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Sample records for laser enucleation vapoenucleation

  1. 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.

  2. 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

  3. 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

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

    2015-04-05

    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). 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. 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). 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.

  4. Thulium:YAG VapoEnucleation of the prostate in large glands: a prospective comparison using 70- and 120-W 2-µm lasers.

    PubMed

    Netsch, Christopher; Bach, Thorsten; Herrmann, Thomas R W; Gross, Andreas J

    2012-03-01

    This study compared the efficacy of 70- and 120-w 2-µm thulium:YAG VapoEnucleation of the prostate (ThuVEP) for patients with benign prostatic obstruction (BPO). A prospective analysis of 84 patients with symptomatic BPO and prostatic enlargement (≥60 ml) who underwent either 70-w (n=44) or 120-w ThuVEP (n=40) non-randomly was carried out. Patient demographics and perioperative and 12-month follow-up data were analysed. The mean prostate volume was 79.90±27.49 ml in patients who had received 70-w ThuVEP, which was less than in those who had received 120-w ThuVEP (88.53±25.10; P=0.033). The mean enucleation (resected weight/laser time, 2.16±1.21 g min(-1) vs. 1.23±0.60 g min(-1); P=0.013), operation efficiency (resected weight/total operation time, 0.76±0.35 g min(-1) vs. 0.42±0.27 g min(-1); P=0.000) and percentage of resected tissue (66.93%±22.79% vs. 45.41%±23.33%; P=0.000) were higher with 120-w treatment compared to 70-w ThuVEP. One patient (1.2% of total patients) (in the 120-w group) required a blood transfusion postoperatively. Sixty-one patients (73%) were available for review at the 12-month follow-up time point. The quality of life (QoL), International Prostate Symptom Score (IPSS), maximum urinary flow rate (Q(max)), postvoiding residual urine (PVR) and prostate volume improved significantly after treatment (P≤0.035) and were not significantly different between those treated with the different devices (70- and 120-w). The median prostate volume reduction was 81.70% and 82.19% with 70- and 120-w ThuVEP, respectively. The incidence of complications was low and did not differ between groups treated with the different devices. Two patients (2.4%) (one per group) had a bladder neck contracture at the follow-up. ThuVEP is a safe and efficacious procedure for the treatment of symptomatic BPO. The incidence of complications was low with both devices. The 120-w thulium:YAG device enhances the effectiveness of ThuVEP with regard to the percentage of

  5. Thulium:YAG VapoEnucleation of the prostate in large glands: a prospective comparison using 70- and 120-W 2-µm lasers

    PubMed Central

    Netsch, Christopher; Bach, Thorsten; Herrmann, Thomas RW; Gross, Andreas J

    2012-01-01

    This study compared the efficacy of 70- and 120-w 2-µm thulium:YAG VapoEnucleation of the prostate (ThuVEP) for patients with benign prostatic obstruction (BPO). A prospective analysis of 84 patients with symptomatic BPO and prostatic enlargement (≥60 ml) who underwent either 70-w (n=44) or 120-w ThuVEP (n=40) non-randomly was carried out. Patient demographics and perioperative and 12-month follow-up data were analysed. The mean prostate volume was 79.90±27.49 ml in patients who had received 70-w ThuVEP, which was less than in those who had received 120-w ThuVEP (88.53±25.10; P=0.033). The mean enucleation (resected weight/laser time, 2.16±1.21 g min−1 vs. 1.23±0.60 g min−1; P=0.013), operation efficiency (resected weight/total operation time, 0.76±0.35 g min−1 vs. 0.42±0.27 g min−1; P=0.000) and percentage of resected tissue (66.93%±22.79% vs. 45.41%±23.33% P=0.000) were higher with 120-w treatment compared to 70-w ThuVEP. One patient (1.2% of total patients) (in the 120-w group) required a blood transfusion postoperatively. Sixty-one patients (73%) were available for review at the 12-month follow-up time point. The quality of life (QoL), International Prostate Symptom Score (IPSS), maximum urinary flow rate (Qmax), postvoiding residual urine (PVR) and prostate volume improved significantly after treatment (P≤0.035) and were not significantly different between those treated with the different devices (70- and 120-w). The median prostate volume reduction was 81.70% and 82.19% with 70- and 120-w ThuVEP, respectively. The incidence of complications was low and did not differ between groups treated with the different devices. Two patients (2.4%) (one per group) had a bladder neck contracture at the follow-up. ThuVEP is a safe and efficacious procedure for the treatment of symptomatic BPO. The incidence of complications was low with both devices. The 120-w thulium:YAG device enhances the effectiveness of ThuVEP with regard to the percentage

  6. 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

  7. Safety and effectiveness of Thulium VapoEnucleation of the prostate (ThuVEP) in patients on anticoagulant therapy.

    PubMed

    Netsch, Christopher; Stoehrer, M; Brüning, M; Gabuev, A; Bach, T; Herrmann, T R W; Gross, A J

    2014-02-01

    To evaluate the safety and efficacy of Thulium VapoEnucleation of the prostate (ThuVEP) for patients on oral anticoagulants (OA) with symptomatic benign prostatic obstruction (BPO). Fifty-six patients, undergoing ThuVEP at two institutions, were evaluated from May 2009 until June 2011. All patients were at high cardiopulmonary risk and presented with a median American Society of Anesthesiology score of 3 [interquartile range (IQR) 2-3]. Thirty-two patients were on aspirin, 8 were on clopidogrel or clopidogrel and aspirin, and 16 on phenprocoumon at the time of surgery. Patient demographic, perioperative, and follow-up data were analyzed. Median prostate volume was 50 (IQR 34-76) cc, and resected tissue weight was 32 (IQR 20-50) g. The median operative time was 61.5 (IQR 40-100.75) min, and the catheter time 2 (IQR 2-3) days. There were no perioperative thromboembolic events. Five patients (8.9%) required a second-look operation in the immediate postoperative course (hemorrhage n = 4, residual adenoma n = 1) and four (7.1%) blood transfusions. Complications within the first 30 days included urinary tract infections (1.7%), urinary retention (3.6%), and delayed bleeding (7.1%). These complications were managed conservatively. At 12-month follow-up, median QoL [5 (IQR 3.75-5) vs. 1 (IQR 1-2)], IPSS [21.5 (IQR 15.5-23.75) vs. 5 (IQR 3-8)], Qmax [7.7 (IQR 6.3-10) vs. 28.3 (IQR 21.25-39.2) ml/s], and postvoiding residual urine [100 (IQR 46-200) vs. 17.5 (IQR 0-36) ml] improved significantly (p < 0.002). Thulium VapoEnucleation of the prostate seems to be a safe and efficacious procedure for the treatment of symptomatic BPO in patients at high cardiopulmonary risk on OA.

  8. Evaluation of the learning curve for Thulium VapoEnucleation of the prostate (ThuVEP) using a mentor-based approach.

    PubMed

    Netsch, C; Bach, T; Herrmann, T R W; Neubauer, O; Gross, A J

    2013-10-01

    To evaluate the learning curve of Thulium:YAG VapoEnucleation of the prostate (ThuVEP) for patients with symptomatic benign prostatic obstruction (BPO) prospectively. ThuVEP was performed using the 120 Watt 2 μm continuous wave Thulium:YAG laser. ThuVEP was done by a resident without experience in transurethral prostate surgery (A, n = 32), an experienced endourologist (B, n = 32), and an experienced surgeon in ThuVEP (C, n = 32), who served as the mentor for A/B. Patients were divided into consecutive subgroups of 8 patients to assess the impact of the learning curve on procedure outcome. Patient demographic, perioperative, and 12-month follow-up data were analysed. ThuVEP was successfully completed in all patients. Enucleation efficiency (g/min) differed significantly between surgeon A (0.48 ± 0.3), B (0.7 ± 0.36), and C (1.4 ± 0.67) (p ≤ 0.001). Enucleation efficiency correlated significantly with the weight of resected tissue in surgeon A (r = 0.88), B (r = 0.73), and C (r = 0.79) (p < 0.001). ThuVEP was performed by surgeon A and B with reasonable enucleation, morcellation, and overall operation efficiency after 8-16 procedures. At 12-month follow-up, 68 (71 %) patients were available for review. IPSS, QoL, Qmax, PVR, PSA, and prostate volume improved significantly at follow-up (p ≤ 0.023). Mean PSA/prostate volume reduction was 81.95/74.5, 80.7/79.4, and 87.6/75.9 % in surgeon A, B, and C, respectively. Urethral stricture and bladder neck contracture developed 2 (A = 1, B = 1; 2.1 %) patients and 1 (C, 1 %) patient each, respectively. ThuVEP can be performed with reasonable efficiency even during the initial learning course of the surgeon when closely mentored. Previous experience in the field of endourology is beneficial.

  9. Vapoenucleation of the prostate using a high-power thulium laser: a one-year follow-up study.

    PubMed

    Chang, Ching-Hsin; Lin, Tzu-Ping; Chang, Yen-Hwa; Huang, William J S; Lin, Alex T L; Chen, Kuang-Kuo

    2015-05-09

    Prostate vaporization and enucleation is a novel treatment option for bladder outlet obstruction caused by benign prostate enlargement. This surgical technique, however, has not yet been standardized. We present our findings of using a high-power thulium laser to accomplish vapoenucleation of the prostate (ThuVEP). We prospectively collected and analyzed data from 29 patients who underwent ThuVEP between August 2010 and May 2012. The control group included 30 patients who underwent traditional transurethral resection of the prostate (TURP). Operative variables, patient profiles, preoperative and postoperative urine flow rates, prostate volume (measured using transrectal ultrasonography), and the international prostate symptom score (IPSS) were recorded and analyzed using a two-tailed Student's t-test and analysis of variance. The ages (mean ± SD) of the patients were 76.1 ± 9.4 and 72.6 ± 7.4 years (p = 0.28) in the ThuVEP and TURP groups, respectively. The average urinary flow rates before and 12 months after the operation (volume/maximum flow/average flow) were 243.3/10.5/5.0 and 302.8/17.6/9.4 (in mL, mL/s, mL/s, respectively) in the ThuVEP group and 247.2/10.8/4.6 and 369.9/20.8/12.0, respectively, in the TURP group. Preoperative and postoperative IPSSs were 17.1 ± 5.0 and 6.5 ± 3.8, respectively, in the ThuVEP group and 18.2 ± 4.5 and 6.2 ± 3.3, respectively, in the TURP group. The mean ratio of the estimated postoperative residual prostate volume to the preoperative total volume was 0.47 (p = 0.449) in both groups. The overall complication rate was 20.7% in the ThuVEP group and 30.0% in the TURP group. One year of follow-up showed that ThuVEP and TURP effectively alleviated subjective and objective voiding symptoms with a low rate of complications. Thus, vapoenucleation using a high-power laser is feasible in elderly patients. ISRCTN registry with study ID ISRCTN52339705 . Date assigned: 06/03/2015.

  10. Impact of thulium VapoEnucleation of the prostate on erectile function: a prospective analysis of 72 patients at 12-month follow-up.

    PubMed

    Tiburtius, Christian; Knipper, Sophie; Gross, Andreas J; Netsch, Christopher

    2014-01-01

    To evaluate changes in erectile function after thulium VapoEnucleation of the prostate (ThuVEP) for the treatment of benign prostatic obstruction at 12-month follow-up. We prospectively evaluated 72 patients who underwent ThuVEP between January and July 2011. Preoperative evaluation included maximum urinary flow rate (Qmax), international prostate symptom score (IPSS), quality of life (QoL), postvoiding residual urine (PVR), and the Erectile function domain of the International Index of Erectile Function (IIEF-EF). According to preoperative IIEF-EF score, patients were classified into subgroup A (IIEF-EF ≥19, n = 38) and subgroup B (IIEF-EF <19, n = 34). All complications during the perioperative period were noted and classified according to the modified Clavien classification system. All patients were reassessed at 12-month follow-up by Qmax, IPSS, QoL, PVR, and IIEF-EF score. Patient data were expressed as median (interquartile range). Median patient age was 70 (65-73) years, and the median prostate volume was 52.5 (39.75-72) mL, respectively. At 12-month follow-up, IPSS (20 vs 4), QoL (4 vs 1), Qmax (9.7 vs 22.15 mL/s), and PVR (100 vs 15 mL) improved significantly in comparison with preoperative assessment (P ≤.001) without differences between subgroup A and B. A slight but not statistically significant increase of the IIEF-EF domain score was reported at 12-month follow-up (19.5 vs 20), which could be shown in subgroup A (25 vs 26) and B (6 vs 8). ThuVEP is a safe and effective procedure for the treatment of benign prostatic obstruction. At 12-month follow-up, marginal nonsignificant erectile function improvement was reported after surgery. Copyright © 2014 Elsevier Inc. All rights reserved.

  11. [Effect and impact of holmium laser versus thulium laser enucleation of the prostate on erectile function].

    PubMed

    Hong, Kai; Liu, Yu-qing; Lu, Jian; Xiao, Chun-lei; Huang, Yi; Ma, Lu-lin

    2015-03-01

    To compare the effect and impact of holmium laser enucleation of the prostate (HoLEP) and 120-W thulium: YAG vapoenucleation of the prostate (ThuVEP) on erectile function in the treatment of benign prostatic hyperplasia (BPH). We retrospectively analyzed 93 cases of symptomatic BPH treated by HoLEP or 120 W ThuVEP. We made comparisons between the two groups of patients in the baseline and postoperative clinical and surgical indexes as well as their IPSS, quality of life (QOL), maximum flow rate (Qmax), postvoid residual urine volume (PVR), and IIEF-EF scores before surgery and during the 12-month follow-up. ThuVEP, in comparison with HoLEP, achieved a significantly shorter operation time ([57.6 +/- 12. 8] vs. [70.4 +/- 21.8] min, P = 0.001) and a higher laser efficiency ([0.71 +/- 0.18] vs. [0.62 +/- 0.19] g/min, P = 0. 021). At 1, 6, or 12 months of follow-up, no significant differences were observed in IPSS, OOL, Omax, and PVR between the two groups (P > 0.05). Both the HoLEP and ThuVEP groups showed low incidences of complications and remarkably improved IIEF-EF scores at 12 months postoperatively, but with no significant differences (both P > 0.05). However, in those with relatively normal erectile functions before operation, the mean IIEF-EF score was reduced from 22.8 +/- 2.2 preoperatively to 21.0 +/- 2.7 after HoLEP, (P = 0.036). Both HoLEP and 120W ThuVEP are effective and safe in the treatment of BPH. Compared with HoLEP, 120 W ThuVEP has even a higher laser efficiency. However, neither can significantly improve erectile function, and HoLEP may have a short-term negative impact on the relatively normal erectile function of the patient.

  12. Safety and Efficacy of GreenLight XPS Laser Vapoenucleation in Prostates Measuring Over 150 mL.

    PubMed

    Stone, Benjamin V; Chughtai, Bilal; Forde, James C; Tam, Andrew W; Lewicki, Patrick; Te, Alexis E

    2016-08-01

    The GreenLight™ XPS Laser System (GL-XPS) is a safe and efficacious treatment for lower urinary tract symptoms due to benign prostatic hyperplasia (BPH), but there is limited evidence on its use in prostates over 150 mL. We demonstrate the safety and efficacy of the GL-XPS system using a vapoenucleation technique in prostate glands measuring over 150 mL. We prospectively collected data on all consecutive patients with prostates measuring over 150 mL on transrectal ultrasound treated with the GL-XPS (AMS, Inc., Minnetonka, MN) at a tertiary referral center from September 2011 to October 2015. Data collected include prostate volume, International Prostate Symptom Score (IPSS) and quality of life (QoL) scores, maximum urinary flow rate (Qmax), postvoid residual (PVR), prostate-specific antigen, complications, and reintervention rates. Seventy male patients with a median prostate size of 202 mL (range 152-376 mL) were included. There were 41 patients (59%) in preoperative urinary retention with an indwelling catheter preoperatively. Thirty-seven (53%) patients were American Society of Anesthesiologists (ASA) class 2 and 33 (47%) were class 3. Median operative time was 180 minutes, laser time 97 minutes, energy utilization 674 kJ, and energy density 3.3 kJ/mL, with median 3 fibers used per case. Median length of stay and length of catheterization were 1 day. IPSS and QoL scores demonstrated significant improvements from baseline at all endpoints, improving from 16 to 3.5 and from 4 to 1 at 24 months, respectively (p = 0.001). At 12 months, Qmax and PVR improved from 10.1 to 22.4 mL/s (p = 0.043) and from 84 to 31.4 mL (p = 0.015), respectively. Retreatment was required in two patients (2.9%). GL-XPS vapoenucleation provided durable subjective and objective improvements in symptoms and voiding parameters, with no serious adverse events in men with prostates >150 mL.

  13. Evolution and success of holmium laser enucleation of the prostate

    PubMed Central

    Krambeck, Amy E.

    2010-01-01

    Aims: The purpose of this article is to review the development of instruments, current technique, and expected outcomes for holmium laser enucleation of the prostate (HoLEP). Materials and Methods: A review of published, peer-reviewed articles focusing on HoLEP was performed using the MEDLINE database. Results: Historically, the gold-standard management for symptomatic obstructing benign prostatic hyperplasia (BPH) has been transurethral resection of the prostate (TURP). With the development of new laser technology minimally invasive surgical procedures have been introduced in an attempt to decrease the morbidity experienced with standard TURP. Laser treatment of BPH has evolved from coagulation to complete adenoma enucleation. The holmium laser was initially utilized for prostate ablation and soon evolved into holmium laser tissue resection, but was limited by difficulties with extracting the prostate tissue from the bladder. With the development of a compatible tissue morcellator whole prostate lobes could be enucleated similar to an open prostate enucleation and the HoLEP procedure was developed. Currently HoLEP is the only procedure to demonstrate superior outcomes to TURP on urodynamic studies and long-term studies demonstrate its durability up to 7 years post procedure. Changes in enucleation technique have also increased the efficiency of the HoLEP procedure, such that any sized prostate can be treated. Conclusions: HoLEP is a safe and effective surgical treatment for symptomatic BPH, dependent on a high powered laser and morcellation system. The procedure continues to gain acceptance due to excellent short and long-term results, its wide application, and further simplification of technique. PMID:21116363

  14. Enucleation is enucleation is enucleation is enucleation.

    PubMed

    Herrmann, Thomas R W

    2016-10-01

    The latest update of the EAU Guidelines on Management of Non-Neurogenic Male Lower Urinary Tract Symptoms, incl. Benign Prostatic Obstruction in 2016 announced a novel acronym for transurethral Endoscopic Enucleation of the Prostate (EEP). This was inspired by a meta-analysis on randomized controlled trials on Holmium Laser Enucleation of the Prostate (HolEP) and bipolar enucleation versus open simple prostatectomy. EEP codes for the common ground of both techniques: "anatomical enucleation." Although study quality with regard to the availability of long-term randomized controlled trials is at the moment mostly available for HoLEP, and bipolar enucleation, the existing data of all other enucleating techniques that have been demonstrated to perform anatomical enucleation as well should also been summarized under the same term. This editorial is a call for embracing this acronym of EEP for all anatomical enucleating techniques in order to serve for the transition from the age of TURP and open prostatectomy toward the age of EEP.

  15. Outcomes following Thulium vapoenucleation of large prostates

    PubMed Central

    Pearce, Shane M.; Pariser, Joseph J.; Malik, Rena D.; Famakinwa, Olufenwa J.; Chung, Doreen E.

    2016-01-01

    ABSTRACT Introduction: Thulium laser VapoEnucleation of the prostate (ThuVEP) is an evolving surgical technique for BPH. Most studies have focused on outcomes in small to medium sized prostates and have originated from Europe and Asia. We sought to describe our experience with ThuVEP for very large prostates in a North American cohort. Materials and Methods: From December 2010 to October 2014, 25 men underwent ThuVEP using the CyberTM® (Quantastem, Italy) thulium laser, all with prostate volume >75mL. Data collected included patient demographics, comorbidities, intraoperative parameters, complications, and post-operative outcomes including maximum flow rate (Qmax), post-void residual (PVR), International Prostate Symptom Score (IPSS), and quality of life score (QoL) in one year of follow-up. Statistical analysis was done using Wilcoxon signed-rank test. Results: At baseline, mean age was 70±9 years and prostate size was 163±62g. Most patients (84%) were in retention and 10 (40%) patients were on anticoagulation. Seven (28%) patients went home the day of surgery (mean hospital stay: 1.2±1.2d). There were 2 intraoperative complications (8%), both cystotomies related to morcellation. Nine patients (36%) experienced a complication, all within 30 days. There were no Clavien ≥III complications. Significant improvements were seen in Qmax, PVR, IPSS, and QoL score at each time interval to 12-months following surgery (all p<0.05). Of 21 patients initially in retention, all were voiding at last follow-up. Conclusions: Our findings suggest that ThuVEP is an effective treatment for BPH in patients with large prostates with sustained results for one year. PMID:27564287

  16. Outcomes following Thulium vapoenucleation of large prostates.

    PubMed

    Pearce, Shane M; Pariser, Joseph J; Malik, Rena D; Famakinwa, Olufenwa J; Chung, Doreen E

    2016-01-01

    Thulium laser VapoEnucleation of the prostate (ThuVEP) is an evolving surgical technique for BPH. Most studies have focused on outcomes in small to médium sized prostates and have originated from Europe and Asia. We sought to describe our experience with ThuVEP for very large prostates in a North American cohort. From December 2010 to October 2014, 25 men underwent Thu-VEP using the CyberTM® (Quantastem, Italy) thulium laser, all with prostate volume >75mL. Data collected included patient demographics, comorbidities, intraoperative parameters, complications, and post-operative outcomes including maximum flow rate (Qmax), post-void residual (PVR), International Prostate Symptom Score (IPSS), and quality of life score (QoL) in one year of follow-up. Statistical analysis was done using Wilcoxon signed-rank test. At baseline, mean age was 70±9 years and prostate size was 163±62g. Most patients (84%) were in retention and 10 (40%) patients were on anticoagulation. Seven (28%) patients went home the day of surgery (mean hospital stay: 1.2±1.2d). There were 2 intraoperative complications (8%), both cystotomies related to morcellation. Nine patients (36%) experienced a complication, all within 30 days. There were no Clavien III complications. Significant improvements were seen in Qmax, PVR, IPSS, and QoL score at each time interval to 12-months following surgery (all p<0.05). Of 21 patients initially in retention, all were voiding at last follow-up. Our findings suggest that ThuVEP is an effective treatment for BPH in patients with large prostates with sustained results for one year. Copyright© by the International Brazilian Journal of Urology.

  17. Holmium laser enucleation versus laparoscopic simple prostatectomy for large adenomas.

    PubMed

    Juaneda, R; Thanigasalam, R; Rizk, J; Perrot, E; Theveniaud, P E; Baumert, H

    2016-01-01

    The aim of this study is to compare Holmium laser enucleation of the prostate with another minimally invasive technique, the laparoscopic simple prostatectomy. We compared outcomes of a series of 40 patients who underwent laparoscopic simple prostatectomy (n=20) with laser enucleation of the prostate (n=20) for large adenomas (>100 grams) at our institution. Study variables included operative time and catheterization time, hospital stay, pre- and post-operative International Prostate Symptom Score and maximum urinary flow rate, complications and economic evaluation. Statistical analyses were performed using the Student t test and Fisher test. There were no significant differences in patient age, preoperative prostatic size, operating time or specimen weight between the 2 groups. Duration of catheterization (P=.0008) and hospital stay (P<.0001) were significantly less in the laser group. Both groups showed a statistically significant improvement in functional variables at 3 months post operatively. The cost utility analysis for Holmium per case was 2589 euros versus 4706 per laparoscopic case. In the laser arm, 4 patients (20%) experienced complications according to the modified Clavien classification system versus 5 (25%) in the laparoscopic group (P>.99). Holmium enucleation of the prostate has similar short term functional results and complication rates compared to laparoscopic simple prostatectomy performed in large glands with the advantage of less catheterization time, lower economic costs and a reduced hospital stay. Copyright © 2015 AEU. Publicado por Elsevier España, S.L.U. All rights reserved.

  18. Carbon dioxide laser enucleation of polypoid vocal cords.

    PubMed

    Yates, A; Dedo, H H

    1984-06-01

    Polypoid vocal cords have routinely been treated by endoscopic vocal cord stripping, often-times resulting in prolonged hoarseness postoperatively. Submucosal CO2 laser enucleation of the polypoid tissue, with preservation of a mucosal flap on the medial edge of the cord, has proved to be a valuable improvement. The surgical procedure is described and results are presented which suggest that voice quality is better earlier than is the case after vocal cord stripping.

  19. 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

  20. Thulium Laser Enucleation Versus Plasmakinetic Enucleation of the Prostate: A Randomized Trial of a Single Center.

    PubMed

    Feng, Lang; Zhang, Daoxin; Tian, Ye; Song, Jian

    2016-06-01

    To compare the safety and efficacy of thulium laser enucleation of the prostate (ThuLEP) with plasmakinetic enucleation of the prostate (PKEP). A total of 127 patients with benign prostatic hyperplasia (BPH) were randomized to either ThuLEP (n = 61) or PKEP (n = 66). All patients were assessed preoperatively and followed up at 3, 6, and 12 months postoperatively. Baseline characteristics of the patients, perioperative data, postoperative outcomes, and complications were recorded. The decrease in hemoglobin level and the catheter time were statistically significantly lower in the ThuLEP group compared with the PKEP group (0.80 ± 0.49 vs 0.99 ± 0.52, p = 0.037, and 1.85 ± 0.94 vs 2.28 ± 1.34, p = 0.042). There were no statistical differences in complications between the two groups (p > 0.05). There was a significant improvement in 3, 6, and 12 months' parameters compared with preoperative values (p < 0.001). Assessment at the 12-month follow-up showed no difference in urinary parameters between the two groups. ThuLEP and PKEP are both safe and efficient procedures for the treatment of patients with BPH. Compared with PKEP, ThuLEP provided less risk of hemorrhage and shorter catheter time, although the differences may be of little clinical relevance. Further well-designed trials with extended follow-up and larger sample size are needed to draw final conclusions about the efficacy of the two procedures.

  1. Holmium laser enucleation of the prostate: patient selection and perspectives

    PubMed Central

    Marien, Tracy; Kadihasanoglu, Mustafa; Miller, Nicole L

    2016-01-01

    Background Multiple endoscopic surgical options exist to treat benign prostatic hyperplasia (BPH), including holmium laser enucleation of the prostate (HoLEP). HoLEP alleviates obstructive prostatic tissue via enucleation, both bluntly with a resectoscope and by cutting tissue with the holmium laser, and removal of adenoma via morcellation. This article reviews patient selection for HoLEP in order to optimize outcomes, costs, and patient satisfaction. Methods A literature review of all studies on HoLEP was conducted. Studies that focused on outcomes in regard to patient and procedural factors were closely reviewed and discussed. Results Various studies found that men with large or small prostates, on antithrombotic therapy, in urinary retention, with bladder hypocontractility, with prostate cancer, undergoing retreatment for BPH, or in need of concomitant surgery for bladder stones and other pathologies do well with HoLEP, as demonstrated by excellent functional and symptomatic outcomes as well as low complication rates. There is a 74–78% rate of retrograde ejaculation following HoLEP. Techniques to preserve ejaculatory function following enucleative techniques have not been able to demonstrate a significant improvement. Conclusion Patient selection for HoLEP can include most men with bothersome BPH who have evidence of bladder outlet obstruction and are healthy enough to undergo surgery. The ability to safely perform concomitant surgery with HoLEP benefits the patient by sparing them an additional anesthetic and also decreases costs. Patients should be made aware of the risk of retrograde ejaculation following HoLEP and counseled on treatment alternatives if maintaining ejaculatory function is desired. PMID:27800470

  2. A New Laser Platform for Holmium Laser Enucleation of the Prostate: Does the Lumenis Pulse 120H Laser Platform Improve Enucleation Efficiency?

    PubMed

    Stern, Karen L; McAdams, Sean B; Cha, Stephen S; Abdul-Muhsin, Haidar M; Humphreys, Mitchell R

    2017-04-01

    To determine whether the recently introduced Lumenis Pulse 120H laser platform, which offers a dual-pedal footswitch and preset energy modes to easily switch among laser settings, facilitates a more efficient process in holmium laser enucleation of the prostate (HoLEP) for surgical treatment of benign prostatic hyperplasia. Patients at a single institution who underwent HoLEP with the new Lumenis Pulse 120H laser platform were matched 1:2 with patients who underwent the procedure with the previously used 100-watt VersaPulse single-pedal laser platform. Matching was performed by using propensity scores calculated by a logistic model that considered preoperative transrectal ultrasound prostate volume and patient age. The primary outcome was enucleation efficiency of each platform, determined by the weight of prostate tissue resected and enucleation time. The McNemar test and a conditional logistic model were used to associate predictors and cases. Twenty-nine patients who underwent HoLEP with the Lumenis Pulse 120H platform were matched with 58 patients who underwent the procedure with the 100-watt platform. We observed statistically significant differences in operating room total time, procedure time, and enucleation time. Other perioperative and postoperative outcomes were comparable between the 2 groups. Enucleation efficiency was similar between the 2 laser platforms (0.89 g per minute in the control group vs 0.84 g per minute in the Lumenis Pulse 120H group). The efficiency of the new Lumenis Pulse 120H laser platform is comparable to the 100-watt VersaPulse laser platform in HoLEP when comparing g of tissue enucleated per minute. Copyright © 2016 Elsevier Inc. All rights reserved.

  3. [Thulium vapoenucleation of prostates larger than 80 ml using a 1.9-µm and a 2-µm thulium laser. Early perioperative results from two centres].

    PubMed

    Netsch, C; Knoll, T; Gross, A J; Wendt-Nordahl, G

    2015-10-01

    Numerous studies have shown that thulium vapoenucleation of the prostate (ThuVEP) is a size-independent minimally invasive procedure for the treatment of benign prostatic enlargement. All ThuVEP series have been performed with a 2-µm thulium laser device so far. The aim of this study was to evaluate the complications and early postoperative results of two thulium-devices with different wavelengths for ThuVEP in prostates larger than 80 ml. A retrospective bi-centric matched-paired analysis with 296 patients was performed. Based on prostate size, 148 were matched at each centre and laser device, respectively. A 2-µm (RevoLix, LISA Laser products, Katlenburg, Germany n=148) and a 1.9-µm (vela XL, starmedtec, Starnberg, Germany, n=148) thulium laser with a power output of 90 and 80 W was used. Patients' data were assessed and compared. The median prostate volume (interquartile) was 100 ml (range 86.25-120 ml). At discharge, Qmax (preoperative 7.9 and 9 ml/s vs. postoperative 19.35 and 16.2 ml/s) and postvoiding-residual urine (preoperative 130 and 45 ml vs. postoperative 20 and 25 ml) were significantly improved after 2-µm and 1.9-µm ThuVEP (p<0.001). The median catheterization time and hospitalization times were 2 and 4 days in both groups. Perioperative complications occurred in 89 patients (30.1%): Clavien 1 (12.2%), Clavien 2 (9.1%), Clavien 3a (0.7%), Clavien 3b (7.1%), and Clavien 4a (1%). Regarding the occurrence of complications, there were no differences between the two thulium devices. ThuVEP represents a safe and effective treatment for prostates larger than 80 ml. Both thulium laser devices give satisfactory immediate micturition improvement with low perioperative morbidity.

  4. Laparoscopic adenomectomy versus Eraser laser enucleation of the prostate.

    PubMed

    Lusuardi, L; Hruby, S; Janetschek, G; Mitterberger, M; Sieberer, M; Colleselli, D; Kunit, T; Hitzl, W; Kloss, B

    2015-05-01

    To evaluate functional outcomes and morbidity rates after laparoscopic adenomectomy (LA) and Eraser laser enucleation of the prostate (ELEP). Forty patients with lower urinary tract symptoms suggesting bladder outlet obstruction, with a prostate heavier than 70 g on transrectal ultrasound, were selected to undergo laparoscopic adenomectomy or Eraser laser enucleation of the prostate. All patients were consecutively enrolled without randomization and assessed preoperatively, 3 and 6 months postoperatively. Baseline characteristics, perioperative data, and postoperative outcomes were compared. The total operating time was significantly longer in the LA group (138.8 ± 11.4 vs. 78.4 ± 10.0 min, p < 0.000001). Catheter removal was performed earlier (61.2 ± 21.3 vs. 174.0 ± 13.2 h, p < 0.000001) and the hospital stay was significantly shorter (62.4 ± 21.2 vs. 187.2 ± 12.6 h, p < 0.000001) in the ELEP group. The latter group experienced significantly less perioperative hemoglobin (Hb) loss (0.71 ± 0.25 vs. 2.15 ± 1.08 g/dl, p < 0.000001), and their postoperative Hb levels (14.1 ± 1.21 vs. 11.7 ± 1.31 g/dl, p < 0.000001) were significantly higher. The resected tissue was significantly greater in the LA group (58.5 ± 23.3 vs. 87.9 ± 22.4 g, p = 0.0002). Significant improvements in Qmax, Qol, and symptom scores from baseline to each follow-up time point were noted in both groups. No statistically significant difference in symptom scores or Qmax was registered between the LA and the ELEP group throughout the follow-up period. Laparoscopic adenomectomy and ELEP were equally effective for relieving bladder outflow obstruction and lower urinary tract symptoms. The advantages of ELEP include less blood loss, shorter catheterization times, and shorter hospital stays.

  5. Thulium laser (RevoLix) vaporesection versus vapoenucleation with morcellator (Piranha) for the treatment of benign prostatic obstruction: a propensity-matched multicenter analysis.

    PubMed

    Chung, Jae Seung; Kang, Pil Moon; Seo, Won Ik; Oh, Cheol Kyu; Kim, Seong Cheol; Park, Sang Hyun; Choi, Jun Ho; Yoon, Jang Ho; Kang, Dong Il; Chung, Jae Il

    2014-11-01

    To compare the efficacy and safety of vaporesection without a morcellator, and vapoenucleation with a morcellator in thulium laser prostatectomy for the treatment of benign prostatic obstruction. Between March 2010 and January 2013, 405 patients underwent thulium:yttrium-aluminium-garnet laser prostatectomy. Among these patients, 150 patients who underwent thulium:yttrium-aluminium-garnet laser prostatectomy without a morcellator (n = 75) or with a morcellator (n = 75) were analyzed in a propensity matching study. Outcome measures included International Prostate Symptom Score, quality of life score, maximum flow rate, postvoid residual, total operating time, laser time and resected tissue weight. No significant differences were noted between the thulium:yttrium-aluminium-garnet laser prostatectomy without a morcellator and thulium:yttrium-aluminium-garnet laser prostatectomy with a morcellator groups, including the prostate volume (50.3 vs 51.9 mL) and postoperative prostate volume (22.4 vs 18.7 mL). However, there were differences between the groups in total operating time (72.8 vs 61.0 min, P = 0.023) and laser activating time (24.5 vs 19.9 min, P = 0.037). Thulium:yttrium-aluminium-garnet laser prostatectomy with a morcellator showed greater resected tissue volume than thulium:yttrium-aluminium-garnet laser prostatectomy without a morcellator (9.0 vs 18.2 g, P = 0.029). There were also significant differences in total retrieval efficiency (1.14 vs 1.67 g/min, P = 0.031). There were no significant differences in improvement of International Prostate Symptom Score, quality of life scores and urodynamic findings between the two groups, except for the International Prostate Symptom Score (11.2 vs 7.3, P = 0.028) at 6 weeks after surgery. Thulium:yttrium-aluminium-garnet laser prostatectomy with a morcellator provides superior reduction of prostate volume and better short-term clinical outcomes than thulium

  6. 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.

  7. Holmium Laser Enucleation of the Prostate in Patients Requiring Anticoagulation.

    PubMed

    El Tayeb, Marawan M; Jacob, Joseph M; Bhojani, Naeem; Bammerlin, Elaine; Lingeman, James E

    2016-07-01

    Holmium laser enucleation of the prostate (HoLEP) is a well-established technique for the surgical management of benign prostatic hyperplasia (BPH). A significant number of patients who require surgery for BPH are being treated with anticoagulation (AC) or antiplatelet (AP) therapy. We evaluated the efficacy and morbidity of HoLEP in this population. One hundred sixteen patients who required AC/AP therapy undergoing HoLEP from 1999 to 2014 were compared with 1558 HoLEP patients who were not on AC/AP therapy (no AC/AP). Patients on intermittent vs continuous AC/AP therapy were also compared. No significant differences in preoperative characteristics were found between patients who did and did not receive AC/AP therapy. Intraoperative characteristics were similar except for enucleation time (51 minutes vs 65 minutes, AC/AP vs no AC/AP, respectively, p < 0.001) and morcellation rate (5 g/min vs 4.5 g/min, AC/AP vs no AC/AP, respectively, p = 0.02). Postoperative outcomes were comparable in all aspects except for length of hospital stay (27.8 hours vs 24 hours, p < 0.001) and duration of continuous bladder irrigation (15 hours vs 13.5 hours, p < 0.001), both of which were longer in the AC/AP group. There was no difference between cohorts in the lowest postoperative hemoglobin or transfusion rate. Two patients (1.9%) in the AC/AP cohort required clot evacuation vs 10 patients (0.7%) in the no AC/AP cohort. Pre-, intra-, and postoperative characteristics between patients on continuous vs intermittent AC/AP were not statistically significant, except for specimen weight (55.5 g vs 74.5 g, p = 0.028), which was greater in the intermittent AC group. Other than slight prolongation of duration of bladder irrigation and hospital stay, the intermittent or continuous use of anticoagulant therapy did not adversely affect outcomes of HoLEP, suggesting that this approach is an attractive approach for such patients, especially when the prostate is

  8. 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.

  9. 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

  10. 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

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

    PubMed

    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.

  12. 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.

  13. Outcomes of Holmium Laser Enucleation of the Prostate in the Re-Treatment Setting.

    PubMed

    Marien, Tracy; Kadihasanoglu, Mustafa; Tangpaitoon, Teerayut; York, Nadya; Blackburne, Andrew T; Abdul-Muhsin, Haidar; Borofsky, Michael S; Krambeck, Amy E; Humphreys, Mitchell R; Lingeman, James E; Miller, Nicole L

    2017-06-01

    Holmium laser enucleation of the prostate can also be applied in the re-treatment setting when other benign prostatic hyperplasia therapies fail. We compared outcomes in men who underwent holmium laser enucleation of the prostate in the primary vs the re-treatment setting. We retrospectively reviewed the records of 2,242 patients who underwent holmium laser enucleation of the prostate at a total of 4 academic hospitals between 2003 and 2015. Patient demographics, and operative and perioperative outcomes were compared between re-treatment and primary holmium laser enucleation of the prostate. Of the 360 of 2,242 men (16%) who underwent re-treatment holmium laser enucleation of the prostate the procedure was done for residual urinary symptoms in 71%. The most common primary procedure was transurethral resection of the prostate in 42% of cases. Mean time between prior benign prostatic hyperplasia surgery and re-treatment was 68 months (range 1 to 444). There were no significant differences in age, prostate size, AUA (American Urological Association) symptom score or average flow rate between the cohorts. Perioperatively, re-treatment holmium laser enucleation of the prostate was associated with significantly shorter operative time, reduced blood loss, lower specimen weight and shorter length of stay. The AUA symptom score improved in both groups, although it remained higher in men who underwent re-treatment (6.5 vs 5.0, p <0.001). The likelihood of clot retention (4.7% vs 1.8%, p = 0.01) and urethral stricture (3.3% vs 1.5%, p = 0.043) was slightly higher in the re-treatment group. Immediate perioperative outcomes of holmium laser enucleation of the prostate performed in the re-treatment setting were no different from those in the primary setting. While re-treatment was associated with an increased likelihood of clot retention, urethral stricture and higher AUA symptom score, these minimal differences must be considered against the overall favorable symptom

  14. 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

  15. Prostate volume did not affect voiding function improvements in diode laser enucleation of the prostate.

    PubMed

    Yang, Stephen Shei-Dei; Hsieh, Cheng-Hsing; Chiang, I-Ni; Lin, Chia-Da; Chang, Shang-Jen

    2013-03-01

    We compared safety and surgical outcomes in patients with different prostate sizes treated with diode laser enucleation of the prostate. From 2008 to 2012 consecutive patients with benign prostatic obstruction undergoing diode laser prostate enucleation at our institution were enrolled for analysis. A single surgeon performed diode laser prostate enucleation with an end firing, continuous wave diode laser (980 nm). Based on preoperative prostate volume on transrectal ultrasound, patients were stratified into 2 groups, including group 1-65 with less than 60 ml and group 2-55 with 60 ml or greater. Baseline and perioperative characteristics, and postoperative surgical outcomes were compared between the 2 groups. A total of 120 men with a mean ± SD age of 70.2 ± 9.0 years were enrolled for analysis. Compared with group 1 patients, those in group 2 had larger mean total prostate volume (85.0 ± 24.6 vs 40.9 ± 10.8 ml), longer mean operative time (117.7 ± 48.2 vs 60.7 ± 25.0 minutes), higher mean retrieved prostate weight (37.3 ± 16.1 vs 12.5 ± 7.3 gm) and a higher mean tissue retrieval ratio (74.4% ± 22.2% vs 58.8% ± 23.2%, p <0.01). There was no significant difference in the postoperative hemoglobin decrease in the 2 groups (median 0.5 vs 0.9 mg/dl, p = 0.11). The rate of temporary postoperative urinary retention after Foley catheter removal was significantly lower in group 2 (15.4% vs 3.6%, p = 0.04). Postoperative improvements in the peak flow rate, post-void residual urine volume and International Prostate Symptom Score were comparable in the 2 groups. Although patients with a larger prostate required significantly longer operative time and laser energy, voiding function improvements and surgical complication rates of diode laser prostate enucleation were comparable in patients with a larger vs smaller prostate. Copyright © 2013 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

  16. 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

  17. Evaluation of the Learning Curve for Holmium Laser Enucleation of the Prostate Using Multiple Outcome Measures.

    PubMed

    Brunckhorst, Oliver; Ahmed, Kamran; Nehikhare, Osayuki; Marra, Giancarlo; Challacombe, Ben; Popert, Richard

    2015-10-01

    To assess and quantify the surgical learning curve of holmium laser enucleation of the prostate (HoLEP) of a single surgeon. A retrospective analysis of 253 consecutive cases performed by the same surgeon from 2006 to 2013 was conducted. Primary outcomes included enucleation ratio and morcellation efficiencies and complication rates. Three-month postoperative prostate-specific antigen values were used as secondary measures. Cases were divided into cohorts of 20 cases to assess changes in means analyzed through Analysis of Variance (ANOVA) tests. Scatter plots of cases with a best-fit line were drawn to analyze the learning curve. The mean age of patients across the cases was 69.21 years with an average transrectal ultrasound prostate volume of 95.84 cc. Enucleation ratio efficiency was significantly different between cohorts (P = .02) plateau after 50-60 cases conducted. Similarly, a significant difference is shown for morcellation efficiency (P = .01) with stabilization in performance after 60 cases. Complication rates decreased through the caseload but did not show a statistical difference (P = .62) or plateauing on the graph. Finally, no difference between 3-month postoperative prostate-specific antigen values was seen (P = .083); however, a learning curve of 50 cases was observed graphically. Within our single-surgeon cohort, we experienced a learning curve of 40-60 cases for the HoLEP procedure. Large variability in performance late into the caseload demonstrates the technical difficulty of HoLEP. Owing to this, adjuncts to training such as simulation-based training may be of use for the new surgeon to shorten the initial phase of learning. Copyright © 2015 Elsevier Inc. All rights reserved.

  18. Holmium laser enucleation of the prostate: a size-independent new "gold standard".

    PubMed

    Elzayat, Ehab A; Habib, Enmar I; Elhilali, Mostafa M

    2005-11-01

    We report our experience with holmium laser enucleation of the prostate (HoLEP) for treatment of 552 patients with symptomatic benign prostatic hyperplasia (BPH) and their long-term outcome. Between March 1998 and January 2005, a retrospective review was conducted at our institution of 552 cases in which patients underwent HoLEP. Patient characteristics, indications for surgery, preoperative and postoperative International Prostate Symptom Score (I-PSS), peak flow rate (Qmax), postvoid residual urine, operative data, catheterization time, hospital stay, and immediate and long-term complications were recorded. The mean age of patients was 73.7 +/- 7.9 years, and the mean follow-up time was 36 months. The mean preoperative prostate size was 83.7 +/- 49.7 cm3 (range, 20 to 351 cm3), the mean enucleation time was 86 minutes (range, 15 to 255 minutes), and the mean enucleated tissue weight was 52.1 +/- 43.7 g (range, 5 to 340 g). The voiding parameters were significantly improved, with a 200% increase in Qmax, as well as a 75% improvement in I-PSS at 1 year postoperatively, which continued to improve during subsequent follow-up. A total of 11 patients required blood transfusion; 8 of them were on anticoagulant therapy. Irritative symptoms were noted in 9.4% and transient stress incontinence in 4.2% of patients. Bladder neck contracture and urethral stricture each developed in 1.3% of patients. We conclude that HoLEP is a safe and effective procedure for treatment of symptomatic BPH, regardless of prostate size, with low morbidity and short hospital stay. HoLEP appears to be the modern alternative to transurethral resection of the prostate and open prostatectomy, and it may be considered a size-independent new "gold standard."

  19. Does Surgeon Experience Affect Operative Time, Adverse Events and Continence Outcomes in Holmium Laser Enucleation of the Prostate? A Review of More Than 1,000 Cases.

    PubMed

    Shigemura, Katsumi; Yamamichi, Fukashi; Kitagawa, Koichi; Yamashita, Masuo; Oka, Yasuhiko; Tanaka, Hirokazu; Fujisawa, Masato

    2017-09-01

    Holmium laser enucleation of the prostate has become an increasingly common surgical therapy for benign prostatic hyperplasia. However, the relationship between surgeon experience and surgical outcomes has not yet been fully investigated. In this study we investigated how surgeon experience with holmium laser enucleation of the prostate affected operative time, adverse events and outcomes related to urination. We gathered a total of 1,113 cases of holmium laser enucleation of the prostate from 5 hospitals in Hyogo Prefecture, Japan. Included were data on surgeon experience with the procedure, operative time, enucleation time, morcellation time, patient age, perioperative and postoperative surgery related complications, and outcomes related to urination. A total of 39 surgeons were included in analysis. Statistical data showed that increasing surgical experience significantly contributed only to surgical time, enucleation time and urinary incontinence after holmium laser enucleation (p = 0.0146, 0.0216 and 0.0405, respectively). No significant changes were seen postoperatively in surgery related factors such as morcellation time, resected prostate volume, infectious or noninfectious surgery related complications, or urination related outcomes (p >0.05) Experience with at least 20 cases in particular affected surgical time (p = 0.0050), enucleation time (p = 0.0068) and urinary incontinence after holmium laser enucleation (p = 0.0021). Surgeon experience contributed to shortened operative time and enucleation time, and to decreased postoperative urinary incontinence but not to surgery related complications or urination related outcomes as shown by maximum urine flow and post-void residual urine volume. We also found that experienced surgeons with 31 to 50 cases might be associated with complications after holmium laser enucleation in larger prostate cases. Based on these data further prospective studies are scheduled to establish a program for training in holmium

  20. Mantle cell lymphoma of the prostate gland treated with holmium laser enucleation

    PubMed Central

    Cable, Christian T.; Trevathan, Sean; El Tayeb, Marawan M.

    2017-01-01

    Mantle cell lymphoma of the prostate is rare and is seldom encountered in general urologic practice. It either arises primarily from the prostate or is a result of metastatic spread from another site. This specific type of lymphoma has an aggressive course and may respond poorly to traditional chemotherapy with frequent relapses. Mantle cell lymphoma occurs in middle age or older, which is also when symptoms of benign prostatic enlargement begin in men. This overlap makes the diagnosis of lymphoma of the prostate difficult and makes the treatment more complex. We describe a case of mantle cell lymphoma of the prostate that caused significant enlargement and bladder outlet obstruction with urinary retention. The obstruction was treated with holmium laser enucleation of the prostate with good functional results. PMID:28670079

  1. 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

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

    PubMed

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

    2015-11-01

    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. 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. 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. 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.

  3. Erbium:YAG laser photothermal retinal ablation in enucleated rabbit eyes.

    PubMed

    D'Amico, D J; Moulton, R S; Theodossiadis, P G; Yarborough, J M

    1994-06-15

    The erbium:YAG laser has been shown to produce precise tissue ablation because of the high water absorption of the 2.94-microns wave-length emitted by this laser. We used an experimental system to create lesions of various depths in the surface of the rabbit retina in enucleated eyes in vitro to examine the potential application to maneuvers such as retinotomy and the removal of epiretinal membranes in vitrectomy. With an air/retinal interface, single pulses produced discrete craters in the retinal surface with a depth proportional to fluence, ranging from 30 microns for a pulse of 1.3 J/cm2 to a full-thickness retinotomy at 3.9 J/cm2. An adjacent zone of coagulated tissue ranging in size from 15 to 40 microns was noted. Multiple pulses had an additive effect. With a fluid/retinal interface, 20 pulses of 3.6 J/cm2 produced a full-thickness retinotomy, with an adjacent zone of damaged tissue up to 1 mm, caused by effects of volatilization of intervening fluid. The erbium:YAG laser may have a role in vitreoretinal surgery.

  4. 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

  5. En Bloc Thulium Laser Enucleation of the Prostate: Surgical Technique and Advantages Compared With the Classical Technique.

    PubMed

    Saredi, Giovanni; Pacchetti, Andrea; Pirola, Giacomo Maria; Berti, Lorenzo; Ambrosini, Francesca; Martorana, Eugenio; Marconi, Alberto Mario

    2017-07-20

    To report a new technique for thulium laser enucleation of the prostate, which we called "en bloc" ThuLEP. A full anatomic description of the technique is provided. We assessed operative variables of a 50-patient series, treated with the new "en bloc" ThuLEP, and compared them with another series of 50 patients (who had the same preoperative parameters) operated with the classical "3-lobe" technique, to assess the feasibility of the new one. All procedures were carried out by the same surgeon. In our experience, "en bloc" ThuLEP permits an easier enucleation of the adenoma, reduces operating time, and reduces the amount of energy delivered per adenoma gram compared with the classical technique. Further studies are needed to validate this technical evolution of prostatic enucleation and verify the reduction of postoperative irritative symptoms. "En bloc" ThuLEP may represent a valid alternative for prostatic adenoma enucleation, mostly in medium-sized prostates. Copyright © 2017 Elsevier Inc. All rights reserved.

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

    PubMed

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

    2016-01-01

    To determine the predictive factors for postoperative urinary incontinence (UI) following holmium laser enucleation of the prostate (HoLEP) during the initial learning period. 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 hemoglobina levels. The predictive factors for postoperative UI were determined using a multivariable logistic regression analysis. 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. 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. Copyright© by the International Brazilian Journal of Urology.

  7. Thulium Laser Endoscopic En Bloc Enucleation of Nonmuscle-Invasive Bladder Cancer.

    PubMed

    Migliari, Roberto; Buffardi, Andrea; Ghabin, Hassan

    2015-11-01

    To evaluate if thulium laser enucleation of bladder tumor (ThuLEBT) offers any advantage over monopolar resection of nonmuscle-invasive bladder cancer (NMIBC) without increasing complications. From February 2012 to September 2013, 58 patients (41 males and 17 females) newly diagnosed with having a single papillary bladder tumor more than 1 cm in diameter were selected for this prospective study on ThuLEBT. A similar historical cohort of 61 patients who underwent traditional monopolar resection (TURB-T) of NMIBC (Group B) was used to compare the two procedures. Mean tumor diameter in the ThuLEBT group was 2.5 cm (range 0.5-4.5). Mean operative time was 25 minutes (range 12-30). Re-resection and cold cup biopsy of the tumor base (in 90 days) were negative for bladder cancer (BC) persistence or recurrence in all patients with NMIBC treated with ThuLEBT. In Group B, seven patients were found with disease persistence. In eight cases of TURB-T patients, no detrusor muscle was identified, while it was always easily identified in the ThuLEBT group. No patient in Group A experienced obturator nerve reflection intraoperatively and no bladder perforation was evidenced in dome-located neoplasm; when involved, ureteral meatus was sharply excised without subsequent postoperative evidence of distortion. No significant intraoperative or postoperative bleeding occurred in all but one patient in the two groups. ThuLEBT may represent a potential alternative to TURB-T, which nowadays is considered the standard for diagnosis and treatment of NMBIC. In our study, ThuLEBT allowed accurate reporting of neoplastic depth invasion, suggesting the possibility to avoid a second-look resection at 90 days. All the different intravesical sites of the BC may be enucleated with the thulium laser, which offers advantages over the monopolar energy, especially when the tumor is located in the lateral bladder wall, at the bladder dome, or in the perimeatal zone.

  8. 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

  9. Effects of holmium laser enucleation of the prostate on sexual function.

    PubMed

    Placer, José; Salvador, Carlos; Planas, Jacques; Trilla, Enrique; Lorente, David; Celma, Ana; López, Miguel Ángel; Morote, Juan

    2015-03-01

    To evaluate the effects of holmium laser enucleation of the prostate (HoLEP) on sexual function. A retrospective analysis of 202 sexually active patients who underwent HoLEP was performed. Patients were assessed at baseline and 3 and 12 months post-HoLEP. Evaluations included uroflowmetry and symptom questionnaires (five-item version of the International Index of Erectile Function [IIEF-5], ICIQ-male sexual matters associated with LUTS [ICIQ-MLUTSsex], American Urological Association symptom score [AUA-SS], and single-question quality of life [QoL] score). Nonparametric, Fisher's exact, and chi-squared tests were used to assess changes from baseline and to identify risk factors, if any, associated with deterioration of sexual function after surgery. No significant differences were found between the preoperative and postoperative scores on the questionnaires that evaluated erection quality. However, 6.9% and 12.4% of the patients reported an increase or a reduction, respectively, of greater than five points in total IIEF-5 score. The reduction in IIEF-5 score was statistically significant only in the subgroup of patients without preoperative erectile dysfunction (ED). No preoperative characteristics and no parameters related to the surgery or postoperative outcome were significantly associated with the impairment of erection quality after surgery. In fact, neither capsular perforation nor the total laser energy used during the procedure affected erections. Loss of antegrade ejaculation was found in 70.3% of patients, while 21% reported a reduction in semen quantity. However, concern regarding ED or ejaculatory dysfunctions decreased with surgery. Although erectile function was not altered in the vast majority of patients after HoLEP, patients without preoperative ED displayed a relatively small, but still significant, negative effect on erections. The overwhelming majority of patients suffered from retrograde ejaculation after surgery.

  10. Patient satisfaction after holmium laser enucleation of the prostate (HoLEP): A prospective cohort study

    PubMed Central

    Lee, Young Ju; Oh, Shin Ah; Kim, Sung Han

    2017-01-01

    Objective To investigate patient satisfaction after holmium laser enucleation of the prostate (HoLEP) in a prospective study. Subjects and methods From May 2012 to December 2014, 397 patients underwent HoLEP by a single surgeon and enrolled in our prospective registry. Baseline data included age, PSA, transrectal ultrasonography, the international prostate symptom score (IPSS), and overactive bladder symptom score (OABSS). Subjective assessment of surgical outcomes was performed at 6 months postoperatively using self-administered questionnaires consisting of ‘satisfaction with treatment question’ (STQ), ‘overall response assessment’ (ORA), and ‘willingness to undergo surgery question’ (WSQ). Results A total of 331 patients (mean age 69.6±7.0 years) were included in the analysis. Mean total prostate volume was 69.5 (±42.2) ml. Mean preoperative IPSS score was 18.5 (±7.8). The STQ showed that most patients (91.8%) were satisfied after the surgery. Only 11 (3.3%) patients responded with ‘dissatisfied’, and no patients replied with ‘very dissatisfied’. The WSQ showed that 311 (94.0%) patients were willing to undergo the surgery again if they had to reconsider the surgical decision. The ORA showed that all patients (99.4%) experienced an improvement. When compared with satisfied patients, neutral/dissatisfied patients had lower IPSS quality of life scores (2.7 vs. 0.9, p<0.001), higher IPSS voiding symptom scores (7.0 vs. 1.4, p<0.001), and more frequent episodes of urgency urinary incontinence in OABSS (1.0 vs. 0.3, p = 0.017) at 6 months postoperatively. Conclusions The overall level of satisfaction after HoLEP was high. The most common reason for dissatisfaction was the occurrence of urgency urinary incontinence after the surgery. PMID:28793314

  11. 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.

