Search

Hallux valgus is a progressive angular deformity of the big toe, the degree of which is aggravated in weightbearing stance. Hallux valgus and intermetatarsal angles on postoperative weightbearing images are usually larger than those of intraoperative fluoroscopic and immediate postoperative non-weightbearing images. Here, we hypothesized that various angular parameters of hallux valgus would increase postoperatively with weightbearing. A total of 66 feet (58 patients) of moderate to severe hallux valgus were reviewed on consecutive plain foot anteroposterior radiographs. The changes of hallux valgus, intermetatarsal, hallux valgus interphalangeal, and distal metatarsal articular angles were compared. Hallux valgus and intermetatarsal angles were significantly increased with weightbearing postoperatively (p.001). Hallux valgus interphalangeal and distal metatarsal articular angles did not show significant changes with weightbearing (p.5). Hallux valgus and intermetatarsal angles were increased with weightbearing after hallux valgus surgery. Mean angular changes were 5.3 and 2.7 degrees, respectively. These values should be considered in the preoperative planning and intraoperative correction processes.

BACKGROUND: We aimed to validate a pilot study of photodiagnosis using near infrared (NIR) transillumination and assess the clinical efficacy of hypericin-mediated photodynamic therapy (HYP-PDT) in a rabbit laryngeal cancer model in order to develop a novel therapeutic modality with complete remission and preservation of the functional organ. METHODS: (1) In vitro study: VX tumor cells were subcultured and subjected to HYP-PDT. (2) In vivo study: A laryngeal cancer model was developed in which 12 rabbits were inoculated with a VX tumor suspension in the submucosal area of the left vocal fold using a transoral approach. All rabbits underwent NIR transillumination using light with a wavelength of 780 nm. The survival periods of the three treatment groups (6 rabbits in Group A: HYP-PDT, 3 each in Groups B and C: laser irradiation or HYP administration only) were analyzed. RESULTS: The higher the HYP concentration, the lower the VX cell viability in response to HYP-PDT using 590 nm LED. Following HYP-PDT, small tumors in Group A-1 rabbits healed completely and the animals demonstrated a long survival period, and larger tumors in Group A-2 healed partially with a survival period that extended over 3 weeks after inoculation. The survival of Groups B and C were not different over the first 3 weeks of the study, and were shorter than in Group A. CONCLUSION: We found HYP-PDT could be a curative therapy for early-stage cancers that may also preserve organ function, and may inhibit tumor progression and metastasis during advanced stages of laryngeal cancer.

Objective: Endoscopic surgical procedures rigorously underscore the significance of rapid hemostasis for unavoidable intraoperative bleeding, requiring advancement of the immediate hemostatic interventions for favorable clinical outcomes. Here, we report the efficacy of a new optical treatment with dual-wavelengths to develop an endoscopic hemostasis method. Methods: we combine visible (20-W 532 nm at 1.1 kW/cm2) and near-infrared (40-W 980 nm at 2.2 kW/cm2) wavelengths for facilitating noncontact thermal hemostasis on venous and arterial bleeders in in vivo leporine models. Results: Simultaneous irradiation of 60-W dual-wavelengths allows for an increased irradiance of 3.3 kW/cm2, involving both rapid light absorption by hemoglobin and deep thermal penetration. The collective thermal effects from the combined wavelengths contribute to a significant reduction in coagulation time and a high success rate of complete hemostasis for both venous and arterial bleeders. The enhanced hemostatic potential of the dual-wavelengths treatment accompanies minimal hemorrhage, reduces inflammatory responses, and facilitates re-epithelialization. Conclusion: The proposed dual-wavelengths method can achieve rapid and complete hemostasis for endoscopic procedures. Significance: We present the high-irradiance photothermal treatment using the dual-wavelengths as a novel method to regulate venous and arterial bleeding and potentially as a rapid noncontact hemostasis option to mitigate the risk associated with significant blood loss.

