the values of transformation heat, diffusion coefficients and energy activation for water movement.

  11. Transmyocardial Laser Revascularization.

    PubMed

    Horvath, Keith A.

    2004-02-01

    Transmyocardial laser revascularization (TMR) has been performed on over 12,000 patients worldwide. Since 1990, the treatment has provided significant angina relief for symptomatic end-stage coronary disease that is refractory to medical therapy. Seventy-five percent of patients treated with TMR have demonstrated a decrease of two or more angina classes postoperatively. As a result, TMR has provided a significant improvement in quality of life for patients, resulting in fewer hospital admissions and decreased dependency on medications. Two different wavelengths of light, carbon dioxide (CO(2)) and holmium yttrium-aluminum-garnet (Ho:YAG), have been employed. Results obtained using these lasers differ. The CO(2) laser has demonstrated a perfusion benefit as well as long-term improvement in quality of life and angina relief. The Ho:YAG laser has not demonstrated these results. These differences may, in part, explain the failure of percutaneous myocardial laser revascularization. This catheter-based approach was not as successful as TMR due to its partial thickness treatment of the myocardium as well as its use of the Ho:YAG laser. In addition to the patients with end-stage coronary disease who undergo TMR as sole therapy, there are an increasing number of patients who have been treated with a combination of coronary artery bypass grafting and TMR. This provides a more complete revascularization than leaving territories ungrafted. Further enhancement of the angiogenic response seen after TMR may be seen by the addition of gene therapy to TMR treatment. PMID:15023284

  12. Moderate-power cw fibre lasers

    SciTech Connect

    Kurkov, Andrei S; Dianov, Evgenii M

    2004-10-31

    A review of the development and investigation of moderate-power (10{sup -1}-10{sup 2} W) cw fibre lasers is presented. The properties of optical fibres doped with rare-earth ions and methods for fabricating double-clad fibres are considered. The methods for fabrication of fibre Bragg gratings used as selective reflectors are discussed and the grating properties are analysed. The main pump schemes for double-clad fibre lasers are described. The properties of fibre lasers doped with neodymium, ytterbium, erbium, thulium, and holmium ions are also considered. The principles of fabrication of Raman converters of laser radiation based on optical fibres of different compositions are discussed and the main results of their studies are presented. It is concluded that fibre lasers described in the review can produce moderate-power radiation at any wavelength in the spectral range from 0.9 to 2 {mu}m. (review)

  13. Modified endoscopic submucosal dissection with enucleation for treatment of gastric subepithelial tumors originating from the muscularis propria layer

    PubMed Central

    2012-01-01

    Background Gastric subepithelial tumors are usually asymptomatic and observed incidentally during endoscopic examination. Although most of these tumors are considered benign, some have a potential for malignant transformation, particularly those originating from the muscularis propria layer. For this type of tumor, surgical resection is the standard treatment of choice. With recent advent of endoscopic resection techniques and devices, endoscopic submucosal dissection (ESD) has been considered as an alternative way of treatment. The aim of this study is to demonstrate the feasibility of a modified ESD technique with enucleation for removal of gastric subepithelial tumors originating from the muscularis propria layer, and to evaluate its efficacy and safety. Methods From November 2009 to May 2011, a total of 16 patients received a modified ESD with enucleation for their subepithelial tumors. All tumors were smaller than 5 cm and originated from the muscularis propria layer of the stomach, as shown by endoscopic ultrasonography (EUS). The procedure was conducted with an insulated-tip knife 2. Patient’s demographics, tumor size and pathological diagnosis, procedure time, procedure-related complication, and treatment outcome were reviewed. Results Fifteen of the sixteen tumors were successful complete resection. The mean tumor size measured by EUS was 26.1 mm (range: 20–42 mm). The mean procedure time was 52 minutes (range: 30–120 minutes). Endoscopic features of the 4 tumors were pedunculated and 12 were sessile. Their immunohistochemical diagnosis was c-kit (+) stromal tumor in 14 patients and leiomyoma in 2 patients. There was no procedure-related perforation or overt bleeding. During a mean follow up duration of 14.8 months (range: 6–22 months), there was no tumor recurrence or metastasis. Conclusions Using a modified ESD with enucleation for treatment of gastric subepithelial tumors originating from the muscularis propria layer and larger

  14. Expression of selected genes involved in steroidogenesis in the course of enucleation-induced rat adrenal regeneration.

    PubMed

    Tyczewska, Marianna; Rucinski, Marcin; Ziolkowska, Agnieszka; Trejter, Marcin; Szyszka, Marta; Malendowicz, Ludwik K

    2014-03-01

    The enucleation-induced (EI) rapid proliferation of adrenocortical cells is followed by their differentiation, the degree of which may be characterized by the expression of genes directly and indirectly involved in steroid hormone biosynthesis. In this study, out of 30,000 transcripts of genes identified by means of Affymetrix Rat Gene 1.1 ST Array, we aimed to select genes (either up- or downregulated) involved in steroidogenesis in the course of enucleation-induced adrenal regeneration. On day 1, we found 32 genes with altered expression levels, 15 were upregulated and 17 were downregulated [i.e., 3β-hydroxysteroid dehydrogenase (Hsd3β), nuclear receptor subfamily 0, group B, member 1 (Nr0b1), cytochrome P450 aldosterone synthase (Cyp11b2) and sterol O-acyltransferase 1 (Soat1)]. On day 15, the expression of only 2 genes was increased and that of 3 was decreased. The investigated genes were clustered according to an hierarchical clustering algorithm and 4 clusters were obtained. Quantitative PCR (qPCR) confirmed the much lower mRNA expression levels of steroidogenic acute regulatory protein (StAR) during the regeneration process compared to the control, while the cholesterol side-chain cleavage enzyme (cholesterol desmolase; Cyp11a1) and Hsd3β genes presented similar expression profiles throughout the entire regeneration process. Cyp11b2 mRNA levels remained very low during the whole regeneration period. Fatty acid binding protein 6 (Fabp6) was markedly upregulated, whereas hormone-sensitive lipase (Lipe) was downregulated. The expression of Soat1 was lowest on regeneration day 1 and, subsequently, its expression increased from there on, reaching levels higher than the control. Dosage-sensitive sex reversal, adrenal hypoplasia critical region, on chromosome X, gene 1 (Dax-1) mRNA levels were lowest on day 1 of the experiment; however, throughout the entire experimental period, there were no statistically significant differences observed. After the initial

  15. Properties of holmium implanted gold films and yttrium silicide to use as absorbers in microcalorimeters for a holmium neutrino mass experiment

    NASA Astrophysics Data System (ADS)

    Prasai, Krishna P.

    In recent years, there has been huge improvement in microcalorimetric technology and its applications. Today's cryogenic microcalorimeter technology can be used in a large scale experiment with excellent energy and time resolutions. Transition Edge Sensor (TES) microcalorimeters are being developed as imaging spectrometers for a wide range of applications including neutrino mass measurement. We are developing a source (163Ho) embedded TES microcalorimeter for neutrino mass measurement. Energy resolution, rise time of events, decay time, and read-out electronics must be considered carefully in designing a microcalorimeter for the application of neutrino mass experiments. Our research is particularly focused on the investigation of the properties of the 163Ho imbedded metallic absorber for the application of the Ho-neutrino mass experiment. In a microcalorimetric neutrino mass experiment using the radioactive decay of 163Ho, the radioactive material must be fully embedded in the microcalorimeter absorber. One option that is being investigated is to implant the radioactive isotope into a gold absorber, as gold is successfully used in other applications. However, knowing the thermal properties at the working temperature of microcalorimeters is critical for choosing the absorber material and for optimizing the detector performance. In particular, it is paramount to understand if implanting the radioactive material in gold changes its heat capacity. We used a bolometric technique to measure the heat capacity of gold films, implanted with various concentrations of holmium and erbium (a byproduct of the 163Ho fabrication), in the temperature range 70 mK to 300 mK. Our results show that the specific heat capacity of the gold films is not affected by the implant, making this a viable option for a future microcalorimeter holmium experiment. Furthermore, most chemical processes to extract the Ho-163 isotope and insert it into a detector absorber involve yttrium based compounds

  16. Laser therapy in intraocular tumors

    NASA Astrophysics Data System (ADS)

    Carstocea, Benone D.; Gafencu, Otilia L.; Apostol, Silvia

    1995-01-01

    Intraocular tumors present special problems of diagnosis and treatment. Diagnostic methods include, in addition to systemic and ophthalmological examinations, ancillary examinations such as transillumination, fluorescein angiography, ultrasonography, radioactive phosphorus uptake test, radiology, computerized tomography, and fine-needle aspiration biopsy with cytological analyses. Previously, enucleation of the involved eye was generally accepted as management of malignant tumors. Improved therapeutic methods such as photocoagulation and better surgical techniques now provide a variety of therapeutical alternatives. This study consists of 21 cases of intraocular tumors that were managed by Argon laser photocoagulation. Four cases were intraocular metastasis and 17 cases were primitive intraocular tumors. Argon laser therapy proved to be totally ineffective for the intraocular metastasis and a very adequate therapy for the primitive tumors. Tumor extirpations (choroidal, cillary body, or iris tumors) using laser lancet proved to be more suitable than classic surgery.

  17. Single-Frequency Narrow Linewidth 2 Micron Fiber Laser

    NASA Technical Reports Server (NTRS)

    Jiang, Shibin (Inventor); Spiegelberg, Christine (Inventor); Luo, Tao (Inventor)

    2006-01-01

    A compact single frequency, single-mode 2 .mu.m fiber laser with narrow linewidth, <100 kHz and preferably <100 kHz, is formed with a low phonon energy glass doped with triply ionized rare-earth thulium and/or holmium oxide and fiber gratings formed in sections of passive silica fiber and fused thereto. Formation of the gratings in passive silica fiber both facilitates splicing to other optical components and reduces noise thus improving linewidth. An increased doping concentration of 0.5 to 15 wt. % for thulium, holmium or mixtures thereof produces adequate gain, hence output power levels for fiber lengths less than 5 cm and preferably less than 3 cm to enable single-frequency operation.

  18. Outflow facility efficacy of five drugs in enucleated porcine eyes by a method of constant-pressure perfusion

    PubMed Central

    Li, Ning; Shi, Hui-Min; Cong, Lin; Lu, Zhao-Zeng; Ye, Wen; Zhang, Yu-Yan

    2015-01-01

    This study aimed to characterize a technique that assesses the outflow facility (C) efficacy of five kinds of IOP-lowering drugs commonly used clinically in enucleated porcine Eyes. Eyes were perfused at 15 mmHg with GPBS first to establish the baseline outflow facility (C0). Then the anterior chamber contents were exchanged for GPBS with corresponding concentration eye drops (4.9×103 nM Brimonidine, 41.1 nM Latanoprost, 3.4×103 nM Levobunolol, 3.0×103 nM Brinzolamide, 8.3×103 nM Pilocarpine) in five groups (n = 6 each), while 6 eyes received GPBS alone as control. The mean stable facility obtained after drug administration (C1) was continuously recorded. The changes between C0 and C1 (ΔC = C1-C0) were analyzed. Finally, for drugs among the five experiment groups with statistical significance, the concentration was reduced 3 times, otherwise the drugs’ concentration was increased to 10 times to confirm its effectiveness further using the same methods (n = 6 each). We found that the average baseline outflow facility was 0.24±0.01 μl·min-1·mmHg-1. C increased significantly in Brimonidine and Latanoprost groups, even the concentration of Brimonidine and Latanoprost was decreased 3 times (P < 0.05). However, there was no significantly increase in Levobunolol, Brinzolamide, Pilocarpine and control group (P > 0.05), but when drugs’ concentration was increased to 10 times, the C value of Pilocarpine decreased significantly (P = 0.04). No significant washout effects in porcine eyes were observed. To conclude, outflow facility efficacy of five drugs in enucleated porcine eyes may provide a reference for clinical medicine. A constant-pressure perfusion technique should be useful to evaluate effect of pharmacologic agents or surgical manipulations on aqueous humor dynamics. PMID:26221257

  19. Outflow facility efficacy of five drugs in enucleated porcine eyes by a method of constant-pressure perfusion.

    PubMed

    Li, Ning; Shi, Hui-Min; Cong, Lin; Lu, Zhao-Zeng; Ye, Wen; Zhang, Yu-Yan

    2015-01-01

    This study aimed to characterize a technique that assesses the outflow facility (C) efficacy of five kinds of IOP-lowering drugs commonly used clinically in enucleated porcine Eyes. Eyes were perfused at 15 mmHg with GPBS first to establish the baseline outflow facility (C0). Then the anterior chamber contents were exchanged for GPBS with corresponding concentration eye drops (4.9×10(3) nM Brimonidine, 41.1 nM Latanoprost, 3.4×10(3) nM Levobunolol, 3.0×10(3) nM Brinzolamide, 8.3×10(3) nM Pilocarpine) in five groups (n = 6 each), while 6 eyes received GPBS alone as control. The mean stable facility obtained after drug administration (C1) was continuously recorded. The changes between C0 and C1 (ΔC = C1-C0) were analyzed. Finally, for drugs among the five experiment groups with statistical significance, the concentration was reduced 3 times, otherwise the drugs' concentration was increased to 10 times to confirm its effectiveness further using the same methods (n = 6 each). We found that the average baseline outflow facility was 0.24±0.01 μl·min(-1)·mmHg(-1). C increased significantly in Brimonidine and Latanoprost groups, even the concentration of Brimonidine and Latanoprost was decreased 3 times (P < 0.05). However, there was no significantly increase in Levobunolol, Brinzolamide, Pilocarpine and control group (P > 0.05), but when drugs' concentration was increased to 10 times, the C value of Pilocarpine decreased significantly (P = 0.04). No significant washout effects in porcine eyes were observed. To conclude, outflow facility efficacy of five drugs in enucleated porcine eyes may provide a reference for clinical medicine. A constant-pressure perfusion technique should be useful to evaluate effect of pharmacologic agents or surgical manipulations on aqueous humor dynamics. PMID:26221257

  20. Is there a niche for arthroscopic laser surgery of the temporomandibular joint?

    NASA Astrophysics Data System (ADS)

    Nuebler-Moritz, Michael; Hering, Peter; Bachmaier, Uli; Schiessl, Robert; Rueschoff, Josef; Meister, Joerg

    1996-04-01

    The purpose of this in vitro study was to investigate and compare effects of currently available laser systems at different wavelengths (XeCl excimer laser, Holmium:YAG laser, Erbium:YAG laser) on porcine articulating facets, capsule and meniscus of the temporomandibular joint via photomacroscopy, light and scanning electron microscopy. From a critical review of the relevant literature and the preliminary observations of this investigation, it appears that the Neodymium:YAG laser is inappropriate for TMJ arthroscopic surgery with regard to the huge thermal injury caused to the remaining tissue. The Holmium:YAG laser suffers from remarkable photomechanical and photothermal side effects, whereas the Erbium:YAG laser ablates temporomandibular joint tissue efficiently with minimal adjacent damage--similar to the XeCl excimer laser, without entailing the risk of potential mutagenity. To sum up, it can be concluded that there is a clinical need for laser- assisted arthroscopic surgery of the craniomandibular articulation. Nevertheless, at present none of the available laser systems meet the medical demands completely. Currently, the Erbium:YAG laser seems to be the most suitable for TMJ arthroscopic surgery.

  1. Transmyocardial laser revascularization: surgical experience overview.

    PubMed

    Allen, K B; Shaar, C J

    2000-06-01

    Transmyocardial revascularization (TMR) using holmium:yttrium-aluminium-garnet (YAG) and carbon dioxide lasers has been approved by the United States Food and Drug Administration for the treatment of medically refractory angina in patients without conventional options. In prospective, randomized trials, patients who received TMR experienced improved angina, better-event free survival, and reduction in cardiac-related rehospitalizations when compared to patients remaining on medical therapy alone. In addition, TMR as an adjunct to coronary artery bypass grafting (CABG) has resulted in improved clinical status for patients who would not be completely revascularized by CABG alone. PMID:10867764

  2. Synthesis and optical properties of antimony oxide glasses doped with holmium trioxide

    NASA Astrophysics Data System (ADS)

    Raghunatha, S.; Eraiah, B.

    2016-05-01

    Holmium doped lithium-antimony-lead borate glasses having 1mol% AgNO3 with composition 50B2O3-20PbO-25Sb2O3-5Li2O have been prepared using single step melt quenching technique. The XRD spectrum confirms amorphous nature of glasses. The optical absorbance studies were carried out on these glasses. The optical direct band gap energies were found to be in the range of 3.10 eV to 3.31 eV and indirect band gap energies were found to be in the range of 2.28 eV to 3.00 eV. The refractive indexes have been calculated by using Lorentz-Lorenz formula and the calculated values in the range of 2.31 to 2.37.

  3. Quantum theory of the anisotropy of the magnetic properties of ferrimagnetic holmium iron garnet single crystals.

    PubMed

    Yang, Jiehui; Ma, Shengcan; Xu, You

    2009-03-01

    The pronounced anisotropy of the magnetization caused by the Ho(3+) ions in the ferrimagnetic holmium iron garnet has been investigated based on quantum theory. The strong anisotropy of the magnetization of the Ho(3+) ions originates mainly from the effect of the crystal field upon the Ho(3+) ions and the anisotropic Ho(3+)-Fe(3+) superexchange interaction. Following the expression of the Yb(3+)-Fe(3+) exchange interaction used by Alben, the anisotropy of the Ho(3+)-Fe(3+) exchange interaction is defined by three principal values of the exchange tensor G. Because the six Ho(3+) sublattices are magnetically non-equivalent, we calculate the magnetic quantities of the Ho(3+) at the six sublattices and compare the average value of the so-obtained six quantities with the measured values. The calculated results are in good agreement with experiments. An interpretation on the anisotropy of the magnetic properties of HoIG is given. PMID:21817410

  4. Emission spectrum of holmium atoms excited during ionic sputtering of a surface

    SciTech Connect

    Pop, S. S.; Braslavets, V. V.; Evdokimov, S. A.