  12. Holmium laser enucleation of the prostate and perioperative diagnosis of prostate cancer: an outcomes analysis.

    PubMed

    Rivera, Marcelino E; Frank, Igor; Viers, Boyd R; Rangel, Laureano J; Krambeck, Amy E

    2014-06-01

    Our objective is to assess the outcomes of patients with prostate cancer (PCa) diagnoses undergoing holmium laser enucleation of the prostate (HoLEP). From 2009 to 2012, 450 patients underwent HoLEP at our institution. We performed a retrospective review of these patients to identify those with PCa. PCa was diagnosed in 57 (12.7%) HoLEP patients: 11 (19.2%) preoperatively, 43 (75.4%) in the operative specimen, and 3 (5.4%) during follow-up. Mean time to PCa development in the postoperative group was 16 months (9-23). There was no difference in patient characteristics for those diagnosed with PCa at the time of HoLEP or in the postoperative period. There were 5 patients with a Gleason score (GS)>8 and 52 with GS<8 PCa. In the operative group, 39 (91%) elected for active surveillance and 4 (9%) elected to have cancer treatment. In subgroup analysis, men diagnosed with GS>8 intraoperatively or postoperatively had significantly elevated preoperative, postoperative, and percent change prostate-specific antigen (PSA) levels when compared to patients diagnosed GS ≤ 7 (P=0.01, 0.02, and 0.01, respectively). There were no complications, all voided spontaneously, and one patient had persistent incontinence. HoLEP for the treatment of lower urinary tract symptoms (LUTS) in selectively chosen men with known PCa can safely improve urination. Furthermore, PCa is diagnosed at the time of or post HoLEP in nearly 12% of patients. Those patients with persistently elevated post HoLEP PSA levels or low percent change PSA levels should raise suspicion for high GS PCa. Finally, HoLEP does not preclude active surveillance or treatment for PCa when appropriate.

  13. [A meta-analysis of holmium laser enucleation of the prostate for benign prostatic hyperplasia].

    PubMed

    Zhao, Chu-Biao; Li, Ju-Cong; Yuan, Ping-Qing; Hong, Ying-Qia; Lu, Bin; Zhao, Shan-Chao

    2011-12-01

    To evaluate the effectiveness and safety of holmium laser enucleation of the prostate (HoLEP) and transurethral resection of the prostate (TURP)/open prostatectomy (OP) in the treatment of bladder outlet obstruction (BOO) secondary to benign prostatic hyperplasia (BPH). We searched Medline, Cochrane Library, Embase, Wanfang and CBM for randomized controlled trials (RCT) comparing HoLEP with TURP/OP. Comparable data were extracted from eligible studies and pooled for meta-analysis using RevMan5.1. Nine RCTs were included in this study, 6 comparing HoLEP with TURP, and the other 3 comparing HoLEP with OP. Meta-analysis showed that, compared with TURP, HoLEP was associated with shorter hospital stay and catheterization time, less hemoglobin loss, longer operative time, and better improvement in international prostate symptom score (IPSS) , peak urinary flow rate (Qmax) and post void residual (PVR) , but the incidences of postoperative urethral stricture and urinary incontinence had no statistically significant difference between the two. Compared with OP, HoLEP showed shorter hospital stay and catheterization time, a lower rate of blood transfusion, longer operative time, and removal of fewer tissues, but the two procedures exhibited no significant differences in either the improvement of IPSS and Qmax or the incidence of urethral stricture. HoLEP is a minimally invasive technique, safe and highly effective for the treatment of BOO secondary to BPH, with its advantages of lower peri-operative morbidity and faster recovery over TURP and OP. However, more high-quality RCTs with larger sample sizes and longer follow-ups need to be carried out to obtain better evidence.

  14. 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

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

    PubMed

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

    2015-08-01

    To investigate the factors associated with the occurrence of and recovery from transient urinary incontinence (TUI) after holmium laser enucleation of the prostate (HoLEP). 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. 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. 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.

  16. Day-Case Holmium Laser Enucleation of the Prostate: Prospective Evaluation of 90 Consecutive Cases.

    PubMed

    Comat, Vincent; Marquette, Thibault; Sutter, Willy; Bernhard, Jean-Christophe; Pasticier, Gilles; Capon, Gregoire; Bensadoun, Henri; Ferrière, Jean-Marie; Robert, Gregoire

    2017-09-28

    To prospectively assess the feasibility and safety of holmium laser enucleation of the prostate (HoLEP) as day-case surgery for the treatment of benign prostatic hyperplasia. A prospective observational study was conducted by a single surgeon between June 2012 and October 2015. Except for patients ineligible for day-case surgery due to unstable cardiovascular disease, all patients with lower urinary tract symptoms presumably due to benign prostatic hyperplasia were consecutively included. HoLEP procedures were performed at 8AM, and patients were discharged before 8PM. The urinary catheter was removed at home the following morning. The monitoring of complications related with surgery included systematic assessment of perioperative complications, phone call within 48 hours after surgery, and follow-up visits after 1 and 3 months. Intent-to-treat univariate and multivariate analysis was performed to identify risk factors for day-case surgery failure. Ninety among 211 HoLEP performed by the surgeon were selected for day-case surgery (43%). Hospital stay was <12 hours in 83.4% of them. Prolonged hospitalization was necessary in 15 patients mainly due to gross hematuria requiring continuous bladder irrigation (n = 13). Day-case surgery failure rate (including prolonged hospitalization and readmissions within 48 hours) was 20.0% (18/90). The overall complication rate was 36.7%, with a Clavien III complication rate of only 3.3%. Monocentric design and limited number of patients are the main limitations of this work. This prospective evaluation shows that day-case HoLEP may be performed by a trained surgeon with an appropriate patient selection.

  17. Holmium laser enucleation of the prostate and retropubic prostatic adenomectomy: morbidity analysis and anesthesia considerations.

    PubMed

    Soto-Mesa, D; Amorín-Díaz, M; Pérez-Arviza, L; Fernández-Pello Montes, S; Martín-Huéscar, A

    2015-11-01

    Holmium laser enucleation of the prostate (HoLEP) is an alternative to prostatic adenomectomy for the surgical treatment of benign prostatic hypertrophy. We analyzed our learning curve for this technique, and we compared it in a secondary manner with prostatic adenomectomy. A retrospective comparative study was conducted that included the first 100 cases of HoLEP performed in our center and the latest 50 cases of retropubic adenomectomy. We collected data on the patients, the surgery, the anesthesia, the perioperative variables, the anesthesia complications and the postoperative variables, with a 6-month follow-up. We analyzed the learning curve without mentors for HoLEP and compared the characteristics of HoLEP in 2 separate phases (learning and stabilization phases) with the latest retropubic prostatic adenomectomies performed. Intradural anesthesia was the most common technique. The transfusion needs, length of stay (P<.01) and postoperative morbidity were lower for HoLEP than for adenomectomy. However, the retropubic adenomectomy group had larger initial prostate volumes (P<.001) and shorter surgical times (P<.001). Better surgical performance (P<.001) and a lower incidence of complications were observed in the HoLEP-B group (once the learning curve had been overcome) compared with the HoLEP-A group. In our center, HoLEP was introduced as a valid alternative to open retropubic adenomectomy, with excellent results in terms of morbidity and reduced hospital stay. In terms of the learning curve, we consider that approximately 50 patients (without mentor) is an appropriate cutoff. Local anesthesia is a good choice for the anesthesia technique. Copyright © 2014 AEU. Publicado por Elsevier España, S.L.U. All rights reserved.

  18. Patient satisfaction after holmium laser enucleation of the prostate (HoLEP): A prospective cohort study.

    PubMed

    Lee, Young Ju; Oh, Shin Ah; Kim, Sung Han; Oh, Seung-June

    2017-01-01

    To investigate patient satisfaction after holmium laser enucleation of the prostate (HoLEP) in a prospective study. From May 2012 to December 2014, 397 patients underwent HoLEP by a single surgeon and enrolled in our prospective registry. Baseline data included age, PSA, transrectal ultrasonography, the international prostate symptom score (IPSS), and overactive bladder symptom score (OABSS). Subjective assessment of surgical outcomes was performed at 6 months postoperatively using self-administered questionnaires consisting of 'satisfaction with treatment question' (STQ), 'overall response assessment' (ORA), and 'willingness to undergo surgery question' (WSQ). A total of 331 patients (mean age 69.6±7.0 years) were included in the analysis. Mean total prostate volume was 69.5 (±42.2) ml. Mean preoperative IPSS score was 18.5 (±7.8). The STQ showed that most patients (91.8%) were satisfied after the surgery. Only 11 (3.3%) patients responded with 'dissatisfied', and no patients replied with 'very dissatisfied'. The WSQ showed that 311 (94.0%) patients were willing to undergo the surgery again if they had to reconsider the surgical decision. The ORA showed that all patients (99.4%) experienced an improvement. When compared with satisfied patients, neutral/dissatisfied patients had lower IPSS quality of life scores (2.7 vs. 0.9, p<0.001), higher IPSS voiding symptom scores (7.0 vs. 1.4, p<0.001), and more frequent episodes of urgency urinary incontinence in OABSS (1.0 vs. 0.3, p = 0.017) at 6 months postoperatively. The overall level of satisfaction after HoLEP was high. The most common reason for dissatisfaction was the occurrence of urgency urinary incontinence after the surgery.

  19. 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

  20. [Comparison of the diode laser and the thulium laser in transurethral enucleation of the prostate for treatment of benign prostatic hyperplasia].

    PubMed

    Zhang, Feng-bo; Shao, Qiang; Tian, Ye

    2013-08-18

    To compare the validity and safety of diode laser and thulium laser transurethral enucleation of the prostate in benign prostatic hyperplasia (BPH) patients. In our study, 63 BPH patients treated with transurethral enucleation of the prostate were divided randomly into 2 groups by diode laser (Di group) or thulium laser (Thu group) respectively. The operation time, bleeding volume, electrolyte, international prostatic symptomatic score (IPSS), post-voiding residual volume (PVR) and maximum urine flow rate (Qmax) were recorded and compared. No difference was found in the 2 groups in basic preoperative characteristics. Di group was superior to Thu group in mean operation time [(61.5±19.6) min vs. (71.4±16.5) min, P=0.026] notwithstanding little clinical sense. The mean time of removing catheter was 2.1 d and 2.3 d respectively. No difference in either electrolyte decrease or hemoglobin decrease [(5.0±1.1 g/L) vs. (4.4±0.9) g/L, P=0.32] peri-operation between the 2 groups were found and no transurethral resection (TUR) syndrome was encountered. Lower urinary tract symptom (LUTS) in both the groups were released the 1st and 3nd months post-operation effectively in IPSS, PVR and Qmax respectively and comparable (P>0.05). Both the Diode laser and the Thulium laser transurethral enucleation of the prostate released the LUTS effectively in BPH patients and comparable in the short-time follow-up. Further study about late complications related to enucleation is necessary.

  1. Holmium laser enucleation versus photoselective vaporization for prostatic adenoma greater than 60 ml: preliminary results of a prospective, randomized clinical trial.

    PubMed

    Elmansy, Hazem; Baazeem, Abdulaziz; Kotb, Ahmed; Badawy, Hesham; Riad, Essam; Emran, Ashraf; Elhilali, Mostafa

    2012-07-01

    To our knowledge we report the first single center, prospective, randomized study comparing holmium laser enucleation and high performance GreenLight™ prostate photoselective vaporization as surgical treatment of prostatic adenomas greater than 60 ml. A total of 80 patients with a large prostatic adenoma were randomly assigned to surgical treatment with holmium laser enucleation or photoselective vaporization. International Prostate Symptom Score, International Index of Erectile Function-15, maximum flow rate, post-void residual urine, serum prostate specific antigen and transrectal ultrasound volume were recorded. Patient baseline characteristics were similar for holmium laser enucleation and photoselective vaporization. Operative time and catheter removal time were almost equal in the 2 groups (p = 0.7 and 0.2, respectively). Eight vaporization cases were converted to transurethral prostate resection or holmium laser enucleation intraoperatively due to bleeding. A significantly higher maximum flow rate and lower post-void residual urine were noted in holmium laser cases during the entire followup (at 1 year each p = 0.02). However, no significant difference in International Prostate Symptom Score, quality of life or International Index of Erectile Function-15 was detected. Prostate volume and serum PSA decreased 78% and 88% in the holmium laser group, and 52% and 60% in the vaporization group, respectively. Holmium laser enucleation and photoselective vaporization are effective for lower urinary tract symptoms due to a large prostatic adenoma. Early subjective functional results (maximum flow rate and post-void residual urine) of holmium laser enucleation appear to be superior to those of photoselective vaporization. In our hands cases intended to be treated with photoselective vaporization were at 22% risk of conversion to another modality. This could reflect our determination to vaporize to the capsule in all vaporization cases. Copyright © 2012 American

  2. 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.

  3. 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

  4. Comparison of the efficacy and feasibility of laser enucleation of bladder tumor versus transurethral resection of bladder tumor: a meta-analysis.

    PubMed

    Yang, Huan; Wang, Ning; Han, Shanfu; Male, Musa; Zhao, Chenming; Yao, Daqiang; Chen, Zhiqiang

    2017-08-23

    The transurethral resection of bladder tumor (TURBT) remains the most widely used method in the surgical treatment of the non-muscle invasive bladder tumor (NMIBT). Despite its popularity, the laser technique has been widely used in urology as an alternative, via the application of transurethral laser enucleation of bladder tumor. The aim of the present study was to compare the efficacy and feasibility between transurethral laser enucleation and transurethral resection of bladder tumor. A systematic search of the following databases was conducted: PubMed, Wed of Science, Cochrane Library, EMBASE, Google scholar, and Medline. The search included studies up to the 1st of January 2017. The outcomes of interest that were used in order to assess the two techniques included operation time, catheterization time, hospitalization time, obturator nerve reflex, bladder perforation, bladder irritation, 24-month-recurrence rate, and the postoperative adjuvant intravesical chemotherapy. A total of 13 trials with 2012 participants were included, of which 975 and 1037 underwent transurethral laser enucleation and transurethral resection of bladder tumor, respectively. No significant difference was noted in the operation time between the two groups, although significant differences were reported for the variables catheterization time, hospitalization time, obturator nerve reflex, bladder perforation, bladder irritation, and 24-month-recurrence rate. In the mitomycin and epirubicin subgroups, no significant differences were observed in the laser enucleation and TURBT methods with regard to the 24-month-recurrence rate. The laser enucleation was superior to TURBT with regard to the parameters obturator nerve reflex, bladder perforation, catheterization time, hospitalization time, and 24-month-recurrence rate. Moreover, laser enucleation can offer a more accurate result of the tumor's pathological stage and grade.

  5. Impact of Thulium Laser Enucleation of the Prostate on Erectile, Ejaculatory and Urinary Functions.

    PubMed

    Saredi, Giovanni; Pacchetti, Andrea; Pirola, Giacomo Maria; Martorana, Eugenio; Berti, Lorenzo; Scroppo, Fabrizio Ildefonso; Marconi, Alberto Mario

    2016-01-01

    To test the impact of Thulium laser enucleation of the prostate (ThuLEP) on erectile and ejaculatory functions, on lower urinary tract symptoms and on quality of life (QoL). From July 2013 to May 2015, we prospectively evaluated 177 patients with LUTS related to benign prostatic hyperplasia. All patients were assessed with the International Index of Erectile Function (IIEF-5), Male Sexual Health Questionnaire-Ejaculatory Disease (MSHQ-EjD), International Prostate Symptom Score (IPSS), QoL, PSA and uroflowmetry before and at 4 and 8 months after surgery. Erectile function did not show variation with IIEF-5 preoperative score 22.49 ± 1.8 and postoperative score 22.14 ± 3.1 (p = 0.195) and 22.18 ± 3.2 (p = 0.26) at 4 and 8 months after treatment. The ejaculatory function on the MSHQ-EjD test indicated the reduction of ejaculation, changing from 14.90 ± 6.88 to 5.51 ± 4.17 (p < 0.0001) and 5.38 ± 3.93 (p < 0.0001) at 4 and 8 months follow-up. IPSS score decreased from preoperative 21.12 ± 5.81 to 3.14 ± 3.16 (p < 0.0001) and 3.08 ± 3.12 (p < 0.0001) 4 and 8 months after surgery. PSA decreased from 4.50 ± 3.72 to 1.39 ± 1.04 (p < 0.0001) and 1.47 ± 1.14 ng/ml (p < 0.0001) at 4 and 8 months follow-up, while QoL score improved from 5.41 ± 0.69 to 0.57 ± 0.84 (p < 0.0001) and 0.51 ± 0.80 (p < 0.0001) at 4 and 8 months follow-up. ThuLEP does not affect erectile function and determines the resolution of LUTS with improvement of QoL. Loss of ejaculation did not impair the sexual intercourse activities of the patients. © 2016 S. Karger AG, Basel.

  6. The en-bloc no-touch holmium laser enucleation of the prostate (HoLEP) technique.

    PubMed

    Scoffone, Cesare Marco; Cracco, Cecilia Maria

    2016-08-01

    Holmium laser enucleation of the prostate (HoLEP) is currently considered a safe and effective therapeutic option for the treatment of adenomas of any size. Being considered difficult to learn and to teach, HoLEP is not as diffused as it would deserve. In 2011, we started performing HoLEP reproducing the traditional Gilling's technique. Case after case, we introduced alterations in the surgical approach, trying to overcome our difficulties and minimize our learning curve. We present a detailed step-by-step description of our modified HoLEP technique, developed in Torino, Italy, which we called en-bloc no-touch. The main steps of the en-bloc no-touch enucleation phase include: (1) the identification of the correct plane between adenoma and capsule only once, at the apex of the left lobe laterally to the veru montanum, extending the incision retrogradely towards the bladder at 5 o'clock; (2) the en-bloc enucleation of a horseshoe-like adenoma, sparing the 7 and 12 o'clock incisions; (3) the use of the beak of the endoscope, gently raising up the lobe from the capsular plane and creating a dihedral angle, crossed by connective bundles put in tension by this movement; and (4) the gradual no-touch lasing of such fibres, exploiting the effects of the plasma bubble at the tip of laser fibre, with no direct energy supply to the capsule. In our experience, the en-bloc no-touch technique has the potential to ease some difficult intraoperative steps and to improve the learning curve of HoLEP.

  7. Holmium Laser Enucleation of the Prostate versus Laparoscopic Transcapsular Prostatectomy: Perioperative Results and Three-Month Follow-Up.

    PubMed

    Baldini, Arnaud; Fassi-Fehri, Hakim; Duarte, Ricardo C; Crouzet, Sebastien; Ecochard, René; Abid, Nadia; Martin, Xavier; Badet, Lionel; Colombel, Marc

    2017-07-01

    Symptomatic benign prostatic hypertrophy greater than 70 cc used to be treated by invasive procedures. Holmium laser enucleation of prostate (HoLEP) and laparoscopic transcapsular prostatectomy (LTP) are two techniques whose efficacy has been demonstrated compared to standard onesmore invasive standard procedures. The objective was to evaluate and compare perioperative results from these two techniques for the treatment of benign prostatic hypertrophy greater than 70 cc. This was a non-randomized retrospective study comparing the HoLEP technique with LTP. From January 2012 to January 2015, 39 patients had HoLEP and 28 had LTP. Perioperative outcomes, complications, and functional results at 3 months were compared. A chi-2 squared test and Student's t test were used for statistical analysis. In multivariate analysis, there was a statistically significant difference in favor of HoLEP for the duration of catheterization (1.9 vs. 3.7 days; p = 0.004) and the average length of stay (2.8 vs. 4.0 days, p = 0.010). There was a trend towards a greater decrease in postoperative hemoglobin levels in LTP (138 vs. 218 g/l; p = 0.082), which was statistically significant in univariate analysis (p = 0.033). Other endpoints were not significant, particularly the enucleated prostate volume compared to the total prostate volume (61.8 vs. 68.4%; p = 0.319) and postoperative complications. There was no increased morbidity for LTP compared to the HoLEP technique. However, the HoLEP technique appeared to be a less invasive technique, reducing the duration of catheterization, blood loss, and the average length of stay while maintaining good efficacy for the enucleated prostate volume.

  8. Complications and early postoperative outcome in 1080 patients after thulium vapoenucleation of the prostate: results at a single institution.

    PubMed

    Gross, Andreas J; Netsch, Christopher; Knipper, Sophie; Hölzel, Jasmin; Bach, Thorsten

    2013-05-01

    Thulium vapoenucleation of the prostate (ThuVEP) has been introduced as a minimally invasive treatment for benign prostatic obstruction (BPO). To analyze immediate outcomes and the institutional learning curve of ThuVEP, and to report its standardized complication rates, using the modified Clavien classification system (CCS) to grade perioperative complication rates. A prospective evaluation of 1080 patients undergoing ThuVEP from January 2007 until May 2012 at our institution. ThuVEP was performed using the 2-μm, continuous-wave, thulium:yttrium-aluminum-garnet laser. Preoperative status, surgical details, and immediate outcome were recorded for each patient. Perioperative complications were classified according to the modified CCS. Median prostate size was 51 ml (interquartile range [IQR]: 36-78.7). Median operation time was 56 min (IQR: 40-80), and median enucleation time was 32.5 min (IQR: 22-50). Median catheterization time was 2 d (IQR: 2-2); median length of hospital stay was 4 d (IQR: 3-5). Median resected tissue weight was 30 g (IQR: 16.00-51.25). Incidental carcinoma of the prostate was detected in 59 (5.5%) patients. Median maximum urinary flow rate (8.9 vs 18.4 ml/s) and postvoid residual urine volume (120 vs 20 ml) changed significantly (p<0.001). Minor complications occurred in 24.6% of the patients (Clavien 1: 20.8%; Clavien 2: 3.8%). Early reinterventions were necessary in 6.6% of the patients (Clavien 3a: 0.6%; Clavien 3b: 6%). One Clavien 4 complication occurred (0.09%). The overall complication rates decreased significantly over time due to decreasing Clavien 1, 2, and 3b events. The major limitations of the study are the prospective, unicentric study design, the lack of a control group, and that only short-term data were documented on morbidity and efficacy of the ThuVEP procedure. ThuVEP is a safe and effective procedure for the treatment of symptomatic BPO, with low perioperative morbidity. Copyright © 2012 European Association of Urology

  9. Outcomes of transurethral resection and holmium laser enucleation in more than 60 g of prostate: A prospective randomized study

    PubMed Central

    Jhanwar, Ankur; Sinha, Rahul J.; Bansal, Ankur; Prakash, Gaurav; Singh, Kawaljit; Singh, Vishwajeet

    2017-01-01

    Aim: Transurethral resection of prostate (TURP) is considered a gold standard surgical procedure. The management of benign prostatic hyperplasia (BPH) has undergone tremendous change in recent years and shifted from open to minimal invasive procedure. With the advancement in technology and skills of surgeons, lasers have been used more liberally, particularly holmium laser. Holmium laser enucleation of prostate (HoLEP) is seen as close rival of TURP. The objective if this study is to observe long- and short-term outcomes of transurethral resection and holmium laser enucleation in the prostate of more than 60 g. Materials and Methods: This prospective randomized study includes 164 patients. Inclusion criteria were age <75 years after failed or poor response to medical therapy, prostatic size >60 g, gross hematuria secondary to BPH, recurrent urinary tract infection, acute urinary retention, postvoid residual >150 ml, and Schafer Grade II or more. BPH associated with neurogenic bladder, stricture urethra, and carcinoma prostate were excluded from the study. Group 1 comprises patients who underwent TURP and Group 2 comprises who underwent HoLEP. Follow-up was done at 1, 3, 6, 12, and 24 months after the surgery. Results: Data of 144 patients were analyzed. The mean age of patients in TURP and HoLEP group was 66.78 ± 7.81 and 67.70 ± 7.44 years, respectively (P = 0.47), mean prostatic volume was 74.5 ± 12.56 and 75.6 ± 12.84 g, respectively (P = 0.60), operative time was 73.10 ± 10.49 and 89.56 ± 13.81 min, respectively (P = 0.0001). Mean resected tissue was 44.80 ± 9.87 and 48.49 ± 10.87, respectively (P = 0.03). The sexual function did not changed significantly in postoperative follow-up. Conclusion: HoLEP is associated with less blood loss, lower transfusion rates, and a shorter hospital stay. The disadvantage of HoLEP is longer operative time and postoperative dysuria. PMID:28216929

  10. In 2013, holmium laser enucleation of the prostate (HoLEP) may be the new 'gold standard'.

    PubMed

    van Rij, Simon; Gilling, Peter J

    2012-12-01

    In this review article, we assess why holmium laser enucleation of the prostate (HoLEP) has become an important treatment modality for benign prostatic hypertrophy (BPH). Meta-analysis comparing HoLEP with both open prostatectomy (OP) and transurethral resection of prostate (TURP) shows TURP to be as effective with less morbidity. More recently, HoLEP has long-term durability data confirming a very low reoperation rate. This article investigates how previous hurdles to the widespread uptake of HoLEP have been overcome. Recent literature shows that the learning curve is actually similar to many other current urological procedures, and that the efficiency of HoLEP is equal to that of other surgical procedures. HoLEP is also beneficial in the growing population of men on anticoagulation who require treatment for BPH. Finally, HoLEP is the only laser treatment for BPH with level 1 evidence and endorsement in both the American Urological Association (AUA) and European Association of Urology (EAU) guidelines.

  11. 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

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

    PubMed

    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

    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. 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. 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. Our data suggest that PVP and HoLEP are efficient and safe surgical treatment options for patients with small prostate volume.

  13. Direct Comparison of GreenLight Laser XPS Photoselective Prostate Vaporization and GreenLight Laser En Bloc Enucleation of the Prostate in Enlarged Glands Greater than 80 ml: a Study of 120 Patients.

    PubMed

    Misrai, Vincent; Kerever, Sebastien; Phe, Veronique; Zorn, Kevin C; Peyronnet, Benoit; Rouprêt, Morgan

    2016-04-01

    We compare patient outcomes after 180 W XPS™ GreenLight™ photoselective vaporization of the prostate and GreenLight laser enucleation of the prostate used to surgically manage benign prostatic obstruction. Two groups of 60 consecutive patients with enlarged glands (greater than 80 ml) underwent GreenLight laser prostate enucleation or photoselective prostate vaporization (performed by the same surgeon and including the learning curve) and were retrospectively evaluated. Perioperative data from both groups were compared. The operative time was significantly shorter in the GreenLight laser prostate enucleation group (60 vs 82 minutes, p <0.0001). Complication rates were comparable between the groups. At 2 months the rate of urinary incontinence was significantly higher in the GreenLight laser prostate enucleation group (25% vs 3.4%, p <0.0001) but incontinence rates were similar at 6 months (3.4% vs 0%, p=0.50). At 6 months International Prostate Symptom Score quality of life and post-void residual urine volume had similarly decreased in the 2 groups after the procedure (compared to baseline), whereas the maximum urinary flow rate had greatly improved, significantly favoring the GreenLight laser prostate enucleation group (+78% vs +64%, p <0.0001). Prostate size and prostate specific antigen reductions were significantly higher in the GreenLight laser prostate enucleation group (74% vs 57%, p <0.0001 and 67% vs 40%, respectively, p=0.007). The unplanned hospital readmission rates were similar in both groups (16.7% vs 6.7%, p=0.16). Photoselective vaporization of the prostate and GreenLight laser enucleation of the prostate are safe and provide satisfactory short-term functional outcomes in patients with a prostate volume greater than 80 ml. However, the surgical time was longer in the photoselective prostate vaporization group, which also had a higher rate of unplanned hospital readmission, and lower decreases in prostate specific antigen and prostate size

  14. Comparison of Surgical Outcomes Between Holmium Laser Enucleation and Transurethral Resection of the Prostate in Patients With Detrusor Underactivity

    PubMed Central

    2017-01-01

    Purpose Currently, holmium laser enucleation of the prostate (HoLEP) and transurethral resection of the prostate (TURP) are the standard surgical procedures used to treat benign prostatic hyperplasia (BPH). Several recent studies have demonstrated that the surgical management of BPH in patients with detrusor underactivity (DU) can effectively improve voiding symptoms, but comparative data on the efficacy of HoLEP and TURP are insufficient. Therefore, we compared the short-term surgical outcomes of HoLEP and TURP in patients with DU. Methods From January 2010 to May 2015, 352 patients underwent HoLEP or TURP in procedures performed by a single surgeon. Of these patients, 56 patients with both BPH and DU were enrolled in this study (HoLEP, n=24; TURP, n=32). Surgical outcomes were retrospectively compared between the 2 groups. DU was defined as a detrusor pressure at maximal flow rate of <40 cm H2O as measured by a pressure flow study. Results The preoperative characteristics of patients and the presence of comorbidities were comparable between the 2 groups. The TURP group showed a significantly shorter operative time than the HoLEP group (P=0.033). The weight of the resected prostate was greater in the HoLEP group, and postoperative voiding parameters, including peak flow rate and postvoid residual urine volume were significantly better in the HoLEP group than in the TURP group. Conclusions HoLEP can be effectively and safely performed in patients with DU and can be expected to have better surgical outcomes than TURP in terms of the improvement in lower urinary tract symptoms. PMID:28361512

  15. Thulium Laser Prostate Enucleation in Refractory Urinary Retention: Operative and Functional Outcomes in a Large Cohort of Patients.

    PubMed

    Carmignani, Luca; Pastore, Antonio Luigi; Picozzi, Stefano Carlo Maria; Finkelberg, Elisabetta; Ratti, Dario; Vizziello, Damiano; Schirinzi, Maria Lucia; Saccà, Antonino; Pisano, Francesca; Maruccia, Serena

    2016-07-01

    To evaluate the functional and operative results of thulium laser enucleation of the prostate (ThuLEP) in patients with indwelling catheters for refractory urinary retention. Patients with indwelling catheter, undergoing ThuLEP for benign prostate hyperplasia, were prospectively enrolled. Every episode of urinary retention was treated with urinary catheter positioning followed by at least 2 attempts of catheter removal. Patients were investigated with flowmetry and the self-administered International Prostate Symptom Score questionnaire at 30 and 90 days following ThuLEP. Three hundred eighty-one patients underwent ThuLEP, and 99 of these had indwelling catheters, but only 93 (24%) were eligible according to the inclusion criteria. In 46 patients the bladder catheter was removed on the first postoperative day, in 31 patients on the second postoperative day, in 5 patients on the third postoperative day, in 6 patients on the fourth postoperative day, in 1 patient on the fifth postoperative day, and in 2 patients each on the sixth and seventh postoperative days. The average hospital stay was 2.3 (±1.7) days. No patients undergoing ThuLEP, at the 90-day follow-up, required further catheterization. Flowmetry showed significant improvement in all parameters, and the mean International Prostate Symptom Score dropped from 21.33 preoperatively to 3.2 (P = .004) at 90 days postoperatively. This prospective study shows that ThuLEP is a safe and effective approach in refractory urinary retention patients. In our case series, no patients required postoperative intermittent catheterization. All functional outcomes investigated reported a statistical significant improvement. Copyright © 2016 Elsevier Inc. All rights reserved.

  16. [Holmium laser enucleation of the prostate as a day case surgery: prospective evaluation of the first 30 patients].

    PubMed

    Gabbay, G; Bernhard, J-C; Renard, O; Ballanger, P; Ferriere, J-M; Fallot, J; Comat, V; Robert, G

    2015-01-01

    To evaluate the feasibility of holmium laser enucleation of the prostate (HoLEP) as a day case surgery. Observational prospective study including 30 consecutive patients after exclusion of unstable diseases and anticoagulant therapy. Patients were discharged before 8PM and the urinary catheter was removed at home the next morning. The monitoring included a phone call after 24hours and clinical evaluations after 1 and 3month follow-up. Clinical data were prospectively collected and complications were classified according to the Clavien-Dindo classification. The mean age of the study population was 63.8, prostate volume was 75.3cc, maximum urinary flow rate was 9.5mL/s, and IPSS was 22.9. The conversion rate to conventional hospitalization was 3.3%. After 3months follow-up, readmission and reoperation rates were respectively 16.6% and 3.3%. The overall complication rate was 66% (Clavien I=57.7%, II=38.5%, III=3.8%). The satisfaction rate was 100% (score=9.2/10). The mean prostate volume at 3months follow-up was 23.3cc, maximum urinary flow was 25.6mL/s, and IPSS was 4.7. This study confirmed the feasibility of HoLEP as a day case surgery for selected patients. Conversion rate to conventional hospitalization and complications of grade >2 were less than 5% while the satisfaction rate was high. 3. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

  17. 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

  18. 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

  19. [Six-o'clock tunnel holmium laser enucleation of the prostate: a modified procedure for benign prostate hyperplasia].

    PubMed

    Gu, Mieng; Cai, Zhi-kang; Chen, Qi; Chen, Yan-bo; Wang, Zhong

    2015-02-01

    To evaluate the safety and effectiveness of a modified method of holmium laser enucleation of the prostate (HoLEP)--6-o'clock tunnel HoLEP for the treatment of benign prostate hyperplasia (BPH). We included 112 cases of BPH in this study, 57 treated by 6-o'clock tunnel HoLEP (experimental group) and the other 55 by conventional HoLEP (control group). We compared the operation time, volume of the resected prostatic tissue, intraoperative blood transfusion, volume of bladder irrigation solution, postoperative hemoglobin change, and incidence of urinary incontinence between the two groups. Statistically significant differences were observed between the experimental and control groups in the operation time ([56.01 ± 8.62] min vs [68.65 ± 9.08] min), cases of intraoperative blood transfusion (0 vs 2), volume of bladder irrigation solution ([27.51 ± 3.67] L vs [36.89 ± 6.47] L), postoperative hemoglobin decrease ([10.70 ± 2.50] g/L vs [12.60 ± 3.30] g/L), and cases of postoperative stress-induced urinary incontinence (2 vs 7) (all P <0.05). One-month follow-up revealed smooth urination in both groups of patients but no true urinary incontinence or secondary bleeding in either. Modified 6-o'clock tunnel HoLEP can significantly reduce the operation time, bladder irrigation, and intraoperative bleeding, and therefore can be used as a safe and effective option for the treatment of BPH.

  20. Patient-reported sexual outcomes after holmium laser enucleation of the prostate: a 3-year follow-up study.

    PubMed

    Klett, Dane E; Tyson, Mark D; Mmeje, Chinedu O; Nunez-Nateras, Rafael; Chang, Yu-Hui; Humphreys, Mitchell R

    2014-08-01

    To evaluate the long-term patient reported sexual function outcomes of holmium laser enucleation of the prostate (HoLEP) for the treatment of lower urinary tract symptoms secondary to prostate enlargement. Three hundred ninety-three patients underwent a HoLEP between August 2007 and July 2013 and were reviewed in this retrospective analysis. Sexual function outcomes were assessed before HoLEP, and again at 3, 6, 12, 24, and 36 months after surgery using the International Index of Erectile Function 5 survey. International Prostate Symptom Scores (IPSS) were included for comparison and contextual functional outcome analysis. At the time of surgery, the mean age was 70.9 years (52.0-89.0 years), mean body mass index was 27.7 kg/m(2) (18.0-48.0 kg/m(2)), and mean prostate volume was 96.7 g (20.1-375.0 g). Mean International Index of Erectile Function 5 scores at 3 (13.3 ± 8.37), 6 (12.1 ± 8.76), 12 (12.1 ± 8.83), 24 (12.6 ± 8.80), and 36 months (12.5 ± 8.45) showed no significant change from baseline. There was, however, a significant improvement from baseline seen in IPSS over the same time period (P = .0001). These data confirm HoLEP has a significant impact on IPSS and no adverse impact on long-term patient reported sexual function. We believe this series represents the largest cohort with the longest follow-up to date. It represents an important tool for preoperative patient counseling for those patients considering surgical therapy for benign prostatic hyperplasia. Copyright © 2014 Elsevier Inc. All rights reserved.

  1. 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

  2. Predictors of urgency improvement after Holmium laser enucleation of the prostate in men with benign prostatic hyperplasia

    PubMed Central

    Hur, Won Sok; Kim, Joon Chul; Kim, Hyo Sin; Koh, Jun Sung; Kim, Sang Hoon; Kim, Hyun Woo; Cho, Su Yeon

    2016-01-01

    Purpose To investigate the change in urinary urgency and predictors of urgency improvement after holmium laser enucleation of the prostate (HoLEP) in men with benign prostatic hyperplasia (BPH). Materials and Methods We retrospectively analyzed the medical records of patients who were treated with HoLEP for BPH and had preoperative urgency measuring ≥3 on a 5-point urinary sensation scale. Those with prostate cancer diagnosed prior to or after HoLEP, a history of other prostatic and/or urethral surgery, moderate to severe postoperative complications, and neurogenic causes were excluded. Patients who had improved urgency with antimuscarinic medication after HoLEP were excluded. We divided the patients into 2 groups based on urgency symptoms 3 months after HoLEP: improved and unimproved urgency. Improved urgency was defined as a reduction of 2 or more points on the 5-point urinary sensation scale. Preoperative clinical and urodynamic factors as well as perioperative factors were compared between groups. Results In total, 139 patients were included in this study. Voiding parameters in all patients improved significantly after HoLEP. Seventy-one patients (51.1%) had improved urgency, while 68 (48.9%) did not show any improvement. A history of acute urinary retention (AUR) and postvoid residual were associated with postoperative urgency improvement in univariate analysis. In multivariate analysis, a history of AUR was an independent factor affecting urgency improvement. Conclusions A preoperative history of AUR could influence the change in urgency after HoLEP surgery in patients with BPH. PMID:27847917

  3. 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

  4. 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

  5. Plasmakinetic enucleation of prostate versus 160-W laser photoselective vaporization for the treatment of benign prostatic hyperplasia

    PubMed Central

    Wang, Si-Jun; Mu, Xiao-Nan; Chen, Ji; Jin, Xun-Bo; Zhang, Shi-Bao; Zhang, Long-Yang

    2017-01-01

    To evaluate the safety and efficacy of plasmakinetic enucleation of the prostate (PKEP) for the treatment of symptomatic benign prostatic hyperplasia (BPH) compared with 160-W lithium triboride laser photoselective vaporization of the prostate (PVP). From February 2011 to July 2012, a prospective nonrandomized study was performed. One-hundred one patients underwent PKEP, and 110 underwent PVP. No severe intraoperative complications were recorded, and none of the patients in either group required a blood transfusion. Shorter catheterization time (38.14 ± 23.64 h vs 72.54 ± 28.38 h, P < 0.001) and hospitalization (2.32 ± 1.25 days vs 4.07 ± 1.23 days, P < 0.001) were recorded in the PVP group. At 12-month postoperatively, the PKEP group had a maintained and statistically improvement in International Prostate Symptom Score (IPSS) (4.07 ± 2.07 vs 5.00 ± 2.10; P < 0.001), quality of life (QoL) (1.08 ± 0.72 vs 1.35 ± 0.72; P = 0.007), maximal urinary flow rate (Qmax) (24.75 ± 5.87 ml s−1 vs 22.03 ± 5.04 ml s−1; P < 0.001), postvoid residual urine volume (PVR) (14.29 ± 6.97 ml vs 17.00 ± 6.11 ml; P = 0.001), and prostate-specific antigen (PSA) value (0.78 ± 0.57 ng ml−1 vs 1.27 ± 1.07 ng ml−1; P < 0.001). Both PKEP and PVP relieve low urinary tract symptoms (LUTS) due to BPH with low complication rates. PKEP can completely remove prostatic adenoma while the total amount of tissue removed by PVP is less than that can be removed by PKEP. Based on our study of the follow-up, PKEP provides better postoperative outcomes than PVP. PMID:26732101

  6. Long-term sexual outcomes after holmium laser enucleation of the prostate: which patients could benefit the most?

    PubMed

    Capogrosso, P; Ventimiglia, E; Ferrari, M; Serino, A; Boeri, L; Capitanio, U; Briganti, A; Damiano, R; Montorsi, F; Salonia, A

    2016-09-01

    Assess rate and predictors of erectile function (EF) outcomes at long-term follow-up (FU) after holmium laser enucleation of the prostate (HoLEP). Cross-sectional analyses were performed on 135 patients with a mean FU of 12 years post HoLEP. Patients completed both a baseline and a FU International Index of Erectile Function (IIEF)-EF domain and the International Prostatic Symptoms Score (IPSS). Postoperative EF outcomes, including rate and predictors of EF improvement considering minimal clinically important differences (MCIDs) criteria, were assessed. Logistic regression models tested the association between predictors and EF. At a mean (median) FU of 152.1 (163) months, patients showed a significant decrease in the IIEF-EF score P<0.01) and significant IPSS improvement (P<0.01). Overall, 50 (37%) patients worsened by at least one IIEF-EF category. Conversel, 23 (17%) patients reported an improvement in postoperative IIEF-EF score; 75 (55.6%) and 10 (7.4%) patients maintained and eventually improved their IIEF-EF category, respectively. Patients reporting a decrease in the postoperative IIEF-EF score were significantly older (P=0.03) and showed a significantly longer mean FU (P<0.01) than those reporting postoperative improvements of IIEF-EF. Nine (6.7%) patients showed significant EF improvement according to MCIDs criteria. Both higher IPSS scores (odds ratio (OR): 1.12; P=0.02) and lower IIEF-EF (OR: 0.88; P<0.01) at baseline, emerged as independent predictors of postoperative EF improvement. HoLEP was associated with a decrease in EF and a persistent amelioration of BPH-related urinary symptoms at long-term FU. Almost one third of patients worsened by at least one IIEF-EF category. However, a clinically meaningful EF improvement was observed in roughly 7% of the individuals. Patients with more severe preoperative urinary symptoms and ED benefited more from HoLEP in terms of EF.

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

    PubMed

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

    2016-03-01

    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. 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 (Q max) 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. 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 Q max, 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). The results of the meta-analysis have shown that HoLEP and OP possess

  8. [Prospective evaluation of the direct costs of prostate enucleation by the HoLEP(®) laser during the learning curve period].

    PubMed

    Roger, M; Goris-Gbenou, M; Guillermet, A; Vial, R; Cunin, N; Tomas, J; Bourgue, L; Combe, M; Lopez, J-G; Combe, C

    2017-04-01

    Holmium laser enucleation of the prostate (HoLEP) has been shown to be effective in treating large prostates compared to prostate transurethral resection (TURP). There are no published data evaluating specifically the impact of the learning curve on the direct costs of HoLEP. The objective of this study was to evaluate the direct costs generated by the use of HoLEP laser during the learning curve period. The costs of all medical devices (DM) and drugs used, pre- and post-operative parameters during surgery have been prospectively collected between March and October 2016. A total of 32 patients were included in the study with a mean age of 70.8 years and a mean prostate volume of 68.6 cm(3). The mean cost of anesthesia was 39.0 € and that of drugs and DM used for surgery was 257.95 € but could reach 470.76 € in case of conversion to bipolar resection. The mean duration of enucleation and morcellation was 150minutes with a mean weight of enucleated specimens of 40.4g. The total mean duration of patient care was 197minutes at an estimated hourly cost of € 636. Despite some limitations, this study makes it possible to analyze the direct costs of the management of benign prostatic hypertrophy using HoLEP, an innovative surgical technique, and to specify that these costs are more related to bipolar conversion and voluminous adenomas especially during the learning curve. 5. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  9. A review of the recent evidence (2006-2008) for 532-nm photoselective laser vaporisation and holmium laser enucleation of the prostate.

    PubMed

    Naspro, Richard; Bachmann, Alexander; Gilling, Peter; Kuntz, Rainer; Madersbacher, Stephan; Montorsi, Francesco; Reich, Oliver; Stief, Christian; Vavassori, Ivano

    2009-06-01

    Holmium laser enucleation of the prostate (HoLEP) and 532-nm laser vaporisation of the prostate (with potassium titanyl phosphate [KTP] or lithium borate [LBO]) are promising alternatives to transurethral resection of the prostate (TURP) and open prostatectomy (OP). To assess safety, efficacy, and durability by analysing the most recent evidence of both techniques, aiming to identify advantages, pitfalls, and unresolved issues. A Medline search of recently published data (2006-2008) regarding both techniques over the last 2 yr (January 2006 to September 2008) was performed using evidence obtained from randomised trials (level of evidence: 1b), well-designed controlled studies without randomisation (level of evidence: 2a), individual cohort studies (level of evidence: 2b), individual case control studies (level of evidence: 3), and case series (level of evidence: 4). In the last 2 yr, several case-control and cohort studies have demonstrated reproducibility, safety, and efficacy of HoLEP and 80-W KTP laser vaporisation. Four randomised controlled trials (RCTs) were available for HoLEP, two compared with TURP and two compared with OP, with follow-up >24 mo. Results confirmed general efficacy and durability of HoLEP, as compared with both standard techniques. Only two RCTs were available comparing KTP laser vaporisation with TURP with short-term follow-up, and only one RCT was available comparing KTP laser vaporisation with OP. The results confirmed the overall low perioperative morbidity of KTP laser vaporisation, although efficacy was comparable to TURP in the short term, despite a higher reoperation rate. Although they are at different points of maturation, KTP or LBO laser vaporisation and HoLEP are promising alternatives to both TURP and OP. Sufficient data proves HoLEP's durability for most prostate sizes at long-term follow-up; KTP laser vaporisation needs further evaluation to define the reoperation rate. Increasing the number of quality prospective RCTs with

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

    PubMed

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

    2015-03-01

    To evaluate the efficacy and safety of holmium laser enucleation of the prostate (HoLEP) for extremely large prostates. 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. 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, R(2)=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. HoLEP in patients with an extremely large prostate can be performed efficiently and safely.

  11. 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

  12. Practical Index of Urinary Incontinence Following Holmium Laser Enucleation of the Prostate: A Case-Series Study of the 24-Hour Pad Test Immediately after Catheter Removal.

    PubMed

    Fujisaki, Akiko; Goto, Aya; Endo, Fumiyasu; Muraishi, Osamu; Hattori, Kazunori; Yasumura, Seiji

    2016-01-01

    Epidemiological data regarding complications after holmium laser enucleation of the prostate (HoLEP) are scarce in Japan. We examined the associations of the 24-hour pad test results immediately after HoLEP with continence acquisition at 3 months postoperatively. In this hospital-based case-series study, we reviewed medical charts of 341 patients without catheterization and 150 patients with catheterization at the time of surgery. The 24-hour pad test was conducted immediately after catheter removal to measure the leakage weight. Subjects were divided into 2 groups: leakage weight = 0 g (negative) and >0 g (positive). Urinary incontinence (UI) at 3 months postoperatively was self-reported by patients. Significant relationships were observed between pad test positivity and UI at 3 months postoperatively and between the pad test weight and the timing of continence acquisition in patients with and without catheterization. In multivariate analyses, the pad test positivity was associated significantly with the Overactive Bladder Symptom Score and enucleated tissue weight in patients without perioperative catheterization and with age in patients with catheterization. The 24-hour pad test immediately after catheter removal could indicate the need for early and active intervention to prevent continuous postoperative UI. Patients' symptoms and clinical items predictive of test positivity should be carefully assessed. © 2016 S. Karger AG, Basel.

  13. 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…

  14. 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…

  15. 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.

  16. Prostatic Arterial Embolization Followed by Holmium Laser Enucleation of the Prostate as a Planned Combined Approach for Extremely Enlarged Benign Prostate Hyperplasia.

    PubMed

    Li, Pu; Wang, Chengming; Cao, Qiang; Zhang, Jiexiu; Shi, Haibin; Meng, Xiaoxin

    2017-08-03

    This study was aimed at reporting the initial experience with prostatic arterial embolization (PAE) followed by holmium laser enucleation of the prostate (HoLEP) as a planned combined approach for extremely enlarged benign prostate hyperplasia (BPH), and retrospectively estimating the efficacy and safety of this novel technique. Twenty-four BPH patients who underwent PAE and subsequent HoLEP were included. The PAE procedure was performed under local anesthesia at the supine position with polyvinyl alcohol spherical particles and gelatin sponge particles. HoLEP was performed 3 months after PAE by the "en-bloc" enucleation technique. Clinical data before and 6 months after the procedure were analyzed. PAE and HoLEP were technically successful in all 24 patients. The mean prostate volume was 219 ± 38 mL; the mean total operative time and enucleation time for HoLEP were 117.8 ± 21.9 and 83.5 ± 15.4 min, respectively; and the mean resected prostate weight was 118.3 ± 20.7 g. No transurethral resection of the prostate syndrome was observed during and after HoLEP. The estimated blood loss during HoLEP was 72.1 ± 33.7 mL, and no case required transfusion. International Prostate Symptom Score and post void residual volume decreased significantly (24.1 ± 2.84 vs. 13.5 ± 3.39, p < 0.001; 107.1 ± 40.8 vs. 21.8 ± 16.8, p < 0.001, respectively), maximal flow rate increased significantly (6.25 ± 1.42 vs. 17.63 ± 16.56, p < 0.001), and prostatic specific antigen level also decreased after the procedure (9.29 ± 2.28 vs. 4.99 ± 1.35, p < 0.001). PAE followed by HoLEP as a planned combined approach can be performed safely, feasibly, and efficiently in patients with extremely enlarged BPH. © 2017 S. Karger AG, Basel.

  17. Robot-Assisted Radical Prostatectomy in Patients with a History of Holmium Laser Enucleation of the Prostate: Feasibility and Evaluation of Initial Outcomes.

    PubMed

    Gellhaus, Paul T; Monn, M Francesca; Leese, Joshua; Flack, Chandra K; Lingeman, James E; Koch, Michael O; Boris, Ronald S

    2015-07-01

    To evaluate outcomes of post-holmium laser enucleation of the prostate (HoLEP) robot-assisted radical prostatectomy (RARP). Using an institutional database, we identified 11 HoLEP patients who subsequently underwent RARP. These were matched 1:2 to RARP patients without a previous transurethral surgical procedure. Variables matched were age, pre-RARP prostate-specific antigen level, and biopsy Gleason score. Urinary continence and sexual function were evaluated by physician questioning, American Urological Association symptom score, and Sexual Health in Men (SHIM) scores. Descriptive statistics were used to compare cohorts. RARP pathologic outcomes were similar between cases and controls. Twenty-seven percent of previous HoLEP patients reached strict urinary continence (leak free, pad free) at last follow-up compared with 64% of matched controls (P=0.071). The average (range) SHIM score at last follow-up was 2.6 (1-5) for previous HoLEP patients compared with 13.9 (5-20) (P<0.001). The posterior bladder neck and apical dissections were significantly more challenging in the setting of previous HoLEP and necessitated a low threshold for wider resection to minimize positive surgical margins. Post-HoLEP RARP is challenging but preliminarily appears safe and feasible when performed by an experienced robotic surgeon. Patients should be counseled regarding expectations of urinary continence and sexual function in this setting.

  18. Evaluation of the learning curve for thulium laser enucleation of the prostate with the aid of a simulator tool but without tutoring: comparison of two surgeons with different levels of endoscopic experience.

    PubMed

    Saredi, Giovanni; Pirola, Giacomo Maria; Pacchetti, Andrea; Lovisolo, Jon Alexander; Borroni, Giacomo; Sembenini, Federico; Marconi, Alberto Mario

    2015-06-09

    The aim of this study was to determine the learning curve for thulium laser enucleation of the prostate (ThuLEP) for two surgeons with different levels of urological endoscopic experience. From June 2012 to August 2013, ThuLEP was performed on 100 patients in our institution. We present the results of a prospective evaluation during which we analyzed data related to the learning curves for two surgeons of different levels of experience. The prostatic adenoma volumes ranged from 30 to 130 mL (average 61.2 mL). Surgeons A and B performed 48 and 52 operations, respectively. Six months after surgery, all patients were evaluated with the International Prostate Symptom Score questionnaire, uroflowmetry, and prostate-specific antigen test. Introduced in 2010, ThuLEP consists of blunt enucleation of the prostatic apex and lobes using the sheath of the resectoscope. This maneuver allows clearer visualization of the enucleation plane and precise identification of the prostatic capsule. These conditions permit total resection of the prostatic adenoma and coagulation of small penetrating vessels, thereby reducing the laser emission time. Most of the complications in this series were encountered during morcellation, which in some cases was performed under poor vision because of venous bleeding due to surgical perforation of the capsule during enucleation. Based on this analysis, we concluded that it is feasible for laser-naive urologists with endoscopic experience to learn to perform ThuLEP without tutoring. Those statements still require further validation in larger multicentric study cohort by several surgeon. The main novelty during the learning process was the use of a simulator that faithfully reproduced all of the surgical steps in prostates of various shapes and volumes.

  19. Comparison of thulium laser enucleation and plasmakinetic resection of the prostate in a randomized prospective trial with 5-year follow-up.

    PubMed

    Yang, Zhonghua; Liu, Tongzu; Wang, Xinghuan

    2016-12-01

    The aim of this study was to compare the clinical outcomes between thulium laser enucleation of the prostate (ThuLEP) and plasmakinetic bipolar resection of the prostate (PKRP) for treating benign prostatic hyperplasia (BPH) in a prospective randomized trial with 5 years of follow-up. One hundred fifty-eight consecutive patients with BPH were randomized to receive operation of either ThuLEP (n = 79) or PKRP (n = 79). All cases were evaluated preoperatively, and a part of them were evaluated at 3-5 years postoperatively by the International Prostate Symptom Score (IPSS), quality of life score (QoLS), maximum flow rate (Q max), and postvoid residual (PVR) urine volume. Eighty patients completed the 5-year follow-up. Each study arm showed no significant difference in preoperative parameters. Compared with PKRP, ThuLEP required longer operation time (65.4 vs 47.4 min, p = 0.022) but resulted in less hemoglobin decrease (1.5 vs 3.0 g/L, p = 0.045), catheterization time (2.1 vs 3.5 days, p = 0.031), irrigated volume (12.4 vs 27.2 L, p = 0.022), and hospital stay (2.5 vs 4.6 days, p = 0.026). During the 60-month follow-up, both procedures demonstrated no significant difference in terms of Q max, IPSS, PVR urine volume, and QoLS. ThuLEP was statistically superior to PKRP in blood loss, catheterization time, irrigated volume, and hospital stay but inferior to PKRP in operation time. However, both procedures showed no significant difference in terms of Q max, IPSS, PVR urine volume, and QoLS through the 60-month follow-up.

  20. Holmium laser enucleation of the prostate is effective in the treatment of symptomatic benign prostatic hyperplasia of any size including a small prostate.

    PubMed

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

    2014-11-01

    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. 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. 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. 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.

  1. Analysis of early morbidity and functional outcome of thulium: yttrium-aluminum-garnet laser enucleation for benign prostate enlargement: patient age and prostate size determine adverse surgical outcome.

    PubMed

    Rausch, Steffen; Heider, Thomas; Bedke, Jens; Kruck, Stephan; Schwentner, Christian; Fischer, Karsten; Stenzl, Arnulf; Kälble, Tilman

    2015-01-01

    To evaluate complications and functional outcome and to identify patient-associated risk factors, we analyzed consecutive patients undergoing thulium:yttrium-aluminum-garnet laser enucleation of the prostate (ThuLEP) in our department. A total of 234 patients were prospectively analyzed. Preoperative data, postoperative complications, and outcome at 6, 12, and 24 months were recorded. Individual risk factors for complications and treatment failure were assessed by univariate and multivariate analyses. Mean age at surgery was 72.88 ± 7.83 years. Mean preoperative prostate size was 84.8 ± 34.9 mL. Thirty-day complication rate was 19.7%. Functional treatment failure occurred in 9.0% of all patients. Decline of mean International Prostate Symptom Score was -75%, quality of life index -76%, and postvoid residual -86% at 24 months. Maximum urine flow at 24 months was improved at +231%. In univariate analysis, age >80 years and prostate size <50 mL were significant predictors of complications, which was confirmed by multivariate analysis (P = .0277 and .0409, respectively). Age >80 years, prostate size <80 mL or <50 mL, and American Society of Anesthesiologists classification were significant predictors of functional treatment failure in univariate analysis. Prostate size <80 mL or <50 mL was significantly associated with treatment failure (P < .001) in multivariate analysis. ThuLEP is a safe and efficient surgical procedure, even in a patient cohort with high prostate volumes, age, and comorbidities. However, high patient age and small prostate size were significant determinants of adverse outcomes after surgery. To address the question of optimal therapy selection for patients with prostates smaller than 80 mL, further prospective randomized evaluation of ThuLEP and alternative surgical interventions is needed. Copyright © 2015 Elsevier Inc. All rights reserved.

  2. Holmium laser enucleation (HoLEP) and photoselective vaporisation of the prostate (PVP) for patients with benign prostatic hyperplasia (BPH) and chronic urinary retention.

    PubMed

    Jaeger, Christopher D; Mitchell, Christopher R; Mynderse, Lance A; Krambeck, Amy E

    2015-02-01

    To evaluate short-term outcomes of holmium laser enucleation of the prostate (HoLEP) and photoselective vaporisation of the prostate (PVP) in patients with benign prostatic hyperplasia (BPH) and chronic urinary retention (CUR). A retrospective chart review was performed of all patients with CUR who underwent HoLEP or PVP at our institution over a 3-year period. CUR was defined as a persistent post-void residual urine volume (PVR) of >300 mL or refractory urinary retention requiring catheterisation. We identified 72 patients with CUR who underwent HoLEP and 31 who underwent PVP. Preoperative parameters including median catheterisation duration (3 vs 5 months, P = 0.71), American Urological Association Symptom Index score (AUASI; 18 vs 21, P = 0.24), and PVR (555 vs 473 mL, P = 0.096) were similar between the HoLEP and PVP groups. The HoLEP group had a larger prostate volume (88.5 vs 49 mL, P < 0.001) and higher PSA concentration (4.5 vs 2.4 ng/mL, P = 0.001). At median 6-month follow-up, 71 (99%) HoLEP patients and 23 (74%) PVP patients were catheter-free (P < 0.001). Of the voiding patients, postoperative AUASI (3 vs 4, P = 0.06), maximum urinary flow rate (23 vs 18 mL/s, P = 0.28) and PVR (56.5 vs 54 mL, P = 1.0) were improved in both groups. Both HoLEP and PVP are effective at improving urinary parameters in men with CUR. Despite larger prostate volumes, HoLEP had a 99% successful deobstruction rate, thus rendering patients catheter-free. © 2014 The Authors. BJU International © 2014 BJU International.