Fibrosis is a prevalent problem that pathologically accompanies chronic inflammatory diseases. Despite the availability of various fibrosis treatments, therapeutic efficacy must be further improved to achieve better clinical outcomes. The purpose of this study is to develop a novel treatment by combining phloroglucinol (PHL) with photobiomodulation (PBM) to prevent skin fibrosis. In in vitro, 635 nm PBM at 8 J/cm2 significantly reduced TNF-alpha levels, and 100 μg/ml of PHL suppressed the expression of α-smooth muscle actin and type I collagen due to the downregulation of SMAD 2/3 and MAPK signaling pathways. The 1470 nm laser light created the initial wound (97.1 mm2), leading to scar formation after complete wound closure (21 days) on rodent skin. In comparison to other groups, the dual treatment accelerated wound closure and achieved rapid and complete healing in 17 days. Histological analysis presented the reduced fibrotic scar and collagen deposition in the dual treatment group. PHL-combined PBM treatment enhanced the anti-inflammatory effect by 36% in comparison to single treatment groups. Overall, the proposed combined treatment promoted wound healing and enhanced anti-inflammatory and anti-fibrotic effects in the overexpressed in vitro and in vivo models.

Background The therapeutic capacity of multiple cylindrical interstitial laser ablations (CILAs) of pancreatic tissue was evaluated with 1064 nm laser light in ex vivo and in vivo porcine pancreatic models. Methods A diffusing applicator was sequentially employed to deliver 1064 nm laser light in a cylindrical distribution to ablate a large volume of pancreatic tissue. Ex vivo tissue was tested at various power levels (5, 7, and 10 W) under US imaging. An in vivo porcine model was used to evaluate the clinical feasibility of multiple CILAs on pancreatic tissue at 5 W via laparotomy (N = 3). Results Multiple CILAs symmetrically ablated a range of ex vivo tissue volumes (2.4–6.0 cm3) at various power levels. Multiple CILAs warranted a therapeutic capacity of symmetrically ablating in vivo pancreatic tissue. Both ex vivo and in vivo pancreatic tissues after multiple CILAs at 5 W confirmed the absence of or minimal thermal injury to the peripheral tissue and carbonization. Conclusions The current findings suggest that the collective thermal effects from multiple CILAs can help widely ablate pancreatic tissue with minimal thermal injury. Further in vivo studies will investigate the safety of the proposed CILA treatment as well as acute/chronic responses of pancreatic tissue for clinical translations.

In this paper, we demonstrated an optical fiber biosensor based on heterodyne demodulation to detect five pathogenic bacteria species forming biofilms, such as Escherichia Coli, Vibrio Vulnificus, Pseudomonas Aeruginosa, Staphylococcus Aureus, and Streptococcus Iniae, with their fluorescence characteristics. The proposed sensor detects the fluorescence of the five bacteria species with the intrinsic fluorescence characteristics of amino acid tryptophan, whose excitation and emission wavelengths are 280 and 350 nm, respectively. The fabricated sensor consists of an UV light source for excitation of bacteria, a high sensitivity detector for detection of fluorescence signals emitted from the excited bacteria, and a lock-in amplifier for amplification of the detected fluorescence signals. The lock-in amplifier can remove various noise signals coupled with the desired fluorescence signals and amplify the magnitude of the desired signal through the heterodyne demodulation technique. This signal processing technique enables the detection of the weak picowatt (pW) fluorescence signals. Consequently, it is concluded that our sensor can successfully detect the intensity of the fluorescence signal emitted from five pathogenic bacteria species whose concentration lies within 10² to 107 CFU/ml.

BackgroundStiff knees, like completely ankylosed or arthrodesed knees, can be painless. Total knee arthroplasty (TKA) for these painless, stiff knees is technically demanding. However, it can correct the alignment and advance the range of motion to improve quality of life. So, we reviewed the preoperative and postoperative results of functional and pain scores, range of motion (ROM) and complications in painless, stiff knees treated by TKA.MethodsFifteen painless, stiff knees underwent TKA from January 1998 to January 2017. The mean follow-up period was 15.4 (2.4–22.2) years. All the knees were completely ankylosed or arthrodesed. Clinical outcome and complications were evaluated using medical record review, serial plan radiography, ROM assessment, Knee Society score (KSS), Knee Society function score (FS), and a visual analog scale for pain (VAS).ResultsAll patients were satisfied with their operated knees. Mean KSS and FS scores were improved from 36 and 50.9 to 76.9 and 67.2, respectively (P P = 0.01). The mean ROM increased from 0º preoperatively to 77.6º (15–130) at the final follow-up (P P = 0.1). Major postoperative complications were reported in five of the knees (33.3%).ConclusionsThe results of TKA for painless, stiff knees were satisfactory with improved ROM and quality of life. Although some patients had mild pain and complications postoperatively, they were satisfied with the result. However, our study recommends that surgeons should consider the high rate of complications in the completely ankylosed or arthrodesed knees.Level of evidenceA retrospective case series, Level IV.