    1988-08-01

    The article shows the fundamental possibility of using the bombardment of the surface of solids by kilo V ions for exciting the emission spectrum of particles of the target material and for obtaining spectroscopic data. The method is tested by studying the emission spectra of holmium as an example. It is shown that the sensitivity of the method can be substantially increased by using the so-called chemical effect, i.e., the effect of strengthening the spectral lines of sputtered excited metal atoms during bombardment of the target in the presence of oxygen. It is proposed that the chemical effect, which takes place only for atomic lines, in contrast to ionic ones, can also be used for simplifying the identification of atomic lines. It is noted that the proposed method is suitable for studying the atomic spectra of any solids, including refractory and chemically reactive substances.

  5. STM and ab initio study of holmium nanowires on a Ge(111) surface

    NASA Astrophysics Data System (ADS)

    Eames, C.; Bonet, C.; Probert, M. I. J.; Tear, S. P.; Perkins, E. W.

    2006-11-01

    A nanorod structure has been observed on the Ho/Ge(111) surface using scanning tunneling microscopy (STM). The rods do not require patterning of the surface or defects such as step edges in order to grow as is the case for nanorods on Si(111). At low holmium coverage the nanorods exist as isolated nanostructures while at high coverage they form a periodic 5×1 structure. We propose a structural model for the 5×1 unit cell and show using an ab initio calculation that the STM profile of our model structure compares favorably to that obtained experimentally for both filled and empty states sampling. The calculated local density of states shows that the nanorod is metallic in character.

  6. Intracavitary Radiation Therapy for Recurrent Cystic Brain Tumors with Holmium-166-Chico : A Pilot Study

    PubMed Central

    Ha, Eun Jin; Rhee, Chang Hun; Youn, Sang Min; Choi, Chang-Woon; Cheon, Gi Jeong

    2013-01-01

    Objective Intracavitary injection of beta-emitting radiation source for control of cystic tumors has been tried with a benefit of localized internal radiation. The authors treated cystic brain tumor patients with Holmium-166-chitosan complex (Ho-166-chico), composed of a beta-emitting radionuclide Holmium-166 and biodegradable chit polymer, and evaluated the safety and effective measurement for response. Methods Twenty-two patients with recurrent cystic brain tumor and/or located in a deep or eloquent area were enrolled in this pilot study. The cyst volume and wall thickness were determined on CT or MRI to assess radiological response. The activity of Ho-166-chico injected via Ommaya reservoir was prescribed to be 10-25 Gy to the cyst wall in a depth of 4 mm. Results There was neither complications related to systemic absorption nor leakage of Ho-166-chico in all 22 patients. But, two cases of oculomotor paresis were observed in patients with recurrent craniopharyngioma. Radiological response was seen in 14 of 20 available follow-up images (70%). Seven patients of 'evident' radiological response experienced more than 25% decrease of both cyst volume and wall thickness. Another 7 patients with 'suggestive' response showed decrease of cyst volume without definitive change of the wall thickness or vice versa. All patients with benign tumors or low grade gliomas experienced symptomatic improvement. Conclusion Ho-166-chico intracavitary radiation therapy for cystic tumor is a safe method of palliation without serious complications. The determination of both minimal effective dosage and time interval of repeated injection through phase 1 trial could improve the results in the future. PMID:24278644

  7. Percutaneous laser disc decompression.

    PubMed

    Choy, D S

    1995-06-01

    Herniated disc disease has an incidence of 1.7% in the U.S. Heretofore, open operative procedures were the rule for this condition when conservative measures were ineffective. Choy and Ascher introduced this new technique in February 1986 using a Nd:YAG laser introduced into the disc through an optical fiber in a needle. Percutaneous laser disc decompression is based on the principle that in an enclosed hydraulic space, such as an intact disc, a small reduction in volume is associated with a disproportionate fall in pressure. In the disc, this partial vacuum causes the herniated portion to move away from the nerve root back toward the center of the disc. This technique has been taught worldwide and is being performed in most of Europe, Japan, the United States, and Korea. In this special issue devoted to percutaneous laser disc decompression (PLDD), we will set forth the basic science of PLDD, patient selection, use of the holmium:YAG, and the Nd:YAG lasers, operative technique, and results. PMID:10150634

  8. Qualification Testing of Laser Diode Pump Arrays for a Space-Based 2-micron Coherent Doppler Lidar

    NASA Technical Reports Server (NTRS)

    Amzajerdian, Farzin; Meadows, Byron L.; Baker, Nathaniel R.; Barnes, Bruce W.; Singh, Upendra N.; Kavaya, Michael J.

    2007-01-01

    The 2-micron thulium and holmium-based lasers being considered as the transmitter source for space-based coherent Doppler lidar require high power laser diode pump arrays operating in a long pulse regime of about 1 msec. Operating laser diode arrays over such long pulses drastically impact their useful lifetime due to the excessive localized heating and substantial pulse-to-pulse thermal cycling of their active regions. This paper describes the long pulse performance of laser diode arrays and their critical thermal characteristics. A viable approach is then offered that allows for determining the optimum operational parameters leading to the maximum attainable lifetime.

  9. RNA-Seq Profiling of Intact and Enucleated Oocyte SCNT Embryos Reveals the Role of Pig Oocyte Nucleus in Somatic Reprogramming.

    PubMed

    Bai, Lin; Li, Mengqi; Sun, Junli; Yang, Xiaogan; Lu, Yangqing; Lu, Shengsheng; Lu, Kehuan

    2016-01-01

    The specific molecular mechanisms involved in somatic reprogramming remain unidentified. Removal of the oocyte genome is one of the primary causes of developmental failure in cloned embryos, whereas intact oocyte shows stronger reprogramming capability than enucleated oocyte. To identify the reason for the low efficiency of cloning and elucidate the mechanisms involved in somatic reprogramming by the oocyte nucleus, we injected pig cumulus cells into 539 intact MII oocytes and 461 enucleated MII oocytes. Following activation, 260 polyploidy embryos developed to the blastocyst stage whereas only 93 traditionally cloned embryos (48.2% vs. 20.2%, P < 0.01) reached blastocyst stage. Blastocysts generated from intact oocytes also had more cells than those generated from enucleated oocytes (60.70 vs. 46.65, P < 0.01). To identify the genes that contribute to this phenomenon, two early embryos in 2-cell and 4-cell stages were collected for single-cell RNA sequencing. The two kinds of embryos were found to have dramatically different transcriptome profiles. Intact oocyte nuclear transfer embryos showed 1,738 transcripts that were up-regulated relative to enucleated cloned embryos at the 2-cell stage and 728 transcripts that were down-regulated (|log2Ratio| ≥ 5). They showed 2,941 transcripts that were up-regulated during the 4-cell stage and 1,682 that were down-regulated (|log2Ratio| ≥ 5). The most significantly enriched gene ontology categories were those involved in the regulation of binding, catalytic activity, and molecular transducer activity. Other genes that were notably up-regulated and expressed in intact oocyte nuclear transfer embryos were metabolic process. This study provides a comprehensive profile of the differences in gene expression between intact oocyte nuclear transfer embryos and traditional nuclear transfer embryos. This work thus paves the way for further research on the mechanisms underlying somatic reprogramming by oocytes. PMID:27070804

  10. RNA-Seq Profiling of Intact and Enucleated Oocyte SCNT Embryos Reveals the Role of Pig Oocyte Nucleus in Somatic Reprogramming

    PubMed Central

    Bai, Lin; Li, Mengqi; Sun, Junli; Yang, Xiaogan; Lu, Yangqing; Lu, Shengsheng; Lu, Kehuan

    2016-01-01

    The specific molecular mechanisms involved in somatic reprogramming remain unidentified. Removal of the oocyte genome is one of the primary causes of developmental failure in cloned embryos, whereas intact oocyte shows stronger reprogramming capability than enucleated oocyte. To identify the reason for the low efficiency of cloning and elucidate the mechanisms involved in somatic reprogramming by the oocyte nucleus, we injected pig cumulus cells into 539 intact MII oocytes and 461 enucleated MII oocytes. Following activation, 260 polyploidy embryos developed to the blastocyst stage whereas only 93 traditionally cloned embryos (48.2% vs. 20.2%, P < 0.01) reached blastocyst stage. Blastocysts generated from intact oocytes also had more cells than those generated from enucleated oocytes (60.70 vs. 46.65, P < 0.01). To identify the genes that contribute to this phenomenon, two early embryos in 2-cell and 4-cell stages were collected for single-cell RNA sequencing. The two kinds of embryos were found to have dramatically different transcriptome profiles. Intact oocyte nuclear transfer embryos showed 1,738 transcripts that were up-regulated relative to enucleated cloned embryos at the 2-cell stage and 728 transcripts that were down-regulated (|log2Ratio| ≥ 5). They showed 2,941 transcripts that were up-regulated during the 4-cell stage and 1,682 that were down-regulated (|log2Ratio| ≥ 5). The most significantly enriched gene ontology categories were those involved in the regulation of binding, catalytic activity, and molecular transducer activity. Other genes that were notably up-regulated and expressed in intact oocyte nuclear transfer embryos were metabolic process. This study provides a comprehensive profile of the differences in gene expression between intact oocyte nuclear transfer embryos and traditional nuclear transfer embryos. This work thus paves the way for further research on the mechanisms underlying somatic reprogramming by oocytes. PMID:27070804

  11. Angiogenesis in the course of enucleation-induced adrenal regeneration--expression of selected genes and proteins involved in development of capillaries.

    PubMed

    Tyczewska, Marianna; Rucinski, Marcin; Trejter, Marcin; Ziolkowska, Agnieszka; Szyszka, Marta; Malendowicz, Ludwik K

    2012-12-01

    Enucleation-induced rapid proliferation of adrenocortical cells and restoration of adrenals structure requires formation of new blood vessels. The performed studies aimed to select from around 30,000 transcripts, identified by means of Affymetrix(®) Rat Gene 1.1 ST Array, the genes involved in angiogenesis in the course of enucleation-induced adrenal regeneration and to characterize their expression levels in regenerating gland between days 1 and 15 after surgery. At day 1 of regeneration almost 2000 genes showed more than 2-fold up/down-regulation. At days 1-3 after surgery the highest expression demonstrated genes involved in the development of inflammation and blood clot formation. From around 2000 genes we selected genes involved in angiogenesis. During the regeneration 62 genes involved in angiogenesis were identified as up- or down-regulated. Some data were also validated by QPCR. Levels of Vegfa and Kdr (Vegfr-2) mRNAs were very low at day 1 of regeneration and remained unchanged thereafter. The highest expression of Figf gene was found at day 5 while that of Vwf gene at days 1 and 2 after surgery. Levels of Thy1 mRNA increased notably between days 2 and 5 of the experiment. In comparison to control rats, Mc2r (ACTH receptor) expression was lowered at day 1 of the experiment and remained unchanged thereafter. This suggests that enucleation-induced adrenal neoangiogenesis does not require elevated expression of ACTH receptor. Results of our studies strongly suggest that enucleation-induced adrenal regeneration is an angiogenesis-dependent process. Moreover, immunohistochemistry suggests that regenerating adrenal parenchymal cells release numerous angiogenic factors which paracrinally may regulate formation of new vessels. PMID:23041583

  12. Single-frequency fiber laser operating at 2.9 μm.

    PubMed

    Hudson, Darren D; Williams, Robert J; Withford, Michael J; Jackson, Stuart D

    2013-07-15

    We report the demonstration of a single-longitudinal-mode fiber laser operating at 2914 nm, which exhibits a spectrometer-limited linewidth of <0.4 nm, in a 49 mm long holmium/praseodymium co-doped ZBLAN fiber. Narrow-linewidth feedback is provided by a fiber Bragg grating inscribed directly in the ZBLAN fiber using the femtosecond laser point-by-point technique. Measurements of the temporal stability and coherence confirm that the laser is operating on a single longitudinal mode. PMID:23939057

  13. Improving Reliability of High Power Quasi-CW Laser Diode Arrays Operating in Long Pulse Mode

    NASA Technical Reports Server (NTRS)

    Amzajerdian, Farzin; Meadows, Byron L.; Barnes, Bruce W.; Lockard, George E.; Singh, Upendra N.; Kavaya, Michael J.; Baker, Nathaniel R.

    2006-01-01

    Operating high power laser diode arrays in long pulse regime of about 1 msec, which is required for pumping 2-micron thulium and holmium-based lasers, greatly limits their useful lifetime. This paper describes performance of laser diode arrays operating in long pulse mode and presents experimental data of the active region temperature and pulse-to-pulse thermal cycling that are the primary cause of their premature failure and rapid degradation. This paper will then offer a viable approach for determining the optimum design and operational parameters leading to the maximum attainable lifetime.

  14. Laser lithotripsy of a urethral calculus via ischial urethrotomy in a steer.

    PubMed

    Streeter, R N; Washburn, K E; Higbee, R G; Bartels, K E

    2001-09-01

    A steer examined because of obstructive urolithiasis and urethral rupture underwent laser lithotripsy, using a chromium-thulium-holmium:yttrium-aluminum-garnet (Ho:YAG) laser inserted through an ischial urethrotomy. Procedures were performed with caudal epidural anesthesia. Six months after surgery, the urethra was patent with no clinical evidence of urethral stricture or fistula. Ischial urethrotomy provided rapid access to the bladder for catheterization and to the obstructive urolith for lithotripsy. Laser lithotripsy was a rapid and effective means of urolith removal in this steer. PMID:11549094

  15. Reconstruction of severe anophthalmic orbits and atresic eye sockets after enucleation and irradiation of retinoblastoma by vascular anastomosed free dorsalis pedis flaps' transplantation.

    PubMed

    Bi, Xiaoping; Fan, Xianqun; Zhou, Huifang; Shi, Wodong; Xiao, Caiwen; Lin, Min; Li, Zhenkang

    2011-05-01

    Retinoblastoma is a common malignant intraocular tumor in childhood, and most patients require enucleation or exenteration even with irradiation. Severe anophthalmic orbits and atresic eye sockets are not rare. We conducted a retrospective study to evaluate the results of surgical management of reconstruction of severe anophthalmic orbits and atresic eye sockets with vascular anastomosed free dorsalis pedis flap transplantation. There were 5 patients (5 eyes) who underwent reconstructive surgery of severe anophthalmic orbits and atresic eye sockets after enucleation and irradiation of retinoblastoma in our hospital during the 3 years. All patients had enucleation and irradiation immediately after the retinoblastoma was diagnosed and had never worn artificial eyes because of the atresic eye sockets. Vascular anastomosed free dorsalis pedis flaps, whose dimensions were typically 6.5 × 5.5 cm(2), were transplanted to reconstruct the severe anophthalmic orbits and atresic eye sockets. The donor sites were covered by free abdominal skin flaps. All the vascular anastomosed free dorsalis pedis flaps were valid after more than 6 months of follow-up. And then all the 5 patients underwent secondary autogenous dermal fat implantation to augment the supraorbital area depression. After the 2-stage reconstruction surgery, the dimensions of the eye sockets were adequate, and all patients were able to wear their prosthesis and had a satisfactory cosmetic result. Implantation of alloplastic materials is not recommended because of insufficient blood supply of the irradiated orbital area. PMID:21558948

  16. Ultrasonographic determination of the dimensions of ocular components in enucleated eyes of the one-humped camel (Camelus dromedarius).

    PubMed

    Osuobeni, E P; Hamidzada, W A

    1999-10-01

    The refractive status and visual capabilities of the one-humped camel are not currently known. Schematic eyes are important tools in studying the optical characteristics and refractive status of an eye. The variables required in developing a schematic eye for a particular animal species include the dimensions of the optical components. We have employed A-scan ultrasonography to measure the dimensions of optical components in freshly enucleated eyes of the one-humped camel. Measurements were made in eyes immersed in distilled water kept at 20 degrees C. The average values of the optical components were as follows: anterior chamber depth = 5.27 mm, lens thickness = 10.93 mm, vitreous chamber depth = 14.85 mm and axial length = 31.05 mm. The uncorrected average corneal thickness was 0.76 mm. These values would have to be confirmed in live animal subjects before they can be used to design a schematic eye for the one-humped camel. PMID:10502480

  17. Inhibition of secondary cartilage of the intermaxillary suture in Sprague-Dawley rats following the enucleation of maxillary molars

    SciTech Connect

    Forbes, D.P.; Al-Bareedi, S.

    1986-01-01

    A single craniofacial suture can undergo several morphologic transformations during its development. From 3 to 7 weeks of age, the intermaxillary suture of the rat is synchondrotic in character, featuring secondary cartilage; at later times, this suture is syndesmotic in character, featuring a fibrous tissue interface. Since intermittent mechanical stimulation has been reported to initiate secondary cartilage formation, a study was done to determine if the functioning dentition were responsible for secondary cartilage formation in the intermaxillary suture of the rat. Twenty-two female Sprague-Dawley rats were used. At 3 weeks of age, prior to eruption, the maxillary molars were enucleated from nine animals. Body weights were recorded weekly. Animals were sacrificed weekly from 4 to 7 weeks of age. One hour prior to sacrifice, each rat was injected with (/sup 35/S)sulfate at a dosage of 2 microCi/g body weight. The tissues were evaluated by light microscopy and autoradiography. In the experimental group, the midpalatal suture did not undergo the normal synchondrotic transformation. Instead, this suture remained fibrous with negligible metachromatic staining. In the control animals, the peak period of (/sup 35/S)sulfate incorporation was 4 weeks of age and was five times greater than in the experimental group. The primary stimulus for the initiation of secondary cartilage formation in the midpalatal suture of the rat was molar function. Also, functioning molars were found to be important in the maintenance of the palatal bone.