  3. Thulium laser enucleation (ThuLEP) versus transurethral resection of the prostate in saline (TURis): A randomized prospective trial to compare intra and early postoperative outcomes.

    PubMed

    Bozzini, G; Seveso, M; Melegari, S; de Francesco, O; Buffi, N M; Guazzoni, G; Provenzano, M; Mandressi, A; Taverna, G

    2017-06-01

    To compare clinical intra and early postoperative outcomes between thulium laser transurethral enucleation of the prostate (ThuLEP) and transurethral bipolar resection of the prostate (TURis) for treating benign prostatic hyperplasia (BPH) in a prospective randomized trial. The study randomized 208 consecutive patients with BPH to ThuLEP (n=102) or TURis (n=106). For all patients were evaluated preoperatively with regards to blood loss, catheterization time, irrigation volume, hospital stay and operative time. At 3 months after surgery they were also evaluated by International Prostate Symptom Score (IPSS), maximum flow rate (Qmax), and postvoid residual urine volume (PVR). The patients in each study arm each showed no significant difference in preoperative parameters. Compared with TURIS, ThuLEP had same operative time (53.69±31.44 vs 61.66±18.70minutes, P=.123) but resulted in less hemoglobin decrease (0.45 vs 2.83g/dL, P=.005). ThuLEP also needed less catheterization time (1.3 vs 4.8 days, P=.011), irrigation volume (29.4 vs 69.2 L, P=.002), and hospital stay (1.7 vs 5.2 days, P=.016). During the 3 months of follow-up, the procedures did not demonstrate a significant difference in Qmax, IPSS, PVR, and QOLS. ThuLEP and TURis both relieve lower urinary tract symptoms equally, with high efficacy and safety. ThuLEP was statistically superior to TURis in blood loss, catheterization time, irrigation volume, and hospital stay. However, procedures did not differ significantly in Qmax, IPSS, PVR, and QOLS through 3 months of follow-up. Copyright © 2016 AEU. Publicado por Elsevier España, S.L.U. All rights reserved.

  4. [The state of antimicrobial prophylaxis for holmium laser enucleation of the prostate : HoLEP and the results of a questionnaire survey].

    PubMed

    Ishikawa, Kiyohito; Maruyama, Takahiro; Kusaka, Mamoru; Shiroki, Ryoichi; Hoshinaga, Kiyotaka

    2011-10-01

    Holmium laser enucleation of the prostate (HoLEP) has been established as a procedure for the treatment of patients with benign prostate hyperplasia, instead of transurethral resection of prostate (TURP). To determine the appropriate antimicrobial prophylaxis for the prevention of perioperative urinary tract infection following HoLEP we sent a questionnaire to 79 institutes belonging to the Japanese Urological Association. We surveyed 1) the performance of HoLEP, 2) number of HoLEP performed in 2009, 3) antimicrobial agents and the term of the administration for prophylaxis, 4) rate of perioperative infections, and 5) usage of other antimicrobial prophylaxis in HoLEP, as compared with in TUR-P. We received answers from 59 institutes (74. 9%). We examined 43 responses, which were obtained from executive members who performed more than eleven cases of HoLEP in 2009. Thirty-one of these institutes (72.1%) indicated parenteral antibiotics ; three of them adopted oral antibiotics, and nine of them added oral antibiotics following parenteral antibiotics. In 40 of them (93.0%), the rate of perioperative infections was reported to be fewer than 5%. Twenty-seven of them (62. 7%) adopted the same schedule for the prophylaxis in both HoLEP and TUR-P. Eleven of them indicated shorter antimicrobial usage in HoLEP than in TUR-P. Ten of the eleven institutes reported that the rate of perioperative infections in HoLEP had been lower than in TUR-P. Our questionnaire survey demonstrated that shorter antimicrobial prophylaxis might be possible in HoLEP than in TUR-P.

  5. Reoperation After Holmium Laser Enucleation of the Prostate for Management of Benign Prostatic Hyperplasia: Assessment of Risk Factors with Time to Event Analysis.

    PubMed

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

    2015-07-01

    To determine risk factors of reoperation after holmium laser enucleation of the prostate (HoLEP) for management of lower urinary tract symptoms (LUTS) secondary to benign prostatic hyperplasia (BPH) with time to event analysis. A prospectively maintained database was reviewed for patients undergoing HoLEP. Baseline and follow-up data were compared in terms of International Prostate Symptoms Score, quality of life, peak flow rate, residual urine, and prostate-specific antigen (PSA) at 1, 6, and 12-months and then annually. Perioperative and late adverse events were recorded. Reoperation was defined as the need for any surgical intervention to relieve bothersome LUTS after HoLEP. Multivariate logistic regression was used to determine covariates associated with reoperation and the Kaplan-Meier curve assessed the time to reoperation. A total of 1216 HoLEP procedures were performed between March 1998 and October 2013 with a mean prostate volume of 94.8 ± 52.7 cc. Catheter time and hospital stay were 1.4 ± 1.9 and 1.3 ± 1.6 days, respectively. After a median follow-up of 7.6 years (1-14 years), 52 (4.3%) patients needed reoperation for recurrent LUTS, including 13 (1.07%) for residual/recurrent adenoma, 14 (1.15%) for bladder neck contracture (BNC), and 25 (2.05%) for de novo urethral stricture. In multivariate regression, smaller prostate size (< 62 cc), PSA reduction < 50%, and history of previous prostate surgery were significantly associated with recurrence of adenoma. BNC was significantly associated with smaller glands (< 54 cc) while longer operative time and postoperative catheterization were significantly associated with urethral stricture. Kaplan-Meier curve demonstrates post-HoLEP freedom from reoperation of 96.9% at 5 years and 95.1% at 10 years. In a single center large series, HoLEP has 95% reoperation-free probability at 10 years. Relatively small-size prostate may have an impact on recurrence of adenoma and bladder neck contracture. PSA reduction < 50

  6. 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

    Iacono, Fabrizio; Prezioso, Domenico; Di Lauro, Giovanni; Romeo, Giuseppe; Ruffo, Antonio; Illiano, Ester; Amato, Bruno

    2012-01-01

    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. 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. 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. 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.

  7. 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

  8. 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.

  9. Transpalpebral eye enucleation in 40 standing horses.

    PubMed

    Pollock, Patrick J; Russell, Tom; Hughes, Thomas K; Archer, Michael R; Perkins, Justin D

    2008-04-01

    To report a technique for eye enucleation in standing sedated horses and to report outcome in 40 horses. Retrospective study. Horses (n=40) requiring eye enucleation. The eye was enucleated using a transpalpebral technique in 40 horses restrained in stocks and sedated. Anesthesia of orbital structures was provided by local nerve blocks and infiltration of the surgical site with local anesthetic solution. Affected eyes were successfully enucleated with the horse standing. Short-term complications included moderate swelling (5 horses) and wound discharge (1). Long-term complications were not observed. A diseased eye can be safely enucleated with a horse standing. Enucleating an equine eye in the standing position eliminates the risks and costs of general anesthesia.

  10. Successful enucleation of retroperitoneal cyst.

    PubMed

    Singal, Rikki; Gupta, Samita; Singh, Bir

    2012-01-01

    Retroperitoneal mesenteric cyst is a rare entity among the other mesenteric cysts and intra-abdominal tumours. A 42-year-old woman reported with pain abdomen off and on since one month. There were no other complaints. On ultrasonography a mesenteric cyst was diagnosed. Surgery was planned which revealed a retroperitoneal mesenteric cyst. Enucleation of the cyst was done. In follow-up of 6 months patient is asymptomatic. We are reporting a rarely reported retroperitoneal mesenteric cyst in the mesentery of the descending colon or sigmoid.

  11. Association of prostate size and perioperative morbidity in thulium:YAG vapoenucleation of the prostate.

    PubMed

    Netsch, Christopher; Tiburtius, Christian; Bach, Thorsten; Knipper, Sophie; Gross, Andreas J

    2014-01-01

    To evaluate the association between perioperative morbidity and prostate size in patients with benign prostatic obstruction treated with thulium:YAG vapoenucleation of the prostate (ThuVEP). 687 patients were prospectively analyzed. Prostate size was <40 ml in 196 (group A), 40-79 ml in 336 (group B) and ≥80 ml in 155 (group C) patients. The mean prostate sizes were 27.94 ± 6.77, 54.38 ± 10.54 and 109.8 ± 28.31 ml for groups A, B and C, respectively (p < 0.001). Hemoglobin loss (g/dl) differed significantly among group A (1.09 ± 1.02), group B (1.28 ± 1.27) and group C (1.62 ± 1.49) (p < 0.001). The correlation between hemoglobin loss and prostate size was very weak in all patients (r = 0.13, p ≤ 0.001). Peak urinary flow rates and post-voiding residual urine improved significantly (p < 0.001) without differences among the groups. The incidence of complications was low and not different among the groups (acute urinary retention 8%, urinary tract infection 4.66%, secondary apical resection 2.91%, transfusion rate 2.03%). Perioperative morbidity and micturition improvement are not associated with prostate size in ThuVEP. © 2014 S. Karger AG, Basel.

  12. 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.

  13. 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

  14. 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.

  15. Evaluation of eyes enucleated for scleritis.

    PubMed Central

    Fraunfelder, F. T.; Watson, P. G.

    1976-01-01

    A series of 30 enucleated eyes, all of which had a primary histological diagnosis of scleritis, was analysed. The average age of patients at enucleation was 68 years; many of these patients had had the disease for more than 30 years. In 40 per cent the diagnosis of scleritis was unsuspected and was often masked by multiple complications. Scleritis with uveitis and glaucoma was the most common combination to come to enucleation. In 82 per cent, pain was the reason for enucleation, which suggests that some patients were on inadequate levels of steroid treatment or were unable to tolerate them. In the series, 37 per cent of the eyes perforated. Perforation occurred in those patients who were having steriods but not in those who were not, but the data are inconclusive as to which method of steroid administration was most likely to cause ocular perforation. PMID:1268181

  16. One day surgery in the treatment of benign prostatic enlargement with thulium laser: A single institution experience

    PubMed Central

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

    2015-01-01

    Purpose Various articles have previously addressed the introduction of new surgical laser therapies for an enlarged prostate gland causing obstructive symptoms. The objective of this study was to report the feasibility of performing the thulium laser vapo-enucleation of the prostate (ThuVEP) procedure for benign prostatic obstruction in a 1-day surgery. Materials and Methods From September 2011 to September 2013, we conducted a prospective study on patients who underwent ThuVEP in a 1-day surgery. The primary outcomes measured perioperatively included operative time, resected tissue weight, hemoglobin decrease, transfusion rate, postoperative irrigation and catheterization time, and postoperative hospital stay. Also, the preoperative and postoperative International Prostate Symptom Score (IPSS) and results of uroflowmetry performed on the 7th and 30th postoperative days were recorded. All perioperative and postoperative complications were monitored. Results A total of 53 patients underwent the surgical treatment in a 1-day surgery. Seven patients continued antiaggregant therapy with aspirin. Mean preoperative prostatic adenoma volume was 56.6 mL. Mean operative time was 71 minutes. The average catheter time was 14.8 hours. The peak urinary flow rate on day 7 improved from 9.3 to 17.42 mL/s (p<0.001) and the IPSS improved from 18 to 10.2 (p<0.01). Patients were routinely discharged on the day of catheter removal. No complications were recorded. Conclusions ThuVEP can be safely conducted as a 1-day surgical procedure. This strategy results in cost savings. ThuVEP shows good standardized outcomes with respect to improvement in flow parameters and length of bladder catheterization. PMID:25964837

  17. One day surgery in the treatment of benign prostatic enlargement with thulium laser: A single institution experience.

    PubMed

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

    2015-05-01

    Various articles have previously addressed the introduction of new surgical laser therapies for an enlarged prostate gland causing obstructive symptoms. The objective of this study was to report the feasibility of performing the thulium laser vapo-enucleation of the prostate (ThuVEP) procedure for benign prostatic obstruction in a 1-day surgery. From September 2011 to September 2013, we conducted a prospective study on patients who underwent ThuVEP in a 1-day surgery. The primary outcomes measured perioperatively included operative time, resected tissue weight, hemoglobin decrease, transfusion rate, postoperative irrigation and catheterization time, and postoperative hospital stay. Also, the preoperative and postoperative International Prostate Symptom Score (IPSS) and results of uroflowmetry performed on the 7th and 30th postoperative days were recorded. All perioperative and postoperative complications were monitored. A total of 53 patients underwent the surgical treatment in a 1-day surgery. Seven patients continued antiaggregant therapy with aspirin. Mean preoperative prostatic adenoma volume was 56.6 mL. Mean operative time was 71 minutes. The average catheter time was 14.8 hours. The peak urinary flow rate on day 7 improved from 9.3 to 17.42 mL/s (p<0.001) and the IPSS improved from 18 to 10.2 (p<0.01). Patients were routinely discharged on the day of catheter removal. No complications were recorded. ThuVEP can be safely conducted as a 1-day surgical procedure. This strategy results in cost savings. ThuVEP shows good standardized outcomes with respect to improvement in flow parameters and length of bladder catheterization.

  18. Five-year outcomes of thulium vapoenucleation of the prostate for symptomatic benign prostatic obstruction.

    PubMed

    Gross, A J; Orywal, A K; Becker, B; Netsch, C

    2017-04-12

    To assess the 5-year outcomes of thulium vapoenucleation of the prostate (ThuVEP) in patients with benign prostatic obstruction (BPO) retrospectively. Five-hundred patients were treated with ThuVEP between January 2007 and January 2010 at our institution. Patients were reassessed 1 and 5-years after ThuVEP with International Prostate Symptom Score (IPSS), Quality of Life (QoL), urinary peak flow (Qmax), postvoid residual volume (PVR), PSA and prostate volume. Patient data were expressed as median (interquartile range). One-hundred and thirty-one patients completed the 5-year follow-up. According to preoperative prostate volume, patients were divided into two groups: group A (<60 ml, n = 80) and B (≥60 ml, n = 51). IPSS, QoL, Qmax, and PVR improved significantly at discharge and continued to do so during 5-year follow-up (p ≤ 0.001). At 1-year follow-up, prostate volume had decreased significantly (50 vs. 13 mL, p < 0.001) corresponding to a prostate volume reduction of 80.8%. PSA was significantly reduced at 5-year (0.72 µg/l) follow-up compared to preoperative PSA (3.39 µg/l, p ≤ 0.001). PSA-reduction (total 77.1%) at 5-year follow-up was significantly different between group A (70.2%) and B (83.5%) (p ≤ 0.006). IPSS was significantly lower in group B than in A (2.5 vs. 6, p < 0.001) at 5-year follow-up. Bladder neck contractures (n = 4) and urethral strictures (n = 4) occurred in 3.1% of the patients each. Three patients (2.3%) were re-treated for regrowth of prostatic tissue. ThuVEP is a durable procedure with regard to micturition improvement and PSA-reduction. The reintervention rate after ThuVEP was low during long-term follow-up.

  19. 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.

  20. Eyelash growth after enucleation and evisceration surgery.

    PubMed

    Williams, Zinaria Y; Richard, Michael; Stinnett, Sandra S; Woodward, Julie A

    2010-01-01

    Acquired eyelash hypertrichosis is associated with medications, systemic diseases, and ocular inflammation. The authors present a study showing that eyelash length is significantly longer following enucleation and evisceration surgery compared with the contralateral side. This may be related to factors involved in postoperative conjunctival and orbital inflammation and healing.

  1. Enucleation and Evisceration in the Palestinian Territories

    PubMed Central

    Keenan, Tiarnan D. L.; Sargent, Nicholas J.

    2011-01-01

    Purpose: To examine the demographics and indications in patients undergoing eye removal at St. John Eye Hospital (SJEH) in Jerusalem, the largest single provider of ophthalmic care in the Palestinian Territories. Materials and Methods: In this retrospective study, medical records were reviewed for patients undergoing enucleation or evisceration at SJEH from November 2004 to March 2007. Calculation of percentage, mean and median was performed for the demographics, and indications for enucleation and evisceration. Results: Thirty-three eyes of 32 patients were removed during the period under study. Twelve enucleations and 21 eviscerations were performed. Mean age was 39 years, and 19 patients were male. Indications included severe trauma (8 eyes), painful blind eye with (5 eyes) or without (9 eyes) infection, and ophthalmic neoplasm (3 eyes). Conclusion: The incidence of surgical eye removal at SJEH from 2004 to 2007 was around one patient per month for a population over three million. This rate appears far lower than those reported in previous studies of similar Palestinian populations. Prompt access to medical care for Palestinians is required to mitigate ophthalmic morbidity. Approximately half of the cases were caused by severe trauma or infection, with rubber bullet injuries responsible for 20% of the traumatic cases. PMID:21731330

  2. THE EFFECT OF ENUCLEATION ON THE DPN LEVEL OF AMEBA

    PubMed Central

    Cohen, Adolph I.

    1956-01-01

    1. Amebae contain DPN at levels of from 1 to 4 x 10–13 moles per cell. 2. Following enucleation, nucleate and enucleate halves continue to have equal DPN contents over the six day period studied. Similarly, starving whole amebae maintain their DPN level over this period. 3. No reduced DPN could be detected in these aerobic animals. This remained true for whole amebae and for nucleate and enucleate halves over 5 days of starvation. 4. A method is described for the preparation and rapid separation of nucleate and enucleate ameba halves, based on a response of amebae to light. PMID:13295307

  3. Enucleation of human erythroblasts involves non-muscle myosin IIB

    PubMed Central

    Ubukawa, Kumi; Guo, Yong-Mei; Takahashi, Masayuki; Hirokawa, Makoto; Michishita, Yoshihiro; Nara, Miho; Tagawa, Hiroyuki; Takahashi, Naoto; Komatsuda, Atsushi; Nunomura, Wataru; Takakuwa, Yuichi

    2012-01-01

    Mammalian erythroblasts undergo enucleation, a process thought to be similar to cytokinesis. Although an assemblage of actin, non-muscle myosin II, and several other proteins is crucial for proper cytokinesis, the role of non-muscle myosin II in enucleation remains unclear. In this study, we investigated the effect of various cell-division inhibitors on cytokinesis and enucleation. For this purpose, we used human colony-forming unit-erythroid (CFU-E) and mature erythroblasts generated from purified CD34+ cells as target cells for cytokinesis and enucleation assay, respectively. Here we show that the inhibition of myosin by blebbistatin, an inhibitor of non-muscle myosin II ATPase, blocks both cell division and enucleation, which suggests that non-muscle myosin II plays an essential role not only in cytokinesis but also in enucleation. When the function of non-muscle myosin heavy chain (NMHC) IIA or IIB was inhibited by an exogenous expression of myosin rod fragment, myosin IIA or IIB, each rod fragment blocked the proliferation of CFU-E but only the rod fragment for IIB inhibited the enucleation of mature erythroblasts. These data indicate that NMHC IIB among the isoforms is involved in the enucleation of human erythroblasts. PMID:22049517

  4. Large deformation mechanics of the enucleated eyeball.

    PubMed

    Taber, L A

    1984-08-01

    Large deformation of enucleated pig eyeballs under rigid cylindrical indenters was studied analytically and experimentally. The analytic model for the eyeball consists of a fluid-filled spherical membrane composed of an incompressible, elastic material with an exponential strain energy function. The Rayleigh-Ritz technique provided an approximate solution via a potential energy formulation. Comparison with results from tests on eyeballs and a water-filled rubber (Mooney-Rivlin) shell shows good agreement at large deflection, where membrane action dominates. Due to the highly nonlinear stress-strain relations for the sclera, the load remains relatively small until the indenter displacement approaches 40-60 percent of the eyeball radius, and then the load increases rapidly. Depending on the indenter size, either a perforation or a rupture type of failure occurs.

  5. Formation of mammalian erythrocytes: chromatin condensation and enucleation.

    PubMed

    Ji, Peng; Murata-Hori, Maki; Lodish, Harvey F

    2011-07-01

    In all vertebrates, the cell nucleus becomes highly condensed and transcriptionally inactive during the final stages of red cell biogenesis. Enucleation, the process by which the nucleus is extruded by budding off from the erythroblast, is unique to mammals. Enucleation has critical physiological and evolutionary significance in that it allows an elevation of hemoglobin levels in the blood and also gives red cells their flexible biconcave shape. Recent experiments reveal that enucleation involves multiple molecular and cellular pathways that include histone deacetylation, actin polymerization, cytokinesis, cell-matrix interactions, specific microRNAs and vesicle trafficking; many evolutionarily conserved proteins and genes have been recruited to participate in this uniquely mammalian process. In this review, we discuss recent advances in mammalian erythroblast chromatin condensation and enucleation, and conclude with our perspectives on future studies.

  6. The sorting of blood group active proteins during enucleation.

    PubMed

    Satchwell, Timothy J; Bell, Amanda J; Toye, Ashley M

    2015-04-01

    Enucleation represents the critical stage during red blood cell development when the nucleus is extruded from an orthochromatic erythroblast in order to generate a nascent immature reticulocyte. Extrusion of the nucleus results in loss of a proportion of the erythroblast plasma membrane, which surrounds the nucleus, the bulk of the endoplasmic reticulum and a small region of cytoplasm. For this reason enucleation provides an important point in erythroblast differentiation at which proteins not required for the function of the erythrocyte can be lost, whilst those that are important for the structure-function properties of the mature erythrocyte must be efficiently retained in the reticulocyte plasma membrane. Disturbances in protein distribution during enucleation are envisaged to occur during human diseases such as Hereditary Spherocytosis. This article will discuss the current knowledge of erythroblast enucleation in the context of retention and loss of proteins that display antigenic blood group sites and that exist within multiprotein complexes within the erythrocyte membrane.

  7. 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

  8. 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.

  9. A simplified approach for oocyte enucleation in mammalian cloning.

    PubMed

    Iuso, Domenico; Czernik, Marta; Zacchini, Federica; Ptak, Grazyna; Loi, Pasqualino

    2013-12-01

    Despite its success in almost all farm and laboratory animals, somatic cell nuclear transfer (SCNT) is still a low-efficiency technique. In this investigation, we determined the impact of each enucleation step on oocyte viability (assessed by parthenogenetic activation): Hoechst (HO) staining, cytochalasin B, ultraviolet (UV) exposure, and demecolcine. Our data showed that of all the factors analyzed, UV exposure impaired oocyte development (cleavage, 59% for untreated oocytes vs. 8% UV exposed; blastocyst stage, 32% untreated vs. 0% UV exposed). A minor toxicity was detected following demecolcine treatment (cleavage, 62%; blastocyst stage, 13%). Next, we compared HO/UV (canonical) and demecolcine-assisted enucleation (DAE), with a straight removal of metaphase chromosomes without any chemical or physical aid (straight enucleation). DAE improved the preimplantation development of sheep cloned embryos compared to HO/UV enucleation (cleavage, 38% vs. 19%; blastocysts, 17% vs. 4%), yet straight enucleation resulted in the highest cleavage and blastocysts rates (61% and 30%, respectively). We concluded that: (1) UV exposure harms sheep oocyte and embryo development; (2) DAE may represent an alternative approach, especially for unskilled operators; and (3) straight enucleation remains, in our estimation, the most reliable and least harmful protocol for SCNT.

  10. Tumor Enucleation for Renal Cell Carcinoma

    PubMed Central

    Malkowicz, S. Bruce

    2015-01-01

    The increased number of small renal masses (SRMs) detected annually has led to a rise in the use of nephron-sparing surgery (NSS). These techniques aim to preserve the largest amount of healthy renal tissue possible while maintaining the same oncologic outcomes as radical nephrectomy (RN). Additionally, partial nephrectomy (PN) has been linked to a lower risk of chronic kidney disease, cardiovascular morbidity, and mortality when compared to RN. There has been continual progress toward resecting less renal parenchyma. While the predominant surgical method of performing NSS is through traditional PN, simple enucleation (SE) of the tumor has increased in popularity over recent years. SE is a technique that aims to preserve the maximal amount of renal parenchyma possible by utilizing the renal tumor pseudocapsule to bluntly separate the lesion from its underlying parenchyma, offering the smallest possible margin of excised healthy renal tissue. Several studies have demonstrated the oncological safety of SE compared with PN in the treatment of SRMs, with lower overall incidence of positive surgical margins. Additionally, SE has been shown to have similar 5- and 10-year progression-free and cancer-specific survival as PN. We present a review of the literature and an argument for SE to be a routine consideration in the treatment of all renal tumors amenable to NSS.

  11. Endoscopically assisted enucleation of a large mandibular periapical cyst.

    PubMed

    Nestal Zibo, Heleia; Miller, Ene

    2011-01-01

    Enucleation of large cysts in the jaws is an invasive method that might be associated with complications. Marsupialization is a less invasive alternative method but it involves a prolonged and uncomfortable healing period. This study addresses a contemporaneous and less invasive surgical technique for treating larger mandibular cysts. MATERIALS AND METHODS. A 48-year-old woman presented with a large mandibular apical cyst involving the left parasymphysis, body, ramus and condylar neck, with involvement of the alveolar inferior nerve. The cystic lesion was enucleated using a 30° 4.0 mm endoscopic scope and endoscopic instruments through two small accesses: the ostectomy site of previously performed marsupialization and the alveolus of the involved third molar extracted of the time of the enucleation of the cyst. RESULTS. The endoscopic scope provided good visualization of the whole cystic cavity allowing the removal of any residual pathologic tissue and preservation of the integrity of the involved inferior alveolar nerve. The morbidity of the surgical procedure was extremely reduced. At a 6-month follow-up the patient did not present any symptom of inflammation and a panoramic X-ray showed good bone repair and remodelation. CONCLUSIONS. Endoscopically assisted enucleation proved to be effective method of treating a large mandibular cyst, providing total enucleation with a minimal invasive technique.

  12. Molecular signature of erythroblast enucleation in human embryonic stem cells.

    PubMed

    Rouzbeh, Shaghayegh; Kobari, Ladan; Cambot, Marie; Mazurier, Christelle; Hebert, Nicolas; Faussat, Anne-Marie; Durand, Charles; Douay, Luc; Lapillonne, Hélène

    2015-08-01

    While enucleation is a critical step in the terminal differentiation of human red blood cells, the molecular mechanisms underlying this unique process remain unclear. To investigate erythroblast enucleation, we studied the erythroid differentiation of human embryonic stem cells (hESCs), which provide a unique model for deeper understanding of the development and differentiation of multiple cell types. First, using a two-step protocol, we demonstrated that terminal erythroid differentiation from hESCs is directly dependent on the age of the embryoid bodies. Second, by choosing hESCs in two extreme conditions of erythroid culture, we obtained an original differentiation model which allows one to study the mechanisms underlying the enucleation of erythroid cells by analyzing the gene and miRNA (miR) expression profiles of cells from these two culture conditions. Third, using an integrated analysis of mRNA and miR expression profiles, we identified five miRs potentially involved in erythroblast enucleation. Finally, by selective knockdown of these five miRs we found miR-30a to be a regulator of erythroblast enucleation in hESCs.

  13. Piezosurgery versus conventional surgery in radicular cyst enucleation.

    PubMed

    Kocyigit, Ismail Doruk; Atil, Fethi; Alp, Yunus Emre; Tekin, Umut; Tuz, Hakan H

    2012-11-01

    This study compared the use of piezosurgery and conventional surgery in radicular cyst enucleation. The study was conducted with 29 patients who were radiologically and cytologically prediagnosed with radicular cysts in the jaw region. Nineteen patients were treated using piezosurgery, and 10 were treated using conventional surgical procedures. Surgical procedures were evaluated according to the following criteria: hemorrhage, soft-tissue damage, manipulation complexity, major perforation areas on the enucleated cyst tissue, and approximate operation duration. Patients were monitored postoperatively and evaluated for hemorrhaging at 24, 48, and 72 hours following surgery. Follow-up was conducted to check for recurrences and ranged from 5 to 24 months. No complications were observed in any of the 20 patients treated using piezosurgery, although the duration of surgery was longer than expected. Of the 10 patients treated using conventional methods, hemorrhaging that affected the operation occurred in 3 cases, perforation of the cyst epithelium and difficulties in enucleation occurred in 5 cases, postoperative hemorrhage occurred in 2 cases, and recurrence was observed in 2 cases. Piezosurgery may be considered effective in procedures such as enucleation that require sensitive manipulation, despite the increase in the length of the overall surgical procedure. Given the results of the present study and the current lack of information in the literature regarding postoperative pain, infection, and long-term success rates associated with the use of piezosurgery in cyst enucleation, further study in this area is recommended.

  14. Transurethral vapor enucleation and resection of the prostate with plasma vaporization button electrode for the treatment of benign prostatic hyperplasia: a feasibility study.

    PubMed

    Xie, Liping; Mao, Qiqi; Chen, Hong; Qin, Jie; Zheng, Xiangyi; Lin, Yiwei; Wang, Xiao; Liu, Ben

    2012-10-01

    Various improvements and modifications to the surgical treatment of benign prostatic hyperplasia have emerged over the last decade. Most techniques often initially claimed superiority only to turn out to be mediocre with time. Holmium laser enucleation of the prostate has been associated with superior outcomes compared with transurethral resection of the prostate and demonstrated improvement in long-term outcomes, while its clinical use has limitations. We describe the first use of plasma vaporization button electrode combined with loop electrode for transurethral vapor enucleation and resection of the prostate.

  15. Enucleation and evisceration: indications, complications and clinicopathological correlations

    PubMed Central

    Kord Valeshabad, Ali; Naseripour, Masood; Asghari, Rajab; Parhizgar, Seyed Hamid; Parhizgar, Seyed Ehsan; Taghvaei, Mohammad; Miri, Shahin

    2014-01-01

    AIM To assess main indications, postoperative complications and clinicopathological correlation of ocular enucleation-evisceration. METHODS A total of 107 subjects who underwent enucleation and/or evisceration and received hydroxyapatite implants (Scleral wrap or mesh) were assessed. For each patient clinicopathological data was collected which included demographic information, clinical history, primary clinical diagnosis, main cause of ophthalmic surgery (traumatic, non-traumatic), type of surgical procedure (enucleation, evisceration) and pathological report. Patients' postoperative clinical visits were checked for procedure-related complications during first year after surgery. RESULTS One hundred and seven patients (male: 65.4%; mean age: 26y) underwent enucleation (n=100) or evisceration (n=7) due to traumatic (n=41) and non-traumatic (n=66) causes. Disfiguring painful blind eye was the most common indication of surgery (66.4%), followed by leukocoria (19.6%) and endophthalmitis (4.7%). The main types of injury included firecracker, traffic and work accidents, and sharp object perforating injury. In 53 (80.3%) subjects in non-traumatic group the initial clinical diagnosis matched the histopathological results. Malignant tumors (retinoblastoma: 47.5%, malignant melanoma: 27.3%) were the most common pathological diagnoses followed by phthisis bulbi (25.8%). The most common procedure-related complications were major eye discharge (39.6%), and implant exposure and discharge (20.8%). CONCLUSION Trauma and malignant tumors are the leading causes of enucleation-evisceration. Despite developing new techniques and materials, enucleation is still associated with considerable postoperative complications. PMID:25161942

  16. 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

  17. SELF- ENUCLEATION OF EYES IN SCHIZOPHRENIA- AN UNUSUAL MODE OF DELIBERATE SELF HARM

    PubMed Central

    Kumar, P.N. Suresh; Subramanian, N.; Koyamu, A.M. Kunchi; Kumar, Ranja

    2001-01-01

    Self inflicted injury to the eyes including self-enucleation is a rare phenomenon. The authors describe a case of bilateral self-enucleation in a patient with paranoid schizophrenia. A review of literature shows that self-enucleation is correlated with moral, religious and psychodynamic paradigms and various unconscious mechanisms have been proposed to explain this unusual behaviour. PMID:21407887

  18. Inflammatory responses in the rat superior colliculus after eye enucleation.

    PubMed

    Hernandes, Marina S; Britto, Luiz R G

    2014-02-01

    Ocular enucleation induces profound morphological alterations in central visual areas. However, little is known about the response of glial cells and possible inflammatory processes in visual brain areas resulting from eye enucleation. In this study, immunoblotting and immunostaining assays revealed increased expression of astrocyte and microglia markers in the rat superior colliculus (SC) between 1 and 15 days after contralateral enucleation. A transient increase of neuronal COX-2 protein expression was also found in the SC. To evaluate the role of an anti-inflammatory drug in attenuating both COX-2 and glial cell activation, the synthetic glucocorticoid dexamethasone (DEX) was administered (1 mg/kg i.p., for 3 days) to enucleated rats. Immunoblotting data revealed that DEX treatment significantly inhibited COX-2 protein expression. Postlesion immunostaining for astrocyte and microglia markers was also significantly reduced by DEX treatment. These findings suggest that the removal of retinal ganglion cell input generates inflammatory responses in central retinorecipient structures. Copyright © 2013 Elsevier Inc. All rights reserved.

  19. The Hook and Release Technique During Enucleation Surgery.

    PubMed

    Jordan, David R; Stoica, Bazil; Dutton, Jonathan J

    2017-01-05

    To describe the results and potential benefit of direct muscle release from the globe during enucleation surgery without identifying sutures in the rectus muscle insertion sites, a technique referred to as the hook and release technique. Single center, retrospective chart review of patients who underwent enucleation with direct removal of the rectus muscles without identifying sutures in their insertion sites between January 2011 and September 2015 was carried out. The inclusion criteria were primary enucleation without previous strabismus surgery, retinal detachment surgery, or orbital surgery that entered the fibrous connective tissue framework. Forty charts of enucleated patients that had direct release of their extraocular muscles without identifying sutures before releasing them from the globe were identified and reviewed. The primary outcome measure was intraoperative or immediate postoperative complications. This retrospective chart review was performed with research ethics board approval and in compliance with the Declaration of Helsinki. Data show that following the hook and release technique, the rectus muscles were easily located and reconnected to the orbital implant wrap. The oblique muscles were not reattached. In each of the 40 patients, the 4 rectus muscles were easily located by gently applying traction anteriorly at the conjunctiva/Tenons' edge using double-pronged skin hooks. There was no instance of a lost or slipped muscle following the hook and release technique. The hook and release technique is a simple and efficient method to remove the 4 rectus muscles from the globe and still easily locate them. They are not "lost" and do not "slip out of position" but held in place by the orbital connective tissue framework and the extraocular muscle pulley system. This technique has been very helpful teaching resident staff how to do enucleation surgery as it avoids the more time consuming placement of double-armed locking sutures through the rectus

  20. Return to work following unilateral enucleation in 34 horses (2000-2008).

    PubMed

    Utter, M E; Wotman, K L; Covert, K R

    2010-03-01

    REASONS FOR STUDY: The effect of unilateral enucleation on vision and potential loss of performance in horses has received little study. To evaluate the likelihood of return to prior discipline following unilateral enucleation in horses, assessing the role of age at enucleation, equine discipline, reason for enucleation, time to vision loss and eye enucleated. Unilateral enucleation has no significant effect on likelihood of return to work in horses, for both right and left eyes, across age and discipline. A retrospective review of medical records identified 92 horses that underwent unilateral enucleation at the University of Pennsylvania New Bolton Center from April 2000-April 2008. Case variables determined from the medical record included breed and sex of horse, age at enucleation, which eye was enucleated, reason for enucleation and onset of vision loss. Pre- and post operative occupations were determined by telephone interview with the owner or trainer of each horse. Based on hospital surgery logs, 92 enucleations were performed over the 8 year period and 77 records were available for review, with follow-up information available for 34 horses. Of these, 29/34 (85%) horses returned to work in pleasure or trail riding (11/13), flat racing (7/10), hunter/jumpers (4/4), dressage (3/3), group lessons (1/1), eventing (1/1), steeplechase (1/1) and as a broodmare (1/1). Four of 5 horses (4/34, or 12% sample) that did not return to work (2 pleasure and 2 racing) were retired due to anticipated or perceived decrease in performance or behaviour change following unilateral enucleation, with the remaining horse retired from racing for lameness issues unrelated to enucleation. Twenty-two of 25 horses (88%) with acute vision loss and 7/9 horses (78%) with gradual vision loss returned to their previous discipline. Horses are able to return to a variety of occupations after unilateral enucleation.

  1. Undergoing enucleation of the eye. Part 2: postoperative care.

    PubMed

    Cooper, John

    In this, the second of a 2-part article, the author discusses the postoperative care of patients who undergo enucleation of the eye. Part one explored aspects of preoperative care of enucleated patients. In the immediate period following surgery, patients require support and advice regarding pain, nausea and simple care of the eye socket. Apart from the intrinsic postoperative demands of the surgery, there are also the difficulties and challenges associated with providing psychological support and helping patients cope with the loss of an eye. Ultimately, the patient can overcome any initial problems and eventually be able to wear a custom-made prosthesis, which will hopefully allow the patient to move on with their lives. As in the first part, the author will use both referenced material and anecdotal references (upon personal reflection) to analyze the ongoing postoperative care and support of these patients.

  2. Radical resection and enucleation in Chinese adolescents with pancreatic tumors

    PubMed Central

    Yao, Lie; Xie, Zhi-Bo; Jin, Chen; Jiang, Yong-Jian; Li, Ji; Yang, Feng; Lin, Quan-Jun; Fu, De-Liang

    2017-01-01

    Abstract Pancreatic tumors rarely occur in adolescents, and the appropriateness of radical resection for these patients remains controversial. Medical records were retrospectively reviewed for patients younger than 19 years who underwent radical resection or limited resection (enucleation) between 2000 and 2015. Patient demographics, clinical characteristics, operative details, growth, and survival were analyzed. During the study period, 11 adolescents (mean age, 16.18 years; standard deviation, 1.99; interquartile range, 15.0–18.0) underwent radical resection (n = 7) or enucleation (n = 4) to treat solid pseudopapillary tumors (n = 5), pancreatic neuroendocrine tumors (n = 5), or pancreatic ductal adenocarcinoma (n = 1). None of the 7 patients who underwent radical resection experienced recurrence or serious complications, while 3 of 4 patients who underwent enucleation experienced recurrence (P = 0.02). Recurrence-free survival was slightly longer in patients who underwent radical resection, and this procedure did not appear to affect adolescent growth and development. Radical resection might be safe and effective for adolescents with pancreatic tumors. PMID:28328854

  3. 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.

  4. Thulium Vaporesection of the Prostate and Thulium Vapoenucleation of the Prostate in Patients on Oral Anticoagulants: A Retrospective Three-Centre Matched-Paired Comparison.

    PubMed

    Netsch, Christopher; Magno, Carlo; Butticè, Salvatore; Macchione, Luciano; Mucciardi, Giuseppe; Herrmann, Thomas R W; Gross, Andreas J

    2016-01-01

    To evaluate the short-term results of thulium vaporesection of the prostate (ThuVEP) and thulium vapoenucleation of the prostate (ThuVARP) in patients with benign prostatic obstruction on oral anticoagulants (OA). A 3-centre retrospective matched-paired comparison of patients treated by ThuVEP (n = 26) or ThuVARP (n = 26) was performed. Thirty-four patients were on aspirin/ticlopidin, 7 on clopidogrel or clopidogrel and aspirin, and 11 on phenprocoumon at the time of surgery. Haemoglobin decrease was higher after ThuVEP compared to ThuVARP (1.5 vs. 0.3 g/dl, p < 0.001). The rate of postoperative blood transfusions (3.9 vs. 0%), clot retention (3.9 vs. 0%), and re-operation (7.7 vs. 0%) was not different between ThuVEP and ThuVARP (p = 0.274). Catheterization time was shorter for ThuVARP (1 vs. 2 days, p < 0.01). Qmax was significantly higher after ThuVEP at 6-month follow-up (31 vs. 21.5 ml/s, p < 0.001), while improvements in International Prostate Symptom Score, quality of life, and post-voiding residual urine showed no differences between the groups. Urethral or bladder neck strictures did not occur during the 6-month follow-up in both groups. ThuVEP and ThuVARP are safe and efficacious procedures in patients on OA. Although patients assigned to ThuVEP had higher Qmax at 6-month follow-up, ThuVARP resulted in similar functional outcomes. © 2015 S. Karger AG, Basel.

  5. A Chemical Screening Approach to Identify Novel Key Mediators of Erythroid Enucleation.

    PubMed

    Wölwer, Christina B; Pase, Luke B; Pearson, Helen B; Gödde, Nathan J; Lackovic, Kurt; Huang, David C S; Russell, Sarah M; Humbert, Patrick O

    2015-01-01

    Erythroid enucleation is critical for terminal differentiation of red blood cells, and involves extrusion of the nucleus by orthochromatic erythroblasts to produce reticulocytes. Due to the difficulty of synchronizing erythroblasts, the molecular mechanisms underlying the enucleation process remain poorly understood. To elucidate the cellular program governing enucleation, we utilized a novel chemical screening approach whereby orthochromatic cells primed for enucleation were enriched ex vivo and subjected to a functional drug screen using a 324 compound library consisting of structurally diverse, medicinally active and cell permeable drugs. Using this approach, we have confirmed the role of HDACs, proteasomal regulators and MAPK in erythroid enucleation and introduce a new role for Cyclin-dependent kinases, in particular CDK9, in this process. Importantly, we demonstrate that when coupled with imaging analysis, this approach provides a powerful means to identify and characterize rate limiting steps involved in the erythroid enucleation process.

  6. New insights into the mechanisms of mammalian erythroid chromatin condensation and enucleation.

    PubMed

    Ji, Peng

    2015-01-01

    A unique feature in mammalian erythropoiesis is the dramatic chromatin condensation followed by enucleation. This step-by-step process starts at the beginning of terminal erythropoiesis after the hematopoietic stem cells are committed to erythroid lineage. Although this phenomenon is known for decades, the mechanisms of chromatin condensation and enucleation remain elusive. Recent advances in cell and molecular biology have started to reveal the molecular pathways in the regulation of chromatin condensation, the establishment of nuclear polarity prior enucleation, and the rearrangement of actin cytoskeleton in enucleation. However, many challenging questions, especially whether and how the apoptotic mechanisms are involved in chromatin condensation and how to dissect the functions of many actin cytoskeleton proteins in cytokinesis and enucleation, remain to be answered. Here I review our current understanding of mammalian erythroid chromatin condensation and enucleation during terminal differentiation with a focus on more recent studies. I conclude with my perspective of future works in this rising topic in developmental and cell biology.

  7. Holmium laser treatment of benign prostatic hyperplasia: an update.

    PubMed

    Matlaga, Brian R; Miller, Nicole L; Lingeman, James E

    2007-01-01

    The surgical treatment of benign prostatic hyperplasia is a dynamic, evolving field. Holmium laser enucleation of the prostate has been one of the most rigorously analyzed interventions for benign prostatic hyperplasia. In the 12 months since July 2005, a number of important studies have been published concerning this technique. In the 12-month period of this review, there have been a number of articles published on holmium laser enucleation of the prostate. Among these are five randomized controlled trials. These studies emphasize the unique advantages of holmium laser enucleation of the prostate over other surgical treatments for benign prostatic hyperplasia. Holmium laser enucleation of the prostate is a more efficient procedure than competitor techniques, when grams of tissue removed per unit time are quantified. Additionally, holmium laser enucleation of the prostate is associated with a reduced length of catheterization and hospitalization when compared with other surgical therapies for men with benign prostatic hyperplasia. Outcome measures for men undergoing holmium laser enucleation of the prostate are in many cases superior to those of other modalities. It is likely that the completeness of adenoma removal with holmium laser enucleation of the prostate confers many of these advantages.

  8. Review of enucleation methods and procedures used in animal cloning: state of the art.

    PubMed

    Li, Guang-Peng; White, Kenneth L; Bunch, Thomas D

    2004-01-01

    Enucleation of a recipient oocyte is a crucially important process for nuclear transfer efficiency. Several procedures have been developed and used in the production of nuclear transfer embryos. Although the use of excitable fluorochromes and ultraviolet (UV) light are commonly used for complete enucleation, they also pose the risk of damaging the maternal cytoplast. Telophase and chemically assisted enucleation have also been used for cloning, but the quality and quantity of the recipient cytoplasm varies with the procedure used. This paper reviews various methods used for enucleation, and discusses their benefits and limitations with respect to cloning efficiency.

  9. [Enucleation: causes of extrusion of orbital implants (author's transl)].

    PubMed

    Hanselmayer, H; Ritzinger, I

    1978-02-01

    The frequency and the causes of extrusion of orbital implants have been investigated. Of the 294 patients in which enucleation was done, in 17 cases (5.8%) extrusion of the first implant developed; in 9 cases with second or third implantations another 5 implants have been extruded. The extrusion of implants is caused mainly by the operative technique and only rarely by intolerance reactions. For a reliable healing exact sutures of the muscles and also exact closure of the implant with plenty of covering tissue is important.

  10. Video-assisted thoracoscopic enucleation after congenital cardiac surgery

    PubMed Central

    Maeda, Hideyuki; Kanzaki, Masato; Isaka, Tamami; Onuki, Takamasa

    2015-01-01

    A 26-year-old man underwent arterial switch surgery for transposition of the great arteries in infancy. During a routine evaluation, a nodule was detected in the left lower lobe on chest computed tomography. The tumor had enlarged at follow-up and he underwent surgical resection. Because of past cardiac surgery, the pericardium was defective; therefore, the heart was exposed to the pleural cavity and severe adhesions surrounding the left lung. We had to encircle the left main pulmonary artery to perform enucleation safely. The tumor was diagnosed as a pulmonary sclerosing hemangioma using permanent pathology results. PMID:26385193

  11. Enucleated eye model for intraocular retinal prosthesis implantation.

    PubMed

    Ratanapakorn, Tanapat; Ameri, Hossein; Humayun, Mark S; Weiland, James D

    2006-01-01

    An enucleated porcine eye model was developed to assess intraocular retinal prosthesis implantation surgery. The surgical technique consists of corneal and crystalline lens removal, keratoprosthesis replacement, and vitrectomy. To test the eye model, the scleral incision was increased to 5 mm and a 10-mm wide retinal prosthesis folded and inserted. One retinal tack was used to fix the prosthesis to the retina. A retinal prosthesis array was inserted without significant damage to the array and conformed to the curvature of the eye. Fundus photography and optical coherence tomography were performed at the end of surgery.

  12. 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. © 2013 Blackwell Verlag GmbH.

  13. Enucleation of cultured mouse fetal erythroblasts requires Rac GTPases and mDia2.

    PubMed

    Ji, Peng; Jayapal, Senthil Raja; Lodish, Harvey F

    2008-03-01

    Mammalian erythroid cells undergo enucleation, an asymmetric cell division involving extrusion of a pycnotic nucleus enveloped by the plasma membrane. The mechanisms that power and regulate the enucleation process have remained obscure. Here, we show that deregulation of Rac GTPase during a late stage of erythropoiesis completely blocks enucleation of cultured mouse fetal erythroblasts without affecting their proliferation or differentiation. Formation of the contractile actin ring (CAR) on the plasma membrane of enucleating erythroblasts was disrupted by inhibition of Rac GTPases. Furthermore, we demonstrate that mDia2, a downstream effector of Rho GTPases and a formin protein required for nucleation of unbranched actin filaments, is also required for enucleation of mouse fetal erythroblasts. We show that Rac1 and Rac2 bind to mDia2 in a GTP-dependent manner and that downregulation of mDia2, but not mDia1, by small interfering RNA (siRNA) during the late stages of erythropoiesis blocked both CAR formation and erythroblast enucleation. Additionally, overexpression of a constitutively active mutant of mDia2 rescued the enucleation defects induced by the inhibition of Rac GTPases. These results reveal important roles for Rac GTPases and their effector mDia2 in enucleation of mammalian erythroblasts.

  14. Late onset muscle plasticity in the whisker pad of enucleated rats.

    PubMed

    Toscano-Márquez, Brenda; Martínez-Martínez, Eduardo; Manjarrez, Elías; Martínez, Lourdes; Mendoza-Torreblanca, Julieta; Gutiérrez-Ospina, Gabriel

    2008-10-14

    Blindness leads to a major reorganization of neural pathways associated with touch. Because incoming somatosensory information influences motor output, it is plausible that motor plasticity occurs in the blind. In this work, we evaluated this issue at the peripheral level in enucleated rats. Whisker muscles in enucleated rats 160 days of age or older showed increased cytochrome oxidase activity, capillary density, motor plate size, and amplitude of evoked field potentials as compared with their control counterparts. Such differences were not observed at ages 10 and 60 days, the capillary density was the exception being greater in the enucleated rat at the latter age. Interestingly, there was a trend to increased neurotrophin-3 concentrations in the whisker pads of enucleated rats throughout postnatal development. Our results show that neonatal enucleation leads to late onset plasticity of the whisker's motor system.

  15. Late onset muscle plasticity in the whisker pad of enucleated rats

    PubMed Central

    Toscano-Márquez, Brenda; Martínez-Martínez, Eduardo; Manjarrez, Elías; Martínez, Lourdes; Mendoza-Torreblanca, Julieta; Gutiérrez-Ospina, Gabriel

    2008-01-01

    Blindness leads to a major reorganization of neural pathways associated with touch. Because incoming somatosensory information influences motor output, it is plausible that motor plasticity occurs in the blind. In this work, we evaluated this issue at the peripheral level in enucleated rats. Whisker muscles in enucleated rats 160 days of age or older showed increased cytochrome oxidase activity, capillary density, motor plate size, and amplitude of evoked field potentials as compared with their control counterparts. Such differences were not observed at ages 10 and 60 days, the capillary density was the exception being greater in the enucleated rat at the latter age. Interestingly, there was a trend to increased neurotrophin-3 concentrations in the whisker pads of enucleated rats throughout postnatal development. Our results show that neonatal enucleation leads to late onset plasticity of the whisker's motor system. PMID:18838691

  16. Symptomatic subserosal gastric lipoma successfully treated with enucleation.

    PubMed

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

    2008-10-14

    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.

  17. 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

  18. 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. © 2015 American Academy of Forensic Sciences.

  19. Attempted bilateral manual enucleation (gouging) during a physical assault.

    PubMed

    Shneck, Marina; Oshry, Tzafrir; Marcus, Mira; Lifshitz, Tova

    2003-03-01

    To report a rare, severe case of partial traumatic bilateral enucleation and its assessment and management. Case report and literature review. A report of clinical and imaging findings, surgical procedure, medical treatment, and final outcome. Complete avulsion of the extraocular muscles and optic nerve resulted in total loss of vision in one eye. Partial visual recovery was achieved by operating on the fellow eye, which was partially avulsed. Both eyes underwent lateral canthotomy in the emergency room. This was followed by exploration, repair of all ruptured extraocular muscles, and anterior chamber tap under general anesthesia. The few previously reported cases of traumatic manual avulsion of the globe are reviewed and discussed in the context of the present case. Partial visual recovery can be achieved after severe orbital and optic nerve trauma. A multidisciplinary approach to the assessment and management of these patients is recommended.

  20. Transscleral optical spectroscopy of uveal melanoma in enucleated human eyes.

    PubMed

    Krohn, Jørgen; Svenmarker, Pontus; Xu, Can T; Mørk, Sverre J; Andersson-Engels, Stefan

    2012-08-09

    The aims of this study were to use transscleral optical spectroscopy to analyze normal and tumor-infiltrated areas of enucleated human eyes, and to characterize the spectral properties of uveal melanomas in relation to various morphological features. Nine consecutive eyes enucleated for uveal melanoma were examined by transscleral spectroscopy, using a fiber-optic probe that exerted a fixed pressure on the scleral surface. Spectroscopic measurements, covering the wavelength range of 400-1100 nm, were sequentially performed over the uveal melanoma and on the opposite (normal) side of each eye. The eyes were then processed for histological and immunohistochemical analyses. Comparisons between spectral and morphological parameters were performed by Spearman's rank correlation coefficient and unpaired t-test. The average reflection intensity obtained from the normal side of the eyes was higher than that from the tumors. The spectral imprint of hemoglobin was lower and that of water was considerably stronger when compared with the tumor side. The diffuse reflection spectra from the melanomas showed a strong correlation with the degree of tumor pigmentation (Spearman's rho = -0.87, P < 0.0001). A weaker correlation was observed between the amount of hemoglobin-related absorption and the density of intratumoral blood vessels (Spearman's rho = -0.25, P = 0.023). The mean diffuse reflection intensity obtained from the spindle cell melanomas was significantly higher than that from the mixed and epithelioid cell melanomas (P < 0.0001). Although future in vivo studies are required, these data suggest that transscleral optical spectroscopy is a feasible method for identification and morphological assessment of choroidal tumors.

  1. Discharge and infection in retinoblastoma post-enucleation sockets

    PubMed Central

    Mourits, Daphne L; Hartong, Dyonne T; Budding, Andries E; Bosscha, Machteld I; Tan, H Stevie; Moll, Annette C

    2017-01-01

    Purpose To investigate the causes and treatment options for socket discharge and infection in patients enucleated for retinoblastoma (Rb). Methods A questionnaire was filled out by (parents of) ocular prosthesis-wearing patients with a history of enucleation as treatment for Rb. We collected data on patients’ characteristics, cleaning habits of the prosthesis, frequency of socket irritation, discharge, and infection, and use of antibiotics. With ordinal logistic regression analysis, factors related to the outcome parameters (frequency of irritation, mucoid and purulent discharge) were identified. In a subset of young asymptomatic and symptomatic patients, a swab culture of the socket was performed to determine the presence of microorganisms. Results A total of 186 patients or their parents (mean age of the patients: 17.3 years, ranging from 0.8 to 88.3 years) filled out the questionnaire. Irritation, mucoid discharge, and purulent discharge were frequently (once a month or more often) experienced in 75 (39.5%), 127 (66.8%), and 15 (13.2%) sockets, respectively. Younger age was associated with a higher frequency of mucoid and purulent discharge. Radiation therapy, chemotherapy, gender, age at surgery, cleaning frequency, and nocturnal wear were not associated with the outcome parameters. In a subgroup of 26 patients, the sockets were swabbed and cultured. All symptomatic patients had a positive bacterial culture versus 15% (2/13) of the asymptomatic patients (P<0.001). Common cold was correlated with both symptoms and presence of bacteria. Haemophilus influenzae and Staphylococcus aureus were the species most frequently cultured. Conclusion Ocular prosthesis-wearing patients often experienced mucoid discharge, and less often irritation and socket infection. These complaints were found to decrease with increasing age, but did not seem to be influenced by cleaning or wearing habits. Symptomatic sockets, with and without discharge, were correlated with the presence

  2. 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

  3. 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)

  4. 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)

  5. Demecolcine effects on microtubule kinetics and on chemically assisted enucleation of bovine oocytes.

    PubMed

    Saraiva, Naiara Zoccal; Perecin, Felipe; Méo, Simone Cristina; Ferreira, Christina Ramires; Tetzner, Tatiane Almeida Drummond; Garcia, Joaquim Mansano

    2009-03-01

    This study aimed to evaluate the effect of demecolcine, a microtubule-depolymerizing agent, on microtubule kinetics; to determine the best concentration of demecolcine as a chemically assisted enucleation agent in metaphase I (MI) and metaphase II (MII) bovine oocytes, and to evaluate the embryonic development after nuclear transfer (NT) using chemically assisted enucleation of recipient oocytes. Oocytes in vitro matured for 12 h (MI) and 21 h (MII) were exposed to several concentrations of demecolcine and evaluated for enucleation or membrane protrusion formation. Demecolcine concentration of 0.05 microg/mL produced the highest rates of enucleation in group MI (15.2%) and protrusion formation in group MII (55.1%), and was employed in the following experiments. Demecolcine effect was seen as early as 0.5 h after treatment, with a significant increase in the frequency of oocytes with complete microtubule depletion in MI (58.9%) and MII (21.8%) compared to initial averages at 0 h (27.4% and 1.9%, respectively). Microtubule repolymerization was observed when MII-treated oocytes were cultured in demecolcine-free medium for 6 h (42.4% oocytes with two evident sets of microtubules). Chemically assisted enucleated oocytes were used as recipient cytoplasts in NT procedures to assess embryonic development. For NT, 219 of 515 oocytes (42.5%) formed protrusions and were enucleated, and reconstructed, resulting in 58 nuclear-transferred one-cell embryos. Cleavage (84.5%) and blastocyst development (27.6%) rates were assessed. In conclusion, demecolcine can be used at lower concentrations than routinely employed, and the chemically assisted enucleation technique was proven to be highly efficient allowing embryonic development in bovine.

  6. 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

  7. A novel technique of needle-guided laparoscopic enucleation of insulinomas.

    PubMed

    Laliotis, Aggelos; Martin, Jack; Worthington, Tim R; Marshall, Michele; Isla, Alberto M

    2015-02-01

    Insulinomas are rare, usually benign and solitary neuroendocrine tumors that cause oversecretion of insulin. Surgical excision remains the only treatment modality with the potential for cure. Compared to open extensive pancreatic resections, laparoscopic enucleation of these tumors offers effective treatment, and significantly reduced risks of complications. However, accurate tumor localization is extremely important, especially in cases of lesions deep seated into the head of the pancreas. We present here a novel technique of intraoperative localization of lesions that are not visible on the surface of pancreas. Using laparoscopic intraoperative ultrasound, tumors were located in the parenchyma of the pancreatic head and then an 18-G needle was inserted into the pancreatic lesion intraoperatively under laparoscopic sonographic guidance. The pancreatic parenchyma was then divided until the dome of tumor was visible, minimizing tissue trauma, and enucleation was performed. This technique is a useful tool that substantially improves the chances of successful laparoscopic enucleation of deep-seated small pancreatic insulinomas.