The present study evaluated the effect of fucoidan/alginate-polyethylene glycol-gellan gum (Fu/AL-PEG@GGH) hydrogel using low-level laser therapy (LLLT) on facilitating wound healing for wound care management. The hydrogel was fabricated and characterized to evaluate the wound healing potential. Cytotoxicity and apoptotic effects were evaluated with L929 and NIH3T3 cells. Uniform spherical sheets were observed with high thermal stability caused by porous matrixes with the increased cell viability and fast cell migration. Scar tissue was reduced by larger wound contraction with faster healing effects from the hydrogel + LLLT-treated group at day 14. The polysaccharides may promote wound healing due to the strong bonds by the physical cross-linking in hydrogel preparation. The results from hydrogel + LLLT-treated group confirmed an effective wound healing potential from the presence of high fibroblast and collagen deposition. Therefore, the combined practice of the hydrogel with LLLT may enhance a wound healing process for effective wound care applications.

The present study investigated effects of low-level laser therapy with cellulose nanocrystals/cellulose nanofibrils loaded in nanoemulsion (NE) against skin cancer cells on apoptosis. The nanoemulsion was fabricated and characterized by the standard methods. The toxicity level by cytotoxicity assays, generation of reactive singlet oxygen (ROS) and antioxidant potential, cell proliferation and migration were confirmed by using standard assays. The cellular uptake efficacy was evaluated by differential staining. The protein levels of EGFR, PI3K, AKT, ERK, GAPDH, and β-actin were detected by western blot. The samples showed a spherical shaped structure with the average size confirmed strong and stable hydrogen bonding forces with high degradation temperature and endothermic transition peaks. The fabricated samples showed no toxicity and high cell proliferation by generating more singlet oxygen levels and antioxidants. The intracellular signaling pathways was regulated with high protein expression levels, which was stimulated by specific molecules for cell proliferation, migration, and differentiation in cancer cells. The results proved that combined treatment regulated the intracellular signaling pathways in cancer cells. The current study showed a novel strategy for improving therapeutic efficacy of nanoemulsion by using low-level laser therapy. Further, the current favorable outcomes will be evaluated in in vivo animal models.

Endoscopic management of benign biliary stricture (BBS) remains challenging. Stenting is currently used for BBS management, but refractory BBS remains problematic. The aim of this study was to assess the safety and feasibility of a dilation balloon-equipped cylindrical light diffuser for BBS in a large animal model. A total of seven mini-pigs were used in the current study. Laser settings were chosen based on the findings of a previous animal study. Five animals were used in a preliminary study to establish process conditions. BBSs were created in the common bile ducts of the other two animals by intraductal radiofrequency ablation (RFA) via endoscopic retrograde cholangiography (ERC). At 4 weeks post-RFA, laser ablation was performed using a customized balloon-equipped cylindrical diffuser at 10 W for 10 s while maintaining balloon inflation for 10 s at 5 atm. A follow-up ERC was performed at 4 weeks post-laser ablation and the animals were sacrificed for histologic evaluation. BBS was observed in all animals by ERC at 4 weeks post-RFA. The mean bile duct stricture diameter in the two animals as determined by ERC was 0.8 mm. Laser ablations were performed without technical difficulty and no adverse event was encountered. At 4 weeks post-laser ablation, mean biliary stricture diameter had dilated to 1.6 mm on cholangiographic finding. On histologic examination, inflammatory cell infiltration in lamina propria and dense collagen deposition were observed, but there was no evidence of bile duct perforation. The devised balloon-equipped cylindrical laser light diffuser appears to be safe and feasible for the treatment of BBS. However, further studies and modifications are required before it can be applied clinically as a monotherapy.