  18. The Safety of Common Voice Prostheses with ENT Lasers.

    PubMed

    Murray, A; Bingham, B J

    1999-06-01

    Silicone voice prostheses, or valves, are inserted into the common tracheo-oesophageal wall of patients after laryngectomy, to allow speech rehabilitation. Granulation tissue around these voice prostheses is often removed by laser and the safety of these valves with lasers had not been confirmed. The common valves were exposed to increasing energies from the carbon dioxide, potassium-titanyl-phosphate and holmium YAG lasers, in air. The energies used were those in common clinical use. The Provox valves proved especially vulnerable to all laser energies. Other methods of removing granulation tissue should be tried prior to lasering, or the valves should be removed, as damage to them, or the patient's airway, can result. PMID:24519172

  19. Design and evaluation of a fiberoptic fluorescence guided laser recanalization system.

    PubMed

    Garrand, T J; Stetz, M L; O'Brien, K M; Gindi, G R; Sumpio, B E; Deckelbaum, L I

    1991-01-01

    Current angioplasty techniques for recanalization of totally occluded arteries are limited by the inability to cross the occlusion and by the risk of perforation. A fiberoptic fluorescence guided laser recanalization system was developed and evaluated in vitro for recanalization of 17 human femoral or tibial totally occluded arterial segments (length 1.9-6.8 cm, diameter 2.5-6.0 mm). A 400 or 600 micron silica fiber was coupled to a helium-cadmium laser (lambda = 325 nm) for fluorescence excitation and to a holmium: YAG laser (lambda = 2.1 micron) for tissue ablation. Fluorescence was recorded during recanalization after every other holmium laser pulse. During recanalization, each arterial segment was bent 30-90 degrees with respect to the fiber to simulate arterial tortuosity. Ablation continued with fiber advancement as long as the fluorescence confirmed that the target tissue was atherosclerotic. Arterial spectra were classified as normal or atherosclerotic by an on-line computerized fluorescence classification algorithm (sensitivity 93%, specificity 95%). Normal fluorescence necessitated redirection of the fiber greater than 30 times per segment to continue recanalization. Fifteen of 17 totally occluded arteries had multiple recanalization channels created following total energy delivery of 40-1,016 Joules per segment with no angiographic or histologic evidence of laser perforation. Two heavily calcified arterial occlusions were not recanalized due to inhibition of holmium: YAG laser ablation by the recording of normal fluorescence spectra. Therefore, this fluorescence guided laser recanalization system appears safe and effective for recanalization of totally occluded arteries and merits in vivo evaluation. However, the lower sensitivity of fluorescence detection of heavily calcified plaques may limit the efficacy (but not safety) of fluorescence guided recanalization of heavily calcified occlusions. PMID:2034008

  20. Thulium Fiber Laser lithotripsy

    NASA Astrophysics Data System (ADS)

    Blackmon, Richard Leious, Jr.

    The Thulium Fiber Laser (TFL) has been studied as a potential alternative to the conventional Holmium:YAG laser (Ho:YAG) for the treatment of kidney stones. The TFL is more ideally suited for laser lithotripsy because of the higher absorption coefficient of the emitted wavelength in water, the superior Gaussian profile of the laser beam, and the ability to operate at arbitrary temporal pulse profiles. The higher absorption of the TFL by water helps translate into higher ablation of urinary stones using less energy. The Gaussian spatial beam profile allows the TFL to couple into fibers much smaller than those currently being used for Ho:YAG lithotripsy. Lastly, the ability of arbitrary pulse operation by the TFL allows energy to be delivered to the stone efficiently so as to avoid negative effects (such as burning or bouncing of the stone) while maximizing ablation. Along with these improvements, the unique properties of the TFL have led to more novel techniques that have currently not been used in the clinic, such as the ability to control the movement of stones based on the manner in which the laser energy is delivered. Lastly, the TFL has led to the development of novel fibers, such as the tapered fiber and removable tip fiber, to be used for lithotripsy which can lead to safer and less expensive treatment of urinary stones. Overall, the TFL has been demonstrated as a viable alternative to the conventional Ho:YAG laser and has the potential to advance methods and tools for treatment of kidney stones.

  1. Solvent extraction of holmium and yttrium with bis(2-ethylhexyl)phosphoric acid

    SciTech Connect

    Yoshizuka, K.; Sakamoto, Y.; Baba, Y.; Inoue, K. ); Nakashio, F. )

    1992-05-01

    This paper discusses a kinetic study on the solvent extraction of holmium(III) and yttrium(III) with bis(2-ethylhexyl) phosphoric acid (D2EHPA) from nitrate media conducted at 303 K using a hollow fiber membrane extractor. Also studied were the distribution equilibria of these metals and interfacial adsorption equilibria of D2EHPA and its metal complexes between the organic and aqueous phases. It was found that the metals (M{sup 3+}) were extracted with D2EHPA (HR) ad MR{sub 3} {center dot} 3HR into the organic phase, and the extraction equilibrium constants were evaluated. Furthermore, it was established that dimeric D2EHPA can be adsorbed at the interface between the organic and aqueous phases, while the interfacial activities of D2EHPA-metal complexes were negligibly small. The apparent orders 2, 1, and 2 of the permeabilities for the extraction of both metals were found with respect to the pH of the aqueous solution and the concentrations of the metal ion and dimeric D2EHPA, while the orders 1, 1, and {minus}1 of the permeabilities for the stripping of both metals were found with respect to the hydrogen ion activity and the concentrations of the metal complex and dimeric D2EHPA, respectively. The diffusional effects were reasonably explained by the diffusion model accompanied by an interfacial reaction, taking into account the velocity distributions of the aqueous and organic phases through the inner and outer sides of a hollow fiber.

  2. Laser therapy in ocular tumors

    NASA Astrophysics Data System (ADS)

    Carstocea, Benone D.; Gafencu, Otilia L.; Apostol, Silvia; Ionita, Marcel A.; Moroseanu, A.; Dascalu, Traian; Lupei, Voicu; Ionita-Manzatu, V.

    1998-07-01

    The medical laser equipments made at NILPRP have been exploited intensively for more than 10 years at CMH. The availability and reliability of the first like-on equipment have increased, following improvements in optical delivery system and cooling circuit. This paper shows the impact of technical advances on the development of ophthalmologic laser therapy. Intraocular tumors pose special problems of diagnosis and treatment. Diagnostic methods include addition to systemic and ophthalmologic examinations, ancillary examinations, such as transillumination, fluorescence angiography, ultrasonography, radioactive phosphorus uptake tests, radiology, computerized tomography and fine-needle aspiration biopsy with cytological analyses. The enucleation of the involved eye used to be a generally accepted management of malignant tumors. Improved therapeutic methods such as photocoagulation and better surgical techniques now provide a variety of therapeutic alternatives. This study covers 31 cases of intraocular tumors that were managed either by Argon Laser photocoagulation and/or by Nd:YAG laser surgical treatment. Four cases were intraocular metastasse and 17 cases were primitive intraocular tumors. Argon laser therapy proved to be totally ineffective for intraocular metastasse but very adequate therapy for primitive tumors. Tumor extirpations (choroidal, cillary body or iris tumors) using Nd:YAG laser lancet proved to be more suitable than classic surgery.

  3. Electron transfer behavior and water photodecomposition ability of calcined material from a cerium-S-phenylene-O-holmium-O-phenylene-S hybrid copolymer.

    PubMed

    Matsui, Hideo; Otsuki, Keigo; Yamada, Hiroyoshi; Kawahara, Tetsuro; Yoshihara, Masakuni

    2006-05-15

    Calcination of a cerium-S-phenylene-O-holmium-O-phenylene-S hybrid copolymer under a vacuum gave cerium oxide-carbon cluster-holmium oxide composite material. The material calcined at 600 degrees C loaded with Pt particles could decompose water to H2 and O2 with a H2/O2 ratio of 2 under visible light irradiation. ESR spectral examinations of the calcined materials revealed the possibility of a two-step electron transfer in the process of CeO2 --> carbon cluster --> Ho2O3 --> Pt with an oxidation site at CeO2 particles and a reduction site at Pt particles. PMID:16313919

  4. Review of Current Laser Therapies for the Treatment of Benign Prostatic Hyperplasia

    PubMed Central

    Choi, Benjamin B.

    2013-01-01

    The gold standard for symptomatic relief of bladder outlet obstruction secondary to benign prostatic hyperplasia has traditionally been a transurethral resection of the prostate (TURP). Over the past decade, however, novel laser technologies that rival the conventional TURP have multiplied. As part of the ongoing quest to minimize complications, shorten hospitalization, improve resection time, and most importantly reduce mortality, laser prostatectomy has continually evolved. Today, there are more variations of laser prostatectomy, each with several differing surgical techniques. Although abundant data are available confirming the safety and feasibility of the various laser systems, future randomized-controlled trials will be necessary to verify which technique is superior. In this review, we describe the most common modalities used to perform a laser prostatectomy, mainly, the holmium laser and the potassium-titanyl-phosphate lasers. We also highlight the physical and clinical characteristics of each technology with a review of the most current and highest-quality literature. PMID:23789041

  5. Probabilities for nonradiative intermultiplet transitions in the holmium ion in lithium-yttrium double fluoride crystals and stimulated emission

    SciTech Connect

    Tkachuk, A.M.; Khilko, A.V.; Petrov, M.V.

    1985-02-01

    Nonradiative transition probabilities have been studied as functions of the energy difference between the closest-lying multiplets of the Ho/sup 3 +/ ion in the LiYF/sub 4/ crystal. The efficiencies of emission from terms of the holmium ion have been determined. The cross sections for stimulated emission for emission lines corresponding to the transition /sup 5/S/sub 2/ ..-->.. /sup 5/I/sub 7/ have also been determined. Some characteristics of the stimulated emission of LiYF/sub 4/:Ho/sup 3 +/ crystals are reported for several wavelengths in the 0.75--3.9-..mu..m spectral interval.

  6. Laser Resection of Fibroepithelial Polyps with Digital Ureteroscopy

    PubMed Central

    Bagley, Demetrius H.

    2015-01-01

    Abstract Fibroepithelial polyps (FEPs) are rare benign upper urinary-tract neoplasms originating from mesodermal components of the ureteral wall covered in normal urothelial epithelium. Historically, these lesions have been treated with endoscopic, laparoscopic, or open means depending on the size, number, and morphology of the polyps. Digital ureteroscopy (DURS) offers many advantages over fiber-optic endoscopy, including superior resolution and potential ergonomic benefits, given the absence of external cameras and light cords. We describe a case involving multiple proximal ureteral FEPs treated with flexible DURS and the holmium (Ho) laser, in which the digital ureteroscope offered exceptional visualization of the FEP stalks allowing for straightforward resection and endoscopic removal.

  7. [Transmyocardial laser revascularization: overview of clinical and experimental data].

    PubMed

    Nishida, H; Endo, M; Koyanagi, H

    2001-10-01

    Transmyocardial laser revascularization (TMLR) using carbon dioxide and Holmium YAG laser has been approved by FDA and is now under clinical evaluation in patients with refractory angina who are not candidate of CABG or PTCA. Original concept of TMLR was direct perfusion from left ventricle through channel created by laser. However, pathological analysis showed closed channel in almost all cases, and most possible mechanism of TMLR are now thought to be angiogenesis following to inflammatory response of laser injury. Most prospective randomized trial comparing TMLR and conservative medical treatment demonstrated significantly less angina in TMLR patients and better exercise tolerance and angina-free survival rate during follow-up period. On the other hand, no significant differences were demonstrated in overall mortality rate, myocardial perfusion or cardiac function. PMID:11676155

  8. Temporal model of an optically pumped co-doped solid state laser

    NASA Technical Reports Server (NTRS)

    Wangler, T. G.; Swetits, J. J.; Buoncristiani, A. M.

    1993-01-01

    Currently, research is being conducted on the optical properties of materials associated with the development of solid state lasers in the two micron region. In support of this effort, a mathematical model describing the energy transfer in a holmium laser sensitized with thulium is developed. In this paper, we establish some qualitative properties of the solution of the model, such as non-negativity, boundedness, and integrability. A local stability analysis is then performed from which conditions for asymptotic stability are attained. Finally, we report on our numerical analysis of the system and how it compares with experimental results.

  9. Percutaneous laser disc decompression (PLDD) update: focus on device and procedure advances.

    PubMed

    Choy, D S

    1993-08-01

    This discussion is an update on the U.S. advances in percutaneous laser disc decompression (PLDD). This report summarizes the knowledge that has been gained about the procedure, advances in technique, and increased information about the three lasers currently in use for PLDD: KTP, Nd:YAG, and holmium. A new surgical approach to the L5-S1 disc is described. It is concluded that PLDD has become an established procedure that will be more widely used because it is simple, effective, and reasonably safe. PMID:10146384

  10. Excitation functions for the helium-ion-induced fission of holmium and erbium

    SciTech Connect

    Iyer, R.H.; Pandey, A.K.; Kalsi, P.C.; Sharma, R.C. )

    1991-12-01

    Excitation functions for the helium-ion-induced fission of holmium ({ital Z}=67) and erbium ({ital Z}=68) in the energy range 34--70 MeV were measured using lexan polycarbonate plastic as the fission fragment track detector. By analyzing the data in terms of the statistical model expression for {Gamma}{sub {ital f}}/{Gamma}{sub {ital n}}, the ratio of the fission width to neutron emission width, the fission barriers of the compound nuclei {sup 1}{sub 69}{sup 69}Tm and {sup 17}{sub 70}{sup 1.3}Yb were determined to be 29.8{plus minus}3 and 27.8{plus minus}3 MeV, respectively. The corresponding values for the fission level density parameter were found to be {ital a}{sub {ital f}}={ital A}/12 and {ital A}/13, respectively. The uncertainties shown in the fission barriers allow for inclusion of other values derived from reasonable upper and lower limits of {ital a}{sub {ital f}} values of {ital A}/8 to {ital A}/20. The measured fission barriers compare very well with the shell-corrected liquid-drop barriers of Myers and Swiatecki. The present measurements extend the range of low-{ital Z} elements which are away from the closed-shell region and which are studied at these medium energies. The results are compared with similar data available in the literature which bring out some interesting correlations and trends in the fission properties, viz., fission barriers and level density parameters of low-{ital Z} elements.

  11. The effects of lasers and electrosurgical devices on human meniscal tissue.

    PubMed

    Sherk, H H; Black, J D; Prodoehl, J A; Diven, J

    1995-01-01

    The purpose of this study was to evaluate the effects of various laser wavelengths on human meniscal tissue in vitro and to compare them with the effects of electrosurgical devices. The carbon dioxide (CO2) laser produced the best cutting and ablating effects among the infrared lasers, although the contact neodymium:yttrium-aluminum-garnet (Nd:YAG) and holmium:YAG (Ho:YAG)lasers were nearly as satisfactory, offering the additional advantage of fiberoptic capability and the ability to be used in saline. The free-beam Nd:YAG laser and coagulation mode electrosurgical device produced unacceptably severe thermal changes. The excimer laser at 308 nm produced the best tissue effect and caused no detectable adjacent thermal change in the tissue. PMID:7641430

  12. Determination of some trace elements in food and soil samples by atomic absorption spectrometry after coprecipitation with holmium hydroxide.

    PubMed

    Saracoglu, Sibel; Soylak, Mustafa; Cabuk, Dilek; Topalak, Zeynep; Karagozlu, Yasemin

    2012-01-01

    The determination of trace elements in food and soil samples by atomic absorption spectrometry was investigated. A coprecipitation procedure with holmium hydroxide was used for separation-preconcentration of trace elements. Trace amounts of copper(II), manganese(II), cobalt(II), nickel(ll), chromium(lll), iron(Ill), cadmium(ll), and lead(ll) ions were coprecipitated with holmium hydroxide in 2.0 M NaOH medium. The optimum conditions for the coprecipitation process were investigated for several commonly tested experimental parameters, such as amount of coprecipitant, effect of standing time, centrifugation rate and time, and sample volume. The precision, based on replicate analysis, was lower than 10% for the analytes. In order to verify the accuracy of the method, the certified reference materials BCR 141 R calcareous loam soil and CRM 025-050 soil were analyzed. The procedure was successfully applied for separation and preconcentration of the investigated ions in various food and soil samples. An amount of the solid samples was decomposed with 15 mL concentrated hydrochloric acid-concentrated nitric acid (3 + 1). The preconcentration procedure was then applied to the final solutions. The concentration of trace elements in samples was determined by atomic absorption spectrometry. PMID:22816279

  13. Gamma spectrometry and chemical characterization of ceramic seeds with samarium-153 and holmium-166 for brachytherapy proposal.