  8. Plant development. Arabidopsis NAC45/86 direct sieve element morphogenesis culminating in enucleation.

    PubMed

    Furuta, Kaori Miyashima; Yadav, Shri Ram; Lehesranta, Satu; Belevich, Ilya; Miyashima, Shunsuke; Heo, Jung-ok; Vatén, Anne; Lindgren, Ove; De Rybel, Bert; Van Isterdael, Gert; Somervuo, Panu; Lichtenberger, Raffael; Rocha, Raquel; Thitamadee, Siripong; Tähtiharju, Sari; Auvinen, Petri; Beeckman, Tom; Jokitalo, Eija; Helariutta, Ykä

    2014-08-22

    Photoassimilates such as sugars are transported through phloem sieve element cells in plants. Adapted for effective transport, sieve elements develop as enucleated living cells. We used electron microscope imaging and three-dimensional reconstruction to follow sieve element morphogenesis in Arabidopsis. We show that sieve element differentiation involves enucleation, in which the nuclear contents are released and degraded in the cytoplasm at the same time as other organelles are rearranged and the cytosol is degraded. These cellular reorganizations are orchestrated by the genetically redundant NAC domain-containing transcription factors, NAC45 and NAC86 (NAC45/86). Among the NAC45/86 targets, we identified a family of genes required for enucleation that encode proteins with nuclease domains. Thus, sieve elements differentiate through a specialized autolysis mechanism.

  9. Evisceration and enucleation: a national survey of practice patterns in the United States.

    PubMed

    Shah, Ruchi D; Singa, Ramesh M; Aakalu, Vinay K; Setabutr, Pete

    2012-01-01

    The management of evisceration and enucleation has changed over time. The authors assessed the practice patterns regarding eye removal among oculoplastic surgeons. Internet-based surveys were sent to American Society of Ophthalmic Plastic and Reconstructive Surgeons members regarding preferences in evisceration and/or enucleation, including indications, surgical techniques, preoperative evaluation modalities, implant types used, and postoperative complications experienced. Surgeons who recently completed fellowship training are more likely to perform eviscerations than their senior counterparts. The variety of viable implant types and the use of enucleation or evisceration for certain indications were not always in concordance with historical guiding principles. However, changing trends are in line with the current literature. Current practice patterns reflect recent literature and historical trends. Copyright 2012, SLACK Incorporated.

  10. Tropomodulin 1 controls erythroblast enucleation via regulation of F-actin in the enucleosome.

    PubMed

    Nowak, Roberta B; Papoin, Julien; Gokhin, David S; Casu, Carla; Rivella, Stefano; Lipton, Jeffrey M; Blanc, Lionel; Fowler, Velia M

    2017-08-31

    Biogenesis of mammalian red blood cells requires nuclear expulsion by orthochromatic erythoblasts late in terminal differentiation (enucleation), but the mechanism is largely unexplained. Here, we employed high-resolution confocal microscopy to analyze nuclear morphology and F-actin rearrangements during the initiation, progression, and completion of mouse and human erythroblast enucleation in vivo. Mouse erythroblast nuclei acquire a dumbbell-shaped morphology during enucleation, whereas human bone marrow erythroblast nuclei unexpectedly retain their spherical morphology. These morphological differences are linked to differential expression of Lamin isoforms, with primary mouse erythroblasts expressing only Lamin B and primary human erythroblasts only Lamin A/C. We did not consistently identify a continuous F-actin ring at the cell surface constriction in mouse erythroblasts, nor at the membrane protein-sorting boundary in human erythroblasts, which do not have a constriction, arguing against a contractile ring-based nuclear expulsion mechanism. However, both mouse and human erythroblasts contain an F-actin structure at the rear of the translocating nucleus, enriched in tropomodulin 1 (Tmod1) and nonmuscle myosin IIB. We investigated Tmod1 function in mouse and human erythroblasts both in vivo and in vitro and found that absence of Tmod1 leads to enucleation defects in mouse fetal liver erythroblasts, and in CD34(+) hematopoietic stem and progenitor cells, with increased F-actin in the structure at the rear of the nucleus. This novel structure, the "enucleosome," may mediate common cytoskeletal mechanisms underlying erythroblast enucleation, notwithstanding the morphological heterogeneity of enucleation across species. © 2017 by The American Society of Hematology.

  11. 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

  12. Study of the efficiency of chemically assisted enucleation method for handmade cloning in goat (Capra hircus).

    PubMed

    Akshey, Y S; Malakar, D; De, A K; Jena, M K; Sahu, S; Dutta, R

    2011-08-01

    The present investigation was carried out to find an efficient chemically assisted procedure for enucleation of goat oocytes related to handmade cloning (HMC) technique. After 22-h in vitro maturation, oocytes were incubated with 0.5 μg/ml demecolcine for 2 h. Cumulus cells were removed by pipetting and vortexing in 0.5 mg/ml hyaluronidase, and zona pellucida were digested with pronase. Oocytes with extrusion cones were subjected to oriented bisection. One-third of the cytoplasm with the extrusion cone was removed with a micro blade. The remaining cytoplasts were used as recipients in HMC. Goat foetal fibroblasts were used as nuclear donors. The overall efficiency measured as the number of cytoplasts obtained per total number of oocytes used was significantly (p < 0.05) higher in chemically assisted handmade enucleation (CAHE) than oriented handmade enucleation without demecolcine (OHE) (80.02 ± 1.292% vs. 72.9 ± 1.00%, respectively, mean ± SEM). The reconstructed and activated embryos were cultured in embryo development medium (EDM) for 7 days. Fusion, cleavage and blastocyst development rate were 71.63 ± 1.95%, 92.94 ± 0.91% and 23.78 ± 3.33% (mean ± SEM), respectively which did not differ significantly from those achieved with random handmade enucleation and OHE. In conclusion, chemically assisted enucleation is a highly efficient and reliable enucleation method for goat HMC which eliminates the need of expensive equipment (inverted fluorescence microscope) and potentially harmful chromatin staining and ultraviolet (UV) irradiation for cytoplast selection.

  13. 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.

  14. Establishment of Immortalized Human Erythroid Progenitor Cell Lines Able to Produce Enucleated Red Blood Cells

    PubMed Central

    Kurita, Ryo; Suda, Noriko; Sudo, Kazuhiro; Miharada, Kenichi; Hiroyama, Takashi; Miyoshi, Hiroyuki; Tani, Kenzaburo; Nakamura, Yukio

    2013-01-01

    Transfusion of red blood cells (RBCs) is a standard and indispensable therapy in current clinical practice. In vitro production of RBCs offers a potential means to overcome a shortage of transfusable RBCs in some clinical situations and also to provide a source of cells free from possible infection or contamination by microorganisms. Thus, in vitro production of RBCs may become a standard procedure in the future. We previously reported the successful establishment of immortalized mouse erythroid progenitor cell lines that were able to produce mature RBCs very efficiently. Here, we have developed a reliable protocol for establishing immortalized human erythroid progenitor cell lines that are able to produce enucleated RBCs. These immortalized cell lines produce functional hemoglobin and express erythroid-specific markers, and these markers are upregulated following induction of differentiation in vitro. Most importantly, these immortalized cell lines all produce enucleated RBCs after induction of differentiation in vitro, although the efficiency of producing enucleated RBCs remains to be improved further. To the best of our knowledge, this is the first demonstration of the feasibility of using immortalized human erythroid progenitor cell lines as an ex vivo source for production of enucleated RBCs. PMID:23533656

  15. A single, continuous spiraling suture for uterine wall reconstruction after laparoscopic enucleation of intramural myomas.

    PubMed

    Barisic, D; Bagovic, D

    2001-08-01

    After laparoscopic enucleation of intramural myomas in eight women, the uterine wall defect was reconstructed with a single continuous spiraling suture. The procedure contained cost and reduced operating time. No patients had postoperative intramural hematoma. Although this is a reproducible method of laparoscopic uterine wall reconstruction, long-term results must be obtained to determine safety in pregnancy and extent of postoperative adhesions.

  16. Prevention of Evisceration or Enucleation in Endogenous Bacterial Panophthalmitis with No Light Perception and Scleral Abscess

    PubMed Central

    Chen, Kuan-Jen; Chen, Yen-Po; Chao, An-Ning; Wang, Nan-Kai; Wu, Wei-Chi; Lai, Chi-Chun; Chen, Tun-Lu

    2017-01-01

    Panophthalmitis is the most extensive ocular involvement in endophthalmitis with inflammation in periocular tissues. Severe inflammation of the anterior and posterior segments is frequently accompanied by corneal opacity, scleral abscess, and perforation or rupture. Enucleation or evisceration was the only remaining viable treatment option when all options to salvage the eye had been exhausted. The purpose of this retrospective study is to examine the outcomes of patients with endogenous bacterial panophthalmitis, no light perception and scleral abscess who were treated with multiple intravitreal and periocular injections of antibiotics and dexamethasone. Evaluation included spreading of infection to contiguous or remote sites, following evisceration or enucleation, and sympathetic ophthalmia. Eighteen patients were diagnosed with EBP, with liver abscesses in eight patients, retroperitoneal infection in four, pneumonia in two, infective endocarditis in one, cellulitis in one, drug abuse in one, and mycotic pseudoaneurysm in one. Culture results were positive for Klebsiella pneumoniae in 12 patients, Streptococcus spp. in three, Pseudomonas aeruginosa in one, Escherichia coli in one, and Staphylococcus aureus in one. The average number of periocular injections was 2.2, and the average number of intravitreal injections was 5.8. No eye required evisceration or enucleation and developed the spreading of infection to contiguous or remote sites during the follow-up. No sympathetic ophthalmia was observed in the fellow eye of all patients. Prevention of evisceration or enucleation in patients with EBP, NLP and scleral abscess can be achieved by multiple intravitreal and periocular injections of antibiotics and dexamethasone. PMID:28056067

  17. Psychosocial Factors Influencing Parental Decision to Allow or Refuse Potentially Lifesaving Enucleation in Children with Retinoblastoma

    PubMed Central

    Domingo, Rolando Enrique D.; Toledo, Maria Socorro W.; Mante, Beverlee Verona L.

    2017-01-01

    Objective: Retinoblastoma is the most common malignancy of the eye and ocular adnexa in the Philippines. It is curable when treated early, but delay in enucleation is common due to the parental refusal of surgery for varied reasons. The aim of this study is to identify the psychosocial barriers and facilitating factors for accepting versus refusing enucleation as treatment for retinoblastoma. Methods: This is a cross-sectional descriptive study utilizing structured interviews and a questionnaire. It was conducted at the Retinoblastoma Clinic of the Philippine General Hospital. A questionnaire using the Likert scale was constructed after performing key informant interviews and focus group discussions. It was pretested and revised before parents of patients with retinoblastoma were invited to participate in the study. Descriptive statistics, quantitative item analyses using inter-item correlations and item-total correlations was performed. Results: Factors that correlate with refusal to enucleate are the beliefs that cancer is a fatal illness, the fear of unacceptable esthetic outcome of the surgery, and the cost of treatment. Favorable factors include value of life, high regard for the opinion of medical practitioners, and appreciation of the efficacy of treatment. Conclusions: There are several favorable factors and barriers that health practitioners must consider in facilitating parental decision-making toward enucleation for retinoblastoma. PMID:28695164

  18. Novel methylene blue staining technique for localizing small esophageal leiomyomas during thoracoscopic enucleation.

    PubMed

    Zhang, Z; Ai, B; Liao, Y; Liu, L; Liu, M

    2016-11-01

    The treatment of choice for leiomyoma, the most common benign esophageal tumor, is thoracoscopic enucleation. One of the most difficult aspects of thoracoscopic enucleation is the precise localization of small tumors (≤1.5 cm) and tumors without external protrusion. No simple, feasible solutions to this problem are available. We developed a novel methylene blue staining technique to localize small esophageal leiomyomas and evaluated the feasibility of our technique. Between January 2013 and July 2014, eight patients with small esophageal leiomyomas (≤1.5 cm) underwent thoracoscopic enucleation in Tongji Hospital. Preoperative endoscopic ultrasonography was performed in all patients. The leiomyomas were located in the middle (n = 5) and lower (n = 3) thirds of the esophagus. We preoperatively injected 0.5-1.0 mL methylene blue in the submucosa adjacent to the tumors under standard gastroscope guidance. The entire staining process took about 10 minutes. Staining was successful in all patients. The unstained tumor was exposed after the blue-stained mediastinal pleura, and overlying muscle were incised longitudinally. All procedures were successfully completed without conversion to open surgery. No abnormalities were detected in the esophageal mucosa. The median operating time was 60 minutes (range, 40-90 minutes). Postoperative histopathology confirmed leiomyoma in all patients. The median postoperative hospital stay was 6 days (range, 5-7 days). No major complications, such as esophageal leakage or esophageal diverticulum, occurred. Endoscopic methylene blue staining is safe and feasible for localizing small esophageal leiomyomas during thoracoscopic enucleation. This method will enable precise and easy enucleation. © 2015 International Society for Diseases of the Esophagus.

  19. Holmium laser applications of the prostate.

    PubMed

    Lerner, Lori B; Tyson, Mark D

    2009-11-01

    The high-powered holmium laser is an excellent tool for the surgical treatment of benign prostatic hyperplasia. This article discusses the background of holmium use in the prostate and describes the surgical techniques of holmium laser ablation of the prostate and holmium laser enucleation of the prostate. Operative challenges are reviewed with suggestions as to how to avoid these problems or deal with them when they arise. Surgical outcomes and a thorough literature review are both presented.

  20. Postoperative Lower Urinary Tract Storage Symptoms: Does Prostate Enucleation Differ from Prostate Vaporization for Treatment of Symptomatic Benign Prostatic Hyperplasia?

    PubMed

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

    2015-10-01

    To assess the degree of postoperative storage symptoms after GreenLight™ laser photoselective vaporization of the prostate (PVP) and Holmium laser enucleation of the prostate (HoLEP) for management of benign prostatic hyperplasia (BPH) and its predictors. A retrospective review was performed for patients who underwent HoLEP or PVP for non catheter-dependent patients with BPH. Patients were followed up at 1, 3, 6, and 12 months and then annually by International Prostate Symptoms Score (IPSS), quality of life index, peak flow rate, residual urine volume, and prostate-specific antigen (PSA) level. Moderate or severe storage symptoms were defined as IPSS storage subscore ≥ 9. Of 1673 laser procedures, a total of 1100 procedures met the inclusion criteria including 809 HoLEPs and 291 PVPs. The HoLEP group had significantly larger preoperative prostates and longer operative time. In the HoLEP group, postoperative IPSS was significantly better than in the PVP group at all follow-up points (P<0.05). Storage subscore was significantly higher after PVP and did not improve until 6 months postoperatively when it became comparable with that of the HoLEP group. The number of patients with IPSS-storage score ≥ 9 were significantly higher in the PVP group at 1 and 3 months follow-up (37.3% vs 15.1%, P<0.001) and (26.4% vs 17.5%, P=0.004), respectively. XPS-180W was associated with the lowest storage symptoms among the three GreenLight generations at all follow-up visits. In multivariate analysis, baseline IPSS-storage subscore ≥ 9, prolonged operative time >100 minutes, and lower percent of postoperative PSA level reduction significantly predicted less improvement of postoperative storage symptoms regardless of the laser procedure. Storage urinary symptoms significantly improved more after HoLEP compared with PVP, irrespective of the generation of GreenLight laser used. Recovery from bothersome storage urinary symptoms after prostate vaporization is time dependent, and

  1. Ophthalmomyiasis caused by a Phormia sp. (Diptera: Calliphoridae) larva in an enucleated patient.

    PubMed

    Kim, Jae-Soo; Kim, Jong-Wan; Lee, Hye-Jung; Lee, In-Yong; Oh, Sang-Ah; Seo, Min

    2011-06-01

    Ophthalmomyiasis rarely occurs worldwide, and has not been reported in Korea. We present here a case of ophthalmomyiasis caused by Phormia sp. fly larva in an enucleated eye of a patient. In June 2010, a 50-year-old man was admitted to Dankook University Hospital for surgical excision of a malignant melanoma located in the right auricular area. He had a clinical history of enucleation of his right eye due to squamous cell carcinoma 5 years ago. During hospitalization, foreign body sensation developed in his right eye, and close examination revealed a fly larva inside the eye, which was evacuated. The larva was proved to be Phormia sp. based on the morphology of the posterior spiracle. Subsequently, no larva was found, and the postoperative course was uneventful without any complaints of further myiasis. This is the first case of ophthalmomyiasis among the literature in Korea, and also the first myiasis case caused by Phormia sp. in Korea.

  2. Ocular rehabilitation following socket reconstruction with amniotic membrane transplantation with failed primary hydroxyapatite implant post enucleation.

    PubMed

    Aggarwal, Himanshi; Kumar, Pradeep; Singh, Raghuwar Dayal; Chand, Pooran; Alvi, Habib A

    2015-02-01

    There are several clinical situations that require enucleation in children, with retinoblastoma being the most common. Intra-orbital implants are routinely placed in children at the time of initial surgery to provide motility and cosmesis in addition to adequate orbital volume. Current practice employs intra-orbital implants made of nonporous silicone, hydroxyapatite, or porous polyethylene. Complications are usually minimal with these implants but they do occur. The purpose of this clinical report is to describe the rehabilitation of a pediatric patient with failed primary intra-orbital coralline hydroxyapatite implant post enucleation, who was successfully fitted with custom ocular prosthesis following secondary socket reconstruction with amniotic membrane transplantation after removal of infected implant. Copyright © 2014 British Contact Lens Association. Published by Elsevier Ltd. All rights reserved.

  3. Ophthalmomyiasis Caused by a Phormia sp. (Diptera: Calliphoridae) Larva in an Enucleated Patient

    PubMed Central

    Kim, Jae-Soo; Kim, Jong-Wan; Lee, Hye-Jung; Lee, In-Yong; Oh, Sang-Ah

    2011-01-01

    Ophthalmomyiasis rarely occurs worldwide, and has not been reported in Korea. We present here a case of ophthalmomyiasis caused by Phormia sp. fly larva in an enucleated eye of a patient. In June 2010, a 50-year-old man was admitted to Dankook University Hospital for surgical excision of a malignant melanoma located in the right auricular area. He had a clinical history of enucleation of his right eye due to squamous cell carcinoma 5 years ago. During hospitalization, foreign body sensation developed in his right eye, and close examination revealed a fly larva inside the eye, which was evacuated. The larva was proved to be Phormia sp. based on the morphology of the posterior spiracle. Subsequently, no larva was found, and the postoperative course was uneventful without any complaints of further myiasis. This is the first case of ophthalmomyiasis among the literature in Korea, and also the first myiasis case caused by Phormia sp. in Korea. PMID:21738274

  4. Nuclear transfer of embryonic cell nuclei to non-enucleated eggs in zebrafish, Danio rerio.

    PubMed

    Hattori, Manabu; Hashimoto, Hisashi; Bubenshchikova, Ekaterina; Wakamatsu, Yuko

    2011-04-15

    We previously established a novel method for nuclear transfer in medaka (Oryzias latipes) using non-enucleated, diploidized eggs as recipients for adult somatic cell nuclei. Here we report the first attempt to apply this method to another fish species. To examine suitability of using non-enucleated eggs as recipients for nuclear transfer in the zebrafish (Danio rerio), we transferred blastula cell nuclei from a wild-type donor strain to non-enucleated, unfertilized eggs from a golden recipient strain. As a result, 31 of 184 (16.8%) operated eggs developed normally and reached the adult stage. Twenty-eight (15.2%) of these transplants showed wild-type phenotype and the remaining three (1.6%) were golden. Except for one individual that exhibited diploid/tetraploid mosaicism, all of the wild-type nuclear transplants were either triploid or diploid. While all of 19 triploid transplants were infertile, a total of six transplants (21.4%) were fertile (five of the eight diploid transplants and one transplant exhibiting ploidy mosaicism). Except for one diploid individual, all of the fertile transplants transferred both the wild-type golden gene allele (slc24a5) as well as the phenotype, the wild-type body color, to their F(1) and F(2) progeny in a typical Mendelian fashion. PCR analysis of slc24a5 suggested that triploidy originated from a fused nucleus in the diploid donor and haploid recipient nuclei, and that the sole origin of diploidy was the diploid donor nucleus. The results of the present study demonstrated the suitability of using non-enucleated eggs as recipients for nuclear transfer experiments in zebrafish.

  5. Efficiency of two enucleation methods connected to handmade cloning to produce transgenic porcine embryos.

    PubMed

    Li, J; Villemoes, K; Zhang, Y; Du, Y; Kragh, P M; Purup, S; Xue, Q; Pedersen, A M; Jørgensen, A L; Jakobsen, J E; Bolund, L; Yang, H; Vajta, G

    2009-02-01

    The purpose of our work was to establish an efficient-oriented enucleation method to produce transgenic embryos with handmade cloning (HMC). After 41-42 h oocytes maturation, the oocytes were further cultured with or without 0.4 microg/ml demecolcine for 45 min [chemically assisted handmade enucleation (CAHE) group vs polar body (PB) oriented handmade enucleation (OHE) group respectively]. After removal of the cumulus cells and partial digestion of the zona pellucida, oocytes with visible extrusion cones and/or polar bodies attached to the surface were subjected to oriented bisection. Putative cytoplasts without extrusion cones or PB were selected as recipients. Two cytoplasts were electrofused with one transgenic fibroblasts expressing green fluorescent protein (GFP), while non-transgenic fibroblasts were used as controls. Reconstructed embryos were cultured in Well of Wells (WOWs) with porcine zygote medium 3 (PZM-3) after activation. Cleavage and blastocyst rates were registered on day 2 and day 7 of in vitro culture respectively. Meanwhile, the total blastocyst cell number was counted on day 7. We found that the difference was only observed between blastocyst rates (38.6 +/- 2% vs 48.1 +/- 3%) of cloned embryos with GFP transgenic fibroblast cells after CAHE vs OHE. With adjusted time-lapse for zonae-free cloned embryos cultured in WOWs with PZM-3, it was obvious that in vitro developmental competence after CAHE was compromised when compared with the OHE method. OHE enucleation method seems to be a potential superior alternative method used for somatic cell nuclear transfer (SCNT) with transgenic fibroblast cells.

  6. 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. Copyright © 2012 Elsevier Inc. All rights reserved.

  7. Highly efficient and reliable chemically assisted enucleation method for handmade cloning in cattle.

    PubMed

    Vajta, Gábor; Maddox-Hyttel, Poul; Skou, Christina T; Tecirlioglu, R Tayfur; Peura, Teija T; Lai, Liangxue; Murphy, Clifton N; Prather, Randall S; Kragh, Peter M; Callesen, Henrik

    2005-01-01

    The purpose of the present study was to find an efficient and reliable chemically assisted procedure for enucleation related to the handmade cloning (HMC) technique. After in vitro maturation oocytes were incubated in 0.5 microg mL(-1) demecolcine for 2 h. Subsequently, zonae pellucidae were digested with pronase, and one-third of the cytoplasm connected to an extrusion cone was removed by hand using a microblade. The remaining two-thirds were used as recipients for HMC, and reconstructed and activated embryos were cultured for 7 days. The time-dependent manner of the development of extrusion cones, the efficiency (oriented bisection per oocyte; 94%), reliability (success per attempted enucleation; 98%), and the blastocyst per reconstructed embryo rates (48%) were measured. Ultrastructural analyses demonstrated that demecolcine treatment resulted in disoriented and haphazardly orientated microtubules. The general ultrastructure of the oocyte organelles, however, appeared to be unaltered by the treatments. Considering that no oocyte selection based on polar body presence was performed, this system seems to be more efficient and reliable than any other enucleation method. Moreover, expensive equipment (inverted fluorescence microscope) and a potentially harmful step (staining and ultraviolet illumination) can be eliminated from the HMC procedure without compromising the high in vitro efficiency.

  8. Transurethral enucleation of prostate with button electrode plasmakinetic vaporization for the treatment of Benign Prostatic Hyperplasia

    PubMed Central

    Peng, Bo; Huang, Jianhua; Wang, Guangchun; Zhang, Haimin; Liu, Min

    2016-01-01

    Benign prostatic hyperplasia (BPH) is a common disease in aged men. In this study, we investigated the efficacy and safety of transurethral enucleation of prostate with button electrode plasmakinetic vaporization for the treatment of BPH. 60 patients diagnosed with BPH who were treated in our hospital from August to December, 2014 by enucleation with button electrode were retrospectively reviewed, and operation time, urinary catheter indwelling time, continuous bladder irrigation time, operation related complications, maximum urinary flow rate (Qmax), post-void residual urine volume (PVR), International Prostate Symptom Score (IPSS), quality of life assessment (QOL), perioperative hemoglobin and electrolytes were recorded. All the operations were completed successfully. The operation time and urinary catheter indwelling time were 45.3 ± 16.2 min and 1.72 ± 0.32 d, respectively. During the follow-up, urethral stricture (n = 1), and urinary incontinence (n = 2) were found with recovery after 1-month training. Postoperative PVR at 1, 3 and 6 months significantly decreased compared with preoperative ones (P < 0.05). IPSS, Qmax, QOL at 1, 3 and 6 months improved significantly (P < 0.05). There was no significant difference in serum hemoglobin, sodium and potassium before and after the operation. Thus, the study proved that enucleation of prostate with button electrode was efficient and safe, which was worth being recommended. PMID:28008957

  9. Clinical Outcomes of Transurethral Enucleation with Bipolar for Benign Prostatic Hypertrophy.

    PubMed

    Kawamura, Yoshiaki; Tokunaga, Masatoshi; Hoshino, Hideaki; Matsushita, Kazuo; Terachi, Toshiro

    2015-12-20

    This study compared outcomes of transurethral enucleation with bipolar (TUEB) with transurethral resection in saline (TURis). Thirty patients who underwent TURis were compared with 30 who underwent TUEB. Perioperative treatment outcomes, preoperative and 1-month postoperative International Prostrate Symptom Scores (IPSS), quality of life (QOL) index, maximum flow rate, average urinary flow, post- void residual urinary volume, and complications were compared. There were no significant differences in IPSS, measurements of urinary flow, or duration of catheterization. However, the improvement of QOL index after surgery was significantly greater in the TUEB group than the TURis group. The TUEB group had significantly longer surgical time, but tended to have greater enucleated tissue weight than the TURis group. There was no significant difference in enucleated tissue weight per unit time between the groups. The TUEB group also tended to have less hemoglobin decrease at postoperative day 1; this tendency was more prominent in patients with an estimated prostate volume of ≥ 50 ml. No significant differences in postoperative complications were observed. This study confirmed that the previously reported safety and efficacy of TUEB are comparable to those of TURis. TUEB appears especially safe for those with a large benign hypertrophic prostate.

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

    PubMed

    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

    2009-09-01

    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.

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

    PubMed

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

    1996-11-01

    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.

  12. Le Fort I osteotomy to enucleation of grand proportions fissural cyst-presentation of case report.

    PubMed

    Cavalcante, Rafael Correia; Durski, Fernanda; Deliberador, Tatiana Miranda; Giovanini, Allan Fernando; Rebellato, Nelson Luís Barbosa; da Costa, Delson João; Klüppel, Leandro Eduardo; Scariot, Rafaela

    2016-01-01

    Fissural cysts (FC) are caused by entraped epithelium between nasal and maxilar processes. They are commonly treated with surgical enucleation precedded or not by marsupialization depending on the cyst size. Biopsy of lesion is recommended due to confirm radiographic evaluation. It is rare to observe Le Fort I surgical approach to this type of injury. This study reports the case of an uncommon grand proportions fissural cyst in a female patient, 53, that was referred to the Oral and Maxillofacial Surgery Departament of Hospital XV presenting volume increase in maxilla associated with numbness of palate. Radiograph examination showed an intimate relationship between incisors apexes and FC. Expansion of both buccal and palate cortical was then confirmed as well as its unusual size, approximately 25 millimeters. Due to the abnormal size of lesion and possible impairment of upper incisors, LeFort I osteotomy associated with downfracture to cystic enucleation was the chosen treatment. After enucleation, the remaining space was filled with BIOSs and bioguide (lyophilized bone and collagen membrane). Patients' twelve months follow-up demonstrate no relapses and maintenance of teeth involved.

  13. 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

  14. Lasers for median lobe hyperplasia.

    PubMed

    Muschter, R; Gilling, A P

    2001-08-01

    Laser treatment encompases a variety of techniques using different laser wavelengths, application systems, and surgical techniques to achieve contrasting tissue effects such as incision, resection, vaporization, or coagulation. Many studies have proven the clinical efficacy of the various laser techniques for the treatment of benign prostatiuc hyperplasia, including randomized studies versus transurethral prostatectomy (TURP). Recently, long-term follow-up of up to 5 years has demonstrated the durability of the results, although in some of the studies, retreatment rates were higher than after TURP. Median lobes were never seen as a contraindication for treatment in the laser based procedures. Technically, laser treatment techniques such as side-firing transurethral coagulation, contact- and free-beam laser vaporization, interstitial laser coagulation, and the holmium laser-based resection and enucleation are fully suitable for treatment of median lobes. Surprisingly, no studies focussing specifically on laser treatment of median lobes have been published.

  15. Bipolar plasma enucleation of the prostate vs open prostatectomy in large benign prostatic hyperplasia cases - a medium term, prospective, randomized comparison.

    PubMed

    Geavlete, Bogdan; Stanescu, Florin; Iacoboaie, Catalin; Geavlete, Petrisor

    2013-05-01

    WHAT'S KNOWN ON THE SUBJECT? AND WHAT DOES THE STUDY ADD?: According to the EAU Guidelines 2012, large size benign prostatic hyperplasia (BPH) cases (>80 mL) continue to have open prostatectomy as the first line treatment alternative, despite the substantial peri-operative morbidity and extended catheterization and convalescence periods related to this undoubtedly invasive approach. During the past two decades, holmium laser enucleation of the prostate was constantly described as a successful choice for this category of patients. According to rather numerous studies, the technique displayed superior results in terms of surgical safety and postoperative recovery compared with the open procedure. On the other hand, the concept of electrosurgical enucleation of the prostate, using either a monopolar or bipolar cutting current, materialized into several technical applications that eventually failed to gain general acknowledgement as reliable alternatives to the BPH transurethral approach. While keeping in mind the already proved advantage of enucleating substantial quantities of BPH tissue, bipolar plasma enucleation of the prostate was introduced as a novel endoscopic approach in cases of large prostates. The present trial represents the first prospective, medium-term, randomized comparison to be published of this innovative technique with standard open prostatectomy. Basically, the premises for a viable alternative relied on the practical advantages provided by the 'button' electrode, mainly the large surface creating the conditions for a fast enucleation process, continuous vaporization and concomitant haemostasis. Eventually, it was concluded that the plasma enucleation procedure distinguished itself as a successful treatment option in large BPH patients, characterized by good surgical efficiency, significantly reduced complications, faster postoperative recovery, similar prostatic tissue ablation capabilities and satisfactory follow-up results compared with the

  16. Bilateral enucleation alters gene expression and intraneocortical connections in the mouse

    PubMed Central

    2012-01-01

    Background Anatomically and functionally distinct sensory and motor neocortical areas form during mammalian development through a process called arealization. This process is believed to be reliant on both activity-dependent and activity-independent mechanisms. Although both mechanisms are thought to function concurrently during arealization, the nature of their interaction is not understood. To examine the potential interplay of extrinsic activity-dependent mechanisms, such as sensory input, and intrinsic activity-independent mechanisms, including gene expression in mouse neocortical development, we performed bilateral enucleations in newborn mice and conducted anatomical and molecular analyses 10 days later. In this study, by surgically removing the eyes of the newborn mouse, we examined whether early enucleation would impact normal gene expression and the development of basic anatomical features such as intraneocortical connections and cortical area boundaries in the first 10 days of life, before natural eye opening. We examined the acute effects of bilateral enucleation on the lateral geniculate nucleus of the thalamus and the neocortical somatosensory-visual area boundary through detailed analyses of intraneocortical connections and gene expression of six developmentally regulated genes at postnatal day 10. Results Our results demonstrate short-term plasticity on postnatal day 10 resulting from the removal of the eyes at birth, with changes in nuclear size and gene expression within the lateral geniculate nucleus as well as a shift in intraneocortical connections and ephrin A5 expression at the somatosensory-visual boundary. In this report, we highlight the correlation between positional shifts in ephrin A5 expression and improper refinement of intraneocortical connections observed at the somatosensory-visual boundary in enucleates on postnatal day 10. Conclusions Bilateral enucleation induces a positional shift of both ephrin A5 expression and

  17. 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

  18. Simple enucleation is equivalent to traditional partial nephrectomy for renal cell carcinoma: results of a nonrandomized, retrospective, comparative study.

    PubMed

    Minervini, Andrea; Ficarra, Vincenzo; Rocco, Francesco; Antonelli, Alessandro; Bertini, Roberto; Carmignani, Giorgio; Cosciani Cunico, Sergio; Fontana, Dario; Longo, Nicola; Martorana, Giuseppe; Mirone, Vincenzo; Morgia, Giuseppe; Novara, Giacomo; Roscigno, Marco; Schiavina, Riccardo; Serni, Sergio; Simeone, Claudio; Simonato, Alchiede; Siracusano, Salvatore; Volpe, Alessandro; Zattoni, Filiberto; Zucchi, Alessandro; Carini, Marco

    2011-05-01

    The excision of the renal tumor with a substantial margin of healthy parenchyma is considered the gold standard technique for partial nephrectomy. However, simple enucleation showed excellent results in some retrospective series. We compared the oncologic outcomes after standard partial nephrectomy and simple enucleation. We retrospectively analyzed 982 patients who underwent standard partial nephrectomy and 537 who had simple enucleation for localized renal cell carcinoma at 16 academic centers between 1997 and 2007. Local recurrence, cancer specific survival and progression-free survival were the main outcomes of this study. The Kaplan-Meier method was used to calculate survival functions and differences were assessed with the log rank statistic. Univariable and multivariable Cox regression models addressed progression-free survival and cancer specific survival. Median followup of the patients undergoing traditional partial nephrectomy and simple enucleation was 51 ± 37.8 and 54.4 ± 36 months, respectively (p = 0.08). The 5 and 10-year progression-free survival estimates were 88.9 and 82% after standard partial nephrectomy, and 91.4% and 90.8% after simple enucleation (p = 0.09). The 5 and 10-year cancer specific survival estimates were 93.9% and 91.6% after standard partial nephrectomy, and 94.3% and 93.2% after simple enucleation (p = 0.94). On multivariable analysis the adopted nephron sparing surgery technique was not an independent predictor of progression-free survival (HR 0.8, p = 0.55) and cancer specific survival (HR 0.7, p = 0.53) when adjusted for the effect of the other covariates. To our knowledge this is the first multicenter, comparative study showing oncologic equivalence of standard partial nephrectomy and simple enucleation. Copyright © 2011 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

  19. 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

  20. 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.

  1. 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

  2. Enhancement of the cosmetic and functional outcome of enucleation with the conical orbital implant.

    PubMed

    Rubin, P A; Popham, J; Rumelt, S; Remulla, H; Bilyk, J R; Holds, J; Mannor, G; Maus, M; Patrinely, J R

    1998-05-01

    The authors evaluated a new design of a conical-shaped enucleation implant to help minimize the occurrence of superior sulcus defects and maximize motility of the prosthesis. The implant shape is a modification of a sphere. It has a posterior conical projection paralleling the orbital walls, a superior projection supporting the soft tissues of the upper eyelid sulcus, a flattened anterior surface, and channels for each rectus muscle. The study design was a consecutive case series from the Oculoplastics and Orbital Service of the Massachusetts Eye and Ear Infirmary. INTERVENTION/PARTICIPANTS: A total of 45 patients (average age, 40 years; range, 13-75 years) had placement of a conical implant (39 primary enucleations, 6 secondary implants) with a minimum of 1 year' follow-up (range, 12-36 months). All of the primary enucleations and two of the secondary procedures had the anterior portion of the implant covered with autologous fascia. Four of the secondary implants were covered with pseudocapsule harvested from the explanted primary implant. Prostheses were fit 6 to 10 weeks after surgery. Postoperative appearance of patients was assessed by qualitative appearance of the superior sulcus and prosthetic motility, and subjectively by patients' satisfaction. A total of 43 patients had minimal or no superior sulcus defect, whereas 2 patients had moderate defects. There were no severe sulcus defects. All patients were satisfied with their appearance and did not seek further surgery to correct any upper sulcus asymmetry. Prosthetic motility with small-angle ductions (<10 degrees) and saccades was good in all cases. There were two cases of conjunctival wound dehiscence. Both occurred within 4 weeks of surgery. One wound dehiscence was sutured, whereas the other healed spontaneously. There were no cases of implant extrusion, migration, or infection. The conical orbital implant provides appropriate reconstitution of orbital volume while minimizing superior sulcus defects with

  3. Techniques for the preservation of enucleated animal eyes in surgical training.

    PubMed

    Muñoz-Rodriguez, P; Peña-Cuesta, R; Garcia-Cosio, J F; Quiroz-Mercado, H

    1990-11-01

    The main problem with using enucleated animal eyes in surgical training is that they remain fresh for such a short time. We describe a simple technique to preserve them by replacing the aqueous humor and part of the vitreous with another substance. We used 18 eyes of nine dogs (nine for the study and nine as controls), and three substances (2% methylcellulose, silicone oil, and gelatin). The methylcellulose group had the best results (including long-lasting mydriasis), preserving the eyes in which it was used in optimal surgical condition for up to 8 days, twice as long as the eyes in the control group (P less than .005).

  4. [A clinical observation of cool-tip radiofrequency ablation assisted enucleation for giant renal angiomyolipoma].

    PubMed

    Zhang, Shiwei; Zhang, Lijin; Zhao, Xiaozhi; Ji, Changwei; Liu, Guangxiang; Li, Xiaogong; Song, Jiannan; Guo, Hongqian

    2016-02-01

    To initially explore the clinical effect of cool-tip radiofrequency ablation combined with enucleation for the giant hamartoma of kidney with narrow base and export-oriented way of growth. The clinical date of 15 patients including 6 male and 9 female with special hamartoma of kidney underwent cool-tip radiofrequency ablation assisted enucleation from July 2011 to October 2014 were reviewed.The median age was 49 years (ranging from 35 to 71 years). There were 6 cases with left renal tumor, 8 cases with right renal tumor and 1 case with solitary kidney tumor.All patients were confirmed by B ultrasound or CT scan, the mean diameter of hamartoma of kidney was 9.7 cm(8.5-12.7)cm, all tumors were located distant from the collecting system and presents with a special way of growth.The preoperative hemoglobin was (129±18)g/L, SCr was (92±41)μmol/L, glomerular filtration rate (GFR) was (32±12)ml·min(-1)·1.73 m(-2). Cool-tip radiofrequency ablation assisted enucleation was technically successful in all patients.The mean operative duration was (115±31)minutes, and the average intraoperative bleeding was (72±21)ml with no blooding transfusion.The postoperative hospital stay was(7±2)days, and the postoperative hemoglobin was(129±18)g/L, SCr (92±41)μmol/L, GFR(30±15)ml·min(-1)·1.73 m(-2). No statistic change of hemoglobin and SCr or glomerular filtration rate after operations(all P>0.05). Postoperative pathology showed that all cases were hamartoma of kidney.During a mean follow-up period of 19.5 months, none of them had local tumor recurrence or chronic renal insufficiency. Cool-tip radiofrequency ablation assisted enucleation is both safe and effective in the treatment of huge hamartoma of kidney with a narrow base and export-oriented way of growth. The short-term follow-up shows a satisfactory therapeutic effect.

  5. miR-191 regulates mouse erythroblast enucleation by down-regulating Riok3 and Mxi1.

    PubMed

    Zhang, Lingbo; Flygare, Johan; Wong, Piu; Lim, Bing; Lodish, Harvey F

    2011-01-15

    Using RNA-seq technology, we found that the majority of microRNAs (miRNAs) present in CFU-E erythroid progenitors are down-regulated during terminal erythroid differentiation. Of the developmentally down-regulated miRNAs, ectopic overexpression of miR-191 blocks erythroid enucleation but has minor effects on proliferation and differentiation. We identified two erythroid-enriched and developmentally up-regulated genes, Riok3 and Mxi1, as direct targets of miR-191. Knockdown of either Riok3 or Mxi1 blocks enucleation, and either physiological overexpression of miR-191 or knockdown of Riok3 or Mxi1 blocks chromatin condensation. Thus, down-regulation of miR-191 is essential for erythroid chromatin condensation and enucleation by allowing up-regulation of Riok3 and Mxi1.

  6. 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.

  7. Aqueous Angiography-Mediated Guidance of Trabecular Bypass Improves Angiographic Outflow in Human Enucleated Eyes.

    PubMed

    Huang, Alex S; Saraswathy, Sindhu; Dastiridou, Anna; Begian, Alan; Mohindroo, Chirayu; Tan, James C H; Francis, Brian A; Hinton, David R; Weinreb, Robert N

    2016-09-01

    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. 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. 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). 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.

  8. 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.

  9. 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.

  10. Randomized clinical study comparing piezosurgery and conventional rotatory surgery in mandibular cyst enucleation.

    PubMed

    Pappalardo, Sabrina; Guarnieri, Renzo

    2014-07-01

    The aim of the present study is to compare piezoelectric surgery to the conventional rotatory surgery in mandibular cyst enucleation, and to determine the 2 method's suitability and the postoperative outcomes. Eighty patients were included in the study. 35 male and 45 female, which showed cystic mandibular lesions, compared with the inferior alveolar nerve or the mental nerve. The patients were randomly divided into two groups. In the test group, cystectomy was performed using conventional rotatory instrumentation (rotatory-group), and in the other one piezoelectric surgery (piezo-group). The swelling was documented 24/48/72 h and 1 week post-surgery and the patients recorded their subjective postoperative pain daily for 7 days using a Visual Analog Scale (VAS). Patients treated with piezoelectric technique have presented a lower VAS, minor swelling and less recovery time compared to the rotatory-group. No lesions of the mandible nerve were detected with piezosurgery whereas surgery with rotary instruments resulted in 8% hypesthesia at least up to one week. The results of this study suggest that piezosurgery may be considered effective in cyst enucleation compared to traditional procedures with burs, since it grants the patients significantly less post-surgical pain and swelling. Copyright © 2013 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

  11. A chemical enucleation method for the transfer of mitochondrial DNA to rho(o) cells.

    PubMed

    Bayona-Bafaluy, Maria Pilar; Manfredi, Giovanni; Moraes, Carlos T

    2003-08-15

    The study of pathogenic mitochondrial DNA mutations has, in most cases, relied on the production of transmitochondrial cybrids. Although the procedure to produce such cybrids is well established, it is laborious and cumbersome. Moreover, the mechanical enucleation procedure is inefficient and different techniques have to be used depending on the adherence properties of the cell. To circumvent these difficulties, we developed a chemical enucleation method that can have wide applicability for the production of transmitochondrial cybrids. The method is based on the use of actinomycin D to render the nuclear genome transcription/replication inactive and unable to recover after treatment. Such treated cells are fused to cells devoid of mitochondrial DNA and selected for the presence of a functional oxidative phosphorylation system. Our results showed that 95% of the clones recovered by this procedure are true transmitochondrial cybrids. This method greatly facilitates the production of transmitochondrial cybrids, thereby increasing the number of mtDNA mutations and the recipient cell types that can be studied by this system.

  12. Giant chylolymphatic mesenteric cyst and its successful enucleation: A case report.

    PubMed

    Al Booq, Yousuf; Hussain, Syed S; Elmy, Mohamed

    2014-01-01

    Cysts of the mesentery are among surgical rarities. The clinical presentation is not characteristic and in addition, the preoperative imaging although suggestive is not diagnostic in this case ultrasound and CTscan was consistent with giant mesenteric cyst. In most cases, the diagnosis is confirmed after surgical exploration. A 42 yrs old male patient on exploratory laparotomy had a 14cm×10cm×10 cm cysts which was seen arising from the mesentery ofdistal jejunum 80cm from the duodeno jejunal flexure. The cyst was enucleated successfully from themesentery without entailing resection. The cyst contained milky white fluid consistent with a chylolymphatic cyst. The diagnosis was confirmed on histopathology which revealed a cyst wall with lymphoidaggregates. After 3 years of follow-up, the patient is doing well and there is no evidence of recurrence. The cysts may be asymptomatic or maymanifest with abdominal pain, distension lump or intestinal obstruction. Our patient was symptomatic with mild and long standing abdominal pain. The definitive diagnosis of these lesions is difficult prior to surgical exploration as there are no pathognomonic symptoms or characteristic imaging findings. Cysts of the mesentery are among surgical rarities. In most of the cases the diagnosis is confirmed after surgical exploration and removal of thecyst. We would like to emphasize the importance of successful enucleation of the cyst irrespective of its size due to its independent blood supply as opposed to enterogenous cyst which requires bowel resection and anastomosis. Copyright © 2014 The Authors. Published by Elsevier Ltd.. All rights reserved.

  13. Giant chylolymphatic mesenteric cyst and its successful enucleation: A case report

    PubMed Central

    Al Booq, Yousuf; Hussain, Syed S.; Elmy, Mohamed

    2014-01-01

    INTRODUCTION Cysts of the mesentery are among surgical rarities. The clinical presentation is not characteristic and in addition, the preoperative imaging although suggestive is not diagnostic in this case ultrasound and CTscan was consistent with giant mesenteric cyst. In most cases, the diagnosis is confirmed after surgical exploration. PRESENTATION OF CASE A 42 yrs old male patient on exploratory laparotomy had a 14cm×10cm×10 cm cysts which was seen arising from the mesentery ofdistal jejunum 80cm from the duodeno jejunal flexure. The cyst was enucleated successfully from themesentery without entailing resection. The cyst contained milky white fluid consistent with a chylolymphatic cyst. The diagnosis was confirmed on histopathology which revealed a cyst wall with lymphoidaggregates. After 3 years of follow-up, the patient is doing well and there is no evidence of recurrence. DISCUSSION The cysts may be asymptomatic or maymanifest with abdominal pain, distension lump or intestinal obstruction. Our patient was symptomatic with mild and long standing abdominal pain. The definitive diagnosis of these lesions is difficult prior to surgical exploration as there are no pathognomonic symptoms or characteristic imaging findings. CONCLUSION Cysts of the mesentery are among surgical rarities. In most of the cases the diagnosis is confirmed after surgical exploration and removal of thecyst. We would like to emphasize the importance of successful enucleation of the cyst irrespective of its size due to its independent blood supply as opposed to enterogenous cyst which requires bowel resection and anastomosis. PMID:24976602

  14. A simple technique for hemostasis control after enucleation of deep located liver tumors or after liver trauma

    PubMed Central

    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

  15. A multicentre study of long-term follow-up and owner satisfaction following enucleation in horses.

    PubMed

    Wright, K; Ireland, J L; Rendle, D I

    2017-08-16

    Horses are reported to return to a variety of disciplines following unilateral enucleation; however, owners of horses with ocular disease are frequently reluctant to consider the procedure. There is little published information investigating owners' attitudes towards, and satisfaction following, enucleation. To investigate the hypotheses: 1. horses return to their previous level of work following unilateral enucleation and, 2. their owners are satisfied with the post-operative outcome. Retrospective case series with cross-sectional survey. Clinical records from eight equine referral centres in the United Kingdom were reviewed to identify horses that underwent enucleation between August 2006 and March 2015. Owner questionnaires were completed to corroborate information provided by medical records and obtain information on client perceptions. 170 cases were identified and 119 owner questionnaires completed. The most frequent primary uses of horses in the study were pleasure/leisure riding, show-jumping and dressage, with 25.2% (n = 30) of horses used for competition. Following enucleation, 77.3% (n = 92) of horses were performing at an equivalent or higher level than prior to enucleation and 60.0% (n = 18/30) of competition horses were competing at an equivalent or higher level. Complications related to the surgical site (predominantly mild post-operative swelling) were reported in 3.7% of cases and non-ocular complications in 3.7% of cases. Of owners who reported being concerned or very concerned about certain factors prior to surgery, ≥86.8% reported that these factors caused little or no issue post-surgery. Most owners, 90.8% (n = 108) were pleased with the outcome following surgery, with 21.3% (n = 23/108) wishing the procedure had been undertaken sooner. Retrospective data collection from clinical records and the potential for recall bias. Horses can return successfully to a variety of disciplines following enucleation. Owners are satisfied with the outcome

  16. Holmium laser for the surgical treatment of benign prostatic hyperplasia.

    PubMed

    Thurmond, Portia; Bose, Sanchita; Lerner, Lori B

    2016-08-01

    Holmium laser ablation of the prostate (HoLAP) is a surgical approach for treatment of benign prostatic hyperplasia (BPH). Limited evidence suggests laser ablation/vaporization is inferior to enucleation with respect to reoperation rates. Our objective was to determine if properly performed laser ablation results in outcomes similar to enucleation. A total of 198 patients with moderate to severe lower urinary tract symptoms and/or acute urinary retention had holmium laser enucleation of the prostate (HoLEP) or HoLAP between 2008 and 2014. Patients with metastatic prostate cancer, prior pelvic radiation, or bladder cancer involving the bladder neck or prostatic urethra were excluded. All procedures involved residents and were supervised by one experienced surgeon. The decision to perform HoLAP versus HoLEP was made intraoperatively. Demographics, pre, peri and postoperative data were collected. A total of 169 men were analyzed: 54 had HoLAP and 115 had HoLEP. Mean follow up was 27.16 months for HoLAP, and 38.18 months for HoLEP. As expected, the HoLEP group had larger prostates, longer mean operative times, and greater reduction in total PSA. There was no difference in the net change of flow rate between groups. Both HoLEP and HoLAP are appropriate surgical interventions for the management of BPH, when properly performed. Our findings suggest that adequate ablation of prostatic adenoma results in similar 2 year outcomes as enucleation.

  17. The Asymmetric Cell Division Regulators Par3, Scribble and Pins/Gpsm2 Are Not Essential for Erythroid Development or Enucleation.

    PubMed

    Wölwer, Christina B; Gödde, Nathan; Pase, Luke B; Elsum, Imogen A; Lim, Krystle Y B; Sacirbegovic, Faruk; Walkley, Carl R; Ellis, Sarah; Ohno, Shigeo; Matsuzaki, Fumio; Russell, Sarah M; Humbert, Patrick O

    2017-01-01

    Erythroid enucleation is the process by which the future red blood cell disposes of its nucleus prior to entering the blood stream. This key event during red blood cell development has been likened to an asymmetric cell division (ACD), by which the enucleating erythroblast divides into two very different daughter cells of alternate molecular composition, a nucleated cell that will be removed by associated macrophages, and the reticulocyte that will mature to the definitive erythrocyte. Here we investigated gene expression of members of the Par, Scribble and Pins/Gpsm2 asymmetric cell division complexes in erythroid cells, and functionally tested their role in erythroid enucleation in vivo and ex vivo. Despite their roles in regulating ACD in other contexts, we found that these polarity regulators are not essential for erythroid enucleation, nor for erythroid development in vivo. Together our results put into question a role for cell polarity and asymmetric cell division in erythroid enucleation.

  18. The Asymmetric Cell Division Regulators Par3, Scribble and Pins/Gpsm2 Are Not Essential for Erythroid Development or Enucleation

    PubMed Central

    Wölwer, Christina B.; Gödde, Nathan; Pase, Luke B.; Elsum, Imogen A.; Lim, Krystle Y. B.; Sacirbegovic, Faruk; Walkley, Carl R.; Ellis, Sarah; Ohno, Shigeo; Matsuzaki, Fumio; Russell, Sarah M.; Humbert, Patrick O.

    2017-01-01

    Erythroid enucleation is the process by which the future red blood cell disposes of its nucleus prior to entering the blood stream. This key event during red blood cell development has been likened to an asymmetric cell division (ACD), by which the enucleating erythroblast divides into two very different daughter cells of alternate molecular composition, a nucleated cell that will be removed by associated macrophages, and the reticulocyte that will mature to the definitive erythrocyte. Here we investigated gene expression of members of the Par, Scribble and Pins/Gpsm2 asymmetric cell division complexes in erythroid cells, and functionally tested their role in erythroid enucleation in vivo and ex vivo. Despite their roles in regulating ACD in other contexts, we found that these polarity regulators are not essential for erythroid enucleation, nor for erythroid development in vivo. Together our results put into question a role for cell polarity and asymmetric cell division in erythroid enucleation. PMID:28095473

  19. [Lasers].

    PubMed

    Passeron, T

    2012-11-01

    Lasers are a very effective approach for treating many hyperpigmented lesions. They are the gold standard treatment for actinic lentigos and dermal hypermelanocytosis, such as Ota nevus. Becker nevus, hyperpigmented mosaicisms, and lentigines can also be successfully treated with lasers, but they could be less effective and relapses can be observed. However, lasers cannot be proposed for all types of hyperpigmentation. Thus, freckles and café-au-lait macules should not be treated as the relapses are nearly constant. Due to its complex pathophysiology, melasma has a special place in hyperpigmented dermatoses. Q-switched lasers (using standard parameters or low fluency) should not be used because of consistent relapses and the high risk of post-inflammatory hyperpigmentation. Paradoxically, targeting the vascular component of the melasma lesion with lasers could have a beneficial effect. However, these results have yet to be confirmed. In all cases, a precise diagnosis of the type of hyperpigmentation is mandatory before any laser treatment, and the limits and the potential side effects of the treatment must be clearly explained to patients.

  20. Lasers.

    PubMed

    Passeron, T

    2012-12-01

    Lasers are a very effective approach for treating many hyperpigmented lesions. They are the gold standard treatment for actinic lentigos and dermal hypermelanocytosis, such as Ota nevus. Becker nevus, hyperpigmented mosaicisms, and lentigines can also be successfully treated with lasers, but they could be less effective and relapses can be observed. However, lasers cannot be proposed for all types of hyperpigmentation. Thus, freckles and café-au-lait macules should not be treated as the relapses are nearly constant. Due to its complex pathophysiology, melasma has a special place in hyperpigmented dermatoses. Q-switched lasers (using standard parameters or low fluency) should not be used because of consistent relapses and the high risk of post-inflammatory hyperpigmentation. Paradoxically, targeting the vascular component of the melasma lesion with lasers could have a beneficial effect. However, these results have yet to be confirmed. In all cases, a precise diagnosis of the type of hyperpigmentation is mandatory before any laser treatment, and the limits and the potential side effects of the treatment must be clearly explained to patients.

  1. Laparoscopic Transgastric Enucleation of a Gastric Leiomyoma near the Esophagogastric Junction and Concomitant Sleeve Gastrectomy: Video Report.

    PubMed

    Genser, Laurent; Torcivia, Adriana; Vaillant, Jean-Christophe; Siksik, Jean-Michel

    2016-04-01

    Obesity and bariatric surgery (BS) are increasing worldwide and can potentially lead to incidental diagnosis of benign gastric tumor including gastric leiomyoma (GL). When indicated, local tumor enucleation, completed through laparoscopic minimal-invasive approaches, has proven to be safe and effective especially when located near the esophagogastric junction (EGJ) with limited morbidity as compared to partial or total gastrectomies. Little is known regarding the most appropriate strategy concerning the management of GL regardless of the location in patients' candidate for BS. We present the case of a 67-year-old morbidly obese woman. She presented with an incidental 3-cm GL developed near the EGJ and antral histologic abnormalities mandating a gastric follow-up. Therefore, we performed both laparoscopic transgastric enucleation and sleeve gastrectomy simultaneously. After identification of the lesion, the gastrocolic ligament was divided and a gastrotomy was performed along the greater curvature to expose the tumor. Once the submucosal plan was identified, the lesion was enucleated from the submucosamuscle junction. After closure of the mucosal defect and ensuring the absence of gastric wall perforation, a conventional laparoscopic sleeve gastrectomy was performed. No adverse outcomes occurred during the post-operative period. The final pathologic diagnosis showed a completely resected and benign leiomyoma. Herein, we report the first laparoscopic transgastric enucleation of a GL localized close to the EGJ performed concomitant with a sleeve gastrectomy. This combined approach appeared feasible, safe, and do not compromise the access to the GI tract as well as potential future curative treatments on the gastric sleeve.

  2. 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.

  3. Prosthetic rehabilitation of surgically treated orbital defects - evisceration, enucleation, and exenteration: A case series.

    PubMed

    Babu, Anna Serene; Manju, V; Nair, Vinod P; Thomas, C Tony

    2016-01-01

    The rehabilitation of a patient who has suffered the psychological trauma due to loss of an eye requires a prosthesis that will provide the optimum cosmetic and functional result. The mode of rehabilitation varies based on the type of defect and surgical approach being adopted. A case series of prosthetic rehabilitation of three types of orbital defects - evisceration, enucleation and exenteration have been reported in this article. The clinical relevance of surgical approaches highlights the preservation of remaining anatomic structures creating a negative space or concavity to aid in future prosthetic rehabilitation. A multidisciplinary management and team approach is essential in providing esthetics and to regain the confidence. Follow-up care for the patient is mandatory.