Background and objective Various clinical and animal studies have applied low-level laser therapy (LLLT) to treat oral ulcers. However, most previous studies applied lasers with small pinpoint irradiation, which required multiple laser irradiations to cover the complete extent of the ulcer. The objective of this study was to evaluate the effect of LLLT using a 635 nm diode laser via a transoral device to cover the whole lesion on oral ulcers in an animal model. Study design/materials and methods An animal model of oral ulcers was developed with a 6 mm skin punch in the right buccal mucosa of Wistar rats (males, body weight 200-250 g). Three days after the mucosal injury, LLLT (spot size 2 cm2 ) was conducted once a day for 5 days. Twenty-eight rats were randomly assigned into four groups according to energy density (control group, 5, 20, 75 J/cm2 ). The size of the ulcers was measured and histologic analysis were performed ten days after the initial mucosal injury. Results The mean size of the oral ulcers was significantly smaller in rats treated with an energy density of 20 J/cm2 than that of any other group (control group or energy densities of 5 or 75 J/cm2 ). The irradiation of oral ulcers with an energy density of 20 J/cm2 accelerated the oral mucosa wound healing process and decreased inflammation and granulation tissue, resulting in good reepithelization. However, the histologic outcomes of rats irradiated with energy densities of 5 or 75 J/cm2 were comparable with those of the control group. Conclusion LLLT using a 635 nm diode laser for oral ulcers with a transoral cylindrical device for wide light distribution may accelerate the wound healing process. LLLT with large-surface irradiation may be a substitute for previous LLLT for oral mucosal lesions conducted in a punctuate manner. Lasers Surg. Med. © 2019 Wiley Periodicals, Inc.

The aim of the current study was to identify the efficient fiber movements for 532-nm laser prostatectomy. 532-nm Lithium triborate (LBO) laser light was tested on 120 kidney tissues at three different translational speeds (TS 1, 2, and 4 mm/s) and four different rotational speeds (RS 0.5, 1.0, 1.6, and 2.1 rad/s). The applied power was 120 W at a 2-mm working distance and 60° sweeping angle. Ablation rate and dimensions of resulting ablation craters were measured. Slower TSs and RSs created deeper and wider ablation craters with thinner coagulation, leading to more efficient ablation performance. Maximal ablation rate was achieved at a TS of 2 mm/s and RSs of 0.5 and 1.0 rad/s. An RS of 0.5 rad/s accompanied surface carbonization for all the TSs. Irrespective of TS, ablation rate became saturated at faster RSs than 1.0 rad/s. Faster TSs or RSs reduced tissue ablation, but increased thermal coagulation due to a shorter interaction time. Optimal ablation efficiency occurred at a TS of 2 mm/s and a RS of 1.0 rad/s with a thin coagulation of around 1.0 mm and no or minimal carbonization. Further studies will validate the current findings with prostate tissue and high-power levels for laser prostatectomy.

Barrett's esophagus (BE) is associated with an intestinal metaplasia that replaces normal squamous epithelium by columnar epithelium. The aim of the current study was to evaluate the feasible endoscopic treatment on esophageal tissue with circumferential laser irradiation. A 532-nm laser was used to deliver 10 W in a continuous manner through a balloon catheter-integrated diffuser. Ex vivo leporine esophagus was tested to identify thermal responses at various irradiation times. In vivo testing in a porcine model was performed to evaluate the feasibility of endoscopic application with the integrated device for BE treatment. Goniometric measurements confirmed that the proposed device yielded uniform radial irradiation (i.e., 0.9 ± 0.1 in arbitrary unit). Emission profiles were well correlated with temperature distribution along the device. Ex vivo leporine testing demonstrated that the temperature rise increased with irradiation time. The maximum temperature increase was around 38 °C after 60-s irradiation (transient increase rate = 0.62 °C/s), and the corresponding thermal coagulation reached esophageal submucosa (1.5 ± 0.2 mm). In vivo porcine testing evidently presented circumferential thermal denaturation around the lumen along with mild inflammatory reaction and the degenerated squamous epithelium. The overall thickness of the irreversible thermal coagulation was 3.1 ± 0.2 mm. The proposed photothermal therapy can be a feasible endoscopic method to treat BE with the aid of circumferential irradiation and mechanical expansion. Further chronic in vivo testing will be pursued to understand chronic tissue response in terms of wound healing and complication.

