고출력 초단펄스파 엔디 야그 레이저를 이용한 안면부 지방제거 미용 성형술의 임상적 고찰

김진왕,이정옥 대한의학레이져학회 1998 대한의학레이져학회지 Vol.2 No.1

Satisfaction with the Effect of Local Dynamical Micro-massage Therapy on the Pain and Discomfort after Breast Reconstruction Surgery

Kwang Hyeon Ahn,Sun Jae Lee,Eun Soo Park,Yu Gil Park 대한의학레이저학회 2020 MEDICAL LASERS Vol.9 No.1

Background and ObjectivesBreast reconstruction has the advantage of reducing the loss of the body image of patients after mastectomy surgery, and also improving the quality of the social and sexual life of breast cancer patients. However, in surprising and unfortunate number of patients, acute postoperative pain persists beyond the normal course of postsurgical recovery. We set out to investigate the effect of local dynamical micro-massage (LDM) treatment for achieving pain relief and reducing other postoperative complications. Materials and MethodsWe performed a retrospective analysis on 58 patients who underwent LDM treatment for postoperative pain management at Soonchunhyang University Bucheon Hospital between February 2017 and June 2019. Those patients who complained of persistent postoperative pain, which was uncontrollable with medication, were treated with LDM. The degree of pain and discomfort with contracture were recorded using numerical rating scale (NRS) scoring system with numbers from 0 to 10 (‘none' to 'worst'). ResultsThe median NRS score of pain was reduced by 62.3% from the start to the end of LDM treatment (p<0.001). Further, the NRS score of discomfort with contracture was reduced 66.0% (p<0.001). There was no complication related to the LDM treatment. ConclusionDual-frequency ultrasound LDM can be an effective therapeutic option for persisting pain after breast reconstruction surgery. It was also effective in improvement of discomfort with contracture and erythema of the surgical wound.

Photobiomodulation Therapy in Recovery of Peripheral Facial Nerve Damage

최지은 대한의학레이저학회 2020 MEDICAL LASERS Vol.9 No.2

Photobiomodulation (PBM) therapy has been investigated to enhance and accelerate the recovery of injured peripheral nerves. Based on the wide range of benefits of PBM therapy and its clinical relevance, this study reviewed the efficacy of PBM in injured facial nerves. The search was performed in the PubMed database to find relevant articles published over the last 10 years. Four animal studies, two randomized controlled studies, one case series, and five case reports were reviewed. Despite the various parameters, functional analysis showed that PBM therapy using near-infrared irradiation has beneficial effects on the recovery of the acute phase of the damaged facial nerve, especially when related to faster functional improvement. There were no reported adverse effects of PBM therapy.

Lasers and Robots: Recent Developments in Transoral Laser and Transoral Robotic Surgery

Andrew Reyes Padalhin 대한의학레이저학회 2020 MEDICAL LASERS Vol.9 No.2

Transoral microsurgery has come a long way as a go-to surgical intervention technique for head and neck cancers. This minimally invasive procedure had gained acceptance through comparative clinical studies against radical neck surgical procedures, radiotherapy, and chemotherapy. Laser technology has vastly improved the oncological outcomes of this procedure and brought about an appreciation of transoral laser surgery (TLM) as a mainstay for re-sectioning malignant tumors along the throat. As an established procedure, TLM has undergone several upgrades regarding the different energy devices used for cutting, ablation, and hemostasis. Continued advances in automation have eventually led to surgical robotics, resulting in the emergence of transoral robotic surgery (TORS) as a viable advanced alternative for TLM. Similarly, expansions and enhancements (image-based guidance, fluorescence spectroscopy, and advanced robotic system) have also been investigated as potential upgrades for TORS. This paper reviews a selection of publications on the significant technological advancements to TLM and TORS over the past five years.

Phototherapy in Allergic Rhinitis: From In Vitro Studies to Clinical Trials

Shin Hyuk Yoo,정영준,배준상,모지훈 대한의학레이저학회 2020 MEDICAL LASERS Vol.9 No.2

Phototherapy has a profound immunosuppressive effect and is widely used for the treatment of inflammatory skin diseases. Since allergic rhinitis (AR) shares several common pathologic features with atopic dermatitis, intranasal phototherapy is a novel approach for treating AR. Phototherapy reduces the antigen presenting capacity of dendritic cells, induces apoptosis of immune cells, and inhibits synthesis and release of pro-inflammatory mediators from inflammatory cells. The effectiveness of phototherapy for AR has been extensively researched: from in vitro studies to several clinical trials. Data indicates the potential of intranasal phototherapy as an alternative treatment for AR as well as other inflammatory mucosal diseases. In this review, we introduce the in vitro, in vivo studies, and clinical trials which demonstrated the effect of phototherapy on AR.