  4. Occurrence and surgical management of a cerebrospinal fluid-filled cystoid space following routine enucleation.

    PubMed

    Elmalem, Valerie I; Harris, Gerald J

    2012-01-01

    A 73-year-old woman underwent routine enucleation for a blind, painful eye related to end-stage diabetic retinopathy and neovascular glaucoma. A large cystoid space, in continuity with the optic nerve stump, formed around the implant in the first few weeks following surgery. Aspirated contents were positive for β-2 transferrin, confirming cerebrospinal fluid origin. Multiple comorbidities delayed surgical intervention, but the condition was ultimately managed with exposure of the patent optic nerve sheath at the compartment's base, temporary control of cerebrospinal fluid leakage with pulmonary hyperventilation and topical fibrin glue, dissection and vascular-clip ligation of the nerve stump, and capping with a dermis-fat graft. To the authors' knowledge, this postenucleation entity has not been previously described, and asymptomatic idiopathic intracranial hypertension may have been an underlying factor.

  5. Bipolar Button Transurethral Enucleation of Prostate in Benign Prostate Hypertrophy Treatment: A New Surgical Technique.

    PubMed

    Giulianelli, Roberto; Gentile, Barbara; Albanesi, Luca; Tariciotti, Paola; Mirabile, Gabriella

    2015-08-01

    To evaluate the safety and efficacy of transurethral bipolar enucleation with a button electrode (B-TUEP) for the treatment of bladder outlet obstruction due to benign prostatic hyperplasia. Between July 2011 and March 2012, a single surgeon performed 50 B-TUEP. Preoperative and postoperative assessments included prostate-specific antigen, International Prostate Symptoms Score (IPSS), International Index of Erectile Function-5 (IIEF-5), quality of life (QoL) index, uroflowmetry with postvoiding residual (PVR) urinary volume, and prostate volume measured by transrectal ultrasonography. Intraoperatively, we evaluated B-TUEP time (enucleation and resection time). Perioperatively, we evaluated hemoglobin dosage, bladder irrigation time, catheterization time, acute urinary retention events, length of stay, patient readmission, and any endoscopic retreatments. Three months after surgery, 82% of the patients presented a significant improvement in maximum urine flow (Qmax; P <.001). At 6 and 12 months, 80% and 83.3% of patients maintained the significant improvement (P <.001). The secondary end points IPSS, QoL, IIEF-5, and PVR presented a statistically significant improvement compared with baseline values. No significant change in hemoglobin values was observed before and after surgery. Bladder irrigation time was comprised between 24 and 36 hours for about 80% of patients. In one case, second-look hemostatic endoscopy was needed. Length of stay after surgery was <48 hours in 88% of cases. Readmission was required for 6% of patients for hematuria, and 6 months later, 2 other patients developed bladder neck contracture treated with transurethral incision of the prostate. B-TUEP using the Gyrus PK system is a rapid and safety technique with optimal outcomes. Copyright © 2015 Elsevier Inc. All rights reserved.

  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

    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.

  8. Effect of retrobulbar nerve block on heart rate variability during enucleation in horses under general anesthesia.

    PubMed

    Oel, Carolin; Gerhards, Hartmut; Gehlen, Heidrun

    2014-05-01

    Analysis of any effect of retrobulbar block during ocular surgery on heart rate variability and oculocardiac reflex. Prospective study. Horses (n = 16) undergoing eye enucleation due to chronic ophthalmologic diseases. Eye enucleation was performed under general anesthesia. The horses were randomly assigned to the first (inhalation anesthesia only, n = 10) or second group (inhalation and local retrobulbar anesthesia, n = 6). The retrobulbar block was performed using 12 mL of mepivacaine hydrochloride 2%. ECG data were taken by a Telemetric ECG before, during, and after surgery. Heart rate variability was analyzed in the time domain as mean heart rate, mean beat-to-beat interval duration, and standard deviation of continuous beat-to-beat intervals. The frequency domain analysis included the low- and high-frequency components of heart rate variability and the sympathovagal balance (low/high frequency). The low frequency represents mainly sympathetic influences on the heart, whereas high frequency is mediated by the parasympathetic tone. All horses without a retrobulbar block showed a significant decrease in the heart rate during traction on the globe and pressure on the orbital fat pad for homoestasis (P = 0.04). Simultaneously, high-frequency power, as an indicator of vagal stimulation, increased significantly. High-frequency and low-frequency power in the retrobulbar block group increased in five horses, and heart rate decreased in only one horse. Both were not significant within the group, but there was a significant difference between both groups relating to the incidence of heart rate decrease occurring at globe traction. Heart rate variability is a sensitive, non-invasive parameter to obtain sympathovagal stimulations during general anesthesia. The retrobulbar block can prevent heart rate decrease associated with initiation of the oculocardiac reflex. © 2013 American College of Veterinary Ophthalmologists.

  9. Evaluation of ultrasound velocity in enucleated equine aqueous humor, lens and vitreous body.

    PubMed

    Meister, Ulrike; Ohnesorge, Bernhard; Körner, Daniel; Boevé, Michael H

    2014-10-14

    Sonographic ophthalmic examinations have become increasingly important in veterinary medicine. If the velocity of ultrasound in ocular tissues is known, the A-mode ultrasound method may be used to determine the axial intraocular distances, such as anterior chamber depth, lens thickness, axial length of the vitreous and axial globe length, which are required for intraocular lens (IOL) power calculations. To the authors' knowledge, the velocity of ultrasound in the ocular tissues of the horse was not previously determined. In the present study, 33 lenses, 29 samples of aqueous and 31 of vitreous from 35 healthy equine eyes have been examined. The corresponding ultrasound velocities are reported in dependence of age, temperature, gender and elapsed time after enucleation. The velocity of ultrasound at 36°C in equine aqueous, lens and vitreous are 1529 ±10 m/s, 1654± 29 m/s and 1527 ±16 m/s respectively, and the corresponding conversion factors are 0.998± 0.007, 1.008 ±0.018 and 0.997 ±0.010. A linear increase of the speed of ultrasound with increasing temperature has been determined for aqueous and vitreous. No temperature dependence was found for the speed of ultrasound in the lens. The ultrasound velocity did not significantly differ (95%) on the basis of gender, age or time after enucleation during the first 72 hours after death. Compared to human eyes, the ultrasound velocity in equine lental tissue deviates by one percent. Therefore, axial length measurements obtained with ultrasound velocities for the human eye must be corrected using conversion factors. For the aqueous and vitreous, deviations are below one percent and can be neglected in clinical settings.

  10. 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

  11. Metabolic changes in the nucleus of the optic tract after monocular enucleation as revealed by cytochrome oxidase histochemistry.

    PubMed

    Vargas, C D; Sousa, A O; Santos, C M; Pereira, A; Bernardes, R F; Rocha-Miranda, C E; Volchan, E

    2001-03-01

    The histochemistry for the mitochondrial enzyme cytochrome oxidase (CO) was used to evaluate the levels of metabolic activity in neurons of the nucleus of the optic tract (NOT) and dorsal terminal nucleus (DTN) in the opossum (Didelphis aurita). The observations were performed in four groups: normal juveniles (4 months old), monocularly enucleated juveniles analysed when adults, normal adults (8 to 18 months old) and monocularly enucleated adults. CO labeled cells were observed to have a similar distribution along the NOT-DTN anteroposterior axis in both juvenile and adult normal animals. Monocular enucleation performed in adults produced a significant reduction of the reactive neuropil but not of the number of CO labeled cells in the deafferented NOT-DTN: the number of labeled neurons per section in the deafferented side matched those of the ipsilateral complex. In juveniles, however, this procedure caused a systematic reduction of the number of CO labeled cells in the contralateral NOT-DTN in comparison to the spared complex. The lack of reduction in the number of neurons found on the deafferented side of the NOT-DTN of monocularly enucleated adult opossums compared with the ipsilateral side might result from the presence of compensatory inputs to maintain their metabolic equivalence. However, when the monocular enucleation was performed in juvenile opossums, a statistically significant asymmetry of CO neurons in the NOT-DTN was observed. In other words, the compensatory mechanisms proposed for the adults were either absent or insufficient to achieve symmetry in juveniles, suggesting a more heavily reliance in the retinal input.

  12. 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.

  13. Effects of neonatal bilateral eye enucleation on postnatal development of the monoamines in posterior thalamus of the rat.

    PubMed

    Vizuete, M L; Santiago, M; Herrera, A J; Venero, J L; Machado, A; Cano, J

    1991-01-01

    Levels of dopamine (DA), noradrenaline (NA) and 5-hydroxytryptamine (serotonin, 5-HT) and their metabolites, and the activities of tyrosine hydroxylase (TH), tryptophan hydroxylase (TPH) and monoamine oxidase A and B (MAO-A and MAO-B) have been determined in the rat posterior thalamus after enucleation during postnatal development. DA and 5-HT turnover rate have been measured as 3,4-dihydroxyphenylalanine (DOPA) and 5-hydroxytryptophan (5-HTP) accumulation rates after central decarboxylase inhibition by 3-hydroxybenzylhydrazine (NSD-1015). The major changes were an increase in noradrenergic and serotoninergic metabolism in enucleated animals compared with control animals. A decrease of the MAO-A to MAO-B ratio during postnatal development was found.

  14. 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.

  15. Ankyrin and band 3 differentially affect expression of membrane glycoproteins but are not required for erythroblast enucleation.

    PubMed

    Ji, Peng; Lodish, Harvey F

    2012-01-27

    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.

  16. [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.

  17. 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

  18. Superiority of resection over enucleation for schwannomas of the cervical vagus nerve: A retrospective cohort study of 22 consecutive patients.

    PubMed

    Illuminati, Giulio; Pizzardi, Giulia; Minni, Antonio; Masci, Federica; Ciamberlano, Bernardo; Pasqua, Rocco; Calio, Francesco G; Vietri, Francesco

    2016-05-01

    Schwannoma of the cervical vagus nerve is rare. Treatment options include intracapsular enucleation and en bloc resection. The purpose of this study was to compare the outcomes of enucleation and resection in terms of postoperative mortality and morbidity, freedom from vocal cord palsy, freedom from local recurrence, quality-adjusted life-year (QALY) and vocal handicap index (VHI). Twentytwo consecutive patients were divided into two groups. Patients in group A (n = 9) underwent intracapsular enucleation, whereas patients in Group B (n = 13) underwent en bloc resection. Main endpoints of the study were postoperative mortality and morbidity, freedom from vocal cord palsy, freedom from local recurrence and quality of life. The quality of life after surgery was assessed according to the quality-adjusted life-year (QALY) EQ-5D-5L methodology, and calculation of the voice handicap index (VHI). Postoperative mortality was nil. Morbidity included 1 wound dehiscence in group A and 2 transitory dysphagias in group B. Freedom from vocal cord palsy was 22% in group A and zero in group B (p = 0.15). Operation-specific local recurrence rate was 33% (3/9 patients) in group A and nil in group B (0/23 patients) (p = 0.05). QALYs was 0.55 in group A and 0.54 in group B (p = 1.0). VHI was 23.77 in group A and 26.15 in group B (p = 1.00). Resection is superior to enucleation in terms of freedom from local recurrence. Functional results are comparable for both techniques. Copyright © 2016 IJS Publishing Group Ltd. Published by Elsevier Ltd. All rights reserved.

  19. 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.

  20. Evaluation of the Learning Curve for Transurethral Plasmakinetic Enucleation and Resection of Prostate Using a Mentor-based Approach.

    PubMed

    Feng, Lang; Song, Jian; Zhang, Daoxin; Tian, Ye

    2017-01-01

    To analyze the mentor-based learning curve of one single surgeon with transurethral plasmakinetic enucleation and resection of prostate (PKERP) prospectively. Ninety consecutive PKERP operations performed by one resident under the supervision of an experienced endourologist were studied. Operations were analyzed in cohorts of 10 cases to determine when a plateau was reached for the variables such as operation efficiency, enucleation efficiency and frequency of mentor advice (FMA). Patient demographic variables, perioperative data, complications and 12-month follow-up data were analyzed and compared with the results of a senior urologist. The mean operative efficiency and enucleation efficiency increased from a mean of 0.49±0.09g/min and 1.11±0.28g/min for the first 10 procedures to a mean of 0.63±0.08g/min and 1.62±0.36g/min for case numbers 31-40 (p=0.003 and p=0.002). The mean value of FMA decreased from a mean of 6.7±1.5 for the first 10 procedures to a mean of 2.8±1.2 for case numbers 31-40 (p<0.01). The senior urologist had a mean operative efficiency and enucleation efficiency equivalent to those of the senior resident after 40 cases. There was significant improvement in 3, 6 and 12 month's parameter compared with preoperative values (p<0.001). PKERP can be performed safely and efficiently even during the initial learning curve of the surgeon when closely mentored. Further well-designed trials with several surgeons are needed to confirm the results. Copyright® by the International Brazilian Journal of Urology.

  1. Enhanced-Depth Imaging Optical Coherence Tomography of the Human Choroid In Vivo Compared With Histology After Enucleation.

    PubMed

    Li, Xiao Qiang; Heegaard, Steffen; Kiilgaard, Jens Folke; Munch, Inger Christine; Larsen, Michael

    2016-07-01

    This study compared in vivo enhanced-depth imaging optical coherence tomography (EDI-OCT) with ex vivo histology of the choroid in human eyes. Three eyes in three patients with advanced iris melanoma without posterior segment involvement underwent EDI-OCT less than 24 hours prior to enucleation and, in one eye, immediately after enucleation. Following fixation in 4% buffered formaldehyde and paraffin embedding, serial sections of the whole eye were cut horizontally, mounted, stained with hematoxylin-eosin and digitized. Alignment between histology and EDI-OCT was made on landmarks such as retinal vessel, the foveal depression, ciliary arteries, drusen, and nevi. Intra- and interindividual variations in relative choroidal thickness were comparable between the two modalities. After histologic fixation of the three melanoma eyes, the fullness of the choroidal vessels was reduced and subfoveal choroid thickness reduced to 56%, 45%, and 56%, respectively, of its in vivo thickness on EDI-OCT. There were no identifiable discrepancies in choroidal structural patterns between clinical EDI-OCT and histologic sections except that after enucleation and histologic fixation choroidal thickness was reduced to roughly half of its in vivo value, a phenomenon that may reflect the high content of blood vessels in the choroid.

  2. Quality of life can be improved by surgical management of giant hepatic haemangioma with enucleation as the preferred option.

    PubMed

    Qiu, Jianguo; Chen, Shuting; Wu, Hong

    2015-06-01

    Surgical resection represents the main curative treatment for giant hepatic haemangioma (GHH). The aim of this study was to compare the respective outcomes of hepatic enucleation (HE) and hepatic resection (HR) for GHH. Giant hepatic haemangioma was defined as haemangioma of 5-15 cm in size. A prospectively maintained database consisting of a series of consecutive patients who underwent HE or HR of GHH from January 2004 to December 2013 was analysed. Hepatic enucleation was performed in 386 (52.9%) patients and HR in 344 (47.1%) of a final cohort of 730 patients. The median size of GHH was similar in the HR and HE groups (9.8 and 10.6 cm, respectively; P = 0.752). The HE group had a shorter median operative time (150 min versus 240 min; P = 0.034), shorter median hospital stay (5.7 days versus 8.6 days; P < 0.001), lower median blood loss (400 ml versus 860 ml; P < 0.001), and fewer complications (17.6% versus 28.2%; P < 0.001) than the HR group. Quality of life scores in both the HR and HE groups significantly improved compared with preoperative levels and were similar to those found in healthy Chinese individuals following surgery, confirming the efficacy of both treatments. Hepatic enucleation was associated with favourable operative outcomes compared with HR and is a safe and effective alternative to partial hepatectomy for GHH. © 2015 International Hepato-Pancreato-Biliary Association.

  3. 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.

  4. Traumatic enucleation with avulsion of the ophthalmic artery resulting in aneurysm-like subarachnoid hemorrhage.

    PubMed

    Limbrick, David D; Behdad, Amir; Derdeyn, Colin P; Custer, Phillip L; Zipfel, Gregory J; Santiago, Paul

    2009-10-01

    Traumatic, nonaneurysmal subarachnoid hemorrhage (SAH) is common after closed head injury and most often results from ruptured cortical microvessels. Here, the authors present the case of a 60-year-old woman who fell and struck her head, causing traumatic enucleation and avulsion of both the optic nerve and ophthalmic artery. The arterial avulsion caused a Fisher Grade 3 SAH. During her stay in the intensive care unit, hydrocephalus and vasospasm developed, clinical conditions commonly observed after aneurysmal SAH. Epileptiform activity also developed, although this may have been related to concurrent Pantoea agglomerans ventriculitis. It is reasonable to suggest that intracerebral arterial avulsion with profuse arterial bleeding may be more likely than traditional traumatic SAH to result in clinical events similar to that of aneurysmal SAH. Special consideration should be given to the acute care of patients with intracranial arterial avulsions (conservative management vs surgical exploration or endovascular treatment), as well as long-term follow-up for vascular or other neurosurgical complications.

  5. A case of lipoma of lateral anterior neck treated with surgical enucleation.

    PubMed

    Grecchi, Francesco; Zollino, Ilaria; Candotto, Valentina; Gallo, Francesco; Rubino, Giuseppe; Bianchi, Raffaella; Carinci, Francesco

    2012-12-01

    Lipoma arise in almost 50% of all soft tumours. The neck lipomas are rare tumours that may present as painless masses with slow growth, in the lateral portions of the neck. Some lipomas, such as the one studied in our case, grow deep in the subcutaneous tissue, in close contact with muscles. Here, we report a case of lipoma extending from pre-tragal region up to the ascending branch of the mandible in a 62 year old man, treated with enucleation. The inferior margin of lipoma involved the pharyngeal and the superior margin was achieved by the top of the skull base. The mass of lipoma caused breathing difficulties in the patient, preventing regular sleep. No complication was recorded in the post-operative period and no further surgery was performed. The complete resolution after one year's follow-up, together with the rarity of the anatomical site, makes this case worthy of description. A correct diagnosis facilitated removal of this lesion with a surgical method.

  6. A case of lipoma of lateral anterior neck treated with surgical enucleation

    PubMed Central

    Grecchi, Francesco; Zollino, Ilaria; Candotto, Valentina; Gallo, Francesco; Rubino, Giuseppe; Bianchi, Raffaella; Carinci, Francesco

    2012-01-01

    Lipoma arise in almost 50% of all soft tumours. The neck lipomas are rare tumours that may present as painless masses with slow growth, in the lateral portions of the neck. Some lipomas, such as the one studied in our case, grow deep in the subcutaneous tissue, in close contact with muscles. Here, we report a case of lipoma extending from pre-tragal region up to the ascending branch of the mandible in a 62 year old man, treated with enucleation. The inferior margin of lipoma involved the pharyngeal and the superior margin was achieved by the top of the skull base. The mass of lipoma caused breathing difficulties in the patient, preventing regular sleep. No complication was recorded in the post-operative period and no further surgery was performed. The complete resolution after one year's follow-up, together with the rarity of the anatomical site, makes this case worthy of description. A correct diagnosis facilitated removal of this lesion with a surgical method. PMID:23814589

  7. Use of corneas for transplant after self-inflicted eyeballs enucleation in the Italian law.

    PubMed

    Montanari Vergallo, G; Pacella, E; Di Luca, A; Di Luca, N M; Cecchi, R; Marinelli, E

    2017-01-01

    The authors analyze from an ethical and legal point of view the case of a 37 year old man, hospitalized for four days because of a 'dissociative syndrome', who had introduced in both his orbits a portable radio antenna. Most likely, he completed the self-enuclation using his own hands. He was brought to the Ophtalmic Hospital by nurses who handed the two eyeballs to the physicians who ascertained that the corneas were intact. Then, they performed the conservative extraction. In the following days those corneas were transplanted (keratoplasty) on two subjects on the waiting list at that hospital. The case raises the question of whether it is lawful and ethically acceptable to take, for transplant use, the corneas of a mentally incapable patient who has excised his own eyeballs. The authors analyze the case from the angle of the Italian law and Oviedo Convention. Neither of them has a specific regulation on this topic. It is therefore necessary to apply general principles that holdvalidfor Italy and a variety of countries worldwide. Particularly, the choice to use the corneas for transplant did not prejudice the physical integrity of the patient, who could no longer utilize his own eyeballs. His self-determination has not been affected; in fact, he was not in the position to make a conscious decision. Additionally, the so-called "implied consent" could be applied. Therefore, the principle of human solidarity, which is the moral duty to benefit others, seems to prevail in the case at hand.

  8. Transient patterns of serotonergic innervation in the rat visual cortex: normal development and effects of neonatal enucleation.

    PubMed

    Nakazawa, M; Koh, T; Kani, K; Maeda, T

    1992-03-20

    The transient aggregation of serotonin (5-HT)-containing fibers in the early development of rat visual cortex was examined immunohistochemically. The aggregation of 5-HT immunoreactive (IR) fibers consisted of three stages which were classified according to the course of time and degree of space occupied. The primary aggregation appeared in the subplate and moved upward along the development of the cortex. The aggregation proceeded to the secondary stage in presumptive layer IV. The fibers extended in a column-like structure following the secondary aggregation and formed the tertiary aggregation. The upper edge of the tertiary aggregation formed a lattice-like pattern in layer I and its structure was recognized to be similar to the structure of a 'blob' which characterizes the primary visual cortex in monkey. This transient aggregation of 5-HT-IR fibers began in the subplate of the anterior visual cortex on postnatal day 2 (PND 2) and progressed towards the posterior. On PND 11, the secondary and tertiary aggregations were completed in the entire region. No further aggregation of 5-HT-IR fibers was observed on PND 15. The anterior-to-posterior axis in the aggregation process corresponds to the direction of differentiation in the layer structure of cortex. In order to investigate the relationship between the transient aggregation of 5-HT-IR fibers and the development of the visual pathway, the secondary and tertiary aggregation on PND 11 were observed after postnatal monocular or binocular enucleation. Enucleation of eye balls did not affect either the area occupied by the 5-HT-IR fibers in the secondary aggregation or the number of column structures in the tertiary aggregation. However, the contralateral and ipsilateral cortices of monocularly enucleated cases were irregularly shaped in the secondary aggregation. The distribution of 5-HT-IR fiber terminals in the binocular area (Oc1B) increased in density on the contralateral side in the monocular enucleation

  9. Early outcome of transurethral enucleation and resection of the prostate versus transurethral resection of the prostate

    PubMed Central

    Palaniappan, Sundaram; Kuo, Tricia Li Chuen; Cheng, Christopher Wai Sam; Foo, Keong Tatt

    2016-01-01

    INTRODUCTION Recurrent prostate adenoma is a long-term complication following transurethral resection of the prostate (TURP). Transurethral enucleation and resection of the prostate (TUERP) is more appealing, since the nodular adenoma can be completely removed through endoscopy. TUERP is also hypothesised to result in a lower frequency of recurrent adenoma. This study aimed to compare the early outcomes of TUERP and TURP, and assess the feasibility and safety of TUERP. METHODS We compared the outcome of 81 patients who underwent TUERP with that of 85 patients who underwent TURP. International prostate symptom score, quality of life score, prostate volume, degree of intravesical prostatic protrusion, maximum flow rate, post-void residual volume and prostate-specific antigen (PSA) level were obtained pre- and postoperatively. Complications (e.g. transfusion rate, incontinence, infection and urethral stricture) were analysed. RESULTS Operative time was significantly longer in the TUERP group compared to the TURP group (85.3 minutes vs. 51.6 minutes). After TUERP, the maximum flow rate was significantly higher (21.1 mL/s vs. 17.1 mL/s) and PSA level was significantly lower (1.2 ng/mL vs. 1.9 ng/mL) than after TURP. The rates of infection, transfusion and urethral stricture were similar for both groups, but the TUERP group had a higher rate of temporary incontinence (13.6% vs. 4.7%). CONCLUSION The lower PSA level and better maximum flow rate achieved following TUERP suggest that prostate adenoma removal was more complete with TUERP. Long-term follow-up is required to establish whether TUERP results in fewer resections for recurrent adenoma. PMID:26875682

  10. 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

  11. 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

  12. 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.

  13. 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

  14. 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

  15. Quality of life can be improved by surgical management of giant hepatic haemangioma with enucleation as the preferred option

    PubMed Central

    Qiu, Jianguo; Chen, Shuting; Wu, Hong

    2015-01-01

    Objectives Surgical resection represents the main curative treatment for giant hepatic haemangioma (GHH). The aim of this study was to compare the respective outcomes of hepatic enucleation (HE) and hepatic resection (HR) for GHH. Methods Giant hepatic haemangioma was defined as haemangioma of 5–15 cm in size. A prospectively maintained database consisting of a series of consecutive patients who underwent HE or HR of GHH from January 2004 to December 2013 was analysed. Results Hepatic enucleation was performed in 386 (52.9%) patients and HR in 344 (47.1%) of a final cohort of 730 patients. The median size of GHH was similar in the HR and HE groups (9.8 and 10.6 cm, respectively; P = 0.752). The HE group had a shorter median operative time (150 min versus 240 min; P = 0.034), shorter median hospital stay (5.7 days versus 8.6 days; P < 0.001), lower median blood loss (400 ml versus 860 ml; P < 0.001), and fewer complications (17.6% versus 28.2%; P < 0.001) than the HR group. Quality of life scores in both the HR and HE groups significantly improved compared with preoperative levels and were similar to those found in healthy Chinese individuals following surgery, confirming the efficacy of both treatments. Conclusions Hepatic enucleation was associated with favourable operative outcomes compared with HR and is a safe and effective alternative to partial hepatectomy for GHH. PMID:25728743

  16. Thulium laser supported nephron sparing surgery for renal cell carcinoma.

    PubMed

    Sciarra, Alessandro; Von Heland, Magnus; Minisola, Francesco; Salciccia, Stefano; Cattarino, Susanna; Gentile, Vincenzo

    2013-08-01

    We analyze the feasibility, advantages and results of the use of a thulium laser in nephron sparing surgery for renal cell carcinoma. In this single center prospective study 10 consecutive high risk patients underwent open or laparoscopic thulium laser assisted enucleation for small peripheral renal cell carcinoma at our department. We used a 2.0 μm continuous or pulsed thulium laser. This diode pumped solid state laser emits a wavelength of 2,013 nm in the infrared spectrum and penetrates tissue to a depth of 0.5 mm. The entire tumor enucleation was performed using the frontal thulium laser fiber. In all cases the thulium laser produced a smooth incision of the renal parenchyma and a safe delineation of the plane between the tumor and the surrounding tissue. In addition, in the off clamp procedures bleeding was limited during the dissection and did not interfere with the definition of the surgical plane. Median surgical time from the beginning of the laser assisted tumor dissection to the end, after verification of bleeding control on the cut surface, was 15 minutes (range 12 to 20). No significant (less than 40 cc) blood loss occurred during the laser assisted tumor dissection. All cases were clear cell renal cell carcinoma and no positive surgical margins were found. In all cases postoperative management was uncomplicated without evidence of hemorrhage. In our prospective preliminary experience, thulium laser assisted enucleation for renal cell carcinoma is a feasible, safe and effective procedure. Copyright © 2013 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

  17. [A comparison between prostatic volume measured during suprapubic ultrasonography (TAUS) and volume of the enucleated gland after open prostatectomy].

    PubMed

    Szewczyk, Wojciech; Prajsner, Andrzej; Kozina, Janusz; Login, Tomasz; Kaczorowski, Marek

    2004-01-01

    General practitioner very often uses transabdominal ultrasonograpy (TAUS) in order to measure prostatic volume. Using this method it is rather impossible to distinguish between tissue of benign prostatic hyperplasia (BPH) and prostatic tissue which forms so called surgical capsule of BPH. The aim of this study was a comparison of prostatic volume measured during suprapubic (transabdominal) ultrasonography and volume of the enucleated gland after open prostatectomy. Regarding the results authors created a nomogram based on TAUS measurement of the prostate which helps to predict the volume of BPH. They also stated that surgical capsule of the BPH makes about 1/3 of the whole volume of the prostate measured by TAUS.

  18. Therapy monitoring of laser cyclophotocoagulation

    NASA Astrophysics Data System (ADS)

    Oberheide, Uwe; Lee, Christoph; Krebs, Ronald; Welling, Herbert; Ertmer, Wolfgang; Lubatschowski, Holger

    2002-06-01

    Laser induced ultrasound provides a powerful tool for solving a major problem of laser cyclophotocoagulation, which is caused by difficulties in localization and determination of optical properties. Furthermore it adds the possibility of an online control mechanism for the process of coagulation of the ciliary body. We have developed a transducer system which is based on a fiber with 600 micrometers core diameter surrounded by a ring shaped piezoelectric PVDF detector. With this detector it is possible to localize the lateral position of the ciliary body on enucleated pigs and rabbit eyes as well as its depth. Our findings correspond well with histological sections of the measured area. Additionally, the changes in the tissue's optical properties induced by coagulation with a diode laser have been detected in real time.

  19. 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.

  20. Fertility and Pregnancy Outcome after Myoma Enucleation by Minilaparotomy under Microsurgical Conditions in Pronounced Uterus Myomatosus.

    PubMed

    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

  1. 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.

  2. Milrinone treatment of bovine oocytes during in vitro maturation benefits production of nuclear transfer embryos by improving enucleation rate and developmental competence.

    PubMed

    Naruse, Kenji; Iga, Kosuke; Shimizu, Manabu; Takenouchi, Naoki; Akagi, Satoshi; Somfai, Tamas; Hirao, Yuji

    2012-01-01

    In the production of cattle nuclear transfer embryos, the production efficiency is affected by the oocyte developmental competence and successful enucleation rate. This study investigated the effect of treating oocytes with milrinone, a phosphodiesterase inhibitor, on these two characteristics. When cumulus-oocyte complexes (COCs) were cultured for 19 h with 0, 50 or 100 μM of milrinone, the enucleation rate was significantly improved by 100 μM milrinone. However, milrinone treatment during in vitro maturation (IVM) also delayed meiotic progression by at least 2 h, which would affect the examination of enucleation rate and developmental competence of oocytes. Thus, in the second experiment, meiotic resumption was temporarily inhibited with butyrolactone I (BL-I; 100 μM, 18 h) to decrease the delayed maturation caused by milrinone; this enabled a more accurate comparison of the effects of milrinone after oocyte maturation. In nuclear transfer embryo production, oocytes treated with milrinone (100 μM, 20 h) showed a significantly higher rate of enucleation compared with that of control oocytes. This improved enucleation rate was associated with a closer location of the metaphase plate to the first polar body in the treated oocytes compared with that in control oocytes. Furthermore, milrinone improved the frequency of development to the blastocyst stage in the resulting embryos. In conclusion, milrinone supplementation during IVM improved enucleation rates by rendering the metaphase plate in close proximity to the first polar body, and this treatment also improved oocyte developmental competence. These benefits additively improved the yield of cloned embryos that developed to the blastocyst stage.

  3. Cloning of Asian yellow goat (C. hircus) by somatic cell nuclear transfer: telophase enucleation combined with whole cell intracytoplasmic injection.

    PubMed

    Chen, Da-Yuan; Jiang, Man-Xi; Zhao, Zhen-Jun; Wang, Hai-Long; Sun, Qing-Yuan; Zhang, Li-Sheng; Li, Rui-Chang; Cao, Heng-Hua; Zhang, Quan-Jun; Ma, Dong-Lian

    2007-01-01

    Our and other previous studies have shown that telophase enucleation is an efficient method for preparing recipient cytoplasts in nuclear transfer. Conventional methods of somatic cell nuclear transfer either by electro-fusion or direct nucleus injection have very low efficiency in animal somatic cell cloning. To simplify the manipulation procedure and increase the efficiency of somatic cell nuclear transfer, this study was designed to study in vitro and in vivo development of Asian yellow goat cloned embryos reconstructed by direct whole cell intracytoplasmic injection (WCICI) into in vitro matured oocytes enucleated at telophase II stage. Our results demonstrated that the rates of cleavage and blastocyst development of embryos reconstructed by WCICI were slightly higher than in conventional subzonal injection (SUZI) group, but no statistic difference (P > 0.05) existed between these two methods. However, the percentage of successful embryonic reconstruction in WCICI group was significantly higher than that in SUZI group (P < 0.05). After embryo transfer at 4-cell stage, the foster in both groups gave birth to offspring. Therefore, the present study suggests that the telophase ooplasm could properly reprogram the genome of somatic cells, produce Asian yellow goat cloned embryos and viable kids, and whole cell intracytoplasmic injection is an efficient protocol for goat somatic cell nuclear transfer.

  4. Recovery of cell nuclei from 15,000 years old mammoth tissues and its injection into mouse enucleated matured oocytes

    PubMed Central

    Kato, Hiromi; Anzai, Masayuki; Mitani, Tasuku; Morita, Masahiro; Nishiyama, Yui; Nakao, Akemi; Kondo, Kenji; Lazarev, Petr A.; Ohtani, Tsuyoshi; Shibata, Yasuyuki; Iritani, Akira

    2009-01-01

    Here, we report the recovery of cell nuclei from 14,000–15,000 years old mammoth tissues and the injection of those nuclei into mouse enucleated matured oocytes by somatic cell nuclear transfer (SCNT). From both skin and muscle tissues, cell nucleus-like structures were successfully recovered. Those nuclei were then injected into enucleated oocytes and more than half of the oocytes were able to survive. Injected nuclei were not taken apart and remained its nuclear structure. Those oocytes did not show disappearance of nuclear membrane or premature chromosome condensation (PCC) at 1 hour after injection and did not form pronuclear-like structures at 7 hours after injection. As half of the oocytes injected with nuclei derived from frozen-thawed mouse bone marrow cells were able to form pronuclear-like structures, it might be possible to promote the cell cycle of nuclei from ancient animal tissues by suitable pre-treatment in SCNT. This is the first report of SCNT with nuclei derived from mammoth tissues. PMID:19644224

  5. Recovery of cell nuclei from 15,000 years old mammoth tissues and its injection into mouse enucleated matured oocytes.

    PubMed

    Kato, Hiromi; Anzai, Masayuki; Mitani, Tasuku; Morita, Masahiro; Nishiyama, Yui; Nakao, Akemi; Kondo, Kenji; Lazarev, Petr A; Ohtani, Tsuyoshi; Shibata, Yasuyuki; Iritani, Akira

    2009-01-01

    Here, we report the recovery of cell nuclei from 14,000-15,000 years old mammoth tissues and the injection of those nuclei into mouse enucleated matured oocytes by somatic cell nuclear transfer (SCNT). From both skin and muscle tissues, cell nucleus-like structures were successfully recovered. Those nuclei were then injected into enucleated oocytes and more than half of the oocytes were able to survive. Injected nuclei were not taken apart and remained its nuclear structure. Those oocytes did not show disappearance of nuclear membrane or premature chromosome condensation (PCC) at 1 hour after injection and did not form pronuclear-like structures at 7 hours after injection. As half of the oocytes injected with nuclei derived from frozen-thawed mouse bone marrow cells were able to form pronuclear-like structures, it might be possible to promote the cell cycle of nuclei from ancient animal tissues by suitable pre-treatment in SCNT. This is the first report of SCNT with nuclei derived from mammoth tissues.

  6. Surgical management of the buccal bifurcation cyst: bone grafting as a treatment adjunct to enucleation and curettage.

    PubMed

    Levarek, Rachel E; Wiltz, Mauricio J; Kelsch, Robert D; Kraut, Richard A

    2014-10-01

    The buccal bifurcation cyst (BBC) is a rare inflammatory odontogenic cyst of unknown etiology. It typically develops on the buccal aspect of the permanent mandibular first molar and occasionally on the permanent mandibular second molar in children 4 to 14 years old. Distinct clinical findings of the BBC include involvement of a vital partially or fully erupted mandibular first or second molar, swelling in the affected mandibular molar region, delayed or altered eruption pattern of the involved tooth, and an increase in periodontal pocket depth when the affected tooth is partially erupted. Specific radiographic features include a radiolucent lesion on the buccal aspect of the tooth involving the roots to a variable extent, tilting of the involved molar so that the root apices are toward the lingual cortical plate, an intact periodontal ligament space and lamina dura, a periosteal reaction on the buccal surface, and an intact inferior border of the mandible. The histopathology of the lesion has been described as similar to a radicular or inflammatory odontogenic cyst. Most of the current literature supports simple enucleation and curettage of the cyst without extraction of the involved tooth as the treatment of choice. This report presents 3 cases of BBCs that were treated with enucleation and curettage without extraction of the involved tooth, in addition to a bone graft placed primarily or secondarily as an adjunctive treatment approach to the current therapies. Copyright © 2014 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

  7. 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.

  8. Neonatal enucleation during a critical period reduces the precision of cortico-cortical projections in visual cortex.

    PubMed

    Bock, A S; Olavarria, J F

    2011-09-01

    Previous studies have reported that intrahemispheric connections between area 17 (V1, striate cortex) and other cortical visual areas are not point-to-point, but instead have some degree of convergence and divergence. Many pathological conditions can interfere with the normal development of patterns of cortico-cortical connections, but there is little information regarding whether or not early pathological insults can also induce permanent changes in the convergence and divergence of cortical connections. Obtaining this information is important because loss of precision in neural projections can contribute to functional deficits and behavioral impairment. In the present study we investigated whether retinal input is required for the development of normal values of convergence and divergence in the visual callosal pathway. We found that enucleation performed at birth induced significant increases in convergence and divergence compared to control animals. In contrast, values of convergence and divergence in rats enucleated at postnatal day 7 (P7) were similar to those in controls. Previous studies have shown that retinal input during the first postnatal week is required for the specification of the overall distribution and internal topography of visual callosal pathways. Our present results therefore extend these previous finding by showing that retinal input during the first postnatal week also specifies the precision of cortico-cortical projections. These findings raise the possibility that the precision of neural connections may be reduced in other pathological conditions that affect early development of neural connections. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

  9. Laser thermokeratoplasty by means of a continuously emitting laser diode in the mid IR

    NASA Astrophysics Data System (ADS)

    Brinkmann, Ralf; Koop, Norbert; Kamm, Katharina; Geerling, Gerd; Kampmeier, Juergen; Birngruber, Reginald

    1996-12-01

    Laser thermokeratoplasty (LTK) has been performed with a continuously emitting, tunable laser diode at 1.86 micrometers . A study on enucleated porcine eyes was conducted in order to demonstrate the feasibility of this laser source for LTK and to determine the useful irradiation modalities. Refractive changes achieved with different application systems and a standard coagulation pattern, consisting of 8 coagulation spots on a 6 mm ring, were measured. The most promising sets of parameters were carried out in a first animal study with mini pigs. Initial refractive changes up to 6 D could be achieved in vitro and in vivo with laser powers between 120 mW and 200 mW and irradiation times of several seconds. In conclusion, the mid-IR laser diode operated at a wavelength of 1.86 micrometers seems to be the optimal source for a clinical LTK system.

  10. Bipolar Plasma Enucleation of the Prostate (B-TUEP) in Benign Prostate Hypertrophy Treatment: 3-Year Results.

    PubMed

    Giulianelli, Roberto; Gentile, Barbara Cristina; Mirabile, Gabriella; Albanesi, Luca; Tariciotti, Paola; Rizzo, Giorgio; Buscarini, Maurizio; Falavolti, Cristina

    2017-09-01

    To investigate numerous endoscopic techniques that have been described for the treatment of benign prostate enlargement. Plasma-button enucleation of the prostate (B-TUEP) is a successful treatment option because the large surface creates a fast enucleation process, vaporization, and concomitant hemostasis. The aim of this study was to evaluate the efficacy of bipolar button electrode transurethral adenoma enucleation (B-TUEP) in saline solution. The second end point was to determine the change of International Prostate Symptom Score (IPSS), post-void residual urine, International Index of Erectile Function, transrectal ultrasound gland volume evaluation, and prostate-specific antigen. Between July 2011 and March 2012, 50 consecutive patients underwent B-TUEP in our facility, all performed by a single surgeon (R.G.). All patients were preoperatively assessed with maximum urinary flow rate, single-question quality of life assessment, IPSS and the International Index of Erectile Function questionnaires, transrectal ultrasound gland volume evaluation, prostate-specific antigen, and post-void residual urine. We observed a significant improvement at 12, 24, and 36 months in terms of maximum urinary flow rate (22.3 ± 4.74 mL/s, 23.2 ± 0.30 mL/s, and 23.6 ± 1.26 mL/s, respectively, P <.01) and quality of life (5.28 ± 0.97, 5.69 ± 0.90, and 5.73 ± 0.87). IPSS and IEEF scores improved significantly (P <.05). Gland volume evaluation and post-void residue decreased (P <.001). The prostate-specific postoperative antigen levels were 0.76 ± 0.61 ng/mL, 0.7 ± 0.51 ng/mL, and 0.62 ± 0.18 ng/mL, at 12, 24, and 36 months, respectively. Two patients (4%) had persistent bladder outlet obstruction requiring reoperation. After 3-year follow-up, B-TUEP represents an effective, durable, and safe form of surgical intervention. B-TUEP is an alternative treatment for symptomatic benign prostate enlargement. Copyright © 2017

  11. ENUCLEATION IN MALIGNANT CHOROIDAL MELANOMA - results in 15 years of using a new material in the prosthesis of the orbital cavity

    PubMed Central

    Tataru, CP; Pop, MD

    2012-01-01

    Rationale: Enucleation implants are covered with a material that allows the fixation of the extraocular rectus muscles. Usually, the implants are covered in donor sclera, which implies the risk of infection transmission, inflammation and implant rejection, being also an expensive procedure. The new materials used for implant meshing should be tested and a safer and cost effective solution should be researched. Objective: This study presents the results obtained after a 15-year use of an original prosthesis for the reconstruction of the orbital cavity after enucleation surgery. Methods and results: 42 eyes of 42 patients who underwent enucleation surgery for choroidal malignant melanoma were included in the study. The surgical technique was very similar to the classic enucleation, the major difference being the implant of a prosthesis made out of a Polymethyl methacrylate (PMMA) ball covered by a Polyethylene terephthalate (dacron) shell used in cardiovascular surgery. All the patients had a very good technical result, without the inflammation of the orbital cavity, conjunctiva or eyelids, which demonstrates a very high material tolerability and an excellent cosmetic result. Late implant expulsion appeared in 7.14% of the patients (3 cases). Discussion: The particularly good results obtained by using this technique, the absence of an inflammatory reaction after surgery, and the long lasting stability of the implant, recommend the method as being safe, with no major complications and a good esthetic result. AbbreviationsPolymethyl methacrylate (PMMA), Malignant choroidal melanoma (CMM) PMID:22802888

  12. [Correlation between the sizes of the individual parts of goldfish Mauthner neuron and its integral function after eye enucleation].

    PubMed

    Grigor'eva, E E; Shtanchaev, R Sh; Mikhaĭlova, G Z; Tiras, N R; Moshkov, D A

    2010-01-01

    Using the method of 3D reconstruction, the structural correlates of significantly increased functional activity of denervated Mauthner neuron (MN) were studied after the unilateral eye enucleation, that resulted in the irreversible shift of the goldfish motor asymmetry to a "blind" side. It was established that in some cases the functional dominance of MN was significantly correlated with the reduction of the volume of its ventral dendrite, while in the other cases it was correlated with the increase in sizes of its soma and the lateral dendrite. Both structural features, probably, were caused by local redistribution of the neurotransmitters due to the stress of sensory inputs that remained undamaged. Thus, it was demonstrated that the prolonged adaptive changes in goldfish behavior could be regulated by means of specific morphological reorganizations of MN at the level of their individual dendrites by the principle of feedback or feedforward mechanisms.

  13. 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

  14. Extrascleral extension of choroidal melanoma: post-enucleation high-dose-rate interstitial brachytherapy of the orbit.

    PubMed

    Finger, Paul T; Tena, Lawrence B; Semenova, Ekaterina; Aridgides, Paul; Choi, Walter H

    2014-01-01

    To investigate if orbital extension of uveal melanoma can be treated with high-dose-rate (HDR) brachytherapy. This study is a retrospective analysis of the results of a clinical case series was performed on 10 patients. Each underwent primary enucleation for uveal melanoma, was discovered to have orbital extension, and consented for HDR brachytherapy. By American Joint Committee on Cancer (AJCC) initial tumor grading, there was one each (T1c, T2c, T2d, and T3d, three T4c, and two T4d-staged uveal melanomas. One was AJCC-staged R2 due to orbital recurrence presenting 16 months after enucleation. (192)Ir HDR brachytherapy involved transcutaneous circumferential orbital incisions allowing for evenly spaced brachytherapy catheters into the orbit. A target dose of 32.85 Gy (range, 32.85-34 Gy) was delivered in 9-10 twice-daily fractions (range, 3.4-3.65 Gy per fraction) over 5 consecutive days. Data analysis included but was not limited to radiation therapy methods, local tumor control, side effects, and metastatic rate. In the 9 patients who tolerated treatment, there has been no orbital recurrence at a median follow-up of 18 months (range, 1-62 months). Four patients died of metastatic disease (one presented with a treated solitary liver metastasis before brachytherapy). There was no significant eyelash or eyebrow loss. There was no radiation-induced eyelid erythema, orbital infection, or contracted sockets. All orbits accepted and maintained ocular prostheses. Brachytherapy was used as an alternative to external beam radiation treatment for postenucleation orbital melanoma. This series reports complete local control, few side effects, and excellent cosmetic results. Copyright © 2014 American Brachytherapy Society. Published by Elsevier Inc. All rights reserved.

  15. Efficiency of asynchronously in vitro-matured oocytes as recipients for nuclear transfer and of blind enucleation in zona-free bovine cloning.

    PubMed

    Malenko, Galina P; Stepanov, Oleg I; Komissarov, Andrey V; Antipova, Tatyana A; Pinyugina, Marina V; Prokofiev, Michael I

    2009-06-01

    We studied the dynamics of in vitro maturation of bovine oocytes, the efficiency of asynchronously matured oocytes as recipients for the generation of embryos produced by nuclear transfer, and the potential for using blind enucleation of zona-free bovine oocytes in bovine cloning. At 15 h after the initiation of maturation (hpm), oocytes were freed from both cumulus cells and the zona pellucida, and the dynamics of oocyte maturation were monitored every 30 min through the criterion of extrusion of the first polar body (PB1). More than 41% of bovine oocytes had extruded PB1 by 16.5 hpm, and were designated as representing a group of rapidly maturing oocytes. A second group, comprising about 25% of all oocytes, had extruded PB1 by 18.5-20.0 hpm. Examination of Hoechst 33342-stained samples demonstrated that PB1 on the surfaces of zona-free bovine oocytes were always located near the maternal chromosomes. Zona-free oocytes were enucleated by removing PB1 and about 3% of the adjacent oocyte cytoplasm without chromatin staining. Successful enucleation of zona-free bovine oocytes was achieved in 96.9% of cases. The rate of development to the blastocyst stage was significantly greater in embryos reconstructed from rapidly maturing oocytes (47.8%) than with oocytes maturing at 18.0-20.0 hpm (33.3%). Overall, two large groups of bovine oocytes could be distinguished during in vitro maturation by the time required to reach the second stage of metaphase. Bovine embryos reconstructed from rapidly maturing enucleated oocytes had a significantly greater rate of development to the blastocyst stage than did embryos derived from later-maturing oocytes. We conclude that blind enucleation is a simple and efficient method for preparing cytoplasts in zona-free bovine cloning.

  16. Demecolcine-induced oocyte enucleation for somatic cell cloning: coordination between cell-cycle egress, kinetics of cortical cytoskeletal interactions, and second polar body extrusion.

    PubMed

    Ibáñez, Elena; Albertini, David F; Overström, Eric W

    2003-04-01

    Studies were designed to further explore the use of pharmacological agents to produce developmentally competent enucleated mouse oocytes for animal cloning by somatic cell nuclear transfer. Metaphase II oocytes from CF-1 and B6D2F1 strains were activated with ethanol and subsequently exposed to demecolcine at various times postactivation. Chromosome segregation, spindle dynamics, and polar body (PB) extrusion were monitored by fluorescence microscopy using DNA-, microtubule-, and microfilament-selective probes. Exposure to demecolcine did not affect rates of oocyte activation induced by ethanol but did disrupt the coordination of cytokinesis and karyokinesis, suppressing the extent and completion of spindle rotation and second PB extrusion in a strain-dependent manner. Moreover, strain- and treatment-specific variations in the rate of oocyte enucleation were also detected. In particular, CF1 oocytes were more efficiently enucleated relative to B6D2F1 oocytes, and demecolcine treatments initiated early after activation resulted in higher enucleation rates than when treatment was delayed. The observed strain differences are possibly caused by a combination of factors, such as the time course of meiotic cell-cycle progression after ethanol activation, the degree of spindle rotation, and the extent of second PB extrusion. These results suggest that developmentally competent cytoplasts can be produced by timely exposure of activated oocytes to agents that disrupt spindle microtubules. However, the utility of the demecolcine-induced enucleation protocol will require further investigation into factors linking karyokinesis to cytokinesis at the levels of cell-cycle control and oocyte cytoskeletal remodeling following artificial or natural means of egg activation.

  17. The Evolution of Laser Therapy in the Treatment of Benign Prostatic Hyperplasia

    PubMed Central

    Issa, Muta M

    2005-01-01

    The 2 basic principles of laser therapy for benign prostatic hyperplasia (BPH), based on the final tissue effect, are laser vaporization and laser coagulation. In laser vaporization techniques, higher-density laser thermal energy is used; effects range from complete tissue vaporization to incision, resection, or enucleation of the obstructing prostatic tissue. Interstitial laser coagulation (ILC) requires lower therapeutic temperatures. The urethral preservation and lack of tissue evaporation/resection with ILC make this treatment different from conventional transurethral free-beam laser prostatectomy. The Indigo® Optima Laser treatment system is the most widely used ILC system. Unlike other BPH laser therapies, Indigo ILC can be satisfactorily performed using pure local anesthesia in an office or outpatient setting. Favorable treatment outcomes are seen in a large percentage of patients, with minimal adverse events. Such favorable results depend on proper surgical technique and operator experience. PMID:16985899

  18. Laser pointers and the human eye: a clinicopathologic study.

    PubMed

    Robertson, D M; Lim, T H; Salomao, D R; Link, T P; Rowe, R L; McLaren, J W

    2000-12-01

    We report the absence of photic retinal injury after exposing the retina to light from class 3A laser pointers for durations of up to 15 minutes. Three patients with uveal melanomas were scheduled to have an enucleation. Each agreed to have his or her retina exposed to laser light from a class 3A laser pointer prior to enucleation. Continuous exposure was directed to the fovea for 1 minute, to the retina 5 degrees below fixation for 5 minutes, and to the retina 5 degrees above fixation for 15 minutes. Ophthalmoscopic evaluation of the cornea, lens, and retina and fluorescein angiographic studies of the retina were conducted before, 24 hours after, and 11 days after laser exposure in the first case; before and 86 hours after exposure in the second case; and before, 96 hours after, and 15 days after exposure in the third case. Other than transient afterimages that lasted only a few minutes, we were unable to document any functional, ophthalmoscopic, fluorescein angiographic, or histologic evidence of damage to any structures of the eyes. Transmission electron microscopic studies of retinal sites targeted by the laser pointers in the second and third cases revealed ultrastructural abnormalities in the outer retina and the pigment epithelium that were similar to abnormalities seen in the retina approximately 8 mm away from the targeted sites. The risk to the human eye from transient exposure to light from commercially available class 3A laser pointers having powers of 1, 2, and 5 mW seems negligible.

  19. 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

  20. 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.

  1. 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

  2. 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

    2016-03-24

    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.

  3. Preliminary experiences on diode laser welding in corneal transplantation

    NASA Astrophysics Data System (ADS)

    Menabuoni, Luca; Dragoni, B.; Pini, Roberto

    1996-12-01

    An experimental study on the applicability of diode laser welding to assist corneal transplantation is presented. Fusion of corneal tissue was accomplished by low power laser irradiation at 810 nm in association with Indocyanine Green (ICG) as the photoenhancing chromophore. Twenty freshly enucleated eyes obtained from young goats were used. In the preliminary experimental phase we examined the effects of laser welding on cuts produced by the scalpel on the cornea. Then we tried to design and test a novel diode laser- assisted corneal transplantation procedure. Our experimental results indicate that this procedure is affordable, but some technical aspects, as the application of ICG to the cut as well as the control of laser action are very critical issues.

  4. Vision-Related Quality of Life and Appearance Concerns Are Associated with Anxiety and Depression after Eye Enucleation: A Cross-Sectional Study.

    PubMed

    Ye, Juan; Lou, Lixia; Jin, Kai; Xu, Yufeng; Ye, Xin; Moss, Timothy; McBain, Hayley

    2015-01-01

    To investigate the association of demographic, clinical and psychosocial variables with levels of anxiety and depression in participants wearing an ocular prosthesis after eye enucleation. This cross-sectional study included 195 participants with an enucleated eye who were attending an ophthalmic clinic for prosthetic rehabilitation between July and November 2014. Demographic and clinical data, and self-reported feelings of shame, sadness and anger were collected. Participants also completed the National Eye Institute Visual Function Questionnaire, the Facial Appearance subscale of the Negative Physical Self Scale, and the Hospital Anxiety and Depression Scale. Regression models were used to identify the factors associated with anxiety and depression. The proportion of participants with clinical anxiety was 11.8% and clinical depression 13.8%. More anxiety and depression were associated with poorer vision-related quality of life and greater levels of appearance concerns. Younger age was related to greater levels of anxiety. Less educated participants and those feeling more angry about losing an eye are more prone to experience depression. Clinical variables were unrelated to anxiety or depression. Anxiety and depression are more prevalent in eye-enucleated patients than the general population, which brings up the issues of psychiatric support in these patients. Psychosocial rather than clinical characteristics were associated with anxiety and depression. Longitudinal studies need to be conducted to further elucidate the direction of causality before interventions to improve mood states are developed.

  5. Vision-Related Quality of Life and Appearance Concerns Are Associated with Anxiety and Depression after Eye Enucleation: A Cross-Sectional Study

    PubMed Central

    Ye, Juan; Lou, Lixia; Jin, Kai; Xu, Yufeng; Ye, Xin; Moss, Timothy; McBain, Hayley

    2015-01-01

    Aims To investigate the association of demographic, clinical and psychosocial variables with levels of anxiety and depression in participants wearing an ocular prosthesis after eye enucleation. Methods This cross-sectional study included 195 participants with an enucleated eye who were attending an ophthalmic clinic for prosthetic rehabilitation between July and November 2014. Demographic and clinical data, and self-reported feelings of shame, sadness and anger were collected. Participants also completed the National Eye Institute Visual Function Questionnaire, the Facial Appearance subscale of the Negative Physical Self Scale, and the Hospital Anxiety and Depression Scale. Regression models were used to identify the factors associated with anxiety and depression. Results The proportion of participants with clinical anxiety was 11.8% and clinical depression 13.8%. More anxiety and depression were associated with poorer vision-related quality of life and greater levels of appearance concerns. Younger age was related to greater levels of anxiety. Less educated participants and those feeling more angry about losing an eye are more prone to experience depression. Clinical variables were unrelated to anxiety or depression. Conclusions Anxiety and depression are more prevalent in eye-enucleated patients than the general population, which brings up the issues of psychiatric support in these patients. Psychosocial rather than clinical characteristics were associated with anxiety and depression. Longitudinal studies need to be conducted to further elucidate the direction of causality before interventions to improve mood states are developed. PMID:26317860

  6. 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.

  7. Maturation and enucleation of primitive erythroblasts during mouse embryogenesis is accompanied by changes in cell-surface antigen expression

    PubMed Central

    Fraser, Stuart T.; Isern, Joan; Baron, Margaret H.

    2007-01-01

    Primitive erythroblasts (EryPs) are the first hematopoietic cell type to form during mammalian embryogenesis and emerge within the blood islands of the yolk sac. Large, nucleated EryPs begin to circulate around midgestation, when connections between yolk sac and embryonic vasculature mature. Two to 3 days later, small cells of the definitive erythroid lineage (EryD) begin to differentiate within the fetal liver and rapidly outnumber EryPs in the circulation. The development and maturation of EryPs remain poorly defined. Our analysis of embryonic blood at different stages reveals a stepwise developmental progression within the EryP lineage from E9.5 to E12.5. Thereafter, EryDs are also present in the bloodstream, and the 2 lineages are not easily distinguished. We have generated a transgenic mouse line in which the human ϵ-globin gene promoter drives expression of green fluorescent protein exclusively within the EryP lineage. Here, we have used this line to characterize changes in cell morphology and surface-marker expression as EryPs mature and to track EryP numbers and enucleation throughout gestation. This study identifies previously unrecognized synchronous developmental stages leading to the maturation of EryPs in the mouse embryo. Unexpectedly, we find that EryPs are a stable cell population that persists through the end of gestation. PMID:16940424

  8. Morbidity of tumour enucleation for renal cell carcinoma (RCC): results of a single-centre prospective study.

    PubMed

    Minervini, Andrea; Vittori, Gianni; Lapini, Alberto; Tuccio, Agostino; Siena, Giampaolo; Serni, Sergio; Carini, Marco

    2012-02-01

    To evaluate the incidence and risk factors of adverse events (AEs) after tumour enucleation (TE). Between 2006 and 2009, clinical, surgical and functional data were prospectively gathered from 200 consecutive patients who had open TE. TE was done by blunt dissection using the natural cleavage plane between the tumour capsule and normal parenchyma. All the AEs were stratified for severity according to the National Cancer Institute Common Toxicity Criteria version 2.0 grading system. Risk factors for AEs were determined by univariate analysis. The mean (range) tumour size was 3.2 (0.8-10.0) cm, and mean (range) warm ischaemia time (WIT) was 16.5 (5-31) min. Overall, 32 AEs (six grade I, 20 grade II, and six grade III) occurred after TE in 30 patients and of those 27 were surgical (13.5%) and five were medical AEs (2.5%). On univariate analysis, imperative/relative surgical indication was the only predictive factor for the development of medical AEs. Statistically significant predictors of overall surgical AEs and urinary fistula were clinical tumour dimension, completely endorenal tumour growth and a positive tumour relationship with the urinary collecting system (UCS). A completely endorenal tumour growth and a positive tumour relationship with the UCS also correlated with bleeding requiring transfusions. Completely endorenal tumour growth was significantly associated with major (grade III) AEs. The TE technique was associated with a 16% AE rate and of those only 3% required re-intervention (grade III). Urinary fistula occurred in six patients (3%) and ureteric stenting was required in 0.5% of cases. © 2011 THE AUTHORS; BJU INTERNATIONAL © 2011 BJU INTERNATIONAL.