    PubMed

    Valente, Eduardo S; Campos, Tarcísio P R

    2010-12-01

    Ceramic seeds were synthesized by the sol-gel technique with Si:Sm:Ca and Si:Ho:Ca. One set of seeds was irradiated in the TRIGA type nuclear reactor IPR-R1 and submitted to instrumental neutron activation analysis (INAA), K(0) method, to determine mass percentage concentration of natural samarium and holmium in the seed as well as to determine all existing radionuclides and their activities. Attention was paid to discrimination of Si-31, Ca-40, Ca-45, Ca-47, Ca-49, Sm-145, Sm-155, Sm-153 and Ho-166. A second sample was submitted to atomic emission spectrometry (ICP-AES) also to determine samarium and holmium concentrations in weight. A third sample was submitted to X-ray fluorescence spectrometry to qualitatively determine chemical composition. The measured activity was due to Sm-153 and Ho-166 with a well-characterized gamma spectrum. The X-ray fluorescence spectrum demonstrated that there is no discrepancy in seed composition. The maximum ranges in the water of beta particles from Sm-153 and Ho-166 decay were evaluated, as well as the dose rate and total dose delivered within the volume delimited by the range of the beta particles. The results are relevant for investigation of the viability of producing Sm-153 and Ho-166 radioactive seeds for use in brachytherapy. PMID:20685128

  14. Endoscopic Enucleation versus Open Prostatectomy for Treating Large Benign Prostatic Hyperplasia: A Meta-Analysis of Randomized Controlled Trials

    PubMed Central

    Hou, Qi; Wang, Dejuan; Huang, Wentao; Hu, Cheng; Li, Ke; Gao, Xin

    2015-01-01

    Objectives To evaluate the overall efficacy and safety of endoscopic enucleation of the prostate (EP) vs open prostatectomy (OP) for large benign prostatic hyperplasia (BPH). Methods We conducted an electronic search of PubMed/Medline, EMBASE, The Cochrane Library, and Web of Science to detect all relevant randomized controlled trials (RCTs) comparing EP with OP. A meta-analysis was performed using Review Manager 5.3. Results Seven RCTs (735 patients) were included. At the 3-, 6- and 12-month follow-up, there were no significant differences in the International Prostate Symptom Score (IPSS), maximum flow rate (Qmax), quality of life (QoL) score and post-void residual urine volume (PVR) between EP and OP. The International Index of Erectile Function (IIEF-5) was higher with EP (weighted mean difference [WMD]: 1.00, 95% confidence interval [CI]: 0.21 to 1.78, p=0.01) at the 12-month follow-up. The catheterization time (WMD: 3.80 d, 95%CI: -5.11 to -2.48, P<0.00001) and hospital stay (WMD: 4.93 d, 95%CI: -5.96 to -3.89, P<0.00001) were shorter with EP. The duration of operation was longer for EP compared with OP (WMD: 16.21 min, 95%CI: 3.72 to 28.70, P=0.01). The resected tissue weight (WMD: -9.63 g, 95%CI: -14.46 to -4.81, P<0.0001) and decrease in hemoglobin (WMD: -1.14 g/dL, 95%CI: -1.81 to -0.47, P=0.0008) were less with EP. EP was associated with fewer blood transfusions (risk ratio: 0.22, 95%CI: 0.10 to 0.47, P=0.0001). There were no significant differences between EP and OP when comparing other complications. Conclusions Although only a limited number of RCTs with relatively limited follow-up are available, EP is shown to have a similar postoperative profile and comparable safety to OP. By contrast, EP may have a more desirable perioperative profile. EP appears to be an effective and safe minimally invasive option for treating large prostates that requires only brief convalescence. PMID:25826453

  15. A rare case of non-insulinoma pancreatic hypoglycaemia syndrome (niphs) in an adult due to localised islet cell hyperplasia–successfully managed by enucleation

    PubMed Central

    Nayak, Hemanta K; Sothwal, Arpit; Raizaida, Nishant; Daga, Mradul kumar; Agarwal, Anil kumar; Durga, Garima

    2011-01-01

    Persistent hyperinsulinemic hypoglycaemia is caused most commonly by an insulinoma in adults or by nesidioblastosis in neonates. In adults, localised islet cell hyperplasia is a rare disorder characterised by localised proliferation of islet cells. The authors present the case of a previously healthy non-obese middle aged female with new-onset severe hypoglycaemia. Laboratory findings confirmed a case of hyperinsulinemic hypoglycaemia. Endoscopic ultrasonography, intra-arterial calcium stimulation test and intraoperative ultrasonography showed a lesion in the uncinate process that was enucleated. Rest of the pancreas was normal. Histological examination and immunostaining of the resected tissue revealed pancreatic tissue with maintained acinar pattern consistent with diagnosis of localised islet cell hyperplasia. The patient did not have further episodes of hypoglycaemia following the procedure. Localised islet cell hyperplasia with such a very high insulin level is exceedingly rare in adult populations and not reported in literature. This diagnosis cannot be easily made through routine diagnostic laboratory or radiological procedures and likely requires a histological diagnosis. Management of this rare entity is by enucleation. PMID:22675010

  16. A fiberoptic compatible midinfrared laser with CO2 laser-like effect: application to atherosclerosis.

    PubMed

    Oz, M C; Treat, M R; Trokel, S L; Andrew, J E; Nowygrod, R

    1989-12-01

    In theory, pulses of laser light in the 2-microns range should ablate tissue in a manner similar to that of the 10.6-microns CO2 laser with the added advantage of efficient transmission through flexible quartz fibers. Using 200-microseconds pulses of 2.15-microns thulium-holmium-chromium:YAG (THC:YAG) laser light, we were able to create 700-microns-diameter holes through calcific atherosclerosis in vitro. In vivo evaluation of thrombogenicity and healing was accomplished by exposing the luminal surface of rabbit aortas to the THC:YAG laser. Serial histologic examinations of laser-treated rabbit aortae revealed a time course of resolution of the lesions which was very similar to that observed with like-sized lesions created with the same amount of continuous wave CO2 energy. No significant differences in thrombogenicity nor healing response were noted. The excellent in vivo response observed is due in part to the pulsed nature of the THC:YAG laser output as well as to the efficient tissue absorption at the 2.15-microns wavelength. We feel that excellent ablative effects with minimal collateral thermal damage can be obtained through fiberoptic delivery systems by taking advantage of laser wavelengths corresponding to the infrared absorption peak of water in the 2-microns region and pulsed delivery of the laser energy. PMID:2511380

  17. Radiosynoviorthesis of knees by means of 166Ho-holmium-boro-macroaggregates.

    PubMed

    Kraft, Otakar; Kaspárek, Richard; Ullmann, Vojtech; Melichar, Frantisek; Kropácek, Martin; Mirzajevova, Marcela

    2007-04-01

    The aim of this study was to evaluate adverse and therapeutic effects of applicated holmium-boro-macroaggregates (HBMAs) in the radiosynoviorthesis (RSO) of knees in patients suffering from chronic synovitis. We started RSO of the knees by means of a new radiopharmaceutical (RF) HBMA in patients with gonarthrosis, rheumatoid arthritis, chronic synovitis, psoriatic arthritis, and gout arthropathy. Seventeen (17) intra-articular injections were performed in 15 patients who were receiving a mean activity of 972 MBq (range, 904-1057) of 166Ho-HBMA. Patient inclusion to the study followed a series of inclusion and exclusion criterions. The patients were hospitalized for 3 days. Side-effects were evaluated during their hospital stay and again after 6-8 weeks. Static scintigraphy of knee joints and measurements of blood radioactivity were performed. Therapeutic effects were evaluated after 6-8 weeks and at 6 months. In 2 hours and 2 days following the application, we proved, by means of knee and inguinal scintigraphy, only insignificant radiopharmaceutical leakage from the joint cavity to the inguinal lymph nodes in 4 patients. In the treated patients, no serious adverse effects occurred. Nine (9) patients were without complaints, 4 patients had slight knee exudation, and 2 patients had great exudation. Therapeutic effects were as follows: 2 patients were without pain, 9 were with lower pain, 3 were with the same pain, and 1 patient was with increased pain. Joint motion was improved in 7 patients, remained the same in 7 patients, and was impaired in 1 patient. Analgesics consumption was lower in 5 patients, the same in 9 patients, and greater in 1 patient. Knee exudation was absent in 2 patients, lower in 4 patients, the same in 6 patients, and greater in 3 patients. In 3 patients it was necessary to do surgical RSO. This RF can extend the range of clinically used radiopharmaceuticals for RSO and to supplement space between 90Y with high energy and 186Re with 169Er with

  18. Chromium sensitized garnets for mid-IR lasers

    NASA Astrophysics Data System (ADS)

    Moulton, Peter F.

    1990-01-01

    The characteristics of chromium-sensitized solid state lasers operating in the mid-infrared wavelength region were studied. There was continued work on crystals doped with holmium and erbium, operating in the 2100 and 2800 nm regions. In addition, preliminary measurements were made on the laser performance of thulium around 2010 nm. For all these materials the effect of pump pulse length on output energy and overall efficiency was measured. A flashlamp-pumped Cr,Nd:GSGG slab laser was operated and characterized at 1061 and 1310 nm. Measurements included comparison of normal mode slope efficiencies, input-output vs. pump pulse length, characterization of thermal lensing and measurement of Q-switched performance at 1061 nm. Spectroscopic properties of GGG crystals doped with Ce4+ ions were measured, including absorption and emission spectra and fluorescence lifetime.

  19. Flexible endoscope deflectability: changes using a variety of working instruments and laser fibers.

    PubMed

    Poon, M; Beaghler, M; Baldwin, D

    1997-08-01

    To measure the effects of different working instruments and holmium laser fibers on the deflectability in a variety of actively deflectable flexible endoscopes, a benchtop study was performed. The endoscopes studied were the Storz 7.5 flexible ureteroscope, the AUR-7 and AUR-9 flexible ureteroscopes (Circon-ACMI), a prototype Mitsubishi flexible ureteroscope (Mitsubishi Optics, Inc.), the ACN flexible cystoscope (Circon-ACMI), and the Storz flexible cystoscope. Working instruments included 1.6F (Wolf) and 1.9F (Microvasive) electrohydraulic lithotripsy (EHL) probes, 1.9F two-prong graspers and Bagley baskets, 2.4F Segura and helical baskets (Microvasive), 3.0F Segura basket, and 200- and 365-micron holmium laser fibers (Xintec). In ureteroscopes, the effect of 1.6F and 1.9F EHL probes ranged from having no effect in the Xintec 6,000, to decreasing deflection by 30 degrees in the AUR-7. Working instruments that were 2.4F or greater reduced deflection from 33 degrees to 93 degrees. Better deflectability was noted with the 200-micron holmium laser fiber than with the 365-micron fiber. The diameter of the working instrument did not affect deflectability as severely in cystoscopes. No significant differences in deflection existed between the 365-micron and 200-micron fibers in the flexible nephroscopes tested. In general, working instruments less than 2.4F and the 200-micron laser fiber have little effect on deflectability compared with working instruments 2.4F or larger and the 365-micron fiber. Flexible cystoscopes, with their larger working channels and stronger deflection cables, are affected less by working instrument diameter than are flexible ureteroscopes. PMID:9376842

  20. The determination of energy transfer rates in the Ho:Tm:Cr:YAG laser material

    NASA Technical Reports Server (NTRS)

    Koker, Edmond B.

    1988-01-01

    Energy transfer processes occurring between atomic, ionic, or molecular systems are very widespread in nature. The applications of such processes range form radiation physics and chemistry to biology. In the field of laser physics, energy transfer processes have been used to extend the lasing range, increase the output efficiency, and influence the spectral and temporal characteristics of the output pulses of energy transfer dye lasers or solid-state laser materials. Thus in the development of solid state lasers, it is important to investigate the basic energy transfer (ET) mechanisms and processes in order to gain detailed knowledge so that successful technical utilization can be achieved. The aim of the present research is to measure the ET rate from a given manifold associated with the chromium sensitizer atom to a given manifold in the holmium activator atom via the thulium transfer atom, in the Ho:Cr:YAG laser material.

  1. Laser reshaping of nasal septum cartilage: clinical results for 40 patients

    NASA Astrophysics Data System (ADS)

    Sobol, Emil N.; Sviridov, Alexander P.; Bagratashvili, Victor N.; Omelchenko, Alexander I.; Ovchinnikov, Yuriy M.; Shekhter, Anatoliy B.; Svistushkin, Valeriy M.; Shinaev, Alexander N.

    2000-05-01

    Clinical results on sparing laser reshaping of nasal septum cartilage are reported for the first time. Forty patients have been treated with holmium laser to correct a deformed cartilage. The laser reshaping is a bloodless, painless procedure which takes few minutes to straighten nasal septum. The stability of the new shape and possible side effects have been examined during twelve months. The headache and other negative symptoms have disappeared, as a result of laser treatment for the most of patients. Rhinoscopic examination show an excellent long-term reshaping effects for nasal septum of 23 patients, and, also, good results for other 12 patients. For 5 patients only a little effect takes place. Our rhinomanometric examinations demonstrate a pronounced improvement of the breathing for 35 patients. No visible undesirable side effects were observed for all patients underwent to laser reshaping procedure.

  2. Visualizing mechanical stress and liquid flow during laser lithotripsy

    NASA Astrophysics Data System (ADS)

    Reinten, Ilja; Verdaasdonk, Rudolf; van der Veen, Albert; Klaessens, John

    2014-03-01

    The mechanism of action of the holmium laser lithotripsy is attributed to explosive expanding and imploding vapor bubbles in association with high-speed water jets creating high mechanical stress and cracking the stone surface. A good understanding of this mechanism will contribute to the improvement and the safety of clinical treatments. A new method has been developed to visualize the dynamics of mechanical effects and fluid flow induced by Holmium laser pulses around the fiber tip and the stone surface. The fiber tip was positioned near the surface of a stone on a slab of polyacrylamide gel submerged in water. The effects were captured with high speed imaging at 2000-10000 f/s. The dynamics of the pressure wave after the pulse could be visualized by observing the optical deformation of a fine line pattern in the background of the water container using digital subtraction software. This imaging technique provides a good understanding of the mechanical effects contributing to the effectiveness and safety of lithotripsy and can be used to study the optimal fiber shape and position towards the stone surface.

  3. Development of mid-infrared solid state lasers for spaceborne lidar

    NASA Technical Reports Server (NTRS)

    Whitney, Donald A.; Kim, Kyong H.

    1989-01-01

    Laser performance of Ho(3+):Tm(3+):Cr(3+):YAG crystals was investigated under both Cr:GSAG laser and flashlamp pumping. A flashlamp pumped Cr:GSAG laser was built to simulate high power quasi-CW laser diode pumping of a 2.1 micrometer holmium laser. The 2.1 micrometer output laser energy exceeded more than 14 mJ, the highest value reported to date under laser pumping near 785 nm. This was obtained in a pulse length of nearly 650 microsec from a 3 x 3 mm Ho:Tm:Cr:YAG rod by using the flashlamp-pumped Cr:CSAG laser as a pumping source at the diode laser wavelength, 785 micrometers. In addition, Ho:Tm:Cr:YAG crystals with various Tm(3+) concentrations were evaluated for flashlamp-pumped normal mode and Q-switched 2.1 micrometer laser operations under a wide variety of experimental conditions in order to understand internal dynamic processes among the ions and to determine an optimum lasing condition. An increase of the laser slope efficiency was observed with the increase of the Tm(3+) concentration from 2.5 to 4.5 atomic percent. The thermal dependence of the laser performance was also investigated. Q-switched laser output energies corresponding to nearly 100 percent of the normal-mode laser energies were obtained in a strong single spike of 200 ns pulse length by optimizing the opening time of a lithium niobate Q-switch.

  4. Neutron diffraction and electrical transport studies on the incommensurate magnetic phase transition in holmium at high pressures

    SciTech Connect

    Thomas, Sarah; Uhoya, Walter; Tsoi, Georgiy; Wenger, Lowell E; Vohra, Yogesh; Chesnut, Gary Neal; Weir, S. T.; Tulk, Christopher A; Moreira Dos Santos, Antonio F

    2012-01-01

    Neutron diffraction and electrical transport measurements have been made on the heavy rare earth metal holmium at high pressures and low temperatures in order to elucidate its transition from a paramagnetic (PM) to a helical antiferromagnetic (AFM) ordered phase as a function of pressure. The electrical resistance measurements show a change in the resistance slope as the temperature is lowered through the antiferromagnetic Neel temperature. The temperature of this antiferromagnetic transition decreases from approximately 122 K at ambient pressure at a rate of -4.9 K GPa(-1) up to a pressure of 9 GPa, whereupon the PM-to-AFM transition vanishes for higher pressures. Neutron diffraction measurements as a function of pressure at 89 and 110 K confirm the incommensurate nature of the phase transition associated with the antiferromagnetic ordering of the magnetic moments in a helical arrangement and that the ordering occurs at similar pressures as determined from the resistance results for these temperatures.

  5. Self-quenching of luminescence in concentrated lithium--erbium and lithium--holmium double fluoride crystals

    SciTech Connect

    Tkachuk, A.M.; Klokishner, S.I.; Petrov, M.V.

    1985-10-01

    For the radiative terms of holmium and erbium ions in concentrated LiErF/sub 4/ and LiHoF/sub 4/ crystals, numerical estimates were made of the microparameters and transfer rates on the basis of known experimental data on the structure of luminescence centers, probabilities of intracenter transitions, phonon spectrum of the crystals, and electron--phonon interaction. The schemes of the most important processes of cross-relaxation quenching and nonlinear (in excitation intensity) interaction have been determined. On the basis of an analysis of numerical values of the rates of intracenter relaxation and interionic transfer of energy, conclusions are reached concerning the processes which significantly affect the radiative characteristics of concentrated crystals. The role of the processes of cross-relaxation quenching and nonlinear interaction in the formation of an inverse population of excited multiplets and the influences of these processes on the characteristics of stimulated emission are discussed.

  6. Radiotherapeutic bandage based on electrospun polyacrylonitrile containing holmium-166 iron garnet nanoparticles for the treatment of skin cancer.