Effectiveness of the Pico-toning Technique for the Treatment of Melasma with a Low Fluence 1,064-nm Nd:YAG Laser in Asian Patients

Dong Gyu Kim,Seung Min Nam,Jin Soo Shin,Eun Soo Park 대한의학레이저학회 2020 MEDICAL LASERS Vol.9 No.2

Background and Objectives Melasma is an acquired pigmentary disorder characterized by brown or dark brown colored macules and patches which mostly involve the face. Compared to nanosecond lasers, picosecond lasers have fewer adverse effects on surrounding tissues and give better results for melanin fragmentation. The purpose of this study was to evaluate the efficacy of the pico-toning technique using a low fluence 1,064-nm Nd:YAG laser on melasma patients. Materials and Methods This study is a retrospective analysis of melasma cases treated using the pico-toning technique from June 2017 to November 2020. Based on photographic images, the modified Melasma Area and Severity Index (mMASI) score was blind evaluated by two independent plastic surgeons. Patient satisfaction was assessed through a 5-point Likert scale questionnaire after treatment sessions. All adverse effects and complications were reviewed based on medical records. Results A total of 23 patients were included in the study. The mMASI scores for baseline and 2 months after the last procedure were 5.1 ± 1.4 and 2.6 ± 0.4, respectively. The mean mMASI score reduced significantly after the treatment session (p < 0.05). The patient satisfaction score with the procedure was 3.8 ± 1.0. The subject satisfaction score and difference in the mMASI score before the procedure and 2 months after the last procedure showed a significant correlation. Adverse effects observed in this study were erythema (n = 1) and edema (n = 1). Conclusion The results of the study show that the pico-toning technique is effective in Asian patients with melasma. We believe that safety was enhanced by using low fluence, and thus better results were achieved with fewer adverse effects.

Potential Efficacy of Multiple-shot Long-pulsed 1,064-nm Nd:YAG in Nonablative Skin Rejuvenation: A Pilot Study

Young-Koo Kim,Hae-Jin Lee,Jihee Kim 대한의학레이저학회 2020 MEDICAL LASERS Vol.9 No.2

Medical Lasers; Engineering, Basic Research, and Clinical Application 159 Original Article Potential Efficacy of Multiple-shot Long-pulsed 1,064-nm Nd:YAG in Nonablative Skin Rejuvenation: A Pilot Study Background and Objectives The ultimate goal in current skin rejuvenation practice is to achieve a good result with minimal pain and downtime. Nonablative skin rejuvenation (NSR) is one technique. The efficacy of the long-pulsed 1064 nm Nd:YAG laser (LPNDY) has not been assessed in NSR. Materials and Methods Three target areas were selected (bilateral cheeks and glabellar region) in six volunteer subjects. A LPNDY with an integral skin temperature monitor delivered three stacked shots to each target area (1064 nm, 12 mm spot, 13 J/cm2, 1 Hz) without any skin cooling or anesthesia. The skin temperature was recorded before, during, and after each set of shots using the system monitor and in real-time using a high-sensitivity (±0.001°C) near-infrared video camera. The skin reaction was observed with the naked eye, and pain and discomfort were assessed by the subjects during and after treatment. Results The subjects reported a mild feeling of heat with no discomfort during or after the test treatments. Mild erythema was observed around the treatment areas, without noticeable edema. A series of three ascending skin temperature stepwise peaks, with a decrease in skin temperature towards the baseline after the third shot, was observed consistently. The mean temperatures for shots 1, 2, and 3 for the cheeks were 39.5°C, 42.0°C, and 44.4°C, respectively, and for the glabella, 40.8°C, 43.9°C, and 46.2°C, respectively. Similar ranges were indicated on the system integral temperature monitor. Conclusion A set of three stacked pulses with the LPNDY at a low fluence achieved ideal dermal temperatures to achieve some dermal remodeling but without any downtime or adverse events. The temperature data from the integral thermal sensor matched the video camera measurements with practical accuracy for skin rejuvenation requirements. These data suggest that LPNDY would satisfy the necessary criteria to achieve effective NSR, but further studies will be needed to assess the actual results in clinical practice.