  9. T(1) and T(2) measurements of the fine structures of the in vivo and enucleated human eye.

    PubMed

    Patz, Samuel; Bert, Robert J; Frederick, Eric; Freddo, Thomas F

    2007-09-01

    To measure T(1) and T(2) of the fine structures of the in vivo eye. Involuntary saccades make it difficult to obtain artifact-free images. Using a method recently reported (Bert et al, Acad Radiol 2006;12:368-378), near artifact-free spin-echo images were obtained. Both an isolated enucleated eye and eight human subjects were studied at 1.5 T. Spin-echo variable TR/TE data was acquired for T(1)/T(2) determination. Average relaxation times were calculated two ways. First, an arithmetic average over different subjects was computed. Second, all data was normalized using the fitted amplitudes of each data set and pooled to obtain a single least squares fit. In vivo T(1)/T(2) (msec) are: arithmetic average T(1), T(2), normalized data T(1), T(2). Anterior chamber: 6233 +/- 979, 468 +/- 149, 5053 +/- 1052, 450 +/- 49. Ciliary body: 1916 +/- 184, 80 +/- 7, 2038 +/- 114, 76 +/- 3. Chorioretina: 1717 +/- 500, 72 +/- 25, 1511 +/- 230, 78 +/- 3. Extraocular muscle: 1581 +/- 646, 41 +/- 7, 1470 +/- 231, 41 +/- 1. Iris: 3334 +/- 989, 163 +/- 63, 3376 +/- 338, 153 +/- 10. Lens cortex: 1712 +/- 466, 93 +/- 36, 1413 +/- 177, 100 +/- 5. Lens nucleus: 1133 +/- 40, 26 +/- 3, 1138 +/- 47, 25 +/- 0.4. Optic nerve: 1906 +/- 301, 68 +/- 16, 1805 +/- 244, 71 +/- 2. Posterior chamber: 7915 +/- 4897, 241 +/- 14, 3323 +/- 2154, 251 +/- 38. Vitreous humor: 5768 +/- 1190, 756 +/- 804, 4855 +/- 1846, 390 +/- 8. In vivo T(1) and T(2) for many of the fine structures of the human eye have been measured. (c) 2007 Wiley-Liss, Inc.

  10. Intra-capsular total thyroid enucleation versus total thyroidectomy in treatment of benign multinodular goiter. A prospective randomized controlled clinical trial.

    PubMed

    Sewefy, Alaa M; Tohamy, Tohamy A; Esmael, Tarek M; Atyia, Ahmed M

    2017-09-01

    Due to high recurrence rate after subtotal thyroidectomy, most of centers have shifted to total thyroidectomy as a surgical treatment for benign multinodular goiter (BMNG), but serious complications, as laryngeal nerve affection & hypocalcaemia, are still present. This study aimed to evaluate treatment of BMNG using intra-capsular total thyroid enucleation in comparison to standard total thyroidectomy. This is a prospective randomized controlled clinical trial conducted in a hospital in the period from December 2009 to December 2015. Of total 224 patients with clinically BMNG. 112 patients operated by intracapsular total thyroid enucleation (ITTE group) and the other 112 patients operated by standard total thyroidectomy (STT group). The minimal follow up period was 36 months. The mean operative time in ITTE group was (93.7 ± 9.6 min) compared to (86.9 ± 8.3 min) in STT group. Transient recurrent laryngeal nerve (RLN) palsy was 0% in ITTE group VS 7.1% in STT group. No cases (0%) developed permanent RLN palsy in ITTE group VS 0.9% in STT group. Symptomatic transient hypocalcaemia occurred in 1.8% in ITTE group VS 11.6% in STT group. No cases (0%) developed permanent hypocalcaemia in ITTE group VS 0.9% in STT group. No recurrence (0%) in both groups after minimal 3 years of follow up. Intracapsular Total thyroid enucleation technique is safe with the least serious complications, especially RLN injury and hypoparathyroidism, with no recurrence, but this technique still not radical so couldn't be used in suspicious cases for malignancy. Copyright © 2017 IJS Publishing Group Ltd. Published by Elsevier Ltd. All rights reserved.

  11. [Final clinical indications and etiology in 1,023 enucleations. Descriptive databank evaluation with SPSS software in variable response mode with dummy variables].

    PubMed

    Becker, H; Bialasiewicz, A A; Schaudig, U; Schäfer, H; von Domarus, D

    2002-05-01

    A new data bank developed for ophthalmopathology using a computer-generated, multidigital data code is expected to be able to accomplish complex clinicopathologic correlations of diagnoses and signs, as provided by (multiple) clinical events and histopathologically proven etiologies, and to facilitate the documentation of new data. In the ophthalmopathology laboratory 2890 eyes were examined between January 20, 1975 and December 12, 1996. The main diagnoses and patient data from this 22-year period were recorded. To facilitate the presentation of data, a 10-year period with eyes of 976 patients enucleated from December, 1986 to December, 1996 was chosen. Principal and secondary diagnoses served for establishing the data bank. The frequencies of successive histologic and clinical diagnoses were evaluated by a descriptive computing program using an SPSS-multi-response mode with dummy variables and a categorical variable listing of the software (SPSS version 10.0) classified as (a) non-filtered random, (b) filtered by multiple etiologies, and (c) filtered by multiple events. The principal groups (e.g., histologic diagnoses concerning etiology) and subgroups (e.g., trauma, neoplasia, surgery, systemic diseases, and inflammations) were defined and correlated with 798 separate diagnoses. From 11 diagnoses/events ascribed to the clinical cases, 11,198 namings resulted. Thus, a comparative study of complex etiologies and events leading to enucleation in different hospitals of a specific area may be performed using this electronic ophthalmopathologic data bank system. The complexity of rare disease and integration into a superimposed structure can be managed with this custom-made data bank. A chronologically and demographically oriented consideration of reasons for enucleation is thus feasible.

  12. Comparison of the exposure rate of wrapped hydroxyapatite (Bio-Eye) versus unwrapped porous polyethylene (Medpor) orbital implants in enucleated patients.

    PubMed

    Tabatabaee, Ziaeddin; Mazloumi, Mehdi; Rajabi, Mohammad Taher; Khalilzadeh, Omid; Kassaee, Abolfazl; Moghimi, Sasan; Eftekhar, Hassan; Goldberg, Robert A

    2011-01-01

    To compare the exposure rate of wrapped hydroxyapatite versus unwrapped porous polyethylene orbital implants in enucleated patients. Medical records of the patients who underwent primary placement of hydroxyapatite (Bio-Eye) or porous polyethylene (Medpor) orbital implants after enucleation between 2002 and 2005 in Farabi Eye Hospital were reviewed, and the occurrence of implant exposure during follow-up visits was recorded. The exclusion criteria were secondary implantation, evisceration, or follow up of less than 1 year unless the exposure had occurred in the year after surgery. In the hydroxyapatite group, the implants were wrapped either in Mersilene mesh (65%) or in donor sclera (35%). Wrapping was not performed for any patient in the porous polyethylene group. A total of 198 cases with hydroxyapatite and 53 cases with porous polyethylene implant were identified. The most common causes of enucleation in both groups were globe trauma and painful blind eye. Rate of exposure was significantly higher [odds ratio (OR) = 7.97, p < 0.001] in patients with porous polyethylene (34.0%) than in those with hydroxyapatite implant (6.1%). This association remained significant after adjustment for potential confounders. Mean time of exposure after surgery was significantly (p < 0.001) longer in patients with porous polyethylene implant. Kaplan-Meier plots depicted a significantly (p < 0.001) higher rate of exposure in patients with porous polyethylene implant during the follow-up time. Unwrapped porous polyethylene implants demonstrated a higher rate of exposure, and longer time interval to exposure, compared with wrapped hydroxyapatite implants.

  13. Can Low Level Laser Therapy Benefit Bone Regeneration in Localized Maxillary Cystic Defects? - A Prospective Randomized Control Trial

    PubMed Central

    Zaky, Ahmed Abbas; El Shenawy, Hanaa Mohamed Mohamed; Harhsh, Tarek Abdel Hamed; Shalash, Mahmoud; Awad, Noha Mohamed Ismael

    2016-01-01

    AIM: The aim of the study was to evaluate the effect of Low-Level Laser Therapy (LLLT) on bone formation in cystic defects following cyst enucleation. PATIENTS AND METHODS: The sample was composed of sixteen patients with enucleated maxillary bony cystic lesions. With an age range from 20 - 44 grouped as eight Laser and eight Control patients. Laser group was subjected to low intensity diode laser immediately after surgery and then for three times per week for two weeks using a therapeutic laser irradiation. Group B (control group): patients were not subjected laser therapy. RESULTS: The predictor variable was exposure of bone defect to LLLT or none. The outcome variable was bone density changes measured by digital radiographs at day 1 and days 90 postoperatively. Descriptive and bivariate statistics were computed. There were no statistically significant differences between the 2 groups for the bone density at day 1. There was a statistically significant difference in bone density changes in each group at day 90: Significant at P ≤ 0.05. After adjusting for differences in day 1 for bone density, the estimated mean change in bone density changes at day 90 was significantly larger for Laser compared with control. CONCLUSION: The results of this study suggested that LLLT can enhance bone healing in maxillary cystic defects. This can serve as an adjunct method in preventing possible delayed healing and pathological fractures This also will be helpful for more researchers in early loading in case of dental implants to accelerate osseointegration. PMID:28028422

  14. EAU guidelines on laser technologies.

    PubMed

    Herrmann, Thomas R W; Liatsikos, Evangelos N; Nagele, Udo; Traxer, Olivier; Merseburger, Axel S

    2012-04-01

    The European Association of Urology (EAU) Guidelines Office has set up a guideline working panel to analyse the scientific evidence published in the world literature on lasers in urologic practice. Review the physical background and physiologic and technical aspects of the use of lasers in urology, as well as current clinical results from these new and evolving technologies, together with recommendations for the application of lasers in urology. The primary objective of this structured presentation of the current evidence base in this area is to assist clinicians in making informed choices regarding the use of lasers in their practice. Structured literature searches using an expert consultant were designed for each section of this document. Searches were carried out in the Cochrane Database of Systematic Reviews, the Cochrane Central Register of Controlled Trials, and Medline and Embase on the Dialog/DataStar platform. The controlled terminology of the respective databases was used, and both Medical Subject Headings and EMTREE were analysed for relevant entry terms. One Cochrane review was identified. Depending on the date of publication, the evidence for different laser treatments is heterogeneous. The available evidence allows treatments to be classified as safe alternatives for the treatment of bladder outlet obstruction in different clinical scenarios, such as refractory urinary retention, anticoagulation, and antiplatelet medication. Laser treatment for bladder cancer should only be used in a clinical trial setting or for patients who are not suitable for conventional treatment due to comorbidities or other complications. For the treatment of urinary stones and retrograde endoureterotomy, lasers provide a standard tool to augment the endourologic procedure. In benign prostatic obstruction (BPO), laser vaporisation, resection, or enucleation are alternative treatment options. The standard treatment for BPO remains transurethral resection of the prostate for

  15. 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

  16. Microchip Lasers

    DTIC Science & Technology

    2016-10-31

    physics that underlies their performance, typical operating parameters for the devices, and several of their applications . Keywords Composite-cavity...laser, Diode -pumped laser, Laser, Microchip laser, Miniature laser, Monolithic laser, Passively Q-switched laser, Q-switched laser, Saturable...cavity mirrors are deposited directly on the gain medium and the laser is pumped with a diode laser, either directly, as shown in Fig. 1, or via an

  17. Safety of cornea and iris in ocular surgery with 355-nm lasers.

    PubMed

    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 ED 50 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.

  18. Correlation of transrectal and transabodominal ultrasound measurement of transition zone volume with post-operative enucleated adenoma volume in benign prostatic hypertrophy.

    PubMed

    Ajayi, Idowu; Aremu, Ademola; Olajide, Abimbola; Bello, Tope; Olajide, Folake; Adetiloye, Victor

    2013-01-01

    Benign prostatic hyperplasia is a common disease of ageing men worldwide. Though transrectal ultrasonography (TRUS) is the standard in most parts of the world in evaluation of benign prostatic hyperplasia (BPH), it is rarely done in some less developed countries because of non availability of appropriate probes and or specialists. Transabdominal ultrasonography (TAUS) remains the mainstay in these areas. Some controversies still exist in literature about the accuracy of TAUS evaluation of prostatic volume in patients with BPH. This study aimed at comparing the transition zone volume estimation of the prostate on transrectal and transabdominal ultrasound with post-operative enucleated adenoma volume in Nigeria patients with BPH and to suggest better predictor of prostate volume in evaluation of BPH. Forty-six (46) patients with lower urinary tract symptoms due to BPH attending the urologic clinic were evaluated ultrasonographically and eventually managed with open surgery (prostatectomy) after due counselling. The post operative samples were weighted using a sensitive top loading weighing balance and converted to volume. Since the specific gravity of the prostate is equivalent to that of water,the weight is the same as volume. Patients' ages ranged between 59 and 90 years with a peak age incidence at seventh decade. Transition Zone (TZ) volume estimation on both transrectal and transabdominal ultrasound showed positive correlation with the post operative enucleated adenoma(r = 0.594, p < 0.001) but the transrectal method was more accurate. There was no significant relationship between the TZ volume and patients' symptoms(r = 0.491, p = 0.007). Both TRUS and TAUS are comparable at TZ volume estimation and therefore TAUS can be utilized in regions where intracavitary probes and or the expertise is/are not available.

  19. Diffusion Tensor Imaging Detects Early Cerebral Cortex Abnormalities in Neuronal Architecture Induced by Bilateral Neonatal Enucleation: An Experimental Model in the Ferret

    PubMed Central

    Bock, Andrew S.; Olavarria, Jaime F.; Leigland, Lindsey A.; Taber, Erin N.; Jespersen, Sune N.; Kroenke, Christopher D.

    2010-01-01

    Diffusion tensor imaging (DTI) is a technique that non-invasively provides quantitative measures of water translational diffusion, including fractional anisotropy (FA), that are sensitive to the shape and orientation of cellular elements, such as axons, dendrites and cell somas. For several neurodevelopmental disorders, histopathological investigations have identified abnormalities in the architecture of pyramidal neurons at early stages of cerebral cortex development. To assess the potential capability of DTI to detect neuromorphological abnormalities within the developing cerebral cortex, we compare changes in cortical FA with changes in neuronal architecture and connectivity induced by bilateral enucleation at postnatal day 7 (BEP7) in ferrets. We show here that the visual callosal pattern in BEP7 ferrets is more irregular and occupies a significantly greater cortical area compared to controls at adulthood. To determine whether development of the cerebral cortex is altered in BEP7 ferrets in a manner detectable by DTI, cortical FA was compared in control and BEP7 animals on postnatal day 31. Visual cortex, but not rostrally adjacent non-visual cortex, exhibits higher FA than control animals, consistent with BEP7 animals possessing axonal and dendritic arbors of reduced complexity than age-matched controls. Subsequent to DTI, Golgi-staining and analysis methods were used to identify regions, restricted to visual areas, in which the orientation distribution of neuronal processes is significantly more concentrated than in control ferrets. Together, these findings suggest that DTI can be of utility for detecting abnormalities associated with neurodevelopmental disorders at early stages of cerebral cortical development, and that the neonatally enucleated ferret is a useful animal model system for systematically assessing the potential of this new diagnostic strategy. PMID:21048904

  20. CO2, excimer and erbium:YAG laser in deep sclerectomy.

    PubMed

    Klink, Thomas; Schlunck, Gunther; Lieb, Wolfgang; Klink, Janine; Grehn, Franz

    2008-01-01

    Deep sclerectomy is a non-penetrating filtering procedure that is not generally accepted, as tissue dissection is difficult and varying success rates have been reported. The purpose of the present study was to compare the use of CO2, excimer and erbium:YAG lasers in dissection of the deep corneoscleral lamella. In enucleated porcine eyes a superficial lamellar scleral flap of 5 x 5 mm was surgically dissected. The deep lamella was removed using a pulsed erbium:YAG, a CO2 or an excimer laser (10 eyes/group). All eyes were analysed histologically and 3 in each group by scanning electron microscopy (SEM). It is feasible to ablate the deep corneoscleral lamella with the CO2, excimer and erbium:YAG lasers without perforating the anterior chamber. The following histology and SEM showed a smoother surface after dissection with the CO2 and excimer lasers compared to the erbium:YAG laser. There was no thermal damage after excimer laser treatment, compared to a damage zone of 10-30 mum using the erbium laser and one of 70-100 microm with the CO2 laser. Excimer,erbium:YAG and CO2 lasers allow the microsurgical dissection of the deep lamella. The excimer and CO2 lasers achieve a more regular and smoother tissue surface. The excimer laser has the advantage to dissect without thermal tissue damage. Copyright 2008 S. Karger AG, Basel.

  1. 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)

  2. 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)

  3. Laser apparatus

    NASA Technical Reports Server (NTRS)

    Koepf, G. A. (Inventor)

    1979-01-01

    A laser apparatus having a pump laser device for producing pump laser energy upon being excited is disclosed. The pump laser device has a resonating cavity for oscillating and amplifying the pump laser energy. A source laser device is used for producing source laser energy upon being excited by the pump laser energy. The source laser device has a resonating cavity for oscillating and amplifying the source laser energy. The source laser's resonating cavity is coupled within a portion of the pump laser's resonating cavity.

  4. Establishment of pregnancy after the transfer of nuclear transfer embryos produced from the fusion of argali (Ovis ammon) nuclei into domestic sheep (Ovis aries) enucleated oocytes.

    PubMed

    White, K L; Bunch, T D; Mitalipov, S; Reed, W A

    1999-01-01

    Cloning mammalian species from cell lines of adult animals has been demonstrated. Aside from its importance for cloning multiple copies of genetically valuable livestock, cloning now has the potential to salvage endangered or even extinct species. The aim of this study was to investigate the effect of the bovine and domestic (Ovis aries) ovine oocyte cytoplasm on the nucleus of an established cell line from an endangered argali wild sheep (Ovis ammon) after nuclear transplantation. A fibroblast cell line was established from skin biopsies from an adult argali ram from the People's Republic of China. Early karyotype analysis of cells between 3-6 passages revealed a normal diploid chromosome number of 56. The argali karyotype consisted of 2 pairs of biarmed and 25 pairs of acrocentric autosomes, a large acrocentric and minute biarmed Y. Bovine ovaries were collected from a local abattoir, oocytes aspirated, and immediately placed in maturation medium consisting of M-199 containing 10% fetal bovine serum, 100 IU/mL penicillin, 100 microg/mL streptomycin, 0.5 microg/mL follicle-stimulating hormone (FSH), 5.0 microg/mL luetinizing hormone (LH) and 1.0 microg/mL estradiol. Ovine (O. aries) oocytes were collected at surgery 25 hours postonset of estrus from the oviducts of superovulated donor animals. All cultures were carried out at 39 degrees C in a humidified atmosphere of 5% CO2 and air. In vitro matured MII bovine oocytes were enucleated 16-20 hours after onset of maturation and ovine oocytes within 2-3 hours after collection. Enucleation was confirmed using Hoechst 33342 and UV light. The donor argali cells were synchronized in G0-G1 phase by culturing in Dulbecco's modified Eagle's medium (DMEM) plus 0.5% fetal bovine serum for 5-10 days. Fusion of nuclear donor cell to an enucleated oocyte (cytoplast) to produce nuclear transfer (NT) embryos was induced by 2 electric pulses of 1.4 kV/cm for 30 microsc. Fused NT embryos were activated after 24 hours of maturation

  5. 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

  6. Noncontact tonometry using laser interferometry

    NASA Astrophysics Data System (ADS)

    Drescher, Joerg; Stork, Wilhelm; Hey, Stefan; Gundlach, Arnd; Mueller-Glaser, Klaus-Dieter; Kreiner, Christine F.

    1999-02-01

    This paper describes a new method to examine the intraocular pressure (IOP) without any contact to the eye. In our new approach the IOP is determined indirectly from the acoustic properties of the eye as the resonance frequencies of the bulbus are shifting with increasing IOP. Simulations with the Finite Element Method were done to explore the coherence between the IOP and the acoustic properties of the bulbus. A three-dimensional model of the eye was developed comprising the elastic cornea and sclera and the vitreous body. The results showed a significant rise of the resonance-frequencies with increasing IOP. This shift is enlarging for higher modes. In parallel measurements were performed on artificial eyes and on enucleated pig eyes to prove this correlation experimentally. A measuring system existing of a transducer to excite the bulbus, a miniaturized laser-vibrometer and PC was built. The eyes were stimulated both contacting the eye with a transducer by a stick and contactless with sonic waves. Several series of measurements were done to examine the pressure dependency of the acoustic behavior. The measurements showed a proportional constant of 1.25 Hz/mmHg in average, which can be detected easily. The standard deviation measuring different pig eyes was 4.5 mmHg.

  7. [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.

  8. Quantitative and ultrastructural studies of excimer laser ablation of the cornea at 193 and 248 nanometers

    SciTech Connect

    Puliafito, C.A.; Wong, K.; Steinert, R.F.

    1987-01-01

    Excimer laser radiation at 193 nm and 248 nm was used to create linear etch perforations of enucleated calf corneas. The etch depth per pulse was determined for various exposures, and specimens were examined by light and transmission electron microscopy. Compared to 248 nm, excimer laser ablation at 193 nm was found to have a lower threshold for onset of ablation, less increase in etch depth per pulse at increasing fluences, and less structural alteration in adjacent cornea. For 193 nm, structural alterations were minimal, confined to an area less than 0.3 micron wide, and did not increase with increasing fluence. These studies suggest that clinical strategies for excimer laser refractive surgery will employ the 193-nm wavelength, with fluence chosen depending on surgical strategy. Ablation exposures above 600 mJ/cm2 at 193 nm may give the most repeatable etch depth.

  9. Update on the use of diode laser in the management of benign prostate obstruction in 2014.

    PubMed

    Lusuardi, Lukas; Mitterberger, Michael; Hruby, Stephan; Kunit, Thomas; Kloss, Birgit; Engelhardt, Paul F; Sieberer, Manuela; Janetschek, Günter

    2015-04-01

    To determine the status quo in respect of various diode lasers and present the techniques in use, their results and complications. We assess how these compare with transurethral resection of the prostate and other types of laser in randomized controlled trials (RCTs). When adequate RCTs were not available, case studies and reports were evaluated. Laser for the treatment of benign prostatic hyperplasia (BPH) has aroused the interest and curiosity of urologists as well as patients. The patient associates the term laser with a successful and modern procedure. The journey that started with coagulative necrosis of prostatic adenoma based on neodymium: yttrium-aluminum-garnet (Nd:YAG) laser has culminated in endoscopic "enucleation" with holmium laser. Diode laser is being used in urology for about 10 years now. Various techniques have been employed to relieve bladder outlet obstruction due to BPH. The diode laser scenario is marked by a diversity of surgical techniques and wavelengths. We summarize the current published literature in respect of functional results and complications. More randomized controlled studies are needed to determine the position and the ideal technique of diode laser treatment for BPH.

  10. A New Subfamily of Sucrose Transporters, SUT4, with Low Affinity/High Capacity Localized in Enucleate Sieve Elements of Plants

    PubMed Central

    Weise, Andreas; Barker, Laurence; Kühn, Christina; Lalonde, Sylvie; Buschmann, Henrik; Frommer, Wolf B.; Ward, John M.

    2000-01-01

    A new subfamily of sucrose transporters from Arabidopsis (AtSUT4), tomato (LeSUT4), and potato (StSUT4) was isolated, demonstrating only 47% similarity to the previously characterized SUT1. SUT4 from two plant species conferred sucrose uptake activity when expressed in yeast. The Km for sucrose uptake by AtSUT4 of 11.6 ± 0.6 mM was ∼10-fold greater than for all other plant sucrose transporters characterized to date. An ortholog from potato had similar kinetic properties. Thus, SUT4 corresponds to the low-affinity/high-capacity saturable component of sucrose uptake found in leaves. In contrast to SUT1, SUT4 is expressed predominantly in minor veins in source leaves, where high-capacity sucrose transport is needed for phloem loading. In potato and tomato, SUT4 was immunolocalized specifically to enucleate sieve elements, indicating that like SUT1, macromolecular trafficking is required to transport the mRNA or the protein from companion cells through plasmodesmata into the sieve elements. PMID:10948254

  11. Five years follow-up of a keratocyst odontogenic tumor treated by marsupialization and enucleation: A case report and literature review.

    PubMed

    de Molon, Rafael Scaf; Verzola, Mario H; Pires, Luana C; Mascarenhas, Vinicius I; da Silva, Rodrigo B; Cirelli, Joni A; Barbeiro, Roberto H

    2015-03-01

    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.

  12. A new subfamily of sucrose transporters, SUT4, with low affinity/high capacity localized in enucleate sieve elements of plants.

    PubMed

    Weise, A; Barker, L; Kühn, C; Lalonde, S; Buschmann, H; Frommer, W B; Ward, J M

    2000-08-01

    A new subfamily of sucrose transporters from Arabidopsis (AtSUT4), tomato (LeSUT4), and potato (StSUT4) was isolated, demonstrating only 47% similarity to the previously characterized SUT1. SUT4 from two plant species conferred sucrose uptake activity when expressed in yeast. The K(m) for sucrose uptake by AtSUT4 of 11.6 +/- 0.6 mM was approximately 10-fold greater than for all other plant sucrose transporters characterized to date. An ortholog from potato had similar kinetic properties. Thus, SUT4 corresponds to the low-affinity/high-capacity saturable component of sucrose uptake found in leaves. In contrast to SUT1, SUT4 is expressed predominantly in minor veins in source leaves, where high-capacity sucrose transport is needed for phloem loading. In potato and tomato, SUT4 was immunolocalized specifically to enucleate sieve elements, indicating that like SUT1, macromolecular trafficking is required to transport the mRNA or the protein from companion cells through plasmodesmata into the sieve elements.

  13. [Learning curve in laser treatment of benign prostatic syndrome: a systematic review].

    PubMed

    Rasch, Andrej; Gruber, Sabine; Perleth, Matthias

    2013-01-01

    The aim of the present systematic review was to evaluate the evidence of a potential learning curve for laser treatment of benign prostatic hyperplasia. A systematic literature search was conducted in November 2011 using The Cochrane Library, EMBASE and MEDLINE. Overall, 18 sources (mostly case series) were included for further assessment. The majority of publications assume that a general learning curve exists. It is estimated that a range of 20 to 50 cases is needed to achieve a stable outcome level. For the most part, these findings are based on the HoLEP (Holmium laser enucleation of prostate) technique and intraoperative measures, such as enucleation efficiency. Valid conclusions regarding patient-related end-points are difficult to make, although some studies report a decreasing trend for complication rates with increasing experience of the surgeon. No statistically significant differences were found for postoperative outcomes such as IPSS (International Prostate Symptom Score), Qmax (peak flow rate) or Quality of Life. Overall, the present results are highly limited by the low evidence level and methodological problems of the publications available. Several publications suggest that adequate training during the implementation phase is relevant.

  14. Microscopic analysis of structural changes in diode-laser-welded corneal stroma

    NASA Astrophysics Data System (ADS)

    Matteini, Paolo; Rossi, Francesca; Menabuoni, Luca; Pini, Roberto

    2007-02-01

    Diode laser welding of the cornea is a technique used to provide immediate sealing of corneal wounds: the cut is stained with a water solution of Indocyanine Green and is then irradiated with an 810 nm laser at low power densities (12-16 W/cm2), which induces a localized heating of the stroma in the range 55-66 °C range. In this study, we present a microscopic analysis aimed at evaluating the structural modifications induced in the stromal collagen of pig eyes during the laser welding of corneal wounds. Cornea samples obtained from twenty freshly-enucleated eyes were cut with a pre-calibrated knife and subjected to the laser welding procedure. Histological slices of the laser-welded stroma were examined by means of optical and transmission electron microscopy. These analyses indicated that bridges of lamellar structures crossed the wound edges with no presence of a coagulation effect. After laser welding, collagen fibrils appeared differently oriented among themselves in comparison with those of the control samples, but with similar mean fibril diameters. The laser-induced effect appeared to be confined to the ICG stained area of the cut walls, and no heat damage was observed at the operative power levels of laser corneal welding.

  15. Transurethral enucleation of the prostate versus transvesical open prostatectomy for large benign prostatic hyperplasia: a systematic review and meta-analysis of randomized controlled trials.

    PubMed

    Lin, Youcheng; Wu, Xun; Xu, Abai; Ren, Rui; Zhou, Xueqiong; Wen, Yong; Zou, Yong; Gong, Mancheng; Liu, Chunxiao; Su, Zexuan; Herrmann, Thomas R W

    2016-09-01

    To evaluate the efficacy and safety of transurethral enucleation of the prostate (TUEP) versus transvesical open prostatectomy (OP) for the management of large benign prostatic hyperplasia (BPH). Randomized controlled trials (RCTs) comparing TUEP and OP were identified from PubMed, Embase and Web of Science up to February 28, 2015. A meta-analysis was conducted with the STATA 12.0 software. Nine RCTs including 758 patients were enrolled in our meta-analysis. There were no significant differences between the two groups in the maximum urinary flow rate at 1, 3, 6 months, 1 and 2 years: postvoiding residual urinary volume, prostate-specific antigen, international prostate symptom score and quality of life score at 1, 3, 6 months and 1 year; or international index of erectile function at 3, 6 months and 1 year. Perioperative outcomes including hemoglobin level drop, catheter period, irrigation length and hospital stay favored TUEP, while operative time and resected prostate weight favored OP. There was significantly less blood transfusion with TUEP, but no significant differences were found in other complications such as recatheterization, urinary tract infection, reintervention for clots and bleeding control, incidence of pneumonia and infarction, transient incontinence, bladder neck contracture, urethral stricture and recurrent adenoma. TUEP can be performed effectively and safely with functional outcomes and complications similar to OP for large BPH, whereas it has the advantages of a shorter catheter period, shorter hospital stays and less blood transfusion. These findings seem to support TUEP as the next-generation "gold standard" of surgery for large BPH.

  16. Plasmakinetic enucleation of the prostate vs plasmakinetic resection of the prostate for benign prostatic hyperplasia: comparison of outcomes according to prostate size in 310 patients.

    PubMed

    Luo, Yu-Hui; Shen, Ji-Hong; Guan, Run-Yun; Li, Hao; Wang, Jia

    2014-10-01

    To compare the safety and efficiency of plasmakinetic enucleation of the prostate (PKEP) with that of plasmakinetic resection of the prostate (PKRP) in the treatment of benign prostatic hyperplasia (BPH). Three hundred ten patients diagnosed to have BPH were randomized to undergo either PKEP or PKRP. The perioperative data and postoperative outcomes followed at 1, 3, 6, 12, 18, and 24 months after surgery were recorded and compared in the groups classified according to the baseline prostate volume: ≤ 60 mL and >60 mL. There were no significant differences in the preoperative data. Compared with PKRP, PKEP costs longer operative time (56.1 ± 14.6 vs 41.3 ± 9.6 min; P < .001) for prostate volume ≤ 60 mL, but reduced operative time (75.6 ± 12.3 vs 88.7 ± 14.3 minutes; P <.001) and caused less blood loss (167.6 ± 44.4 vs 225.7 ± 49.5 mL; P < .001) for prostate volume >60 mL. However, regardless of prostate size, the incidence of transient incontinence after PKEP was higher. The postoperative improvement among these groups in International Prostate Symptom Score, quality of life, and maximal flow rate was similar at 24-month follow-up. PKEP and PKRP are both safe and effective treatments for BPH independent of prostate size. Despite that the incidence of transient incontinence after PKEP was higher, PKEP was significantly superior to PKRP in operative time and blood loss for prostate volume >60 mL and may become the modern alternative to PKRP for large BPH. Copyright © 2014 Elsevier Inc. All rights reserved.

  17. 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

  18. Laser principles.

    PubMed

    Bogdan Allemann, Inja; Kaufman, Joely

    2011-01-01

    Since the construction of the first laser in the 1960s, the role that lasers play in various medical specialities, including dermatology, has steadily increased. However, within the last 2 decades, the technological advances and the use of lasers in the field of dermatology have virtually exploded. Many treatments have only become possible with the use of lasers. Especially in aesthetic medicine, lasers are an essential tool in the treatment armamentarium. Due to better research and understanding of the physics of light and skin, there is now a wide and increasing array of different lasers and devices to choose from. The proper laser selection for each indication and treatment requires a profound understanding of laser physics and the basic laser principles. Understanding these principles will allow the laser operator to obtain better results and help avoid complications. This chapter will give an in-depth overview of the physical principles relevant in cutaneous laser surgery. Copyright © 2011 S. Karger AG, Basel.

  19. Optoacoustic online temperature determination during retinal laser photocoagulation

    NASA Astrophysics Data System (ADS)

    Schlott, Kerstin; Stalljohann, Jens; Weber, Benjamin; Kandulla, Jochen; Herrmann, Katharina; Birngruber, Reginald; Brinkmann, Ralf

    2007-07-01

    Retinal photocoagulation is an established treatment of different retinal diseases. The treatment relies on a short, local heating of the tissue which induces a denaturation. The resulting scar formation may for example prevent the further detachment of the retina. The extent of the coagulation is besides other parameters mostly dependent on the induced temperature increase. However, until today a temperature based dosimetry for photocoagulation does not exist. The dosage is rather based on the experience of the treating physicians to achieve visible whitish lesions on the retina. In this work a technique is presented, which allows an online temperature monitoring during photocoagulation. If an absorbing material is irradiated with short laser pulses, a thermoelastic expansion of the absorber induces an acoustic wave. Its amplitude is dependent on the temperature of the absorber. For analyzing the applicability of the optoacoustic temperature determination for dosimetry, measurements were performed on enucleated porcine eye globes. The pressure transients are detected by an ultrasonic transducer, which is embedded in an ophthalmologic contact lens. As long as no strong lesions occur, the determined temperatures are almost proportional to the power of the treatment laser. Using a spot diameter of 200 μm and different laser powers, the temperature rise at the end of the 400 ms irradiation was found to be approximately 0.16 °C/mW. The onset of the denaturation was observed around 50°C. The far aim of this project is an automatic regulation of the treatment laser onto a desired temperature course.

  20. 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

  1. High-resolution in vivo imaging of regimes of laser damage to the primate retina.

    PubMed

    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.

  2. Laser clock

    SciTech Connect

    Facklam, R.L.

    1983-05-26

    A laser clock includes a linear laser in one embodiment of the clock and a ring laser gyro in the other embodiment. The linear laser is frequency stabilized and utilizes a single active medium in the form of a low pressure gas, such as He-Ne, with a Doppler broadened gain curve. The ring laser gyro is a four frequency laser with a Faraday rotor. Detector and electronic circuitry associated with the laser of each embodiment detects a beat frequency and convert it to a clock signal.

  3. Blue Laser.

    DTIC Science & Technology

    1985-12-01

    HOLLOW CATHODE LASER FABRICATION 13 4. EXPERIENCE WITH THE BLUE LASER 18 4.1 Operational and Processing Experience 18 4.2 Performance Testing 20 5...34 -. - . •. SECTION 3 BLUE HOLLOW CATHODE LASER FABRICATION This section presents an overview of the steps taken in creating a HCL. There is...to the laser assembly. These steps can actually be considered as the final steps in laser fabrication because some of them involve adding various

  4. Corneal photoablation in vivo with the erbium:YAG laser: first report

    NASA Astrophysics Data System (ADS)

    Jean, Benedikt J.; Bende, Thomas; Matallana, Michael; Kriegerowski, Martin

    1995-05-01

    As an alternative to far-UV lasers for corneal refractive surgery, the Erbium:YAG laser may be used in TEM00 mode. The resulting gaussian beam profile leads to a certain amount of myopic correction per laser pulse. Although animal data suggest that the clinical outcome should be comparable to the UV-lasers, no human data were available until now. We performed Erbium:YAG laser areal ablation in 5 blind human eyes. In TEM00 mode, the laser parameters were: effective diameter of laser spot equals 3.4 mm, fluence equals 380 mJ/cm2, pulse duration equals 250 microsecond(s) , Repetition rate equals 4 Hz, Number of applied laser pulses equals 15. Four patients with no light perception, one with intact light projection on one eye (some of them scheduled for enucleation) were treated under topical anaesthesia. Patient selection and informed consent were agreed to by the University's independent Ethics Committee. Prior to laser irradiation, corneal epithelium was removed. A postoperative silicone cast of the cornea was analyzed with a confocal laser micro-topometer for the ablation profile. The eyes were treated with antibiotic ointment until the epithelium was closed. Clinical appearance and, where possible, profilometry of the ablated area was observed. The ablation profile in cornea was gaussian shaped with a maximal depth of 30 micrometers . During laser treatment, the corneal surface becomes opaque, clearing in a matter of seconds. Epithelial healing and clinical appearance was similar to excimer laser treatment. However, during the first week, the irradiated area shows subepithelial irregularities, resembling small bubbles, disappearing thereafter.

  5. Comparing renal function preservation after laparoscopic radio frequency ablation assisted tumor enucleation and laparoscopic partial nephrectomy for clinical T1a renal tumor: using a 3D parenchyma measurement system.

    PubMed

    Zhu, Liangsong; Wu, Guangyu; Huang, Jiwei; Wang, Jianfeng; Zhang, Ruiyun; Kong, Wen; Xue, Wei; Huang, Yiran; Chen, Yonghui; Zhang, Jin

    2017-05-01

    To compare the renal function preservation between laparoscopic radio frequency ablation assisted tumor enucleation and laparoscopic partial nephrectomy. Data were analyzed from 246 patients who underwent laparoscopic radio frequency ablation assisted tumor enucleation and laparoscopic partial nephrectomy for solitary cT1a renal cell carcinoma from January 2013 to July 2015. To reduce the intergroup difference, we used a 1:1 propensity matching analysis. The functional renal parenchyma volume preservation were measured preoperative and 12 months after surgery. The total renal function recovery and spilt GFR was compared. Multivariable logistic analysis was used for predictive factors for renal function decline. After 1:1 propensity matching, each group including 100 patients. Patients in the laparoscopic radio frequency ablation assisted tumor enucleation had a smaller decrease in estimate glomerular filtration rate at 1 day (-7.88 vs -20.01%, p < 0.001), 3 months (-2.31 vs -10.39%, p < 0.001), 6 months (-2.16 vs -7.99%, p = 0.015), 12 months (-3.26 vs -8.03%, p = 0.012) and latest test (-3.24 vs -8.02%, p = 0.040), also had better functional renal parenchyma volume preservation (89.19 vs 84.27%, p < 0.001), lower decrease of the spilt glomerular filtration rate (-9.41 vs -17.13%, p < 0.001) at 12 months. The functional renal parenchyma volume preservation, warm ischemia time and baseline renal function were the important independent factors in determining long-term functional recovery. The laparoscopic radio frequency ablation assisted tumor enucleation technology has unique advantage and potential in preserving renal parenchyma without ischemia damage compared to conventional laparoscopic partial nephrectomy, and had a better outcome, thus we recommend this technique in selected T1a patients.

  6. Laser Analyzer

    NASA Technical Reports Server (NTRS)

    1993-01-01

    Dopant level analysis is important to the laser system designer because it allows him to model the laser's performance. It also allows the end user to determine what went wrong when a laser fails to perform as expected. Under a Small Business Innovation Research (SBIR) contract, Scientific Materials Corporation has developed a process for producing uniform laser rods in which the amount of water trapped in the crystal during growth is reduced. This research led to the formation of a subsidiary company, Montana Analytical Services, which conducts analysis of laser rods for dopant ion concentrations. This is a significant advance in laser technology.

  7. Lasers of All Sizes

    NASA Astrophysics Data System (ADS)

    Balcou, Philippe; Forget, Sébastien Robert-Philip, Isabelle

    2015-10-01

    * Introduction * The Laser in All Its Forms * Gas lasers * Dye lasers * Solid-state lasers * Lasers for Every Taste * The rise of lasers * Lasers of all sizes * The colors of the rainbow... and beyond * Shorter and shorter lasers * Increasingly powerful lasers * Lasers: A Universal Tool? * Cutting, welding, and cleaning * Communicating * Treating illnesses * Measuring * Supplying energy? * Entertaining * Understanding * Conclusion

  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.

  9. Laser microphone

    DOEpatents

    Veligdan, James T.

    2000-11-14

    A microphone for detecting sound pressure waves includes a laser resonator having a laser gain material aligned coaxially between a pair of first and second mirrors for producing a laser beam. A reference cell is disposed between the laser material and one of the mirrors for transmitting a reference portion of the laser beam between the mirrors. A sensing cell is disposed between the laser material and one of the mirrors, and is laterally displaced from the reference cell for transmitting a signal portion of the laser beam, with the sensing cell being open for receiving the sound waves. A photodetector is disposed in optical communication with the first mirror for receiving the laser beam, and produces an acoustic signal therefrom for the sound waves.

  10. Laser speckle tracking for monitoring and analysis of retinal photocoagulation

    NASA Astrophysics Data System (ADS)

    Seifert, Eric; Bliedtner, Katharina; Brinkmann, Ralf

    2014-02-01

    Laser coagulation of the retina is an established treatment for several retinal diseases. The absorbed laser energy and thus the induced thermal damage varies with the transmittance and scattering properties of the anterior eye media and with the pigmentation of the fundus. The temperature plays the most important role in the coagulation process. An established approach to measure a mean retinal temperature rise is optoacoustics, however it provides limited information on the coagulation. Phase sensitive OCT potentially offers a three dimensional temporally resolved temperature distribution but is very sensitive to slightest movements which are clinically hard to avoid. We develop an optical technique able to monitor and quantify thermally and coagulation induced tissue movements (expansions and contractions) and changes in the tissue structure by dynamic laser speckle analysis (LSA) offering a 2D map of the affected area. A frequency doubled Nd:YAG laser (532nm) is used for photocoagulation. Enucleated porcine eyes are used as targets. The spot is 100μm. A Helium Neon laser (HeNe) is used for illumination. The backscattered light of a HeNe is captured with a camera and the speckle pattern is analyzed. A Q-switched Nd:YLF laser is used for simultaneous temperature measurements with the optoacoustic approach. Radial tissue movements in the micrometer regime have been observed. The signals evaluation by optical flow algorithms and generalized differences tuned out to be able to distinguish between regions with and without immediate cell damage. Both approaches have shown a sensitivity of 93% and a specificity above 99% at their optimal threshold.

  11. Laser sampling

    NASA Astrophysics Data System (ADS)

    Gorbatenko, A. A.; Revina, E. I.

    2015-10-01

    The review is devoted to the major advances in laser sampling. The advantages and drawbacks of the technique are considered. Specific features of combinations of laser sampling with various instrumental analytical methods, primarily inductively coupled plasma mass spectrometry, are discussed. Examples of practical implementation of hybrid methods involving laser sampling as well as corresponding analytical characteristics are presented. The bibliography includes 78 references.

  12. Laser ignition

    DOEpatents

    Early, James W.; Lester, Charles S.

    2004-01-13

    Sequenced pulses of light from an excitation laser with at least two resonator cavities with separate output couplers are directed through a light modulator and a first polarzing analyzer. A portion of the light not rejected by the first polarizing analyzer is transported through a first optical fiber into a first ignitor laser rod in an ignitor laser. Another portion of the light is rejected by the first polarizing analyzer and directed through a halfwave plate into a second polarization analyzer. A first portion of the output of the second polarization analyzer passes through the second polarization analyzer to a second, oscillator, laser rod in the ignitor laser. A second portion of the output of the second polarization analyzer is redirected by the second polarization analyzer to a second optical fiber which delays the beam before the beam is combined with output of the first ignitor laser rod. Output of the second laser rod in the ignitor laser is directed into the first ignitor laser rod which was energized by light passing through the first polarizing analyzer. Combined output of the first ignitor laser rod and output of the second optical fiber is focused into a combustible fuel where the first short duration, high peak power pulse from the ignitor laser ignites the fuel and the second long duration, low peak power pulse directly from the excitation laser sustains the combustion.

  13. CW laser pumped emerald laser

    SciTech Connect

    Shand, M.L.; Lai, S.T.

    1984-02-01

    A CW laser-pumped emerald laser is reported. A 34 percent output power slope efficiency is observed with longitudinal pumping by a krypton laser in a nearly concentric cavity. The laser has been tuned from 728.8 to 809.0 nm. Losses in emerald are larger than those of alexandrite determined in a similar cavity. The present data also indicate that the excited state absorption minimum is shifted from that of alexandrite. 13 references.

  14. Cutaneous lasers.

    PubMed

    Fedok, Fred G; Garritano, Frank; Portela, Antonio

    2013-02-01

    There has been a remarkable development and evolution of laser technology, leading to adaptation of lasers for medical use and the treatment of skin problems and disorders. Many treatments that required incisional surgery and other invasive methods are now preferentially treated with a laser. Although laser advances have resulted in the availability of some amazing tools, they require the clinical skill and judgment of the clinician for their optimal use. This article provides a clinically oriented overview of many of the lasers valuable in facial plastic surgery. Basic science, clinical adaptations, and patient management topics are covered. Copyright © 2013 Elsevier Inc. All rights reserved.

  15. Laser device

    DOEpatents

    Scott, Jill R.; Tremblay, Paul L.

    2004-11-23

    A laser device includes a target position, an optical component separated a distance J from the target position, and a laser energy source separated a distance H from the optical component, distance H being greater than distance J. A laser source manipulation mechanism exhibits a mechanical resolution of positioning the laser source. The mechanical resolution is less than a spatial resolution of laser energy at the target position as directed through the optical component. A vertical and a lateral index that intersect at an origin can be defined for the optical component. The manipulation mechanism can auto align laser aim through the origin during laser source motion. The laser source manipulation mechanism can include a mechanical index. The mechanical index can include a pivot point for laser source lateral motion and a reference point for laser source vertical motion. The target position can be located within an adverse environment including at least one of a high magnetic field, a vacuum system, a high pressure system, and a hazardous zone. The laser source and an electro-mechanical part of the manipulation mechanism can be located outside the adverse environment. The manipulation mechanism can include a Peaucellier linkage.

  16. Laser device

    DOEpatents

    Scott, Jill R.; Tremblay, Paul L.

    2007-07-10

    A laser device includes a target position, an optical component separated a distance J from the target position, and a laser energy source separated a distance H from the optical component, distance H being greater than distance J. A laser source manipulation mechanism exhibits a mechanical resolution of positioning the laser source. The mechanical resolution is less than a spatial resolution of laser energy at the target position as directed through the optical component. A vertical and a lateral index that intersect at an origin can be defined for the optical component. The manipulation mechanism can auto align laser aim through the origin during laser source motion. The laser source manipulation mechanism can include a mechanical index. The mechanical index can include a pivot point for laser source lateral motion and a reference point for laser source vertical motion. The target position can be located within an adverse environment including at least one of a high magnetic field, a vacuum system, a high pressure system, and a hazardous zone. The laser source and an electro-mechanical part of the manipulation mechanism can be located outside the adverse environment. The manipulation mechanism can include a Peaucellier linkage.

  17. Laser ignition

    DOEpatents

    Early, James W.; Lester, Charles S.

    2003-01-01

    In the apparatus of the invention, a first excitation laser or other excitation light source is used in tandem with an ignitor laser to provide a compact, durable, engine deployable fuel ignition laser system. Reliable fuel ignition is provided over a wide range of fuel conditions by using a single remote excitation light source for one or more small lasers located proximate to one or more fuel combustion zones. In a third embodiment, alternating short and long pulses of light from the excitation light source are directed into the ignitor laser. Each of the embodiments of the invention can be multiplexed so as to provide laser light energy sequentially to more than one ignitor laser.

  18. Experimental microendoscopic photoablative laser goniotomy as a surgical model for the treatment of dysgenetic glaucoma.

    PubMed

    Jacobi, P C; Dietlein, T S; Krieglstein, G K

    1996-11-01

    The aim of this study was to investigate the feasibility of photoablative Er:YAG laser goniotomy under microendoscopic control in a surgical cloudy corneal model of primary infantile glaucoma. Pectinate ligaments of 12 freshly enucleated cadaver porcine eyes were treated by ab interno single-pulse (5 mJ, 200 microseconds) Er:YAG laser (2.94 microns) photoablation. Through a clear corneal incision near the limbus an ophthalmic microendoscope (18 and 20 gauge) was inserted into the anterior chamber. Internal structures were observed and photoablative laser goniotomy was conducted under video guidance. Following treatment all eyes were prepared for light and scanning electron microscopy. Anterior chamber angle structures and tissue photoablation were clearly visualized on the videoscreen using ophthalmic microendoscopy. Energy settings of 5 mJ per pulse proved to be sufficient for reproducible photoablation of pectinate ligaments, accompanied by the root of the iris falling back and exposing trabecular meshwork. This was confirmed histopathologically. Scatter thermal damage was less than 30 microns. This new therapeutic modality, which combines endoscopic visualization of the internal structures with photoablative laser goniotomy, can be effective in the management of dysgenetic glaucoma in the presence of a cloudy cornea. High reproducibility of contact laser photoablation enabled sufficient control of incision depth and was not accompanied by inadvertent tissue damage to adjacent intraocular structures.

  19. Use of picosecond infrared laser for micromanipulation of early mammalian embryos.

    PubMed

    Karmenyan, Artashes V; Shakhbazyan, Avetik K; Sviridova-Chailakhyan, Tatiana A; Krivokharchenko, Alexander S; Chiou, Arthur E; Chailakhyan, Levon M

    2009-10-01

    A high repetition rate (80 MHz) picosecond pulse (approximately 2 psec) infrared laser was used for the inactivation (functional enucleation) of oocytes and two-cell mouse embryos and also for the fusion of blastomeres of two-cell mouse embryos. The laser inactivation of both blastomeres of two-cell mouse embryos by irradiation of nucleoli completely blocked further development of the embryo. The inactivation of one blastomere, however, did not affect the ability of the second intact blastomere to develop into a blastocyst after treatment. Laser inactivation of oocytes at Metaphase II (MII) stage and parthenogenetically activated pronuclear oocytes also completely blocked their ability for further development. Suitable doses of irradiation in cytoplasm region did not affect the ability of embryos and activated oocytes to development. The efficiency of laser induced fusion for blastomeres of two-cell embryos was 66.7% and all the tetraploid embryos developed successfully into blastocysts in culture. Our results demonstrate unique opportunities of the applications of a suitable infrared periodic pulse laser as a universal microsurgery tool for individual living cells.

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

    PubMed

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

    2015-02-01

    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. 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. 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. 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.

  1. 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

  2. Influence of laser photocoagulation on choroidal capillary cytoarchitecture

    PubMed Central

    Guymer, R.; Hageman, G.; Bird, A.

    2001-01-01

    AIM—To identify if laser photocoagulation induces morphological changes specifically related to the choroidal capillary endothelial processes that protrude into Bruch's membrane.
METHODS—Two human eyes and one adult macaque monkey eye received retinal laser photocoagulation that was just suprathreshold, before enucleation or exenteration. They were examined by electron microscopy to determine the length of the endothelial processes emanating from the choroidal capillaries in the region around the laser burn. One human and two monkey untreated eyes were used for comparison.
RESULTS—In human eyes, there was no increase in the number of processes 15 hours after laser treatment but at 5 days the processes were more numerous and longer within 400-500 µm of the burn than in the untreated half of the same eye. The processes were longer 9 days after photocoagulation in the monkey, when compared with untreated monkeys, and some breached the elastic lamina, a phenomenon not seen in the untreated eyes. Qualitative differences were also noted in the endothelial cell processes following photocoagulation. Neovascularisation was not observed.
CONCLUSIONS—Protrusion of choroidal endothelial cell processes into Bruch's membrane is a normal anatomical feature but the number, length, and morphology of the processes change following mild photocoagulation. It is plausible that these processes may play a part in the clearance of debris from Bruch's membrane, and represent an early stage of angiogenesis. If the latter is true prophylactic laser photocoagulation at just suprathreshold levels may carry a risk of inducing choroidal neovascularisation.

 PMID:11133710

  3. Laser Systems

    NASA Technical Reports Server (NTRS)

    1985-01-01

    Tunable diode lasers are employed as radiation sources in high resolution infrared spectroscopy to determine spectral characteristics of gaseous compounds. With other laser systems, they are produced by Spectra-Physics, and used to monitor chemical processes, monitor production of quantity halogen lamps, etc. The Laser Analytics Division of Spectra-Physics credits the system's reliability to a program funded by Langley in the 1970s. Company no longer U.S.-owned. 5/22/97

  4. Laser apparatus

    DOEpatents

    Lewis, Owen; Stogran, Edmund M.

    1980-01-01

    Laser apparatus is described wherein an active laser element, such as the disc of a face-pumped laser, is mounted in a housing such that the weight of the element is supported by glass spheres which fill a chamber defined in the housing between the walls of the housing and the edges of the laser element. The uniform support provided by the spheres enable the chamber and the pump side of the laser element to be sealed without affecting the alignment or other optical properties of the laser element. Cooling fluid may be circulated through the sealed region by way of the interstices between the spheres. The spheres, and if desired also the cooling fluid may contain material which absorbs radiation at the wavelength of parasitic emissions from the laser element. These parasitic emissions enter the spheres through the interface along the edge surface of the laser element and it is desirable that the index of refraction of the spheres and cooling fluid be near the index of refraction of the laser element. Thus support, cooling, and parasitic suppression functions are all accomplished through the use of the arrangement.

  5. Laser ignition

    DOEpatents

    Early, James W.; Lester, Charles S.

    2002-01-01

    In the apparatus of the invention, a first excitation laser or other excitation light source capable of producing alternating beams of light having different wavelengths is used in tandem with one or more ignitor lasers to provide a compact, durable, engine deployable fuel ignition laser system. Reliable fuel ignition is provided over a wide range of fuel conditions by using the single remote excitation light source for pumping one or more small lasers located proximate to one or more fuel combustion zones with alternating wavelengths of light.

  6. Biocavity Lasers

    SciTech Connect

    Gourley, P.L.; Gourley, M.F.

    2000-10-05

    Laser technology has advanced dramatically and is an integral part of today's healthcare delivery system. Lasers are used in the laboratory analysis of human blood samples and serve as surgical tools that kill, burn or cut tissue. Recent semiconductor microtechnology has reduced the size o f a laser to the size of a biological cell or even a virus particle. By integrating these ultra small lasers with biological systems, it is possible to create micro-electrical mechanical systems that may revolutionize health care delivery.

  7. Laser Physics and Laser Techniques.

    DTIC Science & Technology

    1980-02-01

    is probably better than will ever be needed. Publications that have appeared, or are in the final stages of preparation, covering the FHT algorithm...and the understanding of the energy storage and laser trigger requirements make pursuit of a two photon laser a much more probable success now than...of energy migration for the amlec- 1) In the haigh comipressibility eginic produced by the laser tilar excited states, obtained by studying the decay

  8. Multimegajoule laser design. [Glass lasers

    SciTech Connect

    Manes, K.R.; Ozarski, R.G.; Hagen, W.F.; Holzrichtr, J.F.

    1985-08-01

    New technologies make multimegajoule glass lasers economically feasible. We have devised new laser architectures using harmonic switchout, target-plane holographic injection, phase conjugation, continuous apodization, and higher amplifier efficiencies. Our plan for building a multimegajoule laser for a recurring cost under $300 million relies on the following manufacturing economies of scale: high-volume glass production, rapid harmonic-crystal growth, capacitor sizing and packing to increase energy capacity, and part standardization.

  9. Heterodyne laser spectroscopy system

    DOEpatents

    Wyeth, Richard W.; Paisner, Jeffrey A.; Story, Thomas

    1989-01-01

    A heterodyne laser spectroscopy system utilizes laser heterodyne techniques for purposes of laser isotope separation spectroscopy, vapor diagnostics, processing of precise laser frequency offsets from a reference frequency and the like, and provides spectral analysis of a laser beam.

  10. Heterodyne laser spectroscopy system

    DOEpatents

    Wyeth, Richard W.; Paisner, Jeffrey A.; Story, Thomas

    1990-01-01

    A heterodyne laser spectroscopy system utilizes laser heterodyne techniques for purposes of laser isotope separation spectroscopy, vapor diagnostics, processing of precise laser frequency offsets from a reference frequency, and provides spectral analysis of a laser beam.