    PubMed

    Munaweera, Imalka; Levesque-Bishop, Daniel; Shi, Yi; Di Pasqua, Anthony J; Balkus, Kenneth J

    2014-12-24

    Radiation therapy is used as a primary treatment for inoperable tumors and in patients that cannot or will not undergo surgery. Radioactive holmium-166 ((166)Ho) is a viable candidate for use against skin cancer. Nonradioactive holmium-165 ((165)Ho) iron garnet nanoparticles have been incorporated into a bandage, which, after neutron-activation to (166)Ho, can be applied to a tumor lesion. The (165)Ho iron garnet nanoparticles ((165)HoIG) were synthesized and introduced into polyacrylonitrile (PAN) polymer solutions. The polymer solutions were then electrospun to produce flexible nonwoven bandages, which are stable to neutron-activation. The fiber mats were characterized using scanning electron microscopy, transmission electron microscopy, powder X-ray diffraction, Fourier transform infrared spectroscopy, thermogravimetric analysis and inductively coupled plasma mass spectrometry. The bandages are stable after neutron-activation at a thermal neutron-flux of approximately 3.5 × 10(12) neutrons/cm(2)·s for at least 4 h and 100 °C. Different amounts of radioactivity can be produced by changing the amount of the (165)HoIG nanoparticles inside the bandage and the duration of neutron-activation, which is important for different stages of skin cancer. Furthermore, the radioactive bandage can be easily manipulated to irradiate only the tumor site by cutting the bandage into specific shapes and sizes that cover the tumor prior to neutron-activation. Thus, exposure of healthy cells to high energy β-particles can be avoided. Moreover, there is no leakage of radioactive material after neutron activation, which is critical for safe handling by healthcare professionals treating skin cancer patients. PMID:25396281

  7. Treatment of Hemorrhagic Vocal Polyps by Pulsed Dye Laser-Assisted Laryngomicrosurgery

    PubMed Central

    Byeon, Hyung Kwon; Han, Ji Hyuk; Choi, Byeong Il; Hwang, Hye Jin; Kim, Ji-Hoon; Choi, Hong-Shik

    2015-01-01

    Objective. Conventional surgical techniques of laryngomicrosurgery (LMS) on hemorrhagic vocal polyps are often difficult due to obscuration of the surgical field by inadvertent bleeding from the lesion, and there are often significant amounts of mucosal epithelium loss. Here, we introduce our surgical technique using pulsed dye laser (PDL), which can effectively resect the polyp with vocal fold mucosa preservation. Methods. Patients who were diagnosed with hemorrhagic vocal polyp and who were surgically managed using PDL from March 2013 to October 2014 were retrospectively reviewed. Preoperative and postoperative clinical outcomes and surgical findings were evaluated. Results. A total of 39 patients were treated with PDL-assisted enucleation LMS. The average age was 43.7 years (range 20–73), and there were 20 males and 19 females (17 professional voice users). In all cases, the hemorrhagic polyp was successfully enucleated after application of PDL, thereby preserving the overlying epithelium. Postoperative voice outcomes were favorable with clear preservation of the vocal fold mucosal wave. Conclusion. PDL-assisted enucleation LMS for the treatment of hemorrhagic vocal polyps can be a safe and effective surgical technique. It can be considered a promising treatment option for hemorrhagic vocal polyps. PMID:26557700

  8. Development of porcine embryos reconstituted with somatic cells and enucleated metaphase I and II oocytes matured in a protein-free medium

    PubMed Central

    Miyoshi, Kazuchika; Rzucidlo, S Jacek; Gibbons, John R; Arat, Sezen; Stice, Steven L

    2001-01-01

    Background Many cloned animals have been created by transfer of differentiated cells at G0/G1 or M phase of the cell cycle into enucleated M II oocytes having high maturation/meiosis/mitosis-promoting factor activity. Because maturation/meiosis/mitosis-promoting factor activity during oocyte maturation is maximal at both M I and M II, M I oocytes may reprogram differentiated cell nuclei as well. The present study was conducted to examine the developmental ability in vitro of porcine embryos reconstructed by transferring somatic cells (ear fibroblasts) into enucleated M I or M II oocytes. Results Analysis of the cell cycle stages revealed that 91.2 ± 0.2% of confluent cells were at the G0/G1 phase and 54.1 ± 4.4% of nocodazole-treated cells were at the G2/M phase, respectively. At 6 h after activation, nuclear swelling was observed in 50.0-88.9% and 34.4-39.5% of embryos reconstituted with confluent cells and nocodazole-treated cells regardless of the recipient oocytes, respectively. The incidence of both a swollen nucleus and polar body was low (6.3-10.5%) for all nocodazole-treated donor cell regardless of the recipient oocyte. When embryos reconstituted with confluent cells and M I oocytes were cultured, 2 (1.5%) blastocysts were obtained and this was significantly (P < 0.05) lower than that (7.6%) of embryos produced by transferring confluent cells into M II oocytes. No reconstructed embryos developed to the blastocyst stage when nocodazole-treated cells were used as donors. Conclusions Porcine M I oocytes have a potential to develop into blastocysts after nuclear transfer of somatic cells. PMID:11476669

  9. Ablation of intervertebral discs in dogs using a MicroJet-assisted dye-enhanced injection device coupled with the diode laser

    NASA Astrophysics Data System (ADS)

    Bartels, Kenneth E.; Henry, George A.; Dickey, D. Thomas; Stair, Ernest L.; Powell, Ronald; Schafer, Steven A.; Nordquist, Robert E.; Frederickson, Christopher J.; Hayes, Donald J.; Wallace, David B.

    1998-07-01

    Use of holmium laser energy for vaporization/coagulation of the nucleus pulposus in canine intervertebral discs has been previously reported and is currently being applied clinically in veterinary medicine. The procedure was originally developed in the canine model and intended for potential human use. Since the pulsed (15 Hz) holmium laser energy exerts photomechanical and photothermal effects, the potential for extrusion of additional disc material to the detriment of the patient is possible using the procedure developed for the dog. To reduce this potential complication, use of diode laser (805 nm - CW mode) energy, coupled with indocyanine green (ICG) as a selective laser energy absorber, was formulated as a possible alternative. Delivery of the ICG and diode laser energy was through a MicroJet device that could dispense dye interactively between individual laser 'shots.' Results have shown that it is possible to selectively ablate nucleus pulposus in the canine model using the device described. Acute observations (gross and histopathologic) illustrate that accurate placement of the spinal needle before introduction of the MicroJet device is critically dependent on the expertise of the interventional radiologist. In addition, the success of the overall technique depends on consistent delivery of both ICG and diode laser energy. Minimizing tissue carbonization on the tip of the MicroJet device is also of crucial importance for effective application of the technique in clinical veterinary medicine.

  10. Laser lithotripsy for removal of uroliths in dogs

    NASA Astrophysics Data System (ADS)

    Adams, Larry G.; Lulich, Jody P.

    2006-02-01

    Introduction: This study evaluated the ability to fragment and remove naturally occurring uroliths in dogs using a holmium: YAG laser. Methods: Twenty four dogs with naturally occurring uroliths including 10 spayed females and 14 neutered males. The dogs were 8.7 +/- 2.8 years old and weighed 13.7 +/- 8.0 kg. All dogs had bladder stones and 5 male dogs also had urethral stones. In female dogs, cystoscopy was performed using a rigid cystoscope with sheath diameter of 14 to 19 french. Cystoscopy was performed in males dogs using a 7.5 french diameter pediatric ureteroscope. Uroliths were fragmented using a 20 watt Holmium: YAG laser and the fragments were removed by basket extraction and voiding urohydropropulsion. Results: Average laser parameters for urolith fragmentation were 0.7 Joules at 8 Hertz (range: 0.5 to 1.3 Joules at 5 to 13 Hertz). All urolith fragments were successfully removed in all 10 female dogs and 11 of 14 male dogs. In one male dog, the urethra was too small to allow passage of the ureteroscope. In one of the male dogs, the urethral stones were successfully removed by laser lithotripsy, but removal of the bladder stones was performed by cystotomy. There was one complication of urethral perforation during attempts to pass an access sheath transurethrally in a dog with extensive proliferative urethritis. Conclusions: Laser lithotripsy is a safe and effective method of removing bladder and urethral stones in dogs provided the dog is large enough to permit transurethral passage of a cystoscope or ureteroscope.

  11. Spectroscopic investigation of Yb,Ho,Pr:YAG as a 3 μm laser source

    NASA Astrophysics Data System (ADS)

    Stites, Ronald W.; Harris, Thomas R.

    2016-03-01

    In addition to the well-established 5I7 to 5I8 transition at 2.09 μm in holmium doped laser materials, there also exists a less energetic transition from the 5I6 level to 5I7 at 2.95 μm. As there has been a recent increase in interest and applications for 3.0 μm light, this material stands to be a viable alternative to other rare earth doped laser systems. Unfortunately, the wavelength required to directly pump the 5I6 level at 1.13 μm is not convenient for commercial laser diodes. Furthermore, the emission lifetime of the 5I7 state is longer than the 5I6 level, leading to a suppression of lasing due to "bottlenecking" in the material. To overcome these effects, we investigated the activation and deactivation of holmium doped yttrium aluminum garnet (YAG) using ytterbium and praseodymium respectively. By including ytterbium ions in the host material, readily available 914 nm diode light can be used to resonantly excite the 5I6 level in holmium. Similarly, the presence of praseodymium resonantly de-excites the 5I7 state, reducing its lifetime, and making the material more suitable for lasing. Here, we report the absorption and photoluminescence spectra of this triply doped Yb,Ho,Pr:YAG crystal. In addition, the emission lifetime for both the 2.09 μm and 2.95 μm transitions are reported and compared to a Yb,Ho:YAG control sample.

  12. YAG lasers in restorative dentistry: a histological investigation

    NASA Astrophysics Data System (ADS)

    Koort, Hans J.; Frentzen, Matthias

    1992-06-01

    An important indicator to prove the effectiveness of laser radiation and to control the side effects are histological studies of dental hard tissues. In our study, different pulsed, rare earth doped YAG-laser systems in the range from 1 micrometers to 3 micrometers were investigated. An improved plastic embedding technique based on a penetrating uv-activated PMMA-medium was developed to cut undecalcified sections of 15 micrometers thickness. The Nd:YAG laser showed wide zones of necrosis but little carbonization. The radiation of Holmium and Thullium-doped YAG lasers causes strong but well-defined zones of carbonization comparable to those of pulsed (ms) CO2 lasers. The Erbium-doped YAG-laser was the most effective system. As predominant side effects, residual zones of debris and microcracks were observed. In deeper cavities, the zones of damages increase. The side effects of the pulsed infrared laser types seem to be mainly influenced by the physical or chemical properties of the dental tissues and not by the selected laser parameters.

  13. Laser photoacoustic spectroscopy for trace level detection of actinides in groundwater

    SciTech Connect

    Doxtader, M.M.; Maroni, V.A.; Beitz, J.V.; Heaven, M.

    1986-01-01

    In this paper we examine the utility of the laser photoacoustic spectroscopy (LPAS) technique for elucidating the chemical behavior of species present in the near-field environment of the Basalt Waste Isolation Project (BWIP) repository. We briefly review the existing basis for interpreting actinide spectra at low concentrations, and describe our initial experiments. These experiments include development and demonstration of the methodology under optimum conditions, e.g., stable, well-characterized solutions of holmium; and application of the technique to conditions relevant to the repository, including studies performed with uranium in synthetic groundwater and at elevated temperatures.

  14. Combined usage of Ho:YAG laser with monopolar resectoscope in the treatment of bladder stone and bladder outlet obstruction

    PubMed Central

    Wu, Jian Hui; Yang, Kuo; Liu, Qian; Yang, Shi Qiang; Xu, Yong

    2014-01-01

    Objective: Bladder stones in elderly men are commonly associated with bladder outlet obstruction, and many different treatment modalities have been presented for both these conditions. To evaluate the effectiveness and safety of a novel method concerning spontaneous usage of both monopoplar transurethral resection of the prostate and Holmium Laser cystolithotripsy, we compared the transurethral use of resectoscope and cystoscope lithotripsy approaches retrospectively. Methods: Patients data of one hundred and nine male patients with benign prostatic hyperplasia (BPH) and bladder stone(s) were analyzed retrospectively. Two groups of patients were compared: Group I was treated with combination of transurethral holmium laser cystolithotripsy (HLC) and transurethral resection of the prostate (TURP) using the 24F resectoscope, and group II used 22F cystoscope and 24F resectoscope for treating both these conditions. Result: We reviewed the records of 109 patients undergoing transurethral cystolithotripsy with holmium laser and simultaneous TURP. The mean bladder stone size were 3.6±1.5 cm in Group-I and 3.7±1.1 cm (mean 3.8) in Group-II (p>0.05). The mean operation time of Group-I and Group-II was 49.0±22.5 minutes and 79.0±28.5 minutes, respectively (p<0.05). Stone fragments were removed completely and TURP procedures were done successfully in all of the patients. Mild hematuria was found more frequently in Group-II (22.2%), and four (7.4%) patients had urethral stricture in the same group during the late follow-up. Conclusion: Combination of transurethral laser cystolithotripsy and TURP using the same 24F resectooscope is an effective, safe and economical treatment for bladder stones in BPH patients. It is minimally invasive and involves and has lower complication rates and shorter hospital stay. However, this combined approach should be taken in the treatment of calculus within 4 or 5 centimeters. PMID:25097543

  15. Effect of nonablative laser energy on joint capsular properties: an in-vitro study using a rabbit model

    NASA Astrophysics Data System (ADS)

    Hayashi, Kei; Markel, Mark D.; Thabit, George, III; Bogdanske, John J.; Thielke, Robert J.; Cooley, A. J.; Vailas, Arthur C.; Mascio, Laura N.; Vanderby, Ray, Jr.

    1996-05-01

    Recent scientific studies evaluating laser energy for tissue welding and thermokeratoplasty have demonstrated that the application of laser energy at non-ablative levels can alter collagen's structural and biochemical properties. A recent pilot study has demonstrated that the non-ablative application of holmium: yttrium-aluminum-garnet (Ho:YAG) laser energy to the joint capsule of patients with glenohumeral instability shrank the joint capsule, stabilizing the shoulder in the majority of the patients treated. Based on the collective findings of these studies, we hypothesized that thermal modification of dense collagenous tissues such as joint capsule, ligament, and tendon can be achieved by applying non-ablative laser energy. The purpose of this study was to evaluate the effect of laser energy at non-ablative levels on joint capsular mechanical, biochemical, histological, and ultrastructural properties in an in vitro rabbit model.

  16. Safety of cornea and iris in ocular surgery with 355-nm lasers

    NASA Astrophysics Data System (ADS)

    Wang, Jenny; Chung, Jae Lim; Schuele, Georg; Vankov, Alexander; Dalal, Roopa; Wiltberger, Michael; Palanker, Daniel

    2015-09-01

    A recent study showed that 355-nm nanosecond lasers cut cornea with similar precision to infrared femtosecond lasers. However, use of ultraviolet wavelength requires precise assessment of ocular safety to determine the range of possible ophthalmic applications. In this study, the 355-nm nanosecond laser was evaluated for corneal and iris damage in rabbit, porcine, and human donor eyes as determined by minimum visible lesion (MVL) observation, live/dead staining of the endothelium, and apoptosis assay. Single-pulse damage to the iris was evaluated on porcine eyes using live/dead staining. In live rabbits, the cumulative median effective dose (ED50) for corneal damage was 231 J/cm2, as seen by lesion observation. Appearance of endothelial damage in live/dead staining or apoptosis occurred at higher radiant exposure of 287 J/cm2. On enucleated rabbit and porcine corneas, ED50 was 87 and 52 J/cm2, respectively, by MVL, and 241 and 160 J/cm2 for endothelial damage. In human eyes, ED50 for MVL was 110 J/cm2 and endothelial damage at 453 J/cm2. Single-pulse iris damage occurred at ED50 of 208 mJ/cm2. These values determine the energy permitted for surgical patterns and can guide development of ophthalmic laser systems. Lower damage threshold in corneas of enucleated eyes versus live rabbits is noted for future safety evaluation.

  17. The free electron laser: a system capable of determining the gold standard in laser vision correction

    NASA Astrophysics Data System (ADS)

    Fowler, W. Craig; Rose, John G.; Chang, Daniel H.; Proia, Alan D.

    1999-06-01

    Introduction. In laser vision correction surgery, lasers are generally utilized based on their beam-tissue interactions and corneal absorption characteristics. Therefore, the free electron laser, with its ability to provide broad wavelength tunability, is a unique research tool for investigating wavelengths of possible corneal ablation. Methods. Mark III free electron laser wavelengths between 2.94 and 6.7 μm were delivered in serial 0.1 μm intervals to corneas of freshly enucleated porcine globes. Collateral damage, ablation depth, and ablation diameter were measured in histologic sections. Results. The least collateral damage (12-13 μm) was demonstrated at three wavelengths: 6.0, 6.1 (amide I), and 6.3 μm. Minimal collateral damage (15 μm) was noted at 2.94 μm (OH-stretch) and at 6.2 μm. Slightly greater collateral damage was noted at 6.45 μm (amide II), as well as at the 5.5-5.7 μm range, but this was still substantially less than the collateral damage noted at the other wavelengths tested. Conclusions. Our results suggest that select mid-infrared wavelengths have potential for keratorefractive surgery and warrant additional study. Further, the free electron laser's ability to allow parameter adjustment in the far-ultraviolet spectrum may provide unprecedented insights toward establishing the gold-standard parameters for laser vision correction surgery.

  18. Holmium-166 radioembolization for the treatment of patients with liver metastases: design of the phase I HEPAR trial

    PubMed Central

    2010-01-01

    Background Intra-arterial radioembolization with yttrium-90 microspheres ( 90Y-RE) is an increasingly used therapy for patients with unresectable liver malignancies. Over the last decade, radioactive holmium-166 poly(L-lactic acid) microspheres ( 166Ho-PLLA-MS) have been developed as a possible alternative to 90Y-RE. Next to high-energy beta-radiation, 166Ho also emits gamma-radiation, which allows for imaging by gamma scintigraphy. In addition, Ho is a highly paramagnetic element and can therefore be visualized by MRI. These imaging modalities are useful for assessment of the biodistribution, and allow dosimetry through quantitative analysis of the scintigraphic and MR images. Previous studies have demonstrated the safety of 166Ho-PLLA-MS radioembolization ( 166Ho-RE) in animals. The aim of this phase I trial is to assess the safety and toxicity profile of 166Ho-RE in patients with liver metastases. Methods The HEPAR study (Holmium Embolization Particles for Arterial Radiotherapy) is a non-randomized, open label, safety study. We aim to include 15 to 24 patients with liver metastases of any origin, who have chemotherapy-refractory disease and who are not amenable to surgical resection. Prior to treatment, in addition to the standard technetium-99m labelled macroaggregated albumin ( 99mTc-MAA) dose, a low radioactive safety dose of 60-mg 166Ho-PLLA-MS will be administered. Patients are treated in 4 cohorts of 3-6 patients, according to a standard dose escalation protocol (20 Gy, 40 Gy, 60 Gy, and 80 Gy, respectively). The primary objective will be to establish the maximum tolerated radiation dose of 166Ho-PLLA-MS. Secondary objectives are to assess tumour response, biodistribution, performance status, quality of life, and to compare the 166Ho-PLLA-MS safety dose and the 99mTc-MAA dose distributions with respect to the ability to accurately predict microsphere distribution. Discussion This will be the first clinical study on 166Ho-RE. Based on preclinical studies

  19. A huge benign prostatic hyperplasia presenting with renal failure

    PubMed Central

    Basatac, Cem; Cicek, Mehmet Cagatay

    2015-01-01

    Although transurethral resection of the prostate is still standard of care in many patients suffering from benign prostatic hyperplasia, traditional open prostatectomy (OP) seems as a widely applied method in larger glands. In spite of the fact that holmium laser enucleation can be performed in large glands, upper limits of prostate size in this method are not clearly identified in the current literature. In this case, we aim to report feasibility and efficacy of OP in huge prostate size measured as 680 ml by transrectal ultrasound and review the current literature. PMID:26034239

  20. Study of the line intensity in the optical and magnetooptical spectra in holmium-containing paramagnetic garnets

    NASA Astrophysics Data System (ADS)

    Valiev, Uygun V.; Gruber, John B.; Burdick, Gary W.; Pelenovich, Vasiliy O.; Fu, Dejun; Dzhuraev, Davron R.