Low-level Laser Therapy with Novel Array of Light Source and Individualized Program for Treatment of Androgenetic Alopecia: A 16-week, Randomized, Double-blind, Sham Device-controlled Study

Jee-Woo Kim,Yeo-Seon Kwon,Yoon-Young Chang,Sung-Ho Hong,Jung-Won Shin,Jung-Im Na,허창훈 대한의학레이저학회 2020 MEDICAL LASERS Vol.9 No.2

Background and Objectives Low-level laser therapy (LLLT) is used widely to promote hair growth in androgenetic alopecia (AGA). This study examined the clinical efficacy and safety of a home-use LLLT device with a newly designed array of light sources and software optimized for individual types of AGA. Materials and Methods The study was a randomized, double-blind, sham device-controlled trial. Forty-eight subjects (39 men and nine women) were assigned randomly in a 2:1 ratio to use either the test device (LG Pra’L HGN1, LG electronics, Korea) or sham device. The subjects used the LLLT device three times a week for 16 weeks. Phototrichogram was used to measure the hair density and hair thickness at 0, 8, and 16-weeks. Adverse events were closely monitored. Results After 16 weeks of using the device, the test group showed a significant increase in hair density and hair thickness compared to the control. In the test group, the hair density increased 6.96 counts/cm2 at eight weeks and 13.67 counts/cm2 at 16 weeks from the baseline. The hair thickness increased 7.21 μm at eight weeks and 11.80 μm at 16 weeks compared to the baseline. Conclusion The home-use LLLT device with a novel array of light sources and an individualized program according to the types of hair loss appears to be an effective and safe treatment modality for both male and female AGA patients.

In Vivo and Ex Vivo Skin Reactions after Multiple Pulses of 1,064-nm, Microlens Array-type, Picosecond Laser Treatment

Herin Lyu,Jinyoung Park,Hee Chul Lee,이상주,Young Koo Kim,Sung Bin Cho 대한의학레이저학회 2020 MEDICAL LASERS Vol.9 No.2

Background and Objectives A picosecond-domain laser treatment using a microlens array (MLA) or a diffractive optical element elicits therapeutic micro-injury zones in the skin. This study examined the patterns of tissue reactions after delivering multiple pulses of 1,064-nm, MLA-type, picosecond neodymium:yttriumaluminum- garnet laser treatment. Materials and Methods Multiple pulses of picosecond laser treatment were delivered to ex vivo human or brown micropig skin and analyzed histopathologically. A highspeed cinematographic study was performed to visualize the multiple pulses of picosecond laser energy-induced skin reactions in in vivo human skin. Results In the ex vivo human skin, a picosecond laser treatment at a fluence of 0.3 J/cm2 over 100 non-stacking passes generated multiple lesions of thermally-initiated laser-induced optical breakdown (TI-LIOB) in the epidermis and dermis. In the ex vivo micropig skin, stacking pulses of 20, 40, 60, 80, and 100 at a fluence of 0.3 J/cm2 generated distinct round to oval zones of tissue coagulation in the mid to lower dermis. High-speed cinematography captured various patterns of twinkling, micro-spot reactions on the skin surface over 100 stacked pulses of a picosecond laser treatment. Conclusion Multiple pulses of 1,064-nm, MLA-type, picosecond laser treatment elicit marked TI-LIOB reactions in the epidermis and areas of round to oval thermal coagulation in the mid to deep dermis.

Treatment of Recurrent Respiratory Papillomatosis Using Laser and Available Adjuvant Therapies

우승훈,Phil-Sang Chung,이상준 대한의학레이저학회 2020 MEDICAL LASERS Vol.9 No.2

Recurrent respiratory papillomatosis (RRP) is a benign tumor that occurs in the respiratory tract, especially in the larynx. The etiology of RRP is human papillomavirus (HPV). According to the age of occurrence, RRP is divided into childhood-onset and adult-onset types. Generally, childhoodonset RRP shows a high recurrence rate and diffuse involvement in the respiratory tract. Adult-onset RRP is more localized and appears more frequently as a solitary lesion. It may be the result of sexual transmission or the proliferation of latent HPV infections. At present, the treatment of choice for RRP is CO2 laser ablation. In addition, pulse dye laser or KTP (KTiOPO: potassium-titanyl-phosphate) lasers are also used. Nonsurgical adjuvant therapies can be applied in cases requiring repetitive surgery or with diffuse extensions. This review will introduce the clinical features of RRP and various treatment options including lasers.