  11. Co Laser.

    DTIC Science & Technology

    1976-01-01

    newsletter setvice covering the moj-t recent research findings in 25 areas of industrial, technological , and sociological interest— invaluable information...service will be backdated to furnish you microfiche of reports issued earlier. Because of contractual arrangements with several Special Technology ...pressure electrical CO laser and, thereby, to develop the technology for high pres- sure, scalable, electric CO lasers exhibiting properties of

  12. Laser device

    DOEpatents

    Scott, Jill R.; Tremblay, Paul L.

    2008-08-19

    A laser device includes a virtual source configured to aim laser energy that originates from a true source. The virtual source has a vertical rotational axis during vertical motion of the virtual source and the vertical axis passes through an exit point from which the laser energy emanates independent of virtual source position. The emanating laser energy is collinear with an orientation line. The laser device includes a virtual source manipulation mechanism that positions the virtual source. The manipulation mechanism has a center of lateral pivot approximately coincident with a lateral index and a center of vertical pivot approximately coincident with a vertical index. The vertical index and lateral index intersect at an index origin. The virtual source and manipulation mechanism auto align the orientation line through the index origin during virtual source motion.

  13. Intraocular pressure measurements during flap preparation using 2 femtosecond lasers and 1 microkeratome in human donor eyes.

    PubMed

    Vetter, Jan M; Faust, Melissa; Gericke, Adrian; Pfeiffer, Norbert; Weingärtner, Wolf E; Sekundo, Walter

    2012-11-01

    To evaluate and compare intraocular pressures (IOPs) during flap preparations performed using 2 femtosecond lasers and a mechanical microkeratome in human donor globes. University Medical Center Mainz, Mainz, and Euroeyes Clinic Stuttgart, Stuttgart, Germany. Experimental study. A cannula was inserted through the optic nerve in human globes. The IOP was obtained continuously during flap preparation using the 60 kHz Intralase femtosecond laser, the 200 kHz Visumax femtosecond laser, or the Amadeus II microkeratome. For each experiment, a normal lamellar flap preparation (regular procedure) and a worst-case procedure (femtosecond laser interface was pressed against globe until docking maneuver was aborted) were performed. During the regular procedure, the mean maximum IOP measured was 181.3 mm Hg (range 159.1 to 194.8 mm Hg) with the 60 kHz femtosecond laser, 77.6 mm Hg (range 58.1 to 100.3 mm Hg) with the 200 kHz femtosecond laser, and 198.1 mm Hg (range 162.8 to 299.6 mm Hg) with the microkeratome. During the worst-case procedure, the maximum measured IOP was 319.7 mm Hg (range 299.1 to 341.2 mm Hg) with the 60 kHz laser and 120.4 mm Hg (range 118.1 to 134.7 mm Hg) with the 200 kHz laser. Maximum IOPs during corneal flap preparations in human enucleated eyes were lower during performance of a regular procedure and a worst-case procedure with the 200 kHz femtosecond laser than with the 60 kHz femtosecond laser and the mechanical microkeratome. Dr. Sekundo is a member of the Scientific Advisory Board of Carl Zeiss Meditec AG, Jena, Germany. No author has a financial or proprietary interest in any material or method mentioned. Copyright © 2012 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

  14. Laser welding of chitosan-GNRs films for the closure of a capsulorhexis

    NASA Astrophysics Data System (ADS)

    Rossi, Francesca; Matteini, Paolo; Ratto, Fulvio; Menabuoni, Luca; Lenzetti, Ivo; Pini, Roberto

    2011-03-01

    In this work we present the first attempt to close the anterior lens capsule bag by the use of chitosan patches, where Gold Nanorods (GNRs) are embedded. GNRs exhibit intense localized plasmon resonances at optical frequencies in the near infrared (NIR): upon excitation with a NIR laser, a strong photothermal effect is produced, which can be exploited to develop minimally invasive therapies. Here we use the chitosan-GNRs films as a novel NIR sensitive nanocomposite for the photothermal conversion of NIR laser light during surgical interventions of tissue welding. Chitosan is an attractive biomaterial due to its biodegradability, biocompatibility, antimicrobial and wound healing-promoting activity. Colloidal GNRs were embedded in chitosan based, highly stabilized, flexible and easy-to-handle films, which were stored in water until the time of surgery. In these preliminary tests, a capsulorhexis was performed in freshly enucleated porcine eyes. The lens was aspired, then the patch was put onto the capsule bag and welded: a diode laser (810 nm) was used to deliver single spots (200 μm core diameter optical fiber) of local capsule/patch adhesion. Then the bag was refilled with silicon oil. The result is an immediate closure of the capsular tissue, with high mechanical strength. The laser welded chitosan- GNRs films are an innovative and highly stable solution to be exploited for the treatment of capsular breaks and for the implementation of a lens refilling procedure.

  15. Fs-laser induced elasticity changes to improve presbyopic lens accommodation

    NASA Astrophysics Data System (ADS)

    Ripken, T.; Oberheide, U.; Ziltz, C.; Ertmer, W.; Gerten, G.; Lubatschowski, H.

    2005-04-01

    According to Helmholtz' theory of accommodation one of the mayor reasons for the development of presbyopia is the increasing sclerosis of the lens. One concept to delay the process of sclerosis or even regain the deformation ability of the lens might be the treatment of the lens by femtosecond laser pulses. Our aim was to evaluate appropriate laser parameters for this possible treatment and to analyse potential changes in deformation ability of the treated lenses. We performed different cutting patterns in enucleated pig lenses (ex vivo) using the disruptive effect of an ultrafast near-infrared laser induced optical breakdown. Pulse energies and spot separation of the laser pulses were varied to investigate the effect on the generated cut. For an evaluation of the gain in deformation ability the lenses were rotated before and after treatment and the changes in lens thickness due to centrifugal forces were measured. In result, a smooth cutting was possible with appropriate parameters. The experiments showed an increase of elasticity in 70% of the eyes. When the lenses were treated more statistically, an average deformation ability increase of nearly 20%, determined by the change of thickness between untreated and treated lens, was measured.

  16. New semiconductor diode laser emitting at 2 um for microsurgery applications

    NASA Astrophysics Data System (ADS)

    Gobbi, Pier Giorgio; Ragazzi, D.; Azzolini, Claudio; Trabucchi, Giuseppe; Brancato, Rosario

    1996-01-01

    A surgical laser instrument is presented, based on a semiconductor diode emitting in the spectral region around 2 micrometer, in continuous mode. At this wavelength tissue absorption is via histological water, and the interaction is purely thermal. A portable laser station was built, emitting up to 250 mW of optical power at 1.94 micrometers, out of the tip of a low- hydroxil fused-silica optical fiber of 200 micrometer diameter. Experiments have been performed both in vitro with enucleated porcine eyes and in vivo, on rabbits and rats. In vitreo-retinal surgery, retinectomies and incisions of epiretinal fibrotic membranes have been achieved. At reduced output power the laser radiation has been applied to the welding of tissues, in particular cornea, sclera and skin, with interesting results. This new laser source, characterized by ergonomic advantages like compactness, portability, long lifetime, reduced maintenance, is potentially attractive for a number of microsurgical procedures like micro- incisions, shallow coagulations, and welding of hydrated biological membranes.

  17. Preliminary study on the closure of the lens capsule by laser welding

    NASA Astrophysics Data System (ADS)

    Pini, Roberto; Rossi, Francesca; Menabuoni, Luca; Lenzetti, Ivo; Rossi, Giacomo; Parel, Jean-Marie

    2006-02-01

    We present a preliminary study of a new method, based on the laser welding of suitably prepared patches of capsular tissue for the closure of capsulorhexes in the lens capsule. This technique is proposed for the repair capsular breaks or tears caused by accidental traumas or ones produced intraoperatively during standard IOL implantation. Experiments were carried out ex vivo on freshly enucleated porcine eyes. Patches of anterior capsular tissue, collected from donor eyes, were stained with a solution of Indocyanine Green (ICG) in sterile water. Closure tests on a capsulorhexis were performed by welding a stained patch onto the recipient capsule, using diode laser radiation at 810 nm, which greatly absorbed by the ICG-stained tissue. Laser radiation was delivered by means of a 200-micron-core-fiber, the tip of which was gently pressed onto the patch surface (contact welding technique) so as to produce effective tissue welding in underwater conditions. Laser-welded capsular tissue was found to have good resistance to mechanical load, comparable in fact to that of healthy tissue.

  18. Morphologic evaluations of Q-switched Nd:YAG laser injury of human retina

    NASA Astrophysics Data System (ADS)

    Scales, David K.; Schuschereba, Steven T.; Lund, David J.; Stuck, Bruce E.

    1997-05-01

    Depiction of the cellular and immune responses in the human model is critical to design rational therapies preventing/limiting cellular destruction and ultimately functional visual loss following acute laser injuries. We report the light and electron microscopy histologic findings in a controlled ocular human laser exposure. Following informed consent, the normal eye of a patient scheduled to undergo exenteration for invasive carcinoma of the orbit was exposed to both continuous wave and Q-switched lasers. Four hours prior to exenteration, argon G lesions were placed in the superior/temporal quadrant and Nd:YAG lesions were placed in the inferior/temporal quadrant. After enucleation, the retina was prepared for routine light and transmission electron microscopy. Histology of the argon G lesions showed primarily photoreceptor and RPE photocoagulation damage. Neutrophil adhesion was limited within the choroid and no neutrophils were observed in the subretinal space. In contrast, the 4 hr Nd:YAG lesions showed extensive retinal disruption, hemorrhage within subretinal and intraretinal spaces, neutrophil accumulation in the retina, and an extensive neutrophil chemotaxic and emigration response in the choroid. Severe laser injuries elicit a significant neutrophil response by 4 hr, suggesting that neutrophils should be an early stage therapeutic target.

  19. High throughput laser processing

    SciTech Connect

    Harley, Gabriel; Pass, Thomas; Cousins, Peter John; Viatella, John

    2016-12-27

    A solar cell is formed using a solar cell ablation system. The ablation system includes a single laser source and several laser scanners. The laser scanners include a master laser scanner, with the rest of the laser scanners being slaved to the master laser scanner. A laser beam from the laser source is split into several laser beams, with the laser beams being scanned onto corresponding wafers using the laser scanners in accordance with one or more patterns. The laser beams may be scanned on the wafers using the same or different power levels of the laser source.

  20. Laser goniometer

    DOEpatents

    Fairer, George M.; Boernge, James M.; Harris, David W.; Campbell, DeWayne A.; Tuttle, Gene E.; McKeown, Mark H.; Beason, Steven C.

    1993-01-01

    The laser goniometer is an apparatus which permits an operator to sight along a geologic feature and orient a collimated lamer beam to match the attitude of the feature directly. The horizontal orientation (strike) and the angle from horizontal (dip), are detected by rotary incremental encoders attached to the laser goniometer which provide a digital readout of the azimuth and tilt of the collimated laser beam. A microprocessor then translates the square wave signal encoder outputs into an ASCII signal for use by data recording equipment.

  1. Laser propulsion

    NASA Technical Reports Server (NTRS)

    Rom, F. E.; Putre, H. A.

    1972-01-01

    The use of an earth-based high-power laser beam to provide energy for earth-launched rocket vehicle is investigated. The laser beam energy is absorbed in an opaque propellant gas and is converted to high-specific-impulse thrust by expanding the heated propellant to space by means of a nozzle. This laser propulsion scheme can produce specific impulses of several thousand seconds. Payload to gross-weight fractions about an order of magnitude higher than those for conventional chemical earth-launched vehicles appear possible. There is a potential for a significant reduction in cost per payload mass in earth orbit.

  2. Explosive laser

    DOEpatents

    Robinson, C.P.; Jensen, R.J.; Davis, W.C.; Sullivan, J.A.

    1975-09-01

    This patent relates to a laser system wherein reaction products from the detonation of a condensed explosive expand to form a gaseous medium with low translational temperature but high vibration population. Thermal pumping of the upper laser level and de-excitation of the lower laser level occur during the expansion, resulting in a population inversion. The expansion may be free or through a nozzle as in a gas-dynamic configuration. In one preferred embodiment, the explosive is such that its reaction products are CO$sub 2$ and other species that are beneficial or at least benign to CO$sub 2$ lasing. (auth)

  3. Corneal tissue welding with infrared laser irradiation after clear corneal incision.

    PubMed

    Rasier, Rfat; Ozeren, Mediha; Artunay, Ozgür; Bahçecioğlu, Halil; Seçkin, Ismail; Kalaycoğlu, Hamit; Kurt, Adnan; Sennaroğlu, Alphan; Gülsoy, Murat

    2010-09-01

    The aim of this study was to investigate the potential of infrared lasers for corneal welding to seal corneal cuts done in an experimental animal model. Full-thickness corneal cuts on freshly enucleated bovine eyes were irradiated with infrared (809-nm diode, 980-nm diode, 1070-nm YLF, and 1980-nm Tm:YAP) lasers to get immediate laser welding. An 809-nm laser was used with the topical application of indocyanine green to enhance the photothermal interaction at the weld site. In total, 60 bovine eyes were used in this study; 40 eyes were used in the first part of the study for the determination of optimal welding parameters (15 eyes were excluded because of macroscopic carbonization, opacification, or corneal shrinkage; 2 eyes were used for control), and 20 eyes were used for further investigation of more promising lasers (YLF and Tm:YAP). Laser wavelength, irradiating power, exposure time, and spot size were the dose parameters, and optimal dose for immediate closure with minimal thermal damage was estimated through histological examination of welded samples. In the first part of the study, results showed that none of the applications was satisfactory. Full-thickness success rates were 28% (2 of 7) for 809-nm and for 980-nm diode lasers and 67% (2 of 3) for 1070-nm YLF and (4 of 6) for 1980-nm Tm:YAP lasers. In the second part of the study, YLF and Tm:YAP lasers were investigated with bigger sample size. Results were not conclusive but promising again. Five corneal incisions were full-thickness welded out of 10 corneas with 1070-nm laser, and 4 corneal incisions were partially welded out of 10 corneas with 1980-nm laser in the second part of the study. Results showed that noteworthy corneal welding could be obtained with 1070-nm YLF laser and 1980-nm Tm:YAP laser wavelengths. Furthermore, in vitro and in vivo studies will shed light on the potential usage of corneal laser welding technique.

  4. The efficacy and safety of episcleral pigmentation removal from pig eyes: using a 532-nm quality-switched Nd: YAG laser.

    PubMed

    Kim, Jae Yong; Lee, Hee Gyung; Kim, Myoung Joon; Park, Hye Young; Kook, Michael S; Tchah, Hungwon

    2012-12-01

    To evaluate the efficacy and safety of removing episcleral pigmentation from pig eyes using a 532-nm Q-switched Nd:YAG laser. Forty-four porcine eyes with episcleral pigmentation were enucleated approximately 3 hours after death. After conjunctival dissection, 0.5×1.0 cm-sized segments of pigmented episcleral surface underwent laser treatment. To determine the minimal energy fluence required for effective episcleral pigmentation removal, the laser output was set to 2, 3.2, 4, 5, and 6 J/cm for 20 eyes. To investigate thermal effects, the surface temperatures of the episclera were measured in the remaining 24 eyes before and after laser treatment in which the minimal energy fluence required to effectively remove episcleral pigmentation was used. Episcleral pigmentation began to fade immediately with a laser setting of 2 J/cm and was satisfactorily removed immediately with a laser setting of 4 J/cm. The increase in surface temperature was 0.90±0.37°C from baseline with a laser setting of 4 J/cm (P>0.05). Light-microscopic analysis showed that levels of melanin granules decreased by laser treatment in all tested episcleral tissues. The retinal pigment epithelium and the choroid were not affected by treatment. However, the collagen fiber structure was damaged after laser treatment with settings of more than 5 J/cm, as showed by the loss of straight profiles, although the damage was confined to the outer one third of the scleral stroma. 532-nm Q-switched Nd:YAG laser treatment is effective and safe for the removal of episcleral pigmentation in pig eyes. Our findings indicate that the laser system may be effective for the removal of episcleral pigmentation in cases of oculodermal melanocytosis, and further investigation is necessary to evaluate long-term safety of laser treatment.

  5. Laser fusion

    SciTech Connect

    Smit, W.A.; Boskma, P.

    1980-12-01

    Unrestricted laser fusion offers nations an opportunity to circumvent arms control agreements and develop thermonuclear weapons. Early laser weapons research sought a clean radiation-free bomb to replace the fission bomb, but this was deceptive because a fission bomb was needed to trigger the fusion reaction and additional radioactivity was induced by generating fast neutrons. As laser-implosion experiments focused on weapons physics, simulating weapons effects, and applications for new weapons, the military interest shifted from developing a laser-ignited hydrogen bomb to more sophisticated weapons and civilian applications for power generation. Civilian and military research now overlap, making it possible for several countries to continue weapons activities and permitting proliferation of nuclear weapons. These countries are reluctant to include inertial confinement fusion research in the Non-Proliferation Treaty. 16 references. (DCK)

  6. Shooting Lasers

    NASA Image and Video Library

    2012-11-02

    This picture shows a lab demonstration of the measurement chamber inside the Tunable Laser Spectrometer, an instrument that is part of the Sample Analysis at Mars investigation on NASA Curiosity rover.

  7. [Laser myringotomy].

    PubMed

    Hassmann-Poznańska, Elzbieta; Skotnicka, Bozena

    2002-01-01

    The aim of the study was assessment of the qualities of laser-assisted myringotomy (LAM) as a treatment for acute and secretory otitis media. Laser-assisted myringotomy was performed on 65 children (113 ears) mean age 6.2 years diagnosed with secretory otitis media (80%), recurrent secretory otitis media (11%) and acute otitis media (9%). Myringotomy was performed under general anesthesia using the OtoLAM device (ESC/Sharplan, Israel). In 64 ears pressure equalisation tubes were inserted after fenestration of the tympanic membrane with laser. Adenoidectomy alone or with tonsillectomy was performed at the same time in 51 cases. Laser tympanostomies remained patent for 7-32 days. All tympanostomies healed with no noticeable scarring. LAM appears to be a safe, and easy to performed, alternative technique in the treatment of otitis media.

  8. Laser barometer

    SciTech Connect

    Abercrombie, K.R.; Shiels, D.; Rash, T.

    1998-04-01

    This paper describes an invention of a pressure measuring instrument which uses laser radiation to sense the pressure in an enclosed environment by means of measuring the change in refractive index of a gas - which is pressure dependent.

  9. Laser Cutting

    DTIC Science & Technology

    1988-06-01

    lasers that are optically modified to produce high beam quality at reduced power levels for precision drilling and trepanning. * Nd:YAG lasers with...a smooth, dross-free cut face while the marking consists of a series of precisely placed shallow pits where surface finish and dross are not usually...neodymium:yttrium-aluminum-garnet (Nd:YAG) pulsed cutting data because the technique is considered vital in meeting the detailed precision cutting

  10. Laser Technology

    NASA Technical Reports Server (NTRS)

    1989-01-01

    Amoco Laser Company, a subsidiary of Amoco Corporation, has developed microlasers for the commercial market based on a JPL concept for optical communications over interplanetary distances. Lasers emit narrow, intense beams of light or other radiation. The beams transmit communication signals, drill, cut or melt materials or remove diseased body tissue. The microlasers cover a broad portion of the spectrum, and performance is improved significantly. Current applications include medical instrumentation, color separation equipment, telecommunications, etc.

  11. Evaluation of Color-Changing Effect and Complications After Nd: YAG Laser Application On Iris Surface

    PubMed Central

    Yildirim, Yildiray; Duzgun, Eyup; Kar, Taner; Sonmez, Murat; Kucukodaci, Zafer; Ersanli, Dilaver; Basoglu, Ayhan

    2016-01-01

    Background The aim of this study was to evaluate the color-changing effect and adverse effects after Nd: YAG laser application on the iris surface of rabbit eyes. Material/Methods The study was performed on right eyes of 12 pigmented rabbits. A laser device that produces frequency doubled 532 nm wavelength Nd: YAG laser with 900 μm spot diameter was used. The laser was applied in 3 sessions at 2-week intervals, at energy levels of 0.8 mJ in Group A and 1.5 mJ in Group B. Slit-lamp examinations and measurements of intraocular pressure (IOP) using a Tono-Pen were performed before and 1 day after each laser session. Iris thickness (IT) was measured at the beginning and the end using an ultrasonic biomicroscope. The eyes were enucleated for histopathologic examination on day 60. Results On the first day after each laser session, maximum grade 1 anterior chamber flare and cells were observed in both groups. In all eyes, flare and cells disappeared at the end of the first week. There was no significant difference in the IOP and IT values between measurements performed prior to and after laser sessions during the study (p>0.05). None of the eyes showed complications such as corneal edema, hypopyon, posterior synechia, transillumination defect, or pupillary defect. In histopathological examinations, reduction in pigment density was more profound in Group B compared to Group A, which was statistically significant (p<0.019). Conclusions There were no serious complications apart from mild transient inflammatory signs. Change in iris color was more evident at the end of the second month. PMID:26751845

  12. Laser Physics and Laser Spectroscopy.

    DTIC Science & Technology

    1983-06-01

    Mass Spectroscopy X -ray spectroscopy Single Crystal Fibers X -ray lithography Vacuum Ultraviolet Laser Sow-ce X -ray microscopy as. AISYRACT (Cenue an...UNCLASSIFIED SCUNITYV CLASSIFICATION OF THIS PAGUZ(lM DWO &aeA") 20. (continued) studied and compared the laser produced plasma X -ray source to other X -ray...sourc s such as synchrotron and rotating anodes. It is clear that the laser plasma X -ra source has an important role to play in soft X -ray

  13. Laser optomechanics

    NASA Astrophysics Data System (ADS)

    Yang, Weijian; Adair Gerke, Stephen; Wei Ng, Kar; Rao, Yi; Chase, Christopher; Chang-Hasnain, Connie J.

    2015-09-01

    Cavity optomechanics explores the interaction between optical field and mechanical motion. So far, this interaction has relied on the detuning between a passive optical resonator and an external pump laser. Here, we report a new scheme with mutual coupling between a mechanical oscillator supporting the mirror of a laser and the optical field generated by the laser itself. The optically active cavity greatly enhances the light-matter energy transfer. In this work, we use an electrically-pumped vertical-cavity surface-emitting laser (VCSEL) with an ultra-light-weight (130 pg) high-contrast-grating (HCG) mirror, whose reflectivity spectrum is designed to facilitate strong optomechanical coupling, to demonstrate optomechanically-induced regenerative oscillation of the laser optomechanical cavity. We observe >550 nm self-oscillation amplitude of the micromechanical oscillator, two to three orders of magnitude larger than typical, and correspondingly a 23 nm laser wavelength sweep. In addition to its immediate applications as a high-speed wavelength-swept source, this scheme also offers a new approach for integrated on-chip sensors.

  14. Laser optomechanics

    PubMed Central

    Yang, Weijian; Adair Gerke, Stephen; Wei Ng, Kar; Rao, Yi; Chase, Christopher; Chang-Hasnain, Connie J.

    2015-01-01

    Cavity optomechanics explores the interaction between optical field and mechanical motion. So far, this interaction has relied on the detuning between a passive optical resonator and an external pump laser. Here, we report a new scheme with mutual coupling between a mechanical oscillator supporting the mirror of a laser and the optical field generated by the laser itself. The optically active cavity greatly enhances the light-matter energy transfer. In this work, we use an electrically-pumped vertical-cavity surface-emitting laser (VCSEL) with an ultra-light-weight (130 pg) high-contrast-grating (HCG) mirror, whose reflectivity spectrum is designed to facilitate strong optomechanical coupling, to demonstrate optomechanically-induced regenerative oscillation of the laser optomechanical cavity. We observe >550 nm self-oscillation amplitude of the micromechanical oscillator, two to three orders of magnitude larger than typical, and correspondingly a 23 nm laser wavelength sweep. In addition to its immediate applications as a high-speed wavelength-swept source, this scheme also offers a new approach for integrated on-chip sensors. PMID:26333804

  15. Laser Angioplasty

    NASA Technical Reports Server (NTRS)

    1990-01-01

    The principal method of dealing with coronary artery blockage is bypass surgery. A non-surgical alternative available to some patients is balloon angioplasty. For several years, medical researchers have been exploring another alternative that would help a wider circle of patients than the balloon treatment and entail less risk than bypass surgery. A research group is on the verge of an exciting development: laser angioplasty with a 'cool' type of laser, called an excimer laser, that does not damage blood vessel walls and offers non-surgical cleansing of clogged arteries with extraordinary precision. The system is the Dymer 200+ Excimer Laser Angioplasty System, developed by Advanced Intraventional Systems. Used in human clinical tests since 1987, the system is the first fully integrated 'cool' laser capable of generating the requisite laser energy and delivering the energy to target arteries. Thirteen research hospitals in the U.S. have purchased Dymer 200+ systems and used them in clinical trials in 121 peripheral and 555 coronary artery cases. The success rate in opening blocked coronary arteries is 85 percent, with fewer complications than in balloon angioplasty. Food and Drug Administration approval for the system is hoped for in the latter part of 1990. * Advanced Intraventional Systems became Spectranetics in 1994 and discontinued the product.

  16. Microscopic characterization of collagen modifications induced by low-temperature diode-laser welding of corneal tissue.

    PubMed

    Matteini, Paolo; Rossi, Francesca; Menabuoni, Luca; Pini, Roberto

    2007-08-01

    Laser welding of corneal tissue that employs diode lasers (810 nm) at low power densities (12-20 W/cm(2)) in association with Indocyanine Green staining of the wound is a technique proposed as an alternative to conventional suturing procedures. The aim of this study is to evaluate, by means of light (LM) and transmission electron microscopy (TEM) analyses, the structural modifications induced in laser-welded corneal stroma. Experiments were carried out in 20 freshly enucleated pig eyes. A 3.5 mm in length full-thickness cut was produced in the cornea, and was then closed by laser welding. Birefringence modifications in samples stained with picrosirius red dye were analyzed by polarized LM to assess heat damage. TEM analysis was performed on ultra-thin slices, contrasted with uranyl acetate and lead citrate, in order to assess organization and size of type I collagen fibrils after laser welding. LM evidenced bridges of collagen bundles between the wound edges, with a loss of regular lamellar organization at the welded site. Polarized LM indicated that birefringence properties were mostly preserved after laser treatment. TEM examinations revealed the presence of quasi-ordered groups of fibrils across the wound edges preserving their interfibrillar spacing. These fibrils appeared morphologically comparable to those in the control tissue, indicating that type I collagen was not denatured during the diode laser corneal welding. The preservation of substantially intact, undenatured collagen fibrils in laser-welded corneal wounds supported the thermodynamic studies that we carried out recently, which indicated temperatures below 66 degrees C at the weld site under laser irradiation. This observation enabled us to hypothesize that the mechanism, proposed in the literature, of unwinding of collagen triple helixes followed by fibrils "interdigitation" is not likely to occur in the welding process that we set up for the corneal suturing.

  17. [Long-term results after prostate vaporisation : GreenLight™ laser vaporisation of the prostate and electrovaporisation].

    PubMed

    Rieken, M; Bachmann, A; Shariat, S F

    2016-11-01

    Various minimally invasive techniques are available for the surgical treatment of benign prostatic obstruction. Besides resection and enucleation, vaporization of the prostate is an attractive alternative. The aim of the present article is to provide a comprehensive literature review on long-term results of GreenLight™ laser vaporisation and electrovaporisation of the prostate. A literature search on long-term (≥5 years) results of GreenLight™ laser vaporization of the prostate and electrovaporisation of the prostate. Laser vaporization of the prostate with the GreenLight™ laser leads to an immediate and long-lasting improvement of voiding symptoms beyond 5 years. Currently, no long-term data of the 180 W laser model are available. With the former 80 W laser, an increased rate of reoperation due to recurrent obstruction has been described. As reoperation mainly occurs within the first 2 postoperative years, this suggests insufficient tissue ablation. Electrovaporisation of the prostate also leads to an improvement of voiding symptoms. However, only few studies on long-term results are available which report a relatively high rate of treatment failure. In addition, these studies have limitations in study design. Laser vaporisation of the prostate with the GreenLight™ laser seems to be an effective minimally invasive treatment alternative for BPO. However, long-term results of the current 180 W laser are still awaited. Based on limited data, electrovaporisation of the prostate currently cannot be recommended as an established treatment alternative.

  18. Laser Physics and Laser Spectroscopy.

    DTIC Science & Technology

    1986-03-01

    effect which limits the power throughout of a device; terbium qallium garnet (TGG), a Faraday isolator material; potassium niobate (KNbO 31 a nonlinear...extending the range of materials grown in fiber form. Two materials to be emphasized are terbium gallium garnet for optical isolators and potassium niobate...for doubling gallium arsenide diode lasers. References 1. R.H. Stolen, "Fiber Raman Lasers", Fiber and Integrated Optics, 3 (1980). 2. E. Ipoen and

  19. Laser beam monitoring system

    DOEpatents

    Weil, Bradley S.; Wetherington, Jr., Grady R.

    1985-01-01

    Laser beam monitoring systems include laser-transparent plates set at an angle to the laser beam passing therethrough and light sensor for detecting light reflected from an object on which the laser beam impinges.

  20. Laser Physics and Laser-Tissue Interaction

    PubMed Central

    Welch, A. J.; Torres, Jorge H.; Cheong, Wai-Fung

    1989-01-01

    Within the last few years, lasers have gained increasing use in the management of cardiovascular disease, and laser angioplasty has become a widely performed procedure. For this reason, a basic knowledge of lasers and their applications is essential to vascular surgeons, cardiologists, and interventional radiologists. To elucidate some fundamental concepts regarding laser physics, we describe how laser light is generated and review the properties that make lasers useful in medicine. We also discuss beam profile and spotsize, as well as dosimetric specifications for laser angioplasty. After considering laser-tissue interaction and light propagation in tissue, we explain how the aforementioned concepts apply to direct laser angioplasty and laser-balloon angioplasty. An understanding of these issues should prove useful not only in performing laser angioplasty but in comparing the reported results of various laser applications. (Texas Heart Institute Journal 1989;16:141-9) PMID:15227198

  1. Laser construction

    SciTech Connect

    Martin, D.W.; Osterhage, R.J.; Summa, K.M.

    1989-02-14

    A laser device is described comprising an elongated laser medium of crystal material having a cylindrical shape modified to have a flat face formed on one side thereof, a highly heat conducting mounting member having a flat surface on a portion thereof, the medium being mounted on the mounting member with the flat face of the medium in face-to-face relation with the flat surface on the mounting member, a heat sink member having a surface for attaching the mounting member to, a pump source including an array of laser diodes each having opposite ends and positioned in side-by-side single file relation, a second highly heat conducting mounting member having a surface on which the array of laser diodes is positioned, the second mounting member being mounted on the heat sink member wherein the array of laser diodes are in substantial alignment with the axis of the medium along the side thereof opposite from the flat face of the medium.

  2. Laser acceleration

    NASA Astrophysics Data System (ADS)

    Tajima, T.; Nakajima, K.; Mourou, G.

    2017-02-01

    The fundamental idea of Laser Wakefield Acceleration (LWFA) is reviewed. An ultrafast intense laser pulse drives coherent wakefield with a relativistic amplitude robustly supported by the plasma. While the large amplitude of wakefields involves collective resonant oscillations of the eigenmode of the entire plasma electrons, the wake phase velocity ˜ c and ultrafastness of the laser pulse introduce the wake stability and rigidity. A large number of worldwide experiments show a rapid progress of this concept realization toward both the high-energy accelerator prospect and broad applications. The strong interest in this has been spurring and stimulating novel laser technologies, including the Chirped Pulse Amplification, the Thin Film Compression, the Coherent Amplification Network, and the Relativistic Mirror Compression. These in turn have created a conglomerate of novel science and technology with LWFA to form a new genre of high field science with many parameters of merit in this field increasing exponentially lately. This science has triggered a number of worldwide research centers and initiatives. Associated physics of ion acceleration, X-ray generation, and astrophysical processes of ultrahigh energy cosmic rays are reviewed. Applications such as X-ray free electron laser, cancer therapy, and radioisotope production etc. are considered. A new avenue of LWFA using nanomaterials is also emerging.

  3. Tunable solid state lasers

    SciTech Connect

    Hammerling, R.; Budgor, A.B.; Pinto, A.

    1985-01-01

    This book presents the papers given at a conference on solid state lasers. Topics considered at the conference included transition-metal-doped lasers, line-narrowed alexandrite lasers, NASA specification, meteorological lidars, laser materials spectroscopy, laser pumped single pass gain, vibronic laser materials growth, crystal growth methods, vibronic laser theory, cross-fertilization through interdisciplinary fields, and laser action of color centers in diamonds.

  4. Header For Laser Diode

    NASA Technical Reports Server (NTRS)

    Rall, Jonathan A. R.; Spadin, Paul L.

    1990-01-01

    Header designed to contain laser diode. Output combined incoherently with outputs of other laser diodes in grating laser-beam combiner in optical communication system. Provides electrical connections to laser diode, cooling to thermally stabilize laser operation, and optomechanical adjustments that steer and focus laser beam. Range of adjustments provides for correction of worst-case decentering and defocusing of laser beam encountered with laser diodes. Mechanical configuration made simple to promote stability and keep cost low.

  5. Laser cosmology

    NASA Astrophysics Data System (ADS)

    Chen, P.

    2014-05-01

    Recent years have witnessed tremendous progress in our understanding of the cosmos, which in turn points to even deeper questions to be further addressed. Concurrently the laser technology has undergone dramatic revolutions, providing exciting opportunity for science applications. History has shown that the symbiosis between direct observations and laboratory investigation is instrumental in the progress of astrophysics. We believe that this remains true in cosmology. Current frontier phenomena related to particle astrophysics and cosmology typically involve one or more of the following conditions: (1) extremely high energy events;(2) very high density, high temperature processes; (3) super strong field environments. Laboratory experiments using high intensity lasers can calibrate astrophysical observations, investigate underlying dynamics of astrophysical phenomena, and probe fundamental physics in extreme limits. In this article we give an overview of the exciting prospect of laser cosmology. In particular, we showcase its unique capability of investigating frontier cosmology issues such as cosmic accelerator and quantum gravity.

  6. First application of laser welding in clinical transplantation of the cornea

    NASA Astrophysics Data System (ADS)

    Pini, Roberto; Menabuoni, Luca; Starnotti, Lorenzo

    2001-05-01

    After a 4-year-long pre-clinical experimentation carried out at first on enucleated eyes and then on animal models, we applied a new procedure of laser welding of the cornea on voluntary patients. The welding technique is based on controlled irradiation of the cornea by diode laser radiation (805 nm) operating at low power (60-90 mW) in association with a photoenhancing chromophore applied locally. The welding effect is very effective and selective, because it takes place only in the cut where chromophore is present, while the contiguous tissue remains completely untouched. In the clinical phase, this technique was firstly tested in corneal cuts of increasing length on 25 patients subjected to facoemulsification of the cataract, by both sclero-corneal and corneal tunnels, and to extracapsular cataract extraction by sclero-corneal and corneal cuts. As previously confirmed by histological analysis performed on animal samples, we observed in humans too an early and effective healing process, with a sensible reduction of the post-operatory astigmatism. Based on these positive results, we finally arrived at the first application of diode laser- assisted corneal welding to penetrating keratoplasty (corneal transplantation), where this technique has been employed as far as now in 3 cases to substitute the application of the continuous suture.

  7. fs-lentotomie: changing the accommodation amplitude of presbyopic human lenses by fs laser pulses

    NASA Astrophysics Data System (ADS)

    Schumacher, S.; Oberheide, U.; Theuer, H.; Fromm, M.; Ripken, T.; Gerten, G.; Ertmer, W.; Lubatschowski, H.

    2007-07-01

    According to Helmholtz' theory of accommodation one of the mayor reasons for the development of presbyopia is the increasing sclerosis of the lens. One concept to overcome this hardening of the lens is to regain its flexibility by inducing gliding planes inside the lens. Femtosecond laser pulses are a suitable tool for this treatment. Showing in former work that we could increase the flexibility of enucleated porcine (ex vivo) lenses up to 25%, we focused our recent work on human autopsy lenses. The age of the human donors ranged between 20 and 70 years. For an evaluation of the gain in flexibility the lens' thickness was measured undertaking the Fisher's spinning test before and after laser treatment. Depending on the age and the quality of applied cutting pattern the lens thickness increased after treatment up to 0.4 mm leading to an theoretical increase of several dioptres of optical power. The flexibility could be increased up to 70 % compared to the measurements before treatment. Since the age of the human donors had a broad range, leading to different degrees of lens hardening, the variance of the measured flexibility changes was up to 30%. An addition the influence of the laser treatment onto the lens on the accommodation amplitude will be shown in a three dimensional finite-element simulation.

  8. Excimer lasers

    NASA Technical Reports Server (NTRS)

    Palmer, A. J.; Hess, L. D.; Stephens, R. R.

    1976-01-01

    A theoretical and experimental investigation into the possibility of achieving CW discharge pumped excimer laser oscillation is reported. Detailed theoretical modeling of capillary discharge pumping of the XeF and KXe and K2 excimer systems was carried out which predicted the required discharge parameters for reaching laser threshold on these systems. Capillary discharge pumping of the XeF excimer system was investigated experimentally. The experiments revealed a lower excimer level population density than predicted theoretically by about an order of magnitude. The experiments also revealed a fluorine consumption problem in the discharge in agreement with theory.

  9. Laser barometer

    DOEpatents

    Abercrombie, Kevin R.; Shiels, David; Rash, Tim

    2001-02-06

    A pressure measuring instrument that utilizes the change of the refractive index of a gas as a function of pressure and the coherent nature of a laser light to determine the barometric pressure within an environment. As the gas pressure in a closed environment varies, the index of refraction of the gas changes. The amount of change is a function of the gas pressure. By illuminating the gas with a laser light source, causing the wavelength of the light to change, pressure can be quantified by measuring the shift in fringes (alternating light and dark bands produced when coherent light is mixed) in an interferometer.

  10. Graviton laser

    NASA Astrophysics Data System (ADS)

    Landry, A.; Paranjape, M. B.

    2016-08-01

    We consider the possibility of creating a graviton laser. The lasing medium would be a system of contained, ultra cold neutrons. Ultra cold neutrons are a quantum mechanical system that interacts with gravitational fields and with the phonons of the container walls. It is possible to create a population inversion by pumping the system using the phonons. We compute the rate of spontaneous emission of gravitons and the rate of the subsequent stimulated emission of gravitons. The gain obtainable is directly proportional to the density of the lasing medium and the fraction of the population inversion. The applications of a graviton laser would be interesting.

  11. Laser Resonator

    NASA Technical Reports Server (NTRS)

    Harper, L. L. (Inventor)

    1983-01-01

    An optical resonator cavity configuration has a unitary mirror with oppositely directed convex and concave reflective surfaces disposed into one fold and concertedly reversing both ends of a beam propagating from a laser rod disposed between two total internal reflection prisms. The optical components are rigidly positioned with perpendicularly crossed virtual rooflines by a compact optical bed. The rooflines of the internal reflection prisms, are arranged perpendicularly to the axis of the laser beam and to the optical axes of the optical resonator components.

  12. Laser barometer

    DOEpatents

    Abercrombie, Kevin R.; Shiels, David; Rash, Tim

    2001-02-06

    A pressure measuring instrument that utilizes the change of the refractive index of a gas as a function of pressure and the coherent nature of a laser light to determine the barometric pressure within an environment. As the gas pressure in a closed environment varies, the index of refraction of the gas changes. The amount of change is a function of the gas pressure. By illuminating the gas with a laser light source, causing the wavelength of the light to change, pressure can be quantified by measuring the shift in fringes (alternating light and dark bands produced when coherent light is mixed) in an interferometer.

  13. Dye laser principles, with applications

    SciTech Connect

    Duarte, F.J. . Dept. of Physics); Hillman, L.W. . Dept. of Physics)

    1990-01-01

    This book contains papers which explain dye laser principles. Topics covered include: laser dynamics, femtosecond dye lasers, CW dye lasers, technology of pulsed dye lases, photochemistry of laser dyes, and laser applications.

  14. Laser Accelerator

    DTIC Science & Technology

    2014-09-01

    stretched pulse with a low enough peak power to safely pass through the main laser gain medium usually Nd:glass or Ti:sapphire (3). The amplified pulse ...2.1 Chirped Gaussian Pulse . . . . . . . . . . . . . . . . . . . . . . 11 Figure 2.2 Diagram Illustrating Chirped Pulse Amplification...High Magnetic Field Laboratory . . . . . . . . . . . . . . . . . . . . . . . . . . 19 Figure 2.7 Cutaway Diagram of a Pulsed Magnet System at the

  15. Laser altimeter

    NASA Technical Reports Server (NTRS)

    1972-01-01

    The development of a laser altimeter for use in the Apollo Lunar Orbital Experiments mission is discussed. The altimeter provides precise measurement of an Apollo vehicle above the lunar surface from an orbit of 40 to 80 nautical miles. The technical characteristics of the altimeter are described. Management of the altimeter development program is analyzed.

  16. [Vascular lasers].

    PubMed

    Michaud, T

    2009-10-01

    After reviewing the main technical features of the lasers and flashlamps currently available, the indications for these devices are detailed, mainly port wine stains, facial telangiectasia, hemangiomas, and lower-limb varicosities. Respecting the principles of treatment (briefly reviewed herein), contributes to preventing complications, which are consequently becoming rare.

  17. Excimer lasers

    NASA Technical Reports Server (NTRS)

    Palmer, A. J.; Hess, L. D.; Stephens, R. R.; Pepper, D. M.

    1977-01-01

    The results of a two-year investigation into the possibility of developing continuous wave excimer lasers are reported. The program included the evaluation and selection of candidate molecular systems and discharge pumping techniques. The K Ar/K2 excimer dimer molecules and the xenon fluoride excimer molecule were selected for study; each used a transverse and capillary discharges pumping technique. Experimental and theoretical studies of each of the two discharge techniques applied to each of the two molecular systems are reported. Discharge stability and fluorine consumption were found to be the principle impediments to extending the XeF excimer laser into the continuous wave regime. Potassium vapor handling problems were the principal difficulty in achieving laser action on the K Ar/K2 system. Of the four molecular systems and pumping techniques explored, the capillary discharge pumped K Ar/K2 system appears to be the most likely candidate for demonstrating continuous wave excimer laser action primarily because of its predicted lower pumping threshold and a demonstrated discharge stability advantage.

  18. Laser Balancing

    NASA Technical Reports Server (NTRS)

    1981-01-01

    Mechanical Technology, Incorporated developed a fully automatic laser machining process that allows more precise balancing removes metal faster, eliminates excess metal removal and other operator induced inaccuracies, and provides significant reduction in balancing time. Manufacturing costs are reduced as a result.

  19. Laser Balancing

    NASA Astrophysics Data System (ADS)

    1981-01-01

    Mechanical Technology, Incorporated developed a fully automatic laser machining process that allows more precise balancing removes metal faster, eliminates excess metal removal and other operator induced inaccuracies, and provides significant reduction in balancing time. Manufacturing costs are reduced as a result.

  20. Nanowire Lasers

    NASA Astrophysics Data System (ADS)

    Couteau, C.; Larrue, A.; Wilhelm, C.; Soci, C.

    2015-05-01

    We review principles and trends in the use of semiconductor nanowires as gain media for stimulated emission and lasing. Semiconductor nanowires have recently been widely studied for use in integrated optoelectronic devices, such as light-emitting diodes (LEDs), solar cells, and transistors. Intensive research has also been conducted in the use of nanowires for subwavelength laser systems that take advantage of their quasione- dimensional (1D) nature, flexibility in material choice and combination, and intrinsic optoelectronic properties. First, we provide an overview on using quasi-1D nanowire systems to realize subwavelength lasers with efficient, directional, and low-threshold emission. We then describe the state of the art for nanowire lasers in terms of materials, geometry, andwavelength tunability.Next,we present the basics of lasing in semiconductor nanowires, define the key parameters for stimulated emission, and introduce the properties of nanowires. We then review advanced nanowire laser designs from the literature. Finally, we present interesting perspectives for low-threshold nanoscale light sources and optical interconnects. We intend to illustrate the potential of nanolasers inmany applications, such as nanophotonic devices that integrate electronics and photonics for next-generation optoelectronic devices. For instance, these building blocks for nanoscale photonics can be used for data storage and biomedical applications when coupled to on-chip characterization tools. These nanoscale monochromatic laser light sources promise breakthroughs in nanophotonics, as they can operate at room temperature, can potentially be electrically driven, and can yield a better understanding of intrinsic nanomaterial properties and surface-state effects in lowdimensional semiconductor systems.

  1. Laser diode pumped solid state laser

    SciTech Connect

    Baer, T.M.; Keirstead, M.S.

    1987-04-07

    This patent describes a high-efficiency, laser diode pumped array, frequency doubled, compact solid state laser, comprising: a rare earth doped birefringent solid laser rod selected from the group consisting of Nd:YLF, Nd:YALO having a front end and a back end, the rod producing a polarized output beam; a housing with means holding the laser rod in fixed position in the housing with its front end forward; a laser array having a predetermined wavelength pumping the laser rod, having a output frequency sufficiently matched to the laser rod to pump the laser rod, secured in the housing behind and in optical alignment with the rod; laser cavity means defining a laser cavity mounted in the housing with the laser rod positioned within the cavity, the laser cavity means further including within the cavity an output coupler means; a frequency doubler, positioned to receive a suitably polarized output beam from the laser rod and to halve its wavelength and double its frequency; a polarization means for polarizing the output beam of the laser rod and substantially maintaining a polarization which optimizes frequency doubling at the frequency doubler and means for matching a focused image of the laser diode with a lasing volume of the laser cavity.

  2. "Orientation teeth" in non-mechanical laser corneal trephination for penetrating keratoplasty: 2.94 µm Er:YAG v 193 nm ArF excimer laser

    PubMed Central

    Behrens, A.; Seitz, B.; Kuchle, M.; Langenbucher, A.; Kus, M.; Rummelt, C.; Naumann, G.

    1999-01-01

    BACKGROUND/AIMS—"Orientation teeth" at the donor trephination margin and correspondent "notches" at the host margin facilitate graft orientation and avoid "horizontal torsion" induced by asymmetric suture placement. In this study the quality and reproducibility of these structures created by non-mechanical laser corneal trephination were compared using two laser emissions.
METHODS—The procedure was performed in 20 enucleated pigs' eyes using open metal masks with eight "orientation teeth/notches" (0.3 × 0.15 mm, base × height), an automated globe rotation device, and either a 193 nm ArF excimer laser or a Q switched 2.94 µm Er:YAG laser. "Teeth/notches" were analysed by planimetry and scanning electron microscopy (SEM).
RESULTS—Mean size was 0.30 (0.027) × 0.16 (0.017) mm for "teeth" and 0.30 (0.035) × 0.15 (0.021) mm for "notches" (excimer), and 0.31 (0.022) × 0.16 (0.015) mm and 0.30 (0.031) × 0.14 (0.021) mm respectively (Er:YAG). Overall, variability of notches was higher than that of teeth. By SEM, comparable cut regularity and sustained ablation profile were observed with both lasers. However, the corneal surface at the cut edge appeared slightly elevated (⩽35 µm) in the Er:YAG group.
CONCLUSION—Orientation teeth/notches resembling those obtained with the excimer laser can be created using the Q switched Er:YAG laser, with potential advantages of lower costs, convenient equipment size, and solid state safety.

 PMID:10460766

  3. New laser source technology.

    PubMed

    Christensen, C P

    1984-04-13

    Over the past 5 to 8 years several new laser sources have been developed as a result of R & D efforts stimulated by a growing number of laser applications. Four families of new devices-semiconductor diod laser arrays, free electron lasers, rare gas halide excimer sources, and several new tunable solid-state lasers-show particular promise.

  4. Infrared Lasers in Chemistry.

    ERIC Educational Resources Information Center

    John, Phillip

    1982-01-01

    Selected infrared laser chemistry topics are discussed including carbon dioxide lasers, infrared quanta and molecules, laser-induced chemistry, structural isomerization (laser purification, sensitized reactions, and dielectric breakdown), and fundamental principles of laser isotope separation, focusing on uranium isotope separation. (JN)

  5. Making a Laser Level

    ERIC Educational Resources Information Center

    Hawkins, Harry

    2004-01-01

    This article describes how to construct a laser level. This laser level can be made using a typical 4' (or shorter) bubble level and a small laser point. The laser unit is detachable, so the bubble level can also be used in the conventional way. However, the laser level works better than a simple bubble level. Making this inexpensive device is an…

  6. Infrared Lasers in Chemistry.

    ERIC Educational Resources Information Center

    John, Phillip

    1982-01-01

    Selected infrared laser chemistry topics are discussed including carbon dioxide lasers, infrared quanta and molecules, laser-induced chemistry, structural isomerization (laser purification, sensitized reactions, and dielectric breakdown), and fundamental principles of laser isotope separation, focusing on uranium isotope separation. (JN)

  7. Making a Laser Level

    ERIC Educational Resources Information Center

    Hawkins, Harry

    2004-01-01

    This article describes how to construct a laser level. This laser level can be made using a typical 4' (or shorter) bubble level and a small laser point. The laser unit is detachable, so the bubble level can also be used in the conventional way. However, the laser level works better than a simple bubble level. Making this inexpensive device is an…

  8. Laser Photochemistry.

    DTIC Science & Technology

    1981-07-01

    reaction due to decreased adsorption of the species on the catalytic surface. For example, i. . . 41 in the catalytic decomposition of formic acid ...over platinum (Ulmstead and Lin, 1978), the preexcitation of the gaseous formic acid molecules (by a 10 W/cm2 CW CO2 laser) resulted in a 50% increase...attention is given to selective and thermal excitation and the role of multiphonon couplings, heterogeneous catalysis , and chemical vapor deposition and

  9. Bipolar transurethral enucleation and resection of the prostate versus bipolar resection of the prostate for prostates larger than 60gr: A retrospective study at a single academic tertiary care center.

    PubMed

    Wei, Yong; Xu, Ning; Chen, Shao-Hao; Li, Xiao-Dong; Zheng, Qing-Shui; Lin, Yun-Zhi; Xue, Xue-Yi

    2016-01-01

    To evaluate the efficacy and safety of bipolar transurethral enucleation and resection of the prostate (B-TUERP) versus bipolar transurethral resection of the prostate (B-TURP) in the treatment of prostates larger than 60g. Clinical data for 270 BPH patients who underwent B-TUERP and 204 patients who underwent B-TURP for BPH from May 2007 to May 2013 at our center were retrospectively analyzed. Outcome measures included operative time, decreased hemoglobin level, total prostate specific antigen (TPSA), International Prostate Symptom Score (IPSS), maximal urinary flow rate (Qmax), quality of life (QoL) score, post void residual urine volume (RUV), bladder irrigation duration, hospital stay, and the weight of resected prostatic tissue. Other measures included perioperative complications including transurethral resection syndrome (TURS), hyponatremia, blood transfusion, bleeding requiring surgery, postoperative acute urinary retention, urine incontinence and urinary sepsis. Patients in both groups were followed for two years. Compared with the B-TURP group, the B-TUERP group had shorter operative time, postoperative bladder irrigation duration and hospital stay, a greater amount of resected prostatic tissue, less postoperative hemoglobin decrease, better postoperative IPSS and Qmax, as well as lower incidences of hyponatremia, urinary sepsis, blood transfusion requirement, urine incontinence and reoperation (P<0.05 for all). B-TUERP is superior to B-TURP in the management of large volume BPH in terms of efficacy and safety, but this finding needs to be validated in further prospective, randomized, controlled studies. Copyright© by the International Brazilian Journal of Urology.

  10. Bipolar transurethral enucleation and resection of the prostate versus bipolar resection of the prostate for prostates larger than 60gr: A retrospective study at a single academic tertiary care center

    PubMed Central

    Wei, Yong; Xu, Ning; Chen, Shao-Hao; Li, Xiao-Dong; Zheng, Qing-Shui; Lin, Yun-Zhi; Xue, Xue-Yi

    2016-01-01

    ABSTRACT Objective: To evaluate the efficacy and safety of bipolar transurethral enucleation and resection of the prostate (B-TUERP) versus bipolar transurethral resection of the prostate (B-TURP) in the treatment of prostates larger than 60g. Material and Methods: Clinical data for 270 BPH patients who underwent B-TUERP and 204 patients who underwent B-TURP for BPH from May 2007 to May 2013 at our center were retrospectively analyzed. Outcome measures included operative time, decreased hemoglobin level, total prostate specific antigen (TPSA), International Prostate Symptom Score (IPSS), maximal urinary flow rate (Qmax), quality of life (QoL) score, post void residual urine volume (RUV), bladder irrigation duration, hospital stay, and the weight of resected prostatic tissue. Other measures included perioperative complications including transurethral resection syndrome (TURS), hyponatremia, blood transfusion, bleeding requiring surgery, postoperative acute urinary retention, urine incontinence and urinary sepsis. Patients in both groups were followed for two years. Results: Compared with the B-TURP group, the B-TUERP group had shorter operative time, postoperative bladder irrigation duration and hospital stay, a greater amount of resected prostatic tissue, less postoperative hemoglobin decrease, better postoperative IPSS and Qmax, as well as lower incidences of hyponatremia, urinary sepsis, blood transfusion requirement, urine incontinence and reoperation (P<0.05 for all). Conclusions: B-TUERP is superior to B-TURP in the management of large volume BPH in terms of efficacy and safety, but this finding needs to be validated in further prospective, randomized, controlled studies. PMID:27564286

  11. Project LASER

    NASA Technical Reports Server (NTRS)

    1990-01-01

    NASA formally launched Project LASER (Learning About Science, Engineering and Research) in March 1990, a program designed to help teachers improve science and mathematics education and to provide 'hands on' experiences. It featured the first LASER Mobile Teacher Resource Center (MTRC), is designed to reach educators all over the nation. NASA hopes to operate several MTRCs with funds provided by private industry. The mobile unit is a 22-ton tractor-trailer stocked with NASA educational publications and outfitted with six work stations. Each work station, which can accommodate two teachers at a time, has a computer providing access to NASA Spacelink. Each also has video recorders and photocopy/photographic equipment for the teacher's use. MTRC is only one of the five major elements within LASER. The others are: a Space Technology Course, to promote integration of space science studies with traditional courses; the Volunteer Databank, in which NASA employees are encouraged to volunteer as tutors, instructors, etc; Mobile Discovery Laboratories that will carry simple laboratory equipment and computers to provide hands-on activities for students and demonstrations of classroom activities for teachers; and the Public Library Science Program which will present library based science and math programs.

  12. Laser nitriding and laser carburizing of surfaces

    NASA Astrophysics Data System (ADS)

    Schaaf, Peter

    2003-11-01

    Laser irradiation of surfaces with short pulses in reactive atmospheres (nitrogen, methane) can lead to very effective nitrification and carburization via complicated laser-surface-gas-plasma-interactions. This laser nitriding and laser carburizing and their basic underlying phenomena will be presented and partly explained by results of example materials (iron, titanium, aluminum, silicon) where nitride and carbide coatings can be formed by fast and easily by Excimer Laser, Nd:YAG laser, Free Electron Laser and also by femtosecond Ti:sapphire laser. This implies laser pulse durations from the nanosecond to the femtosecond regime and wavelengths from ultra-violet to infrared. The resulting surfaces, thin films, coatings and their properties are investigated by combining Mossbauer Spectroscopy, x-ray diffraction, x-ray absorption spectroscopy, Nanoindentation, Resonant Nuclear Reaction Analysis, and Rutherford Backscattering Spectroscopy.

  13. Lasers in Medicine.

    ERIC Educational Resources Information Center

    Hill, P. D.

    1989-01-01

    Described are the characteristics of the laser and its effects on the body. Discussed are examples of laser treatments, including angioplasty, ophthalmology, and dermatology. A discussion of lasers of clinical interest and their applications is presented. (YP)

  14. Laser-Driven Fusion.

    ERIC Educational Resources Information Center

    Gibson, A. F.

    1980-01-01

    Discusses the present status and future prospects of laser-driven fusion. Current research (which is classified under three main headings: laser-matter interaction processes, compression, and laser development) is also presented. (HM)

  15. Diode Laser Arrays

    NASA Astrophysics Data System (ADS)

    Botez, Dan; Scifres, Don R.

    2005-11-01

    Contributors; 1. Monolithic phase-locked semiconductor laser arrays D. Botez; 2. High power coherent, semiconductor laser master oscillator power amplifiers and amplifier arrays D. F. Welch and D. G. Mehuys; 3. Microoptical components applied to incoherent and coherent laser arrays J. R. Leger; 4. Modeling of diode laser arrays G. R. Hadley; 5. Dynamics of coherent semiconductor laser arrays H. G. Winfuland and R. K. Defreez; 6. High average power semiconductor laser arrays and laser array packaging with an emphasis for pumping solid state lasers R. Solarz; 7. High power diode laser arrays and their reliability D. R. Scifres and H. H. Kung; 8. Strained layer quantum well heterostructure laser arrays J. J. Coleman; 9. Vertical cavity surface emitting laser arrays C. J. Chang-Hasnain; 10. Individually addressed arrays of diode lasers D. Carlin.

  16. Hypersonic gasdynamic laser system

    SciTech Connect

    Foreman, K.M.; Maciulaitis, A.