    2016-01-01

    Studies of line intensity in the optical and magneto-optical spectra in the holmium-containing paramagnetic garnet Ho3+:YAG were carried out within the visible spectrum at T = 85 K. Detailed investigation of the magnetic circularly polarized luminescence spectra at 85 and 300 K on 5S2 → 5I8 emission transition in Ho3+:YAG was carried out. A quasi-doublet state in the energy spectrum of the Ho3+ ions was observed, characterized by a significant magneto-optical activity, which is caused by a large Zeeman splitting of the quasi-doublet. The measurement of the magnetic circular polarized luminescence spectrum carried out within one of the emission lines of the luminescence band 5S2 → 5I8 in Ho3+:YAG at 85 K shows significant magneto-optical effects of the intensity change of the emitted light, compared to that measured for the other emission lines in the same luminescent band.

  1. Five years follow-up of a keratocyst odontogenic tumor treated by marsupialization and enucleation: A case report and literature review

    PubMed Central

    de Molon, Rafael Scaf; Verzola, Mario H.; Pires, Luana C.; Mascarenhas, Vinicius I.; da Silva, Rodrigo B.; Cirelli, Joni A.; Barbeiro, Roberto H.

    2015-01-01

    Odontogenic cysts are considered as nonneoplasic benign lesions. Among the cysts, keratocyst odontogenic tumor (KCOT) is an intra-osseous tumor characterized by parakeratinized stratified squamous epithelium and a potential for aggressive, infiltrative behavior, and for the possibility to develop carcinomas in the lesion wall. Thus, the aim of this study was to describe a clinical case of KCOT in a young patient and discuss the treatment alternatives to solve this case. A 15-year-old male was referred for treatment of a giant lesion in his left side of the mandible. After the biopsy, a diagnostic of KCOT was made, and the following procedures were planned for KCOT treatment. Marsupialization was performed for lesion decompression and consequent lesion size reduction. Afterward, enucleation for complete KCOT removal was performed followed by third mandibular molar extraction. After 5 years, no signs of recurrence were observed. The treatment proposed was efficient in removing the KCOT with minimal surgical morbidity and optimal healing process, and the first and second mandibular molars were preserved with pulp vitality. In conclusion, this treatment protocol was an effective and conservative approach for the management of the KCOT, enabling the reduction of the initial lesion, the preservation of anatomical structures and teeth, allowing quicker return to function. No signs of recurrence after 5 years were observed. PMID:25821360

  2. Emission characteristics of holmium ions in fluoro-phosphate glasses for photonic applications

    NASA Astrophysics Data System (ADS)

    Babu, S.; Ratnakaram, Y. C.

    2016-05-01

    Optical properties of Ho3+ doped different fluorophosphate (FP) glasses have been synthesized and discussed. Thermal properties have been studied through differential scanning calorimetry (DSC).The Judd-Ofelt (J-O) intensity parameters Ωλ (λ= 2, 4, 6) from absorption spectra have been evaluated. Various radiative parameters have been obtained for the different excited states using J-O theory. From the emission spectra, different laser properties have been studied and discussed. The nature of decay curve analysis was performed for the 5F4(5S2) level. These glasses are expected to give interesting application in the field of photonic applications.

  3. Femtosecond laser lithotripsy: feasibility and ablation mechanism

    NASA Astrophysics Data System (ADS)

    Qiu, Jinze; Teichman, Joel M. H.; Wang, Tianyi; Neev, Joseph; Glickman, Randolph D.; Chan, Kin Foong; Milner, Thomas E.

    2010-03-01

    Light emitted from a femtosecond laser is capable of plasma-induced ablation of various materials. We tested the feasibility of utilizing femtosecond-pulsed laser radiation (λ=800 nm, 140 fs, 0.9 mJ/pulse) for ablation of urinary calculi. Ablation craters were observed in human calculi of greater than 90% calcium oxalate monohydrate (COM), cystine (CYST), or magnesium ammonium phosphate hexahydrate (MAPH). Largest crater volumes were achieved on CYST stones, among the most difficult stones to fragment using Holmium:YAG (Ho:YAG) lithotripsy. Diameter of debris was characterized using optical microscopy and found to be less than 20 μm, substantially smaller than that produced by long-pulsed Ho:YAG ablation. Stone retropulsion, monitored by a high-speed camera system with a spatial resolution of 15 μm, was negligible for stones with mass as small as 0.06 g. Peak shock wave pressures were less than 2 bars, measured by a polyvinylidene fluoride (PVDF) needle hydrophone. Ablation dynamics were visualized and characterized with pump-probe imaging and fast flash photography and correlated to shock wave pressures. Because femtosecond-pulsed laser ablates urinary calculi of soft and hard compositions, with micron-sized debris, negligible stone retropulsion, and small shock wave pressures, we conclude that the approach is a promising candidate technique for lithotripsy.

  4. Wideband thulium-holmium-doped fiber source with combined forward and backward amplified spontaneous emission at 1600-2300  nm spectral band.

    PubMed

    Honzatko, Pavel; Baravets, Yauhen; Kasik, Ivan; Podrazky, Ondrej

    2014-06-15

    We have experimentally demonstrated two extremely wideband amplified spontaneous emission (ASE) sources. High bandwidth is achieved by combining the backward and forward ASEs generated in thulium-holmium-doped fiber using appropriate wideband couplers. The ASE source optimized for flat spectral power density covers a spectral range from 1527 to 2171 nm at a -10  dB level. The ASE source optimized for spectroscopy features an enhancement with respect to single-mode fiber (SMF) coupled halogen lamps within the spectral range from 1540 nm to more than 2340 nm covering the 800 nm bandwidth. PMID:24978559

  5. Comparison of fluoride and sapphire optical fibers for Er: YAG laser lithotripsy.

    PubMed

    Qiu, Jinze; Teichman, Joel; Wang, Tianyi; Elmaanaoui, Badr; Gamez, David; Milner, Thomas E

    2010-06-01

    The long-pulse (200-350 micros) Holmium: YAG (Ho: YAG) laser (lambda = 2.12 microm) is used extensively in urology for laser lithotripsy. The long-pulse Erbium: YAG (Er: YAG) laser (lambda = 2.94 microm) fragments urinary calculi up to 5 times more efficiently than the Ho: YAG laser, however, no optical fibers are available to transmit efficiently 2.94 microm laser light for laser lithotripsy. We report results of a study evaluating a fluoride glass fiber to transmit Er: YAG laser light for laser lithotripsy and compare to a sapphire fiber that provides good transmission of Er: YAG light at low irradiance. The fluoride fiber provides superior light transmission efficiency over the sapphire fiber at an Er: YAG wavelength (2.94 microm). The sapphire fiber provides a more durable and robust delivery waveguide than the fluoride fiber when ablating urinary calculi in contact mode. Results of our study suggest that further development to improve performance of fluoride fibers for laser lithotripsy is warranted. PMID:20414904

  6. Pulsed lasers in dentistry: sense or nonsense?

    NASA Astrophysics Data System (ADS)

    Koort, Hans J.; Frentzen, Matthias

    1991-05-01

    radiation the Er:YAG-laser radiation could also only be delivered via mirror systems, while the radiation of the Ho:YAG-Laser can be well transmitted through quartz fibers. The energy of the well known and in other medical disciplines often used Nd:YAG - laser (1,064 μm, pulse duration 150 us) laser can be transmitted through fiber systems without problems, but this laser has not the effectivity to work sufficient on healthy hard dental tissues due to the high transmission in mineralized dental tissues. The thermal injuries of this laser type are not tolerable. The short pulsed TEA-C02-laser (9,6 and 10,6 μm, pulse duration 200-300 ns), which has an excellent coupling not only to the hydrogeneous tissues but also to the mineralized tissues could be an alternative system to prepare dental tissues. The greatest disadvantage of this system is the noneffective delivery of the light energy through flexible fiber systems, which are still in development. Another good chance perhaps will have the q-switched Neodym, Erbium and Holmium:- YAG lasers with pulse durations of about some hundred ns. Both, possible thermal influences and possible disruptive effects should be small enough to let the adjacent tissues undamaged.

  7. Investigations for the correction of presbyopia by fs-laser-induced cuts

    NASA Astrophysics Data System (ADS)

    Ripken, Tammo; Oberheide, Uwe; Heisterkamp, Alexander; Ertmer, Wolfgang; Gerten, Georg; Lubatschowski, Holger

    2004-07-01

    The most probable reason for presbyopia is an age-related loss of the elasticity of the lens. It develops through the whole life, but is first noticeable typically at the age of about 45. From that on it leads within 15 years to a total loss of the accommodation ability. However, both, the ciliary muscle and the lens capsule stay active and elastic, respectively. With respect to this, a possible treatment conception is to increase or regain the elasticity. The possibility to increase elasticity with ps-laser induced cuts inside the lens was already shown by Krueger. We made an improvement in cutting quality while using a fs laser with 5~kHz repetition rate emitting in the near infrared. Different fs-laser-induced μm smooth cuts inside fresh enucleated ex-vivo pig lenses will be presented.

  8. Expanding rare-earth oxidation state chemistry to molecular complexes of holmium(II) and erbium(II).

    PubMed

    MacDonald, Matthew R; Bates, Jefferson E; Fieser, Megan E; Ziller, Joseph W; Furche, Filipp; Evans, William J

    2012-05-23

    The first molecular complexes of holmium and erbium in the +2 oxidation state have been generated by reducing Cp'(3)Ln [Cp' = C(5)H(4)SiMe(3); Ln = Ho (1), Er (2)] with KC(8) in the presence of 18-crown-6 in Et(2)O at -35 °C under argon. Purification and crystallization below -35 °C gave isomorphous [(18-crown-6)K][Cp'(3)Ln] [Ln = Ho (3), Er (4)]. The three Cp' ring centroids define a trigonal-planar geometry around each metal ion that is not perturbed by the location of the potassium crown cation near one ring with K-C(Cp') distances of 3.053(8)-3.078(2) Å. The metrical parameters of the three rings are indistinguishable within the error limits. In contrast to Ln(2+) complexes of Eu, Yb, Sm, Tm, Dy, and Nd, 3 and 4 have average Ln-(Cp' ring centroid) distances only 0.029 and 0.021 Å longer than those of the Ln(3+) analogues 1 and 2, a result similar to that previously reported for the 4d(1) Y(2+) complex [(18-crown-6)K][Cp'(3)Y] (5) and the 5d(1) La(2+) complex [K(18-crown-6)(Et(2)O)][Cp″(3)La] [Cp″ = 1,3-(Me(3)Si)(2)C(5)H(3)]. Surprisingly, the UV-vis spectra of 3 and 4 are also very similar to that of 5 with two broad absorptions in the visible region, suggesting that 3-5 have similar electron configurations. Density functional theory calculations on the Ho(2+) and Er(2+) species yielded HOMOs that are largely 5d(z(2)) in character and supportive of 4f(10)5d(1) and 4f(11)5d(1) ground-state configurations, respectively. PMID:22583320

  9. Semiempirical quantum chemistry model for the lanthanides: RM1 (Recife Model 1) parameters for dysprosium, holmium and erbium.

    PubMed

    Filho, Manoel A M; Dutra, José Diogo L; Rocha, Gerd B; Simas, Alfredo M; Freire, Ricardo O

    2014-01-01

    Complexes of dysprosium, holmium, and erbium find many applications as single-molecule magnets, as contrast agents for magnetic resonance imaging, as anti-cancer agents, in optical telecommunications, etc. Therefore, the development of tools that can be proven helpful to complex design is presently an active area of research. In this article, we advance a major improvement to the semiempirical description of lanthanide complexes: the Recife Model 1, RM1, model for the lanthanides, parameterized for the trications of Dy, Ho, and Er. By representing such lanthanide in the RM1 calculation as a three-electron atom with a set of 5 d, 6 s, and 6 p semiempirical orbitals, the accuracy of the previous sparkle models, mainly concentrated on lanthanide-oxygen and lanthanide-nitrogen distances, is extended to other types of bonds in the trication complexes' coordination polyhedra, such as lanthanide-carbon, lanthanide-chlorine, etc. This is even more important as, for example, lanthanide-carbon atom distances in the coordination polyhedra of the complexes comprise about 30% of all distances for all complexes of Dy, Ho, and Er considered. Our results indicate that the average unsigned mean error for the lanthanide-carbon distances dropped from an average of 0.30 Å, for the sparkle models, to 0.04 Å for the RM1 model for the lanthanides; for a total of 509 such distances for the set of all Dy, Ho, and Er complexes considered. A similar behavior took place for the other distances as well, such as lanthanide-chlorine, lanthanide-bromine, lanthanide, phosphorus and lanthanide-sulfur. Thus, the RM1 model for the lanthanides, being advanced in this article, broadens the range of application of semiempirical models to lanthanide complexes by including comprehensively many other types of bonds not adequately described by the previous models. PMID:24497945

  10. Semiempirical Quantum Chemistry Model for the Lanthanides: RM1 (Recife Model 1) Parameters for Dysprosium, Holmium and Erbium

    PubMed Central

    Filho, Manoel A. M.; Dutra, José Diogo L.; Rocha, Gerd B.; Simas, Alfredo M.; Freire, Ricardo O.

    2014-01-01

    Complexes of dysprosium, holmium, and erbium find many applications as single-molecule magnets, as contrast agents for magnetic resonance imaging, as anti-cancer agents, in optical telecommunications, etc. Therefore, the development of tools that can be proven helpful to complex design is presently an active area of research. In this article, we advance a major improvement to the semiempirical description of lanthanide complexes: the Recife Model 1, RM1, model for the lanthanides, parameterized for the trications of Dy, Ho, and Er. By representing such lanthanide in the RM1 calculation as a three-electron atom with a set of 5 d, 6 s, and 6 p semiempirical orbitals, the accuracy of the previous sparkle models, mainly concentrated on lanthanide-oxygen and lanthanide-nitrogen distances, is extended to other types of bonds in the trication complexes’ coordination polyhedra, such as lanthanide-carbon, lanthanide-chlorine, etc. This is even more important as, for example, lanthanide-carbon atom distances in the coordination polyhedra of the complexes comprise about 30% of all distances for all complexes of Dy, Ho, and Er considered. Our results indicate that the average unsigned mean error for the lanthanide-carbon distances dropped from an average of 0.30 Å, for the sparkle models, to 0.04 Å for the RM1 model for the lanthanides; for a total of 509 such distances for the set of all Dy, Ho, and Er complexes considered. A similar behavior took place for the other distances as well, such as lanthanide-chlorine, lanthanide-bromine, lanthanide, phosphorus and lanthanide-sulfur. Thus, the RM1 model for the lanthanides, being advanced in this article, broadens the range of application of semiempirical models to lanthanide complexes by including comprehensively many other types of bonds not adequately described by the previous models. PMID:24497945

  11. Chemically Assisted Enucleation Results in Higher G6PD Expression in Early Bovine Female Embryos Obtained by Somatic Cell Nuclear Transfer

    PubMed Central

    Oliveira, Clara Slade; Tetzner, Tatiane Almeida Drummond; de Lima, Marina Ragagnin; de Melo, Danilas Salinet; Niciura, Simone Cristina Méo; Garcia, Joaquim Mansano

    2012-01-01

    Abstract Despite extensive efforts, low efficiency is still an issue in bovine somatic cell nuclear transfer (SCNT). The hypothesis of our study was that the use of cytoplasts produced by chemically assisted enucleation (EN) would improve nuclear reprogramming in nuclear transfer (NT)–derived embryos because it results in lower damage and higher cytoplasm content than conventional EN. For that purpose, we investigated the expression of two X-linked genes: X inactive-specific transcript (XIST) and glucose 6-phosphate dehydrogenase (G6PD). In the first experiment, gene expression was assessed in day-7 female blastocysts from embryonic cell NT (ECNT) groups [conventional, ECNT conv; chemically assisted, ECNT deme (demecolcine)]. Whereas in the ECNT conv group, only one embryo (25%; n=4) expressed XIST transcripts, most embryos showed XIST expression (75%; n=4) in the ECNT deme group. However, no significant differences in transcript abundance of XIST and G6PD were found when comparing the embryos from all groups. In a second experiment using somatic cells as nuclear donors, we evaluated gene expression profiles in female SCNT-derived embryos. No significant differences in relative abundance (RA) of XIST transcripts were observed among the groups. Nonetheless, higher (p<0.05) levels of G6PD were observed in SCNT deme and in vitro–derived groups in comparison to SCNT conv. To know whether higher G6PD expression in embryos derived from SCNT chemically assisted EN indicates higher metabolism in embryos considered of superior quality or if the presence of higher reactive oxygen species (ROS) levels generated by the increased oxygen consumption triggers G6PD activation, the expression of genes related to stress response should be investigated in embryos produced by that technique. PMID:22908977

  12. Laser lithotripsy with the Ho:YAG laser: fragmentation process revealed by time-resolved imaging

    NASA Astrophysics Data System (ADS)

    Schmidlin, Franz R.; Beghuin, Didier; Delacretaz, Guy P.; Venzi, Giordano; Jichlinski, Patrice; Rink, Klaus; Leisinger, Hans-Juerg; Graber, Peter

    1998-07-01

    Improvements of endoscopic techniques have renewed the interest of urologists in laser lithotripsy in recent years. Laser energy can be easily transmitted through flexible fibers thereby enabling different surgical procedures such as cutting, coagulating and lithotripsy. The Ho:YAG laser offers multiple medical applications in Urology, among them stone fragmentation. However, the present knowledge of its fragmentation mechanism is incomplete. The objective was therefore to analyze the fragmentation process and to discuss the clinical implications related to the underlying fragmentation mechanism. The stone fragmentation process during Ho:YAG laser lithotripsy was observed by time resolved flash video imaging. Possible acoustic transient occurrence was simultaneously monitored with a PVDF-needle hydrophone. Fragmentation was performed on artificial and cystine kidney stones in water. We observed that though the fragmentation process is accompanied with the formation of a cavitation bubble, cavitation has only a minimal effect on stone fragmentation. Fragment ejection is mainly due to direct laser stone heating leading to vaporization of organic stone constituents and interstitial water. The minimal effect of the cavitation bubble is confirmed by acoustic transients measurements, which reveal weak pressure transients. Stone fragmentation with the Holmium laser is the result of vaporization of interstitial (stone) water and organic stone constituents. It is not due to the acoustic effects of a cavitation bubble or plasma formation. The fragmentation process is strongly related with heat production thereby harboring the risk of undesired thermal damage. Therefore, a solid comprehension of the fragmentation process is needed when using the different clinically available laser types of lithotripsy.

  13. AB051. Technical improvement of HoLEP and prevention strategies of postoperative incontinence

    PubMed Central

    Ding, Mingxia; Wang, Jiansong; Zuo, Yigang; Chen, Jian; Wang, Haifeng; Li, Ning; Liu, Jingyu; Wang, Wei; Li, Haihao

    2015-01-01

    Objective To improve HoLEP surgical techniques of finding envelope, enucleation, hemostatic and comminution, and to treate the incontinence reason predictably, so as to reduce the complications of HoLEP surgery. Methods Technical improvements were performed in 272 patients who underwent HoLEP during January 2014 to December 2014. (I) The gland was enucleated in three lobes, not overall enucleation; (II) start with both sides of verumontanum to find envelope, the ‘three-lobe’ technique involves 5- and 7-o'clock position incisions with enucleation of the middle lobe and subsequent enucleation of one lateral lobe followed by the other lateral lobe; (III) we only lift the glands gently by lens body, using holmium laser blasting to peel glands, and abandon conventional mirror peeling method; (IV) if bleeding is encountered, the laser fibre can be defocused slightly from the bleeding point to achieve haemostasis; (V) we crushed glands vacantly with the status of bladder filling. The reason why postoperative urinary incontinence occurs may be thermal burns sphincter, mucosal retention inadequate, sphincter weiss at around 12:00, and sphincter injury caused by mirror body elevation, etc. Some precautions during the operation were as follows: (I) reducing laser ablation; (II) separation off the reserved side lobe mucosa before peeling; (III) avoid 12:00 distal mucosal tear; (IV) using blasting holmium laser energy not lens body to peel glands, which can avoid sphincter injury by mirror body elevation force. Results We identified 272 patients who underwent HoLEP. The median volume of enucleated adenomas was 92±24 g. The median IPSS before surgery was 23.3±6.1. Average (range) operation time was 86±21 minutes. Amount of bleeding was 56±14 mL. Postoperative patients of hospital stay was 32±5 h, average time of indwelling catheter time was 22±6 h. Patients were followed up for 6-28 months’ time, an average of 12.4 months. Postoperative patients with international

  14. Spectroscopic properties of bismuth-germanate glasses co-doped with erbium and holmium ions

    NASA Astrophysics Data System (ADS)

    Ragin, Tomasz; Kochanowicz, Marcin; Żmojda, Jacek; Dorosz, Dominik

    2014-05-01

    In the article an analysis of thermal and spectroscopic properties of heavy metal oxide glasses from the Bi2O3-Ga2O3- Na2O-Ge2O3 system doped with rare earth elements were presented. It has been focused on the elaboration of the glass composition in terms of low phonon energy, high transparency in the range of infrared region and high thermal stability (ΔT=160 °C) required in optical fiber technology. Fabricated glasses co-doped with Er3+/Ho3+ions under 980 nm laser diode excitation exhibit emission at 1.55 μm (Er3+: 4I 13/2 → 4I15/2) and 2.0 μm (Ho3+: 4I7 → 5I8). The emission at 2.0 μm results from the Er3+ → Ho3+energy transfer. Taking into account great thermal stability and good optical properties such as high transparency (up to 80%) or high refractive index (2.23), the fabricated bismuth-germanate glass co-doped with Er3+/Ho3+ is promising material for construction of active optical fibers operating in the range of mid-infrared.

  15. Preliminary evaluation of a pulsed 2.15-micron laser system for fiberoptic endoscopic surgery.

    PubMed

    Treat, M R; Trokel, S L; Reynolds, R D; DeFilippi, V J; Andrew, J; Liu, J Y; Cohen, M G

    1988-01-01

    There is a need for lasers that are compatible with fiberoptic endoscopes and that provide greater cutting precision than currently can be produced by the widely used Nd:YAG (1.06 micron) laser. Recently available lasers that operate in the 2-micron region fill this need. This laser light energy can be transmitted by low OH- silica fibers and has much less tissue penetration than radiation at 1.06 micron. We have been evaluating a prototype solid state laser system that produces pulses of 2.15 microns light that is delivered by a silica based fiberoptic delivery system with negligible transmission losses. This system is based on a thulium-holmium-chromium doped YAG (Tm-Ho-Cr: YAG) rod that lases at 2.15 micron. The laser does not require cryogenic cooling, toxic gases, or custom utilities and should be practical in a clinical environment. In vivo animal testing of this laser confirms that it provides greater ablating precision than does the Nd:YAG laser at 1.06 micron. PMID:2839746

  16. Chromium-sensitized garnets for mid-IR lasers. Final report, 30 January 1988-29 January 1990

    SciTech Connect

    Moulton, P.F.

    1990-01-29

    The characteristics of chromium-sensitized solid state lasers operating in the mid-infrared wavelength region have been studied. During the second year of research there was continued work on crystals doped with holmium and erbium, operating in the 2100-nm and 2800-nm regions. In addition, preliminary measurements were made on the laser performance of thulium around 2010 nm. For all these materials the effect of pump pulse length on output energy and overall efficiency has been measured. A flashlamp-pumped Cr,Nd:GSGG slab laser was operated and characterized at 1061 and 1310 nm. Measurements included comparison of normal mode slope efficiencies, input-output vs. pump pulse length, characterization of thermal lensing and measurement of Q-switched performance at 1061 nm. Spectroscopic properties of GGG crystals doped with Ce4+ ions were measured, including absorption and emission spectra and fluorescence lifetime.

  17. Detection of rare earth elements in Powder River Basin sub-bituminous coal ash using laser-induced breakdown spectroscopy (LIBS)

    SciTech Connect

    Tran, Phuoc

    2015-10-01

    We reported our preliminary results on the use of laser-induced breakdown spectroscopy to analyze the rare earth elements contained in ash samples from Powder River Basin sub-bituminous coal (PRB-coal). We have identified many elements in the lanthanide series (cerium, europium, holmium, lanthanum, lutetium, praseodymium, promethium, samarium, terbium, ytterbium) and some elements in the actinide series (actinium, thorium, uranium, plutonium, berkelium, californium) in the ash samples. In addition, various metals were also seen to present in the ash samples

  18. Successful Removal of a Large Common Bile Duct Stone by Using Direct Peroral Cholangioscopy and Laser Lithotripsy in a Patient with Severe Kyphosis.

    PubMed

    Lee, Song I; Lim, Byung Hun; Heo, Won Gak; Kim, Young Jun; Kim, Tae Hyeon

    2016-07-01

    A 75-year-old woman with hypertension presented with acute suppurative cholangitis. Chest radiography revealed severe kyphosis. Abdominal computed tomography revealed a large stone impacted in the common bile duct (CBD). The patient underwent emergent endoscopic retrograde cholangiopancreatography, and cholangiography revealed a large stone (7×3 cm) in the CBD that could not be captured using a large basket. We could not use the percutaneous approach for stone fragmentation by using a cholangioscope because of severe degenerative kyphosis. Finally, we performed holmium laser lithotripsy under peroral cholangioscopy by using an ultraslim endoscope, and the large stone in the CBD was successfully fragmented and removed without complications. PMID:27000425

  19. Successful Removal of a Large Common Bile Duct Stone by Using Direct Peroral Cholangioscopy and Laser Lithotripsy in a Patient with Severe Kyphosis

    PubMed Central

    Lee, Song I; Lim, Byung Hun; Heo, Won Gak; Kim, Young Jun; Kim, Tae Hyeon

    2016-01-01

    A 75-year-old woman with hypertension presented with acute suppurative cholangitis. Chest radiography revealed severe kyphosis. Abdominal computed tomography revealed a large stone impacted in the common bile duct (CBD). The patient underwent emergent endoscopic retrograde cholangiopancreatography, and cholangiography revealed a large stone (7×3 cm) in the CBD that could not be captured using a large basket. We could not use the percutaneous approach for stone fragmentation by using a cholangioscope because of severe degenerative kyphosis. Finally, we performed holmium laser lithotripsy under peroral cholangioscopy by using an ultraslim endoscope, and the large stone in the CBD was successfully fragmented and removed without complications. PMID:27000425

  20. Development of mid-infrared solid state lasers for spaceborne lidar

    NASA Technical Reports Server (NTRS)

    Whitney, Donald A.

    1990-01-01

    Researchers investigated laser performance of Ho(3+):Tm(3+):Cr(3+):YAG crystals under both Cr:GSAG laser and flashlamp pumping. A flashlamp pumped Cr:GSAG laser was built to simulate high power quasi-CW laser diode pumping of a 2.1 micron holmium laser. The 2.1 micron output laser energy exceeded more than 14 mJ, the highest value reported to date under laser pumping near 785 nm. This was obtained in a pulse length of nearly 650 microns from a 3 x 3 mm Ho:Tm:Cr:YAG rod by using the flashlamp-pumped Cr:GSAG laser as a pumping source at the diode laser wavelength, 785 microns. In addition, Ho:Tm:Cr:YAG crystals with various Tm(3+) concentrations have been evaluated for flashlamp-pumped normal mode and Q-switched 2.1 micron laser operations under a wide variety of experimental conditions in order to understand internal dynamic processes among the ions and to determine an optimum lasing condition. An increase of the laser slope efficiency was observed with the increase of the Tm(3+) concentration from 2.5 atomic percent to 4.5 atomic percent. The thermal dependence of the laser performance was also investigated. Q-switched laser output energies corresponding to nearly 100 percent of the normal-mode laser energies were obtained in a strong single spike of 200 ns pulse length by optimizing the opening time of a lithium niobate Q-switch.

  1. Pustulotic arthro-osteitis report of a case successfully treated with laser-assisted arthroscopic synovectomy.

    PubMed

    Yamada, K; Imaizumi, T; Uemura, M

    1999-02-01

    A 61-year-old man with palmoplantar pustulosis had pain and swelling persisting in his left knee for more than 3 years. The rheumatoid factor and HLA B 27 antigen were absent. Plain radiographs of the knee revealed no abnormalities despite the persistent synovitis. The bone scintigraphy showed increased uptake in the manubriosternal joint as well as in the knee. Eventually, the patient underwent arthroscopic synovectomy assisted with a holmium: YAG laser. No postoperative complications such as hemarthrosis were noted. The patient was pain free with full range of motion of the knee 22 months after surgery. Peripheral arthritis associated with palmoplantar pustulosis is usually transient. This unique case suggests that laser-assisted arthroscopic synovectomy would be a useful therapeutic option for persistent severe synovitis resistant to conservative treatment in pustulotic arthro-osteitis. PMID:19078345

  2. Characterization of a 50-μm-core optical fiber for potential use in Thulium fiber laser lithotripsy

    NASA Astrophysics Data System (ADS)

    Blackmon, Richard L.; Hutchens, Thomas C.; Hardy, Luke A.; Irby, Pierce B.; Fried, Nathaniel M.

    2014-03-01

    Our laboratory is currently studying the Thulium fiber laser (TFL) as a potential alternative laser lithotripter to the standard clinical Holmium:YAG laser. We have previously demonstrated efficient coupling of TFL energy into fibers as small as 100-μm-core-diameter without damage to the proximal end. Although smaller fibers have greater tendency to degrade at the distal tip during lithotripsy, fiber diameters (<= 200 μm) have been shown to increase saline irrigation rates through the working channel of a flexible ureteroscope, maximize ureteroscope deflection, and reduce stone retropulsion during laser lithotripsy. In this study, a 50-μm-core-diameter, 85-μm-outer-diameter fiber is characterized for TFL ablation of human calcium oxalate monohydrate urinary stones, ex vivo. The stone ablation rate was measured to be 70 +/- 22 μg/s for 35-mJ-pulse-energy, 500-μs-pulse-duration, and 50-Hz-pulse-rate. The ureteroscope working channel flow rate including the 50-μm fiber decreased by only 10% with no impairment of ureteroscope deflection. The fiber delivered up to 15.4 +/- 5.9 W under extreme bending (5-mm-radius) conditions. Stone retropulsion and fiber burn-back averaged 201 +/- 336 and 3000 +/- 2600 μm, respectively, after 2 minutes. With further development, Thulium fiber laser lithotripsy using ultra-small, 50-μm-core fibers may introduce new integration and miniaturization possibilities and potentially provide an alternatiμe to conventional Holmium:YAG laser lithotripsy using larger fibers.

  3. Thulium fiber laser ablation of kidney stones using a 50-μm-core silica optical fiber

    NASA Astrophysics Data System (ADS)

    Blackmon, Richard L.; Hutchens, Thomas C.; Hardy, Luke A.; Wilson, Christopher R.; Irby, Pierce B.; Fried, Nathaniel M.

    2015-01-01

    Our laboratory is currently studying the experimental thulium fiber laser (TFL) as a potential alternative laser lithotripter to the gold standard, clinical Holmium:YAG laser. We have previously demonstrated the efficient coupling of TFL energy into fibers as small as 100-μm-core-diameter without damage to the proximal end. Although smaller fibers have a greater tendency to degrade at the distal tip during lithotripsy, fiber diameters (≤200 μm) have been shown to increase the saline irrigation rates through the working channel of a flexible ureteroscope, to maximize the ureteroscope deflection, and to reduce the stone retropulsion during laser lithotripsy. In this study, a 50-μm-core-diameter, 85-μm-outer-diameter, low-OH silica fiber is characterized for TFL ablation of human calcium oxalate monohydrate urinary stones, ex vivo. The 50-μm-core fiber consumes approximately 30 times less cross-sectional area inside the single working channel of a ureteroscope than the standard 270-μm-core fiber currently used in the clinic. The ureteroscope working channel flow rate, including the 50-μm fiber, decreased by only 10% with no impairment of ureteroscope deflection. The fiber delivered up to 15.4±5.9 W under extreme bending (5-mm-radius) conditions. The stone ablation rate measured 70±22 μg/s for 35-mJ-pulse-energy, 500-μs-pulse-duration, and 50-Hz-pulse-rate. Stone retropulsion and fiber burnback averaged 201±336 and 3000±2600 μm, respectively, after 2 min. With further development, thulium fiber laser lithotripsy using ultra-small, 50-μm-core fibers may introduce new integration and miniaturization possibilities and potentially provide an alternative to conventional Holmium:YAG laser lithotripsy using larger fibers.

  4. Focusing of laser beams by the eye's optics

    NASA Astrophysics Data System (ADS)

    Zheltov, Georgi I.; Rubanov, Alexander S.

    1998-10-01

    The radial distribution of Gaussian beams radiation intensity on the focal plain of the ocular optical system has been calculated using the human eye Modulation Transfer Function. The dependencies of the distribution on the distance to the beam's constriction have been analyzed for the visible spectral range at a given eye accommodation. More consideration has been given to the conditions of the most `sharp' focusing of laser beams onto the retina (the most dangerous cases) and to the typical errors arising in the process retinal irradiance distribution measurement through the pupil. The analogous model has been created for the eyes of some animals. The results of calculations are in a good agreement with direct measurements data at the back pole of enucleated rabbit eyes.

  5. Mid-Infrared Laser Orbital Septal Tightening

    PubMed Central

    Chu, Eugene A.; Li, Michael; Lazarow, Frances B.; Wong, Brian J. F.