    1990-05-22

    This patent describes a visible, or near to mid infra-red, hypersonic gas dynamic laser system. It comprises: a hypersonic vehicle for carrying the hypersonic gas dynamic laser system, and also providing high energy ram air for thermodynamic excitation and supply of the laser gas; a laser cavity defined within the hypersonic vehicle and having a laser cavity inlet for the laser cavity formed by an opening in the hypersonic vehicle, such that ram air directed through the laser cavity opening supports gas dynamic lasing operations at wavelengths less than 10.6{mu} meters in the laser cavity; and an optical train for collecting the laser radiation from the laser cavity and directing it as a substantially collimated laser beam to an output aperture defined by an opening in the hypersonic vehicle to allow the laser beam to be directed against a target.

  17. Lasers in Medicine.

    ERIC Educational Resources Information Center

    Hill, P. D.

    1989-01-01

    Described are the characteristics of the laser and its effects on the body. Discussed are examples of laser treatments, including angioplasty, ophthalmology, and dermatology. A discussion of lasers of clinical interest and their applications is presented. (YP)

  18. Laser-Driven Fusion.

    ERIC Educational Resources Information Center

    Gibson, A. F.

    1980-01-01

    Discusses the present status and future prospects of laser-driven fusion. Current research (which is classified under three main headings: laser-matter interaction processes, compression, and laser development) is also presented. (HM)

  19. Laser therapy (image)

    MedlinePlus

    A laser is used for many medical purposes. Because the laser beam is so small and precise, it enables ... without injuring surrounding tissue. Some uses of the laser are retinal surgery, excision of lesions, and cauterization ...

  20. Laser Weapons for Naval Applications

    DTIC Science & Technology

    2012-03-27

    IPG fiber lasers , 10 kW/ fiber 7 • Output wavelength is tunable (can operate in atmospheric window) Free Electron Lasers ...Multiple kilowatts over multiple kilometers • Laser power converters can be highly efficient, > 60 % • Fiber lasers are highly compact and... lasers - Free electron lasers • Background • Laser candidates • Additional capabilities - Power beaming 3 Laser Lethality -

  1. Laser accidents: Being Prepared

    SciTech Connect

    Barat, K

    2003-01-24

    The goal of the Laser Safety Officer and any laser safety program is to prevent a laser accident from occurring, in particular an injury to a person's eyes. Most laser safety courses talk about laser accidents, causes, and types of injury. The purpose of this presentation is to present a plan for safety offices and users to follow in case of accident or injury from laser radiation.

  2. Laser satellite power systems

    SciTech Connect

    Walbridge, E.W.

    1980-01-01

    A laser satellite power system (SPS) converts solar power captured by earth-orbiting satellites into electrical power on the earth's surface, the satellite-to-ground transmission of power being effected by laser beam. The laser SPS may be an alternative to the microwave SPS. Microwaves easily penetrate clouds while laser radiation does not. Although there is this major disadvantage to a laser SPS, that system has four important advantages over the microwave alternative: (1) land requirements are much less, (2) radiation levels are low outside the laser ground stations, (3) laser beam sidelobes are not expected to interfere with electromagnetic systems, and (4) the laser system lends itself to small-scale demonstration. After describing lasers and how they work, the report discusses the five lasers that are candidates for application in a laser SPS: electric discharge lasers, direct and indirect solar pumped lasers, free electron lasers, and closed-cycle chemical lasers. The Lockheed laser SPS is examined in some detail. To determine whether a laser SPS will be worthy of future deployment, its capabilities need to be better understood and its attractiveness relative to other electric power options better assessed. First priority should be given to potential program stoppers, e.g., beam attenuation by clouds. If investigation shows these potential program stoppers to be resolvable, further research should investigate lasers that are particularly promising for SPS application.

  3. New laser protective eyewear

    NASA Astrophysics Data System (ADS)

    McLear, Mark

    1996-04-01

    Laser technology has significantly impacted our everyday life. Lasers are now used to correct your vision, clear your arteries, and are used in the manufacturing of such diverse products as automobiles, cigarettes, and computers. Lasers are no longer a research tool looking for an application. They are now an integral part of manufacturing. In the case of Class IV lasers, this explosion in laser applications has exposed thousands of individuals to potential safety hazards including eye damage. Specific protective eyewear designed to attenuate the energy of the laser beam below the maximum permissible exposure is required for Class 3B and Class IV lasers according to laser safety standards.

  4. [Laser physics].

    PubMed

    Banús Gassol, J M

    2008-11-01

    The commission of this article plunged me into doubt. First I should confess that I don't find excuse to escape this part if somebody wants to minimally deepen in the knowledge of the biological effects of this energy source. Secondly, when we talk about results, we use terms made and defined by Physics. Often we have polemics about results, and what really happens is that we don't reach agreements because we refer to different terms to explain the same observation; in conclusion we cannot understand each other because we do not know the adequate terms; for example, hypoxemia as oxygen deficit, which is true in an anemic patient as well as in a low oxygen saturation rate. In consequence, a good review of these concepts seems necessary to me. The third reason is the confusion that exists in our environment, I think sometimes of interest, about properties and effects of different types of laser. Only a minimal knowledge of physics will help us to state the scientific basis for understanding. The problems, nevertheless, accumulate due to the fact that the universe to which this article is directed is formed by urologists. What Physics education should we suppose they have? Superficial? Medium? Is it a collective with a uniform knowledge, being it whatever it is? The implication is clear. The article depth will depend on the answers to these questions. Nevertheless, the aim of the authors is to give a base enough to know what the laser is and how it acts. For that, the answer I gave to my questions is that the reader should understand the article and have enough base for, at least, reading critically the articles about laser published in urological journals.

  5. Laser Stabilization

    SciTech Connect

    Hall, John L.; Taubman, Matthew S.; Ye, Jun

    2010-01-01

    This book chapter covers the basics of the field of stabilizing lasers to optical frequency references such as optical cavities and molecular transitions via the application of servo control systems. These discussions are given with reference to the real-life frequency metrology experienced in Hall-Labs (now Ye-Labs), JILA, University of Colorado. The subjects covered include: the basics of control system stability, a discussion of both the theoretical and experimental limitations, an outline of optical cavity susceptibility to environmental noise, and a brief introduction to the use and limitations of molecular transitions as frequency references.

  6. Laser biophotonics

    NASA Astrophysics Data System (ADS)

    Bashkatov, A. N.; Genina, E. A.; Priezzhev, A. V.; Tuchin, V. V.

    2016-06-01

    This issue of Quantum Electronics presents the papers that reflect the state-of-the-art of laser technologies used in biomedical studies and medical practice. Among the new technologies, one can note the methods of correlation and Doppler spectroscopy, as well as THz spectroscopy, in which biologically significant molecules are characterised by specific resonances. The latter topic is considered in the paper by Nazarov et al., where the dielectric function of aqueous solutions of glucose and albumin is studied using pulsed THz spectroscopy.

  7. Histological aspects of retinal damage following exposure to pulsed Nd:YAG laser radiation in rabbits: indication for mechanism

    NASA Astrophysics Data System (ADS)

    Kadar, T.; Peri, D.; Turetz, J.; Fishbine, E.; Sahar, R.; Egoz, I.; Sapiens, N.; Brandeis, R.

    2007-02-01

    The severity and characteristics of retinal injury following laser radiation derived from laser and tissue related factors. We have previously shown that retinal damage following Nd:YAG Q-switched laser radiation in rabbits was related to physical parameters, i.e. energy levels and number of pulses. Yet, an extremely large variability in the severity of the damage was found under similar exposure paradigms, even within the same retina. This emphasizes the role of the biological variables in the pathological mechanism of laser-induced retinal damage. The aim of the present study was to further study histological parameters of the injury in relation to retinal site and to elucidate their role in the initiation and characteristics of the damage, following various energy levels (10-50 μJ) and number of pulses (1-4). Pigmented rabbits were exposed to Nd:YAG laser radiation (532nm, pulse duration: 20ns). Exposures were conducted in retina tissue, adjacent to the optic nerve, with a total of 20 exposures per retina. Animals were sacrificed 15 min or 24 hours post exposure, eyes enucleated and processed for paraffin embedding. 4μm thick serial sections, stained with hematoxylin and eosin, were examined under light microscopy. Two major types of retinal damage were observed: focal edema confined to the pigmented epithelium and the photoreceptor cells, and hemorrhages, associated with destruction of retinal tissue. While focal edema associated with slight elevation of the photoreceptor layer seems to depend on the pigmented epithelium, hemorrhages were related also to the choroid vasculature at the site of radiation. It is suggested that a thermo-mechanical mechanism is involved in laser induced retinal hemorrhages at energies above 10-30μJ (2-1 pulses, respectively).

  8. Laser Diode Pumped Solid State Lasers

    DTIC Science & Technology

    1987-01-01

    structures, monolithic phased arrays, multiple stripe lasers which were made possible by improved manufacturing technologies su LPE and particular...mass production of single laser diodes in Japan, went a development in the U.S. which is aimed at the fabrication of powerful monolithic arrays. The...Significant progress has been made recently in developing the monolithic , linear laser diode array. Output power, slope efficiency, laser threshold and

  9. Femtosecond laser in laser in situ keratomileusis

    PubMed Central

    Salomão, Marcella Q.; Wilson, Steven E.

    2014-01-01

    Flap creation is a critical step in laser in situ keratomileusis (LASIK). Efforts to improve the safety and predictability of the lamellar incision have fostered the development of femtosecond lasers. Several advantages of the femtosecond laser over mechanical microkeratomes have been reported in LASIK surgery. In this article, we review common considerations in management and complications of this step in femtosecond laser–LASIK and concentrate primarily on the IntraLase laser because most published studies relate to this instrument. PMID:20494777

  10. Laser Propulsion - Quo Vadis

    SciTech Connect

    Bohn, Willy L.

    2008-04-28

    First, an introductory overview of the different types of laser propulsion techniques will be given and illustrated by some historical examples. Second, laser devices available for basic experiments will be reviewed ranging from low power lasers sources to inertial confinement laser facilities. Subsequently, a status of work will show the impasse in which the laser propulsion community is currently engaged. Revisiting the basic relations leads to new avenues in ablative and direct laser propulsion for ground based and space based applications. Hereby, special attention will be devoted to the impact of emerging ultra-short pulse lasers on the coupling coefficient and specific impulse. In particular, laser sources and laser propulsion techniques will be tested in microgravity environment. A novel approach to debris removal will be discussed with respect to the Satellite Laser Ranging (SRL) facilities. Finally, some non technical issues will be raised aimed at the future prospects of laser propulsion in the international community.

  11. The Geoscience Laser Altimeter System Laser Transmitter

    NASA Technical Reports Server (NTRS)

    Afzal, R. S.; Dallas, J. L.; Yu, A. W.; Mamakos, W. A.; Lukemire, A.; Schroeder, B.; Malak, A.

    2000-01-01

    The Geoscience Laser Altimeter System (GLAS), scheduled to launch in 2001, is a laser altimeter and lidar for tile Earth Observing System's (EOS) ICESat mission. The laser transmitter requirements, design and qualification test results for this space- based remote sensing instrument are presented.

  12. Studies on lasers and laser devices

    NASA Technical Reports Server (NTRS)

    Harris, S. E.; Siegman, A. E.; Young, J. F.

    1983-01-01

    The goal of this grant was to study lasers, laser devices, and uses of lasers for investigating physical phenomena are studied. The active projects included the development of a tunable, narrowband XUV light source and its application to the spectroscopy of core excited atomic states, and the development of a technique for picosecond time resolution spectroscopy of fast photophysical processes.

  13. Laser Spectroscopy

    NASA Astrophysics Data System (ADS)

    Katori, H.; Yoneda, H.; Nakagawa, K.; Shimizu, F.

    2010-02-01

    .] -- Ultracold Ytterbium atoms in optical lattices / S. Sugawa ... [et al.] -- Ultracold polar molecules in the rovibrational ground state / J. Deiglmayr ... [et al.] -- Polar molecules near quantum degeneracy / J. Ye and D. S. Jin -- Production of a quantum gas of rovibronic ground-state molecules in an optical lattice / J. G. Danzl ... [et al.] -- Recent progress in x-ray nonlinear optics / K. Tamasaku, K. Sawada, and T. Ishikawa -- Gas in scattering media absorption spectroscopy - laser spectroscopy in unconventional environments / S. Svanberg -- Laser spectroscopy on relativistic ion beams / S. Reinhardt ... [et al.] -- Single frequency microcavity lasers and applications / L. Xu ... [et al.].

  14. Lasers and laser-tissue interaction.

    PubMed

    Peavy, George M

    2002-05-01

    Light produced by a laser differs from incandescent light in that it is monochromatic, coherent, and intense; and it is these properties that allow lasers to be used as such unique tools in biomedical research and patient care. The effect of a laser beam on tissue is dependent on the optical and mechanical properties of the tissue, and the wavelength, power parameters, and time domains of the laser exposure. Understanding these principles is not only important for the selection of an appropriate laser system for a specific application, but also is essential for that application to be successful.

  15. Laser Wire Stripper

    NASA Technical Reports Server (NTRS)

    1983-01-01

    NASA-developed space shuttle technology is used in a laser wire stripper designed by Raytheon Company. Laser beams cut through insulation on a wire without damaging conductive metal, because laser radiation that melts plastic insulation is reflected by the metal. The laser process is fast, clean, precise and repeatable. It eliminates quality control problems and the expense of rejected wiring.

  16. Narrow gap laser welding

    DOEpatents

    Milewski, John O.; Sklar, Edward

    1998-01-01

    A laser welding process including: (a) using optical ray tracing to make a model of a laser beam and the geometry of a joint to be welded; (b) adjusting variables in the model to choose variables for use in making a laser weld; and (c) laser welding the joint to be welded using the chosen variables.

  17. Obstacles to Laser Safety

    SciTech Connect

    Barat, K

    2005-04-25

    The growth of laser development & technology has been remarkable. Unfortunately, a number of traps or obstacles to laser safety have also developed with that growth. The goal of this article is to highlight those traps, in the hope that an aware laser user will avoid them. These traps have been the cause or contributing factor of many a preventable laser accident.

  18. Longitudinal discharge laser baffles

    DOEpatents

    Warner, B.E.; Ault, E.R.

    1994-06-07

    The IR baffles placed between the window and the electrode of a longitudinal discharge laser improve laser performance by intercepting off-axis IR radiation from the laser and in doing so reduce window heating and subsequent optical distortion of the laser beam. 1 fig.

  19. Reverse laser drilling

    NASA Technical Reports Server (NTRS)

    Anthony, Thomas R. (Inventor)

    1984-01-01

    This invention provides a method for laser drilling small diameter, closely-spaced, and accurately located holes in a body of material which is transparent or substantially transparent to the laser radiation employed whereby the holes are drilled through the thickness of the body from the surface opposite to that on which the laser beam impinges to the surface of laser beam impingement.

  20. Lasers in cosmetic dentistry.

    PubMed

    Pang, Peter

    2008-01-01

    Lasers have become a necessary instrument in the esthetic restorative armamentarium. This article presents smile design guidelines for soft tissue lasers, as well as an overview of hard tissue procedures that may be performed using all-tissue lasers. The goal is to help dentists determine the appropriate laser for a given clinical situations.

  1. Narrow gap laser welding

    DOEpatents

    Milewski, J.O.; Sklar, E.

    1998-06-02

    A laser welding process including: (a) using optical ray tracing to make a model of a laser beam and the geometry of a joint to be welded; (b) adjusting variables in the model to choose variables for use in making a laser weld; and (c) laser welding the joint to be welded using the chosen variables. 34 figs.

  2. X-ray lasers

    SciTech Connect

    Elton, R.C.

    1990-01-01

    This paper provides a source that surveys the fundamentals of x-ray lasers and summarizes recent advances. The author emphasizes x-ray lasers created using high temperature plasmas as the medium. Specific topics discussed included electron-collisional excitation pumping, plasma laser pumping, and gamma-ray lasers. Numerous literature references provided.

  3. Laser photobiology and photomedicine

    SciTech Connect

    Martellucci, S.; Chester, A.N.

    1985-01-01

    This book presents information on the following topics: the physical and biological basis of photobiology and photomedicine; the biological effects and applications of laser technology; photochemotherapy; photobiology and dermatology; surgical and ophthalmological applications of lasers; laser safety; and diagnostics and technological aspects of recent laser developments.

  4. Short wavelength laser

    DOEpatents

    Hagelstein, P.L.

    1984-06-25

    A short wavelength laser is provided that is driven by conventional-laser pulses. A multiplicity of panels, mounted on substrates, are supported in two separated and alternately staggered facing and parallel arrays disposed along an approximately linear path. When the panels are illuminated by the conventional-laser pulses, single pass EUV or soft x-ray laser pulses are produced.

  5. Laser therapy for cancer

    MedlinePlus

    ... of organs inside the body. They can treat basal cell skin cancer and cancers of the cervix, vagina, and vulva. Argon lasers. These lasers can treat skin cancer and are also used with light-sensitive drugs in a treatment called photodynamic therapy . Nd:Yag lasers. These lasers ...

  6. Longitudinal discharge laser baffles

    DOEpatents

    Warner, Bruce E.; Ault, Earl R.

    1994-01-01

    The IR baffles placed between the window and the electrode of a longitudinal discharge laser improve laser performance by intercepting off-axis IR radiation from the laser and in doing so reduce window heating and subsequent optical distortion of the laser beam.

  7. Solar driven lasers for power satellite applications

    NASA Technical Reports Server (NTRS)

    Taussio, R.; Cassady, P.; Klosterman, E.

    1980-01-01

    The technological feasibility of using multimagawatt lasers for space power transmission is discussed. Candidate lasers include electric discharge lasers, direct optically pumped lasers, and free electron lasers.

  8. New laser materials for laser diode pumping

    NASA Technical Reports Server (NTRS)

    Jenssen, H. P.

    1990-01-01

    The potential advantages of laser diode pumped solid state lasers are many with high overall efficiency being the most important. In order to realize these advantages, the solid state laser material needs to be optimized for diode laser pumping and for the particular application. In the case of the Nd laser, materials with a longer upper level radiative lifetime are desirable. This is because the laser diode is fundamentally a cw source, and to obtain high energy storage, a long integration time is necessary. Fluoride crystals are investigated as host materials for the Nd laser and also for IR laser transitions in other rare earths, such as the 2 micron Ho laser and the 3 micron Er laser. The approach is to investigate both known crystals, such as BaY2F8, as well as new crystals such as NaYF8. Emphasis is on the growth and spectroscopy of BaY2F8. These two efforts are parallel efforts. The growth effort is aimed at establishing conditions for obtaining large, high quality boules for laser samples. This requires numerous experimental growth runs; however, from these runs, samples suitable for spectroscopy become available.

  9. Agile beam laser

    SciTech Connect

    Valley, G. C.

    1985-01-08

    A laser system for providing a rapidly steerable laser output beam. The laser system includes a phase conjugate reflector, laser gain medium and its associated pump source, an output coupling device, and an optical element which selectably controls the transverse lasing mode of the laser system. The components are arranged to form a laser oscillator between the phase conjugate reflector and the optical device, and is operated in such a manner that each selected transverse mode of laser operation generates an output beam from the system which has a different wavefront tilt. Accordingly, the output beam is steerable and is dependent upon the selected transverse mode which is currently lasing in the oscillator.

  10. Laser extensometer

    NASA Technical Reports Server (NTRS)

    Stocker, P. J.; Marcus, H. L. (Inventor)

    1977-01-01

    A drift compensated and intensity averaged extensometer for measuring the diameter or other properties of a substantially cylindrical sample based upon the shadow of the sample is described. A beam of laser light is shaped to provide a beam with a uniform intensity along an axis normal to the sample. After passing the sample, the portion of the beam not striking said sample is divided by a beam splitter into a reference signal and a measurement signal. Both of these beams are then chopped by a light chopper to fall upon two photodiode detectors. The resulting ac currents are rectified and then divided into one another, with the final output being proportional to the size of the sample shadow.

  11. Lasers in flow cytometry.

    PubMed

    Telford, William G

    2011-01-01

    Laser technology has advanced tremendously since the first gas lasers were incorporated into early flow cytometers. Gas lasers have been largely replaced by solid-state laser technology, making virtually any desirable visible light wavelength available for flow cytometry. Multiwavelength, white light, and wavelength tunable lasers are poised to enhance our analytical capabilities even further. In this chapter, I summarize the role that lasers play in cytometry, and the practical characteristics that make a laser appropriate for flow cytometry. I then review the latest single wavelength lasers available for flow cytometry, and how they can be used to excite the ever-expanding array of available fluorochromes. Finally, I review the contribution and potential of the latest tunable laser technology to flow cytometry, and show several examples of these novel sources integrated into production instruments. Technical details and critical parameters for successful application of these lasers for biomedical analysis are covered in depth.

  12. Tunable lasers- an overview

    SciTech Connect

    Guenther, B.D.; Buser, R.G.

    1982-08-01

    This overview of tunable lasers describes their applicability to spectroscopy in the ultraviolet and middle infrared ranges; to rapid on-line diagnostics by ultrashort cavity lasers; to exploration, by the free electron laser, for its wide tuning in the far infrared to submillimeter region; to remote detection, in areas such as portable pollution monitors, on-line chemical analyzers, auto exhaust analyzers, and production line controls; to photochemistry; and to other potential areas in diagnostics, communications, and medical and biological sciences. The following lasers are characterized by their tunability: solid state lasers, primarily alexandrite, with a tuning range of ca 1000 Angstroms; color center lasers; semiconductor lasers; dye lasers; gas lasers, where high-pressure CO/sub 2/ discharges are the best known example for a wide tunability range, and research is continuing in systems such as the alkali dimers; and, at wavelengths beyond 10 micrometers, the possibilities beyond Cerenkov and free electron lasers.

  13. What is a Laser?

    NASA Astrophysics Data System (ADS)

    Julien, Lucile; Schwob, Catherine

    2015-10-01

    The first laser was built more than 50 years ago, inMay 1960: it was a pulsed ruby laser. It was a simple laboratory curiosity and nobody knew what its usefulness could be. Other devices were rapidly demonstrated, and the variety and number of lasers in the world increased at a huge rate. Currently, the annual laser world market is worth about 6 billion dollars. Thanks to the remarkable properties of laser light, laser applications increase steadily in the domains of industry, building, medicine, telecommunications, etc. One can find many lasers in research laboratories, and they are used more and more in our everyday life and almost everybody has already seen a laser beam. The goal of the first chapter of this book is to explain simply what a laser is, how it is built and how it operates. Firstly, let us point out the outstanding properties of the laser light.

  14. Usage of GreenLight HPS 180-W laser vaporisation for treatment of benign prostatic hyperplasia.

    PubMed

    Jovanović, M; Džamić, Z; Aćimović, M; Kajmaković, B; Pejčić, T

    2014-01-01

    Laser therapy has gained increasing acceptance as a relatively less invasive treatment for lower urinary tract symptoms (LUTS) due to benign prostatic hyperplasia (BPH). From the early procedure of interstitial laser coagulation through to the use of holmium laser enucleation of the prostate, there has been an expanding body of evidence on the efficacy of such procedures. One of the newer lasers is the Green Light HPS 180 W laser. Studies with this GreenLight laser (GLL) (American Medical Systems, Inc, Minnetonka, MN, USA) showing results as good as those of transurethral resection of the prostate (TURP). In this paper, the efficacy of the new GLL 180-W versus the gold standard TURP in patients with LUTS due to BPH was tested in a prospective clinical trial. To compare results of Green light laser (GLL) evaporisation of the prostatae and transurethral resection of the prostate (TURP) for treatment of BPH. MATERIJALS AND METHODS: A total of 62 patients with BPH were randomly assigned to two equal groups: TURP or GLL. Both groups were compared regarding all relevant preoperative, operative, and postoperative parameters. Functional results in terms of improvement of International Prostate Symptom Score (IPSS), maximum flow rate (Qmax), and postvoid residual (PVR) urine were assessed at 1, 3, 6 and 12 mo. A total of 62 patients completed 12 mo of follow-up in the TURP and GLL groups, respectively. Baseline characteristics were comparable. Mean operative time was significantly shorter for TURP. Compared to preoperative values, there was significant reduction in hemoglobin levels at the end of TURP only. A significant difference in favor of GLL was achieved regarding the duration of catheterization and hospital stay. In the GLL, no major intraoperative complications were recorded and none of the patients required blood transfusion. Among TURP patients, 6 required transfusion, 1 developed TUR syndrome, and capsule perforation was observed in 5 patients. There was dramatic

  15. Demecolcine-assisted enucleation for bovine cloning.

    PubMed

    Tani, Tetsuya; Shimada, Hiroaki; Kato, Yoko; Tsunoda, Yukio

    2006-01-01

    The present study demonstrated that demecolcine treatment for at least 30 min produces a membrane protrusion in metaphase II-stage bovine oocytes. The maternal chromosome mass is condensed within the protrusion, which makes it easy to remove the maternal chromosomes for nuclear transfer (NT). Maturation promoting factor activity, but not mitogen-activated protein kinase activity, increased up to 30% in oocytes during demecolcine treatment. One normal healthy calf was obtained after transfer of four NT blastocysts produced following demecolcine treatment. Demecolcine treatment did not increase the potential of NT oocytes to develop into blastocysts. The present study demonstrated that chemically-assisted removal of chromosomes is effective for bovine cloning.

  16. [Pelviscopic myoma enucleation: technique, limits, complications].

    PubMed

    Mecke, H; Wallas, F; Bröcker, A; Gertz, H P

    1995-07-01

    Between 1992 and 1993 surgery conserving the organ was undertaken in 215 patients with uterine myomas. Only myomas of more than 2 cm in diameter were included. It was possible to conserve the organ in 207 cases (90%). Myomectomy by pelviscopy was performed in 131 cases. The procedure was successful in 117 cases (89%), secondary laparotomy had to be done in 14 of these patients. On average the myomas removed by pelviscopy measured 5.2 cm in diameter. The S.E.M.M. (Serrated Edged Macro Morcellator) was used in the procedure. It did not take long to morecellate even larger myomas (the largest one removed by pelviscopy weighed 418 g) and to remove them by means of a 15 mm-trocar. An average of 2 myomas were removed per patient (r: 1-5). The mean Hb drop amounted to 1.5 g%. Repeat pelviscopy had to be done in one patient because of a secondary haemorrhage, a laparotomy and hysterectomy for subilius had to be performed in one case on the 3rd postoperative day. An intestinal loop has adhered to the uterine wound dehiscence. No other complications were observed after pelviscopic myomectomy. A 41-year-old patient wanting children suffered a late complication, namely a ruptured uterus in the 28 w of pregnancy. It is therefore imperative to inform patients who are still in the reproductive phase about the possibility of an uterus rupture after pelviscopic myomectomy.

  17. Reflected laser radiation - relevance for laser safety?

    NASA Astrophysics Data System (ADS)

    Zaeh, M. F.; Braunreuther, S.; Daub, R.; Stadler, T.

    Safety is compulsory in today's production lines. Those lines often use laser material processing applications. The highest risk for the operator or a bystander of a laser application is the exposure to the direct beam. With the present laser beam intensities, an accident at least causes sudden blindness or severe burns. Even if the process works correctly, which means the beam is always oriented towards the workpiece, the scattered and reflected parts of the laser beam still can be powerful enough to cause serious harm. The state-of-the-art safety measures are passive laser safety cabins around the application. Because of the high intensities and the low beam divergence of the highly brilliant laser beam sources, they cannot guarantee a safe use of these laser applications. An option is to use active laser safety barriers that react to an impinging laser beam on its surface. A new approach to guarantee laser safety is to monitor the system and watch for incidents, to ensure that the laser spot never reaches the safety barrier. Assuming that accidents with the direct laser beam cannot occur, the passive safety measures still have to withstand the reflected laser radiation. In this paper a theoretical model is presented with which the energy distribution in a hemisphere above a deep-welding-process can be calculated. The model was calibrated and validated with intensity measurements during a welding process. The results of the measurement can be used to develop a process-tailored safety cabin. Because of the increased mobility such a system increases the flexibility of the production cell. Furthermore, the costs for laser-safety may be decreased significantly.

  18. LASER-tissue interactions.

    PubMed

    Carroll, Lisa; Humphreys, Tatyana R

    2006-01-01

    As new laser devices continue to emerge, it becomes increasingly important for the clinical dermatologist to understand the basic principles behind their operation. A fundamental understanding of how lasers interact with tissue will enable the physician to choose the most appropriate laser for a given clinical situation. Although the physical laws guiding laser design are vastly complex, the fundamental principles of laser-tissue interaction can be summarized as they are applicable to the clinician.

  19. Mercury Bromide Laser Research.

    DTIC Science & Technology

    1981-05-04

    Discharge", Optics Lett., 2(3), (March 1978). 7. R. Burnham, "Discharge Pumped Mercuric Halide Dissociation Lasers", Appl. Phys. Lett., 33: 15 (July 1978...laser and fluorescence signals. Neutral density filters served to prevent saturation of the detector during the laser measurements. F. Laser Output as a...REFERENCES . E. J. Schimitschek and J. E. Celto, " Mercuric Bromide Dissociation Laser in an Electric Discharge," Optics Lett. 2(3), March 1978. This

  20. Surgical lasers in dermatology

    NASA Astrophysics Data System (ADS)

    Szymanczyk, Jacek; Nowakowski, Wlodzimierz; Golebiowska, Aleksandra; Michalska, I.; Mindak, Marek K.

    1997-10-01

    Almost every laser for medical applications was first tried in dermatology. The efficiency of YAG, CO2, and Argon lasers on this area and their potential advantages over conventional methods were mostly evaluated by cosmetic effect of laser therapy. The indications for different laser treatment in such dermatological cases as: angiomas, telangiectasias, pigmented lesions, nevus flammeus congenitus, deep cavernous angiomas, skin neoplasms and condylomata acuminata are discussed in this paper and the results of the laser therapy are also presented.

  1. Intracavity Raman lasers

    SciTech Connect

    Band, Y.B.; Ackerhalt, J.R.; Krasinski, J.S.; Heller, D.F.

    1989-02-01

    Experimental and theoretical studies of intracavity Raman lasers are presented. Advantages of intracavity Raman lasers, particularly for low-emission cross section and broadly tunable vibronic gain media, are described. Experimental studies of a hydrogen gas Raman laser pumped inside the cavity of an alexandrite laser are presented. A theoretical model of the dynamics of a unidirectional intracavity Raman ring laser is developed and solved analytically. This model is adapted to simulate experiments.

  2. Lasers used in dermatology.

    PubMed

    Lim, J T; Goh, C L

    1994-01-01

    This review introduces the various lasers available for the treatment of dermatological conditions. The applications of various lasers used in dermatology, including the carbon dioxide, argon, Q-switch Nd:YAG, ruby, dye and metal vapour lasers are discussed. We present our experience with the use of the carbon dioxide laser, flashlamp pulse-dye laser and Q-switch Nd:YAG laser in the National Skin Centre, Singapore. Our experience indicated that the lasers if used selectively are useful tools in the management of numerous skin disorders. The carbon dioxide laser is a versatile tool, useful for vaporizing or destroying skin lesions. The treatment of vascular or pigmented (melanin) lesions requires lasers that emit wavelengths corresponding to the absorption spectrum of haemoglobin or melanin respectively. Choosing the right laser gives optimal cosmetic result whereas the wrong lasers can lead to a less satisfactory result and even severe scarring. It is important to note that there is no single laser system that is versatile enough to be used to treat all skin disorders. To provide full coverage in the treatment of skin disorders, a laser centre has to be equipped with many different laser systems. This makes using lasers in the treatment of skin disorders very expensive.

  3. Laser communication system

    SciTech Connect

    Fredriksen, H.A.; Walter, R.K.; Mentzer, R.B.

    1987-04-28

    A laser communication system is described for transmission across an atmospheric link between a radio frequency source and a load comprising: a primary transmitter including a primary laser, a primary laser modulator connected to the primary laser and to a signal source, and a laser intensity control means connected to the laser for varying the primary laser intensity; a primary receiver located in the path of a beam from the primary laser; a haze comparator circuit connected to a primary photodetector means and comparing the electrical signal from the primary photodetector means to a standard signal to produce an output signal which indicates the sense and degree of difference between the two; a secondary laser located at the primary receiver location; secondary laser modulator circuit; a secondary laser control circuit; a secondary photodetector; a first control means connected to the secondary photodetector and the primary laser intensity control means; and an interconnection between the output of the haze comparator circuit and the secondary laser intensity control circuit so that the intensity of the output of the secondary laser is varied by the haze comparator in the same manner as is the intensity of the output of the primary laser.

  4. Ceramic Laser Materials

    PubMed Central

    Sanghera, Jasbinder; Kim, Woohong; Villalobos, Guillermo; Shaw, Brandon; Baker, Colin; Frantz, Jesse; Sadowski, Bryan; Aggarwal, Ishwar

    2012-01-01

    Ceramic laser materials have come a long way since the first demonstration of lasing in 1964. Improvements in powder synthesis and ceramic sintering as well as novel ideas have led to notable achievements. These include the first Nd:yttrium aluminum garnet (YAG) ceramic laser in 1995, breaking the 1 KW mark in 2002 and then the remarkable demonstration of more than 100 KW output power from a YAG ceramic laser system in 2009. Additional developments have included highly doped microchip lasers, ultrashort pulse lasers, novel materials such as sesquioxides, fluoride ceramic lasers, selenide ceramic lasers in the 2 to 3 μm region, composite ceramic lasers for better thermal management, and single crystal lasers derived from polycrystalline ceramics. This paper highlights some of these notable achievements. PMID:28817044

  5. Quantum well lasers

    SciTech Connect

    Zory, P.S. Jr.

    1993-01-01

    The semiconductor quantum well (QW) laser structure is rapidly becoming the preferred design in many applications because of its low threshold, design flexibility, and high reliability. The book begins with a brief, interesting foreword by C.H. Henry on the history of the QW laser concept and its early development. Following this introduction is a 79-page chapter by S.W. Corzine et al. on optical gain in III-V bulk and QW lasers. The next chapter on intraband relaxation and line broadening effects by M. Asada is an excellent expanded review of a topic introduced by Corzine. The remaining chapters describe multiple QW lasers, low-threshold QW laser, special aspects of AlGaAs and (short-wavelength) InGaAsP lasers, valence-band engineering, strained-layer QW lasers, AlGaInP QW lasers, and quantum wire lasers. These chapters are well written by recognized experts in the field.

  6. Nanocrystal waveguide (NOW) laser

    DOEpatents

    Simpson, John T.; Simpson, Marcus L.; Withrow, Stephen P.; White, Clark W.; Jaiswal, Supriya L.

    2005-02-08

    A solid state laser includes an optical waveguide and a laser cavity including at least one subwavelength mirror disposed in or on the optical waveguide. A plurality of photoluminescent nanocrystals are disposed in the laser cavity. The reflective subwavelength mirror can be a pair of subwavelength resonant gratings (SWG), a pair of photonic crystal structures (PC), or a distributed feedback structure. In the case of a pair of mirrors, a PC which is substantially transmissive at an operating wavelength of the laser can be disposed in the laser cavity between the subwavelength mirrors to improve the mode structure, coherence and overall efficiency of the laser. A method for forming a solid state laser includes the steps of providing an optical waveguide, creating a laser cavity in the optical waveguide by disposing at least one subwavelength mirror on or in the waveguide, and positioning a plurality of photoluminescent nanocrystals in the laser cavity.

  7. Infrared laser system

    DOEpatents

    Cantrell, Cyrus D.; Carbone, Robert J.; Cooper, Ralph

    1982-01-01

    An infrared laser system and method for isotope separation may comprise a molecular gas laser oscillator to produce a laser beam at a first wavelength, Raman spin flip means for shifting the laser to a second wavelength, a molecular gas laser amplifier to amplify said second wavelength laser beam to high power, and optical means for directing the second wavelength, high power laser beam against a desired isotope for selective excitation thereof in a mixture with other isotopes. The optical means may include a medium which shifts the second wavelength high power laser beam to a third wavelength, high power laser beam at a wavelength coincidental with a corresponding vibrational state of said isotope and which is different from vibrational states of other isotopes in the gas mixture.

  8. Infrared laser system

    DOEpatents

    Cantrell, Cyrus D.; Carbone, Robert J.; Cooper, Ralph S.

    1977-01-01

    An infrared laser system and method for isotope separation may comprise a molecular gas laser oscillator to produce a laser beam at a first wavelength, Raman spin flip means for shifting the laser to a second wavelength, a molecular gas laser amplifier to amplify said second wavelength laser beam to high power, and optical means for directing the second wavelength, high power laser beam against a desired isotope for selective excitation thereof in a mixture with other isotopes. The optical means may include a medium which shifts the second wavelength high power laser beam to a third wavelength, high power laser beam at a wavelength coincidental with a corresponding vibrational state of said isotope and which is different from vibrational states of other isotopes in the gas mixture.

  9. Laser Surveying

    NASA Technical Reports Server (NTRS)

    1978-01-01

    NASA technology has produced a laser-aided system for surveying land boundaries in difficult terrain. It does the job more accurately than conventional methods, takes only one-third the time normally required, and is considerably less expensive. In surveying to mark property boundaries, the objective is to establish an accurate heading between two "corner" points. This is conventionally accomplished by erecting a "range pole" at one point and sighting it from the other point through an instrument called a theodolite. But how do you take a heading between two points which are not visible to each other, for instance, when tall trees, hills or other obstacles obstruct the line of sight? That was the problem confronting the U.S. Department of Agriculture's Forest Service. The Forest Service manages 187 million acres of land in 44 states and Puerto Rico. Unfortunately, National Forest System lands are not contiguous but intermingled in complex patterns with privately-owned land. In recent years much of the private land has been undergoing development for purposes ranging from timber harvesting to vacation resorts. There is a need for precise boundary definition so that both private owners and the Forest Service can manage their properties with confidence that they are not trespassing on the other's land.

  10. Alexandrite laser pumped by semiconductor lasers

    NASA Astrophysics Data System (ADS)

    Scheps, Richard; Gately, Bernard M.; Myers, Joseph F.; Krasinski, Jerzy S.; Heller, Donald F.

    1990-06-01

    We report the first operation of a direct diode-pumped tunable chromium-doped solid-state laser. A small alexandrite (Cr:BeAl2O4) crystal was longitudinally pumped by two visible laser diodes. The threshold pump power was 12 mW using the R1 line at 680.4 nm for the pump transition, and the slope efficiency was 25%. The measured laser output bandwidth was 2.1 nm.

  11. Dye laser chain for laser isotope separation

    NASA Astrophysics Data System (ADS)

    Doizi, Denis; Jaraudias, Jean; Pochon, E.; Salvetat, G.

    1993-05-01

    Uranium enrichment by laser isotope separation uses a three step operation which requires four visible wavelengths to boost an individual U235 isotope from a low lying atomic energy level to an autoionizing state. The visible wavelengths are delivered by dye lasers pumped by copper vapor lasers (CVL). In this particular talk, a single dye chain consisting of a master oscillator and amplifier stages will be described and some of its performance given.

  12. Alexandrite laser pumped by semiconductor lasers

    SciTech Connect

    Scheps, R.; Gately, B.M.; Myers, J.F. ); Krasinski, J.S. ); Heller, D.F. )

    1990-06-04

    We report the first operation of a direct diode-pumped tunable chromium-doped solid-state laser. A small alexandrite (Cr:BeAl{sub 2}O{sub 4}) crystal was longitudinally pumped by two visible laser diodes. The threshold pump power was 12 mW using the {ital R}{sub 1} line at 680.4 nm for the pump transition, and the slope efficiency was 25%. The measured laser output bandwidth was 2.1 nm.

  13. Lasers in periodontics.

    PubMed

    Elavarasu, Sugumari; Naveen, Devisree; Thangavelu, Arthiie

    2012-08-01

    Laser is one of the most captivating technologies in dental practice since Theodore Maiman in 1960 invented the ruby laser. Lasers in dentistry have revolutionized several areas of treatment in the last three and a half decades of the 20(th) century. Introduced as an alternative to mechanical cutting device, laser has now become an instrument of choice in many dental applications. Evidence suggests its use in initial periodontal therapy, surgery, and more recently, its utility in salvaging implant opens up a wide range of applications. More research with better designs are a necessity before lasers can become a part of dental armamentarium. This paper gives an insight to laser in periodontics.

  14. Lasers in aviation

    NASA Astrophysics Data System (ADS)

    Goncharov, I. N.; Dezhin, V. N.; Kutakhov, V. P.; Petukhov, A. V.; Sidorin, V. M.; Sukhar, I. M.

    The way in which lasers are being incorporated into the military aircraft of the United States and the countries of Western Europe is discussed. Descriptions are given of laser weapons-guiding systems (including ranger finders and systems for target illumination), laser systems for navigation and flight-safety assurance (gyroscopes, velocity gauges, altimeters, systems providing meteorological data, proximity warning systems), and laser systems for air reconnaissance, communications, and control. Attention is also given to the Glissada laser guide path system, developed in the USSR. The physics of the systems is emphasized in the description and the principles underlying the operation of a laser are discussed in the introduction.

  15. Maser and laser engineering

    SciTech Connect

    Ishii, T.K.

    1980-01-01

    This book is intended to be a textbook for an upper division one-semester electrical engineering course. Students are expected to have had some undegraduate course work in modern physics and in electromagnetic field theory. General aspects regarding devices based on quantum electronics are considered along with gas masers, solid masers, gas lasers, solid lasers, semiconductor lasers, liquid lasers, modulation techniques for lasers, and opto-electrical demodulators and energy convertors. Attention is given to quantum electric harmonic generators, Raman lasers, optical parametric interactions, holograms, optical terms, crystallographic terms, band theory, Schroedinger formulation and Dirac formation, and the quantum number of electrons in a hydrogen atom.

  16. Tunable chromium lasers

    SciTech Connect

    Chase, L.L.; Payne, S.A.

    1989-01-01

    During the decade that has passed since the discovery of the alexandrite laser, many other tunable vibronic sideband lasers based on Cr/sup 3 +/ have been developed. These lasers span the wavelength range from 700 nm to at least 1235 nm. Experimental and theoretical research has provided an understanding of the important factors that influence the performance of these Cr/sup 3 +/ lasers and other solid state vibronic lasers. The intrinsic performance levels of some of the most promising Cr/sup 3 +/ lasers are evaluated from extrapolated slope efficiency measurements. 7 refs., 4 figs., 2 tabs.

  17. Laser Safety Device

    NASA Technical Reports Server (NTRS)

    1992-01-01

    A major focus of work done at Air Products and Chemicals' Laser Application Laboratory is on use of ultraviolet radiation using high energy excimer lasers. Because light within the wavelength of excimer lasers is invisible, it can cause serious damage to eyes and tissue. To contain the laser beam, Air Products Incorporated a Jet Propulsion Laboratory invention described in a technical support package into its beam stops. The technology interrupts the laser pathway and allows workers to remain in the target area without shutting off the laser.

  18. Laser peening of metals- enabling laser technology

    SciTech Connect

    Dane, C.B.; Hackel, L.A.; Daly, J.; Harrisson, J.

    1997-11-13

    Laser peening, a surface treatment for metals, employs laser induced shocks to create deep and intense residual stresses in critical components. In many applications this technology is proving to be superior to conventional treatments such as shot peening. The laser peening process has generated sufficiently impressive results to move it from a laboratory demonstration phase into a significant industrial process. However until now this evolution has been slowed because a laser system meeting the average power requirements for a high throughput process has been lacking.

  19. Laser amplifier and method

    DOEpatents

    Backus, S.; Kapteyn, H.C.; Murnane, M.M.

    1997-07-01

    Laser amplifiers and methods for amplifying a laser beam are disclosed. A representative embodiment of the amplifier comprises first and second curved mirrors, a gain medium, a third mirror, and a mask. The gain medium is situated between the first and second curved mirrors at the focal point of each curved mirror. The first curved mirror directs and focuses a laser beam to pass through the gain medium to the second curved mirror which reflects and recollimates the laser beam. The gain medium amplifies and shapes the laser beam as the laser beam passes therethrough. The third mirror reflects the laser beam, reflected from the second curved mirror, so that the laser beam bypasses the gain medium and return to the first curved mirror, thereby completing a cycle of a ring traversed by the laser beam. The mask defines at least one beam-clipping aperture through which the laser beam passes during a cycle. The gain medium is pumped, preferably using a suitable pumping laser. The laser amplifier can be used to increase the energy of continuous-wave or, especially, pulsed laser beams including pulses of femtosecond duration and relatively high pulse rate. 7 figs.

  20. Laser amplifier and method

    DOEpatents

    Backus, Sterling; Kapteyn, Henry C.; Murnane, Margaret M.

    1997-01-01

    Laser amplifiers and methods for amplifying a laser beam are disclosed. A representative embodiment of the amplifier comprises first and second curved mirrors, a gain medium, a third mirror, and a mask. The gain medium is situated between the first and second curved mirrors at the focal point of each curved mirror. The first curved mirror directs and focuses a laser beam to pass through the gain medium to the second curved mirror which reflects and recollimates the laser beam. The gain medium amplifies and shapes the laser beam as the laser beam passes therethough. The third mirror reflects the laser beam, reflected from the second curved mirror, so that the laser beam bypasses the gain medium and return to the first curved mirror, thereby completing a cycle of a ring traversed by the laser beam. The mask defines at least one beam-clipping aperture through which the laser beam passes during a cycle. The gain medium is pumped, preferably using a suitable pumping laser. The laser amplifier can be used to increase the energy of continuous-wave or, especially, pulsed laser beams including pulses of femtosecond duration and relatively high pulse rate.

  1. Laser Spectroscopy

    NASA Astrophysics Data System (ADS)

    Hollberg, Leo; Bergquist, James Charles; Kasevich, Mark A.

    2008-04-01

    Degenerate gases. Probing vortex pair sizes in the Berezinskii-Kosterlitz-Thouless regime on a two-dimensional lattice of Bose-Einstein condensates / V. Schweikhard ... [et al.]. Interacting Bose-Einstein condensates in random potentials / P. Bouyer ... [et al.]. Towards quantum magnetism with ultracold atoms in optical lattices / I. Bloch -- Precision measurement and fundamental physics. T-violation and the search for a permanent electric dipole moment of the mercury atom / E. N. Fortson -- Quantum information and control I. Quantum information processing and ramsey spectroscopy with trapped ions / C. F. Roos ... [et al.]. Quantum non-demolition counting of photons in a cavity / S. Haroche ... [et al.] -- Ultra-fast control and spectroscopy. Frequency-Comb- assisted mid-infrared spectroscopy / P. de Natale ... [et al.] -- Precision measurement and applications. Precision gravity tests by atom interferometry / G. M. Tino ... [et al.] -- Novel spectroscopic applications. On a variation of the proton-electron mass ratio / W. Ubachs ... [et al.] -- Quantum information and control II. Quantum interface between light and atomic ensembles / H. Krauter ... [et al.] -- Degenerate Fermi gases. An atomic Fermi gas near a P-wave Feshbach resonance / D. S. Jin, J. P. Gaebler and J. T. Stewart. Bragg scattering of correlated atoms from a degenerate Fermi gas / R. J. Ballagh, K. J. Challis and C. W. Gardiner -- Spectroscopy and control of atoms and molecules. Stark and Zeeman deceleration of neutral atoms and molecules / S. D. Hogan ... [et al.]. Generation of coherent, broadband and tunable soft x-ray continuum at the leading edge of the driver laser pulse / A. Jullien ... [et al.]. Controlling neural atoms and photons with optical conveyor belts and ultrathin optical fibers / D. Meschede. W. Alt and A. Rauschenbeutel -- Spectroscopy on the small scale. Wide-field cars-microscopy / C. Heinrich ... [et al.]. Atom nano-optics and nano-lithography / V. I. Balykin ... [et al

  2. Phased laser array for generating a powerful laser beam

    DOEpatents

    Holzrichter, John F.; Ruggiero, Anthony J.

    2004-02-17

    A first injection laser signal and a first part of a reference laser beam are injected into a first laser element. At least one additional injection laser signal and at least one additional part of a reference laser beam are injected into at least one additional laser element. The first part of a reference laser beam and the at least one additional part of a reference laser beam are amplified and phase conjugated producing a first amplified output laser beam emanating from the first laser element and an additional amplified output laser beam emanating from the at least one additional laser element. The first amplified output laser beam and the additional amplified output laser beam are combined into a powerful laser beam.

  3. Laser surgery - skin

    MedlinePlus

    Surgery using a laser ... used is directly related to the type of surgery being performed and the color of the tissue ... Laser surgery can be used to: Close small blood vessels to reduce blood loss Remove warts , moles , sunspots, and ...

  4. Laser Radar Animation

    NASA Image and Video Library

    Laser and radar instruments aboard NASA aircraft provide measurements of the snow and ice surface and down to the bedrock under the ice. Lasers, with a shorter wavelength, measure the surface eleva...

  5. Laser particle sorter

    DOEpatents

    Martin, J.C.; Buican, T.N.

    1987-11-30

    Method and apparatus are provided for sorting particles, such as biological particles. A first laser is used to define an optical path having an intensity gradient which is effective to propel the particles along the path but which is sufficiently weak that the particles are not trapped in an axial direction. A probe laser beam is provided for interrogating the particles to identify predetermined phenotypical characteristics of the particles. A second laser beam is provided to intersect the driving first laser beam, wherein the second laser beam is activated by an output signal indicative of a predetermined characteristic. The second laser beam is switchable between a first intensity and a second intensity, where the first intensity is effective to displace selected particles from the driving laser beam and the second intensity is effective to propel selected particles along the deflection laser beam. The selected particles may then be propelled by the deflection beam to a location effective for further analysis. 2 figs.

  6. Laser safety in dentistry.

    PubMed

    Sweeney, Caroline

    2008-01-01

    Although many regulations and standards relating to laser safety are in effect, there continue to be an average of 35 laser injuries per year. Laser safety professionals believe that this number under-represents the actual number of injuries and that many more accidents per year occur that are not documented with federal agencies. A review of these accidents has determined that failing to wear available eye protection is one of the most frequent contributing factors to laser injuries. As the purchase and use of lasers in dentistry continues to grow, so must concern for laser safety. This article provides basic information to advance the safe use of lasers in dentistry and to help establish laser safety protocols for the dental office.

  7. Laser hair removal.

    PubMed

    Wanner, Molly

    2005-01-01

    Since 1996, there have been numerous advances in hair laser removal that utilize melanin as a chromophore. All of the devices on the market may be used in patients with light skin (phototypes I-III) and yield hair reduction near 75%. The ruby (694 nm) laser, alexandrite (755 nm) laser, and diode (810 nm) laser, as well as intense pulsed light are commonly used devices for hair laser removal. The long-pulsed Nd:YAG (1064 nm) laser represents the safest device for hair removal in dark-skinned patients because of its long wavelength, although the diode laser, alexandrite laser, and intense pulse light may be used. For treatment of light hair, combination radiofrequency and optical devices as well as photodynamic therapy are under investigation.

  8. Direct nuclear pumped laser

    DOEpatents

    Miley, George H.; Wells, William E.; DeYoung, Russell J.

    1978-01-01

    There is provided a direct nuclear pumped gas laser in which the lasing mechanism is collisional radiated recombination of ions. The gas laser active medium is a mixture of the gases, with one example being neon and nitrogen.

  9. High power laser dump

    NASA Astrophysics Data System (ADS)

    Hsu, M. S.; Hsu, J. P.

    1985-08-01

    A high power laser dump has defined laser beam introduction angles to the internal surface of a cylinder to maximize energy dispersion and absorption and, has two zones formed of distinctive reflective and absorbing materials.

  10. Lasers In Medicine

    NASA Astrophysics Data System (ADS)

    Bernardo, L. M.

    1989-01-01

    Fifty people around have participated in the workshop "Lasers in Medicine": most of them participants on the previous days on the conference "Laser Technologies in Industry", also some invited physicians and others interested in the topic from various University Departments.

  11. LASIK - Laser Eye Surgery

    MedlinePlus

    ... Plastic Surgery Center Laser Surgery Education Center Redmond Ethics Center Global Ophthalmology Guide Academy Publications EyeNet Ophthalmology ... Plastic Surgery Center Laser Surgery Education Center Redmond Ethics Center Global Ophthalmology Guide Find an Ophthalmologist Advanced ...

  12. Lasers in neurosurgery.

    PubMed

    Krishnamurthy, S; Powers, S K

    1994-01-01

    Lasers have been used in neurosurgery for the past 25 years, undergoing modifications to suit the specific needs of this medical discipline. The present report reviews the current use of lasers in neurosurgical practice and examines the pros and cons of lasers in specific neurosurgical applications. In spite of their advantages, laser use is still not widespread in neurosurgery. One reason is the continued lack of complete control over real-time laser interactions with neural tissue. A greater acceptance and use of lasers by neurosurgeons will depend upon automated control over defined specific parameters for laser applications based upon the type of tissue, the desired effect on tissue, and application to the clinical situation without loss of precision and a lot of expense. This will require the integration of newer lasers, computers, robotics, stereotaxy, and concepts of minimally invasive surgery into the routine management of neurosurgical problems.

  13. Laser device and method

    SciTech Connect

    Myers, J. D.

    1985-06-25

    A simplified, relatively inexpensive laser device, wherein the laser elements are fixed in a body exoskeleton of electrical insulating material having a low coefficient of thermal expansion. The preferred embodiment includes a shotgun type laser filter having parallel bores which receive the laser flashlamp and laser rod in fixed relation in a body chamber. The reflector surrounds the laser filter and retains the filter within the body chamber. In the preferred method of this invention, several controlled lasing pulses are generated with each illumination pulse of the flashlamp, substantially increasing the efficiency of the laser device. The number of pulses is generally controlled by increasing the voltage to the flashlamp. The rapid multiple lasing pulses generate an elongated plasma in a fluid medium, such as the vitreous fluid body of an eye which makes the laser device extemely efficient for treating glaucoma and other medical treatments.

  14. Modern retinal laser therapy

    PubMed Central

    Kozak, Igor; Luttrull, Jeffrey K.

    2014-01-01

    Medicinal lasers are a standard source of light to produce retinal tissue photocoagulation to treat retinovascular disease. The Diabetic Retinopathy Study and the Early Treatment Diabetic Retinopathy Study were large randomized clinical trials that have shown beneficial effect of retinal laser photocoagulation in diabetic retinopathy and have dictated the standard of care for decades. However, current treatment protocols undergo modifications. Types of lasers used in treatment of retinal diseases include argon, diode, dye and multicolor lasers, micropulse lasers and lasers for photodynamic therapy. Delivery systems include contact lens slit-lamp laser delivery, indirect ophthalmocope based laser photocoagulation and camera based navigated retinal photocoagulation with retinal eye-tracking. Selective targeted photocoagulation could be a future alternative to panretinal photocoagulation. PMID:25892934

  15. Laser spectroscopy 9

    SciTech Connect

    Feld, M.S. . Dept. of Physics); Thomas, J.E. . Dept. of Physics); Mooradian, A. . Lincoln Lab.)

    1989-01-01

    This book covers subjects under the following headings: New cooling mechanisms; Laser spectroscopy; Cavity Qed; Noise and coherence; Quantum size effects; Surface spectroscopy; Laser light sources; Trapped ion spectroscopy; and Fundamental measurements.

  16. Slender tip laser scalpel

    DOEpatents

    Veligdan, James T.

    2004-01-06

    A laser scalpel includes a ribbon optical waveguide extending therethrough and terminating at a slender optical cutting tip. A laser beam is emitted along the height of the cutting tip for cutting tissue therealong.

  17. Laser programs highlights 1993

    SciTech Connect

    1995-06-01

    Over the last two decades, the scope of our laser research has grown immensely. The small, low-power laser systems of our early days have given way to laser systems of record-breaking size and power. Now we are focusing our activities within the target physics and laser science programs to support the ignition and gain goals of the proposed glass-laser National Ignition Facility. In our laser isotope separation work, we completed the most important set of experiments in the history of the AVLIS Program in 1993, which culminated in a spectacularly successful run that met or exceeded all our objectives. We are also developing lasers and laser-related technologies for a variety of energy, commercial, and defense uses. On the horizon are transfers of important technologies for waste treatment, x-ray lithography, communications and security, optical imaging, and remote sensing, among others.

  18. MESSENGER Laser Altimeter

    NASA Image and Video Library

    MESSENGER's Mercury Laser Altimeter sends out laser pulses that hit the ground and return to the instrument. The amount of light that returns for each pulse gives the reflectance at that point on t...

  19. Lasers in Cancer Treatment

    MedlinePlus

    ... in a narrow beam and creates a very high-intensity light. This powerful beam of light may be ... it used in cancer treatment? Laser therapy uses high-intensity light to treat cancer and other illnesses. Lasers ...

  20. Laser particle sorter

    DOEpatents

    Martin, John C.; Buican, Tudor N.

    1989-01-01

    Method and apparatus for sorting particles, such as biological particles. A first laser defines an optical path having an intensity gradient which is effective to propel the particles along the path but which is sufficiently weak that the particles are not trapped in an axial direction. A probe laser beam interrogates the particles to identify predetermined phenotypical characteristics of the particles. A second laser beam intersects the driving first laser beam, wherein the second laser beam is activated by an output signal indicative of a predetermined characteristic. The second laser beam is switchable between a first intensity and a second intensity, where the first intensity is effective to displace selected particles from the driving laser beam and the second intensity is effective to propel selected particles along the deflection laser beam. The selected particles may then be propelled by the deflection beam to a location effective for further analysis.