    2014-01-01

    IMPORTANCE Blepharoplasty is one of the most commonly performed facial aesthetic surgeries. While myriad techniques exist to improve the appearance of the lower eyelids, there is no clear consensus on the optimal management of the orbital septum. OBJECTIVES To evaluate the safety and feasibility of the use of the holmium:yttrium aluminum garnet (Ho:YAG) laser for orbital septal tightening, and to determine whether modest use of this laser would provide some degree of clinical efficacy. DESIGN, SETTING, AND PARTICIPANTS Direct laser irradiation of ex vivo bovine tissue was used to determine appropriate laser dosimetry using infrared thermal imaging and optical coherence tomography before conducting a pilot clinical study in 5 patients. Laser irradiation of the lower eyelid orbital septum was performed through a transconjunctival approach. Standardized preoperative and postoperative photographs were taken for each patient and evaluated by 6 unbiased aesthetic surgeons. EXPOSURE Use of the Ho:YAG laser for orbital septal tightening. MAIN OUTCOME AND MEASURE To determine appropriate laser dosimetry, infrared thermal imaging and optical coherence tomography were used to monitor temperature and tissue shape changes of ex vivo bovine tissue that was subjected to direct laser irradiation. For the clinical study, preoperative and postoperative photographs were evaluated by 6 surgeons on a 10-point Likert scale. RESULTS Optical coherence tomography demonstrated that laser irradiation of bovine tissue to a temperature range of 60°C to 80°C resulted in an increase in thickness of up to 2-fold. There were no complications or adverse cosmetic outcomes in the patient study. Patient satisfaction with the results of surgery averaged 7 on a 10-point Likert scale. For 3 patients, 3 (50%) of the evaluators believed there was a mild improvement in appearance of the lower eyelids after surgery. The remaining patients were thought to have no significant changes. CONCLUSIONS AND

  6. Laser Technology.

    ERIC Educational Resources Information Center

    Gauger, Robert

    1993-01-01

    Describes lasers and indicates that learning about laser technology and creating laser technology activities are among the teacher enhancement processes needed to strengthen technology education. (JOW)

  7. Comparison of in situ Corneoscleral Disc Excision versus Whole Globe Enucleation in Cornea Donors Regarding Microbial Contamination in Organ Culture Medium – a Prospective Monocentric Study over 9 Years

    PubMed Central

    Schroeter, Jan; Wilkemeyer, Ina; Herrlinger, Frithjof; Pruss, Axel

    2012-01-01

    Summary Background Corneas needed for keratoplasty can be harvested using two techniques: whole globe enucleation and in situ excision of the corneoscleral disc. This study evaluates the rate of microbial contamination of the donor cornea organ culture medium according to the method of retrieval. Methods All donor corneas of our cornea bank received between January 1, 2001 and December 31, 2009 put into organ culture and microbio-logically tested were prospectively analyzed for microbial contamination of the organ culture medium. Results 2,805 donor corneas could be included in this study in total. 975 of them were retrieved by whole globe enucleation (group 1) and 1,830 by in situ corneoscleral disc excision (group 2). 15 corneas of group 1 (1.5%) and 46 corneas of group 2 (2.5%) showed a contamination of the organ culture medium. The difference was shown not to be statistically significant (p = 0.082). Conclusion The rate of microbial contamination in organ-cultured donor corneas does not seem to be dependent on the method of their retrieval. PMID:23801381

  8. Improved efficiency of microsurgical enucleated tripronuclear zygotes development and embryonic stem cell derivation by supplementing epidermal growth factor, brain-derived neurotrophic factor, and insulin-like growth factor-1.

    PubMed

    Fan, Yong; Li, Rong; Huang, Jin; Zhao, Hong-Cui; Ding, Ting; Sun, Xiaofang; Yu, Yang; Qiao, Jie

    2014-03-15

    Human embryonic stem cells (hESCs) hold great promise for future clinical cell therapies because of their unique potential to differentiate into all human cell types. However, the destruction of normal fertilized embryos and the derivation of hESCs for research has resulted in polarized ethical debates, with most of the controversy centered on embryo destruction. Therefore, due to less ethical controversy surrounding them, abnormal fertilized zygotes that are usually discarded are a potential feasible resource for the derivation of hESCs. Microsurgery on human polyspermic zygotes can contribute to the derivation of hESCs, but the efficiency is much lower. Here, we reported a culture system to enhance the developmental competence of such microsurgical human polyspermic zygotes by EGF-BDNF-IGF-1 combination, which eventually resulted in the increased derivation efficiency of hESCs from them. We found that the developmental efficiency of microsurgical enucleated tripronuclear (3PN) embryos cultured with the EGF-BDNF-IGF-1 combination was significantly increased compared with the control group. More importantly, when the microsurgical enucleated 3PN embryos were cultured in medium supplemented with EGF-BDNF-IGF-1, the frequency ratio of chromosome abnormality was reduced. Our present study will facilitate the development of hESC line derivation in subsequent studies and also provide an additional choice for infertile couples. PMID:24261581

  9. Laparoscopic enucleation of pancreatic insulinomas.

    PubMed

    Schraibman, Vladimir; Goldenberg, Alberto; de Matos Farah, Jose Francisco; Apodaca, Franz Robert; Goldman, Suzan; Lobo, Edson Jose

    2007-08-01

    Insulinomas are rare endocrine pancreatic tumors whose incidence has been increasing in recent years owing to early detection by clinical and radiologic, such as remote neural monitoring, computed tomography (CT), and ultrasound (US) findings. The classical treatment consists of open surgical resection, which is associated with relative morbidity and mortality rates. The aim of this paper was to present 5 patients who were diagnosed with pancreatic insulinomas that were treated by laparoscopic resection. Five (5) patients, ranging from 14 to 45 years and presenting with classical Whipple Triad, had lesions ranging from 1.5 to 2.5 cm by CT (body and tail of the pancreas), which were subsequently diagnosed as insulinomas. An ecoendoscopy showed no combined lesions. They were treated by a laparoscopic resection. Glicemic levels were controlled during surgery with an expected glucose rise. All patients had an uneventfull recovery. The mean length of follow-up is 14 months. The laparoscopic resection of pancreatic insulinomas is a reliable procedure for superficial lesions in the body and tail of the pancreas. PMID:17705715

  10. Development of 166Holmium-1,2 Propylene Di-amino Tetra (Methy1enephosphonicacid) as a Possible Bone Palliation Agent

    PubMed Central

    Zolghadri, Samaneh; Jalilian, Amir Reza; Yousefnia, Hassan; Bahrami-Samani, Ali; Ghannadi-Maragheh, Mohammad

    2014-01-01

    166Holmium-1,2-propylene di-amino tetra (methy1enephosphonicacid) (166 Ho-PDTMP) complex was prepared successfully using an in-house synthesized PDTMP ligand and 166 HoCl 3 . Ho-166 chloride was obtained by thermal neutron irradiation (1 × 10 13 n/cm 2 /s) of natural Ho (NO 3 ) 3 samples (specific activity = 3-5 GBq/mg), dissolved in acidic media. Radiochemical purity of 166 Ho-PDTMP was checked by instant thin layer chromatography (>99%). Stability studies of the complex in the final preparation and in the presence of human serum were performed up to 72 h. The biodistribution of 166 Ho-PDTMP and 166 HoCl 3 in wild-type rats was checked in animal tissues up to 48 h. The produced 166 Ho-PDTMP properties suggest a possible new bone palliative therapeutic to overcome the metastatic bone pains. PMID:25191109

  11. Enhanced cathodoluminescence from an amorphous AlN:holmium phosphor by co-doped Gd{sup +3} for optical devices applications

    SciTech Connect

    Maqbool, Muhammad; Kordesch, Martin E.; Kayani, A.

    2009-05-15

    Sputter-deposited thin films of amorphous AlN:Ho (1 at. %) emits in the green (549 nm) region of the visible spectrum under electron excitation. The addition of Gd (1 at. %) in the film enhances the green emission linearly after thermal activation at 900 deg. C for 40 min in a nitrogen atmosphere. The luminescence enhancement saturates when the gadolinium concentration reaches four times the holmium concentration. The optical bandgap of amorphous AlN is about 210 nm, so that the film is transparent in the ultraviolet, allowing us to observe the ultraviolet emission at 313 nm from Gd. No significant quenching of the Gd emission is observed. Energy dispersive x-ray (EDX) spectra confirm the increasing concentration of Gd. X-ray diffraction (XRD) analysis shows no peaks other than those arising from the Si (111) substrate, confirming that the films are amorphous. The enhanced luminescence can be used to make high-efficiency optical devices.

  12. Structural properties of a holmium iron carbide interstitial compound, Ho[sub 2]Fe[sub 17]C[sub 3-x

    SciTech Connect

    Bocelli, G.; Calestani, G. ); Leccabue, F.; Watts, B.E. ); Sanchez, J.L. )

    1993-01-01

    X-ray diffractometric studies were performed on a single-crystalline specimen of the Ho[sub 2]Fe[sub 17]C[sub 3-x] intermetallic alloy. Its crystal data (for x > 2) are a = 8.521 (2), c = 8.309 (2) [angstrom], V = 522.5 [angstrom][sup 3], hexagonal space group P6[sub 3]/mmc. The crystal structure, solved by direct methods, was refined to a final agreement factor R of 0.045. The atoms are distributed in two layers perpendicular to the z axis: while one is composed only of iron atoms forming regular hexagonal nets, the insertion of carbons in the second layer deforms the hexagonal nets which contain holmium atoms in their centers. 19 refs., 3 figs., 2 tabs.

  13. Activation cross sections of proton and deuteron induced nuclear reactions on holmium and erbium, related to the production of (161)Er and (160)Er medical isotopes.

    PubMed

    Tárkányi, F; Ditrói, F; Takács, S; Hermanne, A; Baba, M

    2016-09-01

    Experimental excitation functions for long-lived products in proton induced reactions were measured with the activation method in the 37-65MeV energy range on natural holmium. Stacked foil irradiation technique and high resolution gamma spectrometry were used in order to measure cross-section data for the production of (161)Er, (160)Er and (1)(59,157)Dy. For comparison of the production routes of medically related (161)Er and (160)Er radioisotopes new experimental cross section data were deduced for the (162)Er(p,x)(161,160)Er and (162)Er(d,x)(161,160)Er reactions by re-evaluating gamma-ray spectra from earlier measurements. No earlier data were found in the literature for these reactions. The experimental data are compared with results of TALYS theoretical code reported in TENDL-2015. PMID:27451109

  14. Understanding lasers

    SciTech Connect

    Gibilisco, S.

    1989-01-01

    Covering all different types of laser applications-Gibilisco offers an overview of this fascinating phenomenon of light. Here he describes what lasers are and how they work and examines in detail the different kinds of lasers in use today. Topics of particular interest include: the way lasers work; the different kinds of lasers; infrared, ultraviolet and x-ray lasers; use of lasers in industry and manufacturing; use of lasers for long-distance communications; fiberoptic communications; the way laser shows work; the reality of Star Wars; lasers in surgical and medical applications; and holography and the future of laser technology.

  15. High-Resolution In Vivo Imaging of Regimes of Laser Damage to the Primate Retina

    PubMed Central

    Pocock, Ginger M.; Oliver, Jeffrey W.; Specht, Charles S.; Estep, J. Scot; Noojin, Gary D.; Schuster, Kurt; Rockwell, Benjamin A.

    2014-01-01

    Purpose. To investigate fundamental mechanisms of regimes of laser induced damage to the retina and the morphological changes associated with the damage response. Methods. Varying grades of photothermal, photochemical, and photomechanical retinal laser damage were produced in eyes of eight cynomolgus monkeys. An adaptive optics confocal scanning laser ophthalmoscope and spectral domain optical coherence tomographer were combined to simultaneously collect complementary in vivo images of retinal laser damage during and following exposure. Baseline color fundus photography was performed to complement high-resolution imaging. Monkeys were perfused with 10% buffered formalin and eyes were enucleated for histological analysis. Results. Laser energies for visible retinal damage in this study were consistent with previously reported damage thresholds. Lesions were identified in OCT images that were not visible in direct ophthalmoscopic examination or fundus photos. Unique diagnostic characteristics, specific to each damage regime, were identified and associated with shape and localization of lesions to specific retinal layers. Previously undocumented retinal healing response to blue continuous wave laser exposure was recorded through a novel experimental methodology. Conclusion. This study revealed increased sensitivity of lesion detection and improved specificity to the laser of origin utilizing high-resolution imaging when compared to traditional ophthalmic imaging techniques in the retina. PMID:24891943

  16. A review of Thulium fiber laser ablation of kidney stones

    NASA Astrophysics Data System (ADS)

    Fried, Nathaniel M.; Blackmon, Richard L.; Irby, Pierce B.

    2011-02-01

    The clinical solid-state Holmium:YAG laser lithotripter (λ=2120 nm) is capable of operating at high pulse energies, but its efficient operation is limited to low pulse rates during lithotripsy. The diode-pumped experimental Thulium Fiber Laser (λ=1908 nm) is limited to low pulse energies, but can operate at high pulse rates. This review compares stone ablation threshold, ablation rate, and retropulsion effects for Ho:YAG and TFL. Laser lithotripsy complications also include optical fiber bending failure resulting in endoscope damage and low irrigation rates leading to poor visibility. Both problems are related to fiber diameter and limited by Ho:YAG laser multimode spatial beam profile. This study exploits TFL spatial beam profile for higher power transmission through smaller fibers. A short taper is also studied for expanding TFL beam at the distal tip of a small-core fiber. Stone mass loss, stone crater depths, fiber transmission losses, fiber burn-back, irrigation rates, and deflection through a flexible ureteroscope were measured for tapered fiber and compared with conventional fibers. The stone ablation threshold for TFL was four times lower than for Ho:YAG. Stone retropulsion with Ho:YAG increased linearly with pulse energy. Retropulsion with TFL was minimal at pulse rates < 150 Hz, then rapidly increased at higher pulse rates. TFL beam profile provides higher laser power through smaller fibers than Ho:YAG laser, potentially reducing fiber failure and endoscope damage and allowing greater irrigation rates for improved visibility and safety. Use of a short tapered distal fiber tip also allows expansion of the laser beam, resulting in decreased fiber tip damage compared to conventional fibers, without compromising fiber bending, stone ablation efficiency, or irrigation rates.

  17. A compact, inexpensive infrared laser system for continuous-wave optical stimulation of the rat prostate cavernous nerves

    NASA Astrophysics Data System (ADS)

    Perkins, William C.; Lagoda, Gwen A.; Burnett, Arthur L.; Fried, Nathaniel M.

    2014-03-01

    Optical nerve stimulation (ONS) has been commonly performed in the laboratory using high-power, pulsed, infrared (IR) lasers including Holmium:YAG, diode, and Thulium fiber lasers. However, the relatively high cost of these lasers in comparison with conventional electrical nerve stimulation (ENS) equipment may represent a significant barrier to widespread adoption of ONS. Optical stimulation of the prostate cavernous nerves (CN's) has recently been reported using lower cost, continuous-wave (CW), all-fiber-based diode lasers. This preliminary study describes further miniaturization and cost reduction of the ONS system in the form of a compact, lightweight, cordless, and inexpensive IR laser. A 140-mW, 1560-nm diode laser was integrated with a green aiming beam and delivery optics into a compact ONS system. Surface and subsurface ONS was performed in a total of 5 rats, in vivo, with measurement of an intracavernous pressure (ICP) response during CW laser irradiation for 30 s with a spot diameter of 0.7 mm. Short-term, CW ONS of the prostate CN's is feasible using a compact, inexpensive, batterypowered IR laser diode system. This ONS system may represent an alternative to ENS for laboratory studies, and with further development, a handheld option for ONS in the clinic to identify and preserve the CN's during prostate cancer surgery.

  18. Numerical Simulations of a 2.05 μm Q-switched Ho:YLF Laser for CO2 IPDA Space Remote Sensing

    NASA Astrophysics Data System (ADS)

    Barrientos Pellegrino, Jessica; Edouart, Dimitri; Gibert, Fabien; Cenac, Claire

    2016-06-01

    We report on numerical simulations of the performances of a 2.05 μm double pulse Q-switched Ho:YLF laser for the monitoring of CO2 from space. A Q-switched Holmium laser set-up based on a MOPA configuration is proposed to fulfill the requirements of a IPDA space-borne measurement. Double pulse operation is considered to obtain a 250 μs delay time between the ON and OFF pulse emissions. Numerical simulations results show that up to 40 mJ ON pulse can be extracted from the Ho:YLF laser at a repetition rate of 350 Hz with an optical efficiency of 17 %.

  19. Mid-infrared, external cavity BaWO4 Raman laser at 2602 nm with 1.25-W output power

    NASA Astrophysics Data System (ADS)

    Kuzucu, Onur

    2016-03-01

    An external cavity BaWO4 Raman source pumped by a Q-switched Ho:YAG laser is demonstrated. Watt-level average output power is generated at the first Stokes wavelength of 2602 nm. Output pulse width as short as 8.5 ns was measured at a repetition rate of 5 kHz. Near-diffraction limited beam quality is observed (M2≈1.2). This simplified Raman laser configuration can harness the high average power levels offered by Thulium- and Holmium-doped solid-state and fiber lasers to generate fixed-wavelength and tunable output at 2.3-2.8 μm interval.

  20. Integrated disruptive components for 2µm fibre lasers (ISLA): project overview and passive component development

    NASA Astrophysics Data System (ADS)

    Stevens, G.; Legg, T.; Shardlow, P.

    2016-03-01

    In this paper, an overview of the EU FP7 project ISLA (Integrated disruptive componentS for 2 μm fibre Lasers) is given. The aim of ISLA was to develop a set of "building block" components and a "tool-kit" of processes to define an integrated modular common platform for two micron fibre lasers consisting of compatible and self-consistent active and passive fibres, fused fibre couplers and combiners, fibre-coupled isolators, modulators and high power pump laser diodes. We also present results from our work on developing passive components for 2 μm fibre lasers. This includes high power pump combiners that have been tested up to 0.5 kW and combiners for in-band pumping of holmium lasers. Couplers for use as splitters, power monitors and wavelength division multiplexers have also been demonstrated. Wideband couplers, with a coupling ratio that only varies ± 12% over 400 nm, have also been developed to exploit the wide tuning range possible with thulium fibre lasers. Research into different isolator materials was also conducted to find materials with large Verdet constants to be used in 2 μm isolators. Fibre-coupled isolators were then manufactured using a selection of these materials. Isolators that had insertion losses of < 1 dB and isolation of > 35 dB were demonstrated using PM and non-PM fibres. In the PM isolators, PER > 23 dB was achieved.