With the advancement of nanotechnology, several nanoparticles have been synthesized as antimicrobial agents by utilizing biologically derived materials. In most cases, the materials used for the synthesis of nanoparticles from natural sources are extracts. Natural extracts contain a wide range of bioactive components, making it difficult to pinpoint the exact component responsible for nanoparticle synthesis. Furthermore, the bioactive component present in the extract changes according to numerous environmental factors. As a result, the current work intended to synthesize gold (AuNPs) and zinc oxide (ZnONPs) nanoparticles using pure phloroglucinol (PG). The synthesized PG-AuNPs and PG-ZnONPs were characterized using a UV–Vis absorption spectrophotometer, FTIR, DLS, FE-TEM, zeta potential, EDS, and energy-dispersive X-ray diffraction. The characterized PG-AuNPs and PG-ZnONPs have been employed to combat the pathogenesis of Pseudomonas aeruginosa. P. aeruginosa is recognized as one of the most prevalent pathogens responsible for the common cause of nosocomial infection in humans. Antimicrobial resistance in P. aeruginosa has been linked to the development of recalcitrant phenotypic characteristics, such as biofilm, which has been identified as one of the major obstacles to antimicrobial therapy. Furthermore, P. aeruginosa generates various virulence factors that are a major cause of chronic infection. These PG-AuNPs and PG-ZnONPs significantly inhibit early stage biofilm and eradicate mature biofilm. Furthermore, these NPs reduce P. aeruginosa virulence factors such as pyoverdine, pyocyanin, protease, rhamnolipid, and hemolytic capabilities. In addition, these NPs significantly reduce P. aeruginosa swarming, swimming, and twitching motility. PG-AuNPs and PG-ZnONPs can be used as control agents for infections caused by the biofilm-forming human pathogenic bacterium P. aeruginosa.

Peritendinous adhesion mainly occurs between proliferating fibrous tissues and adjacent normal organs after surgery. Many physical barriers are applied to the implanted site to prevent peritendinous adhesion. However, these barriers often trigger inflammatory responses. Therefore, our study sought to develop phlorotannins-loaded cartilage acellular matrix films as a physical barrier and investigate their inhibitory effect on inflammatory responses, which are associated with the induction of postoperative peritendinous adhesion. Our findings indicated that incorporating phlorotannin into the cartilage acellular matrix film did not affect its unique characteristics including its thermal and spectroscopic properties. Moreover, the phlorotannins-loaded cartilage acellular matrix films suppressed the expression of inflammatory mediators on RAW 264.7 macrophages stimulated using Escherichia coli lipopolysaccharides and exhibited an anti-inflammatory effect when implanted subcutaneously in rats. Therefore, our results highlssssssssssssight the potential of phlorotannins-loaded cartilage acellular matrix films as a promising physical barrier to prevent postoperative peritendinous adhesion. This article is protected by copyright. All rights reserved.

The present study proposes an innovative opto-chemical treatment using a basket-integrated optical device (BIOD) to disinfect mature bacterial biofilm on endoscope channels. A BIOD was designed to position an optical diffuser on the central axis of an endoscope channel and to distribute laser light concentrically to the bacterial biofilm on the channel surface. To apply thermal damage and oxidative stress to the bacterial biofilm, a low concentration of a crosslinking agent (glutaraldehyde ~0.5%) was combined with 808 nm infrared (IR) and 405 nm blue (BL) laser lights. The applied irradiances of IR and BL were 10 W/cm2 and 1.6 W/cm2 for Teflon channel model and 20 W/cm2 and 3.2 W/cm2 for a clinical model, respectively. Individual irradiation of either IR or BL for 180 s induced the maximum temperatures of 62 ± 2 °C and 53 ± 3 °C on the biofilm, respectively. The simultaneous opto-chemical treatment reduced a significant population of the bacterial biofilms (7.5-log10 for Staphylococcus aureus and 7.1-log10 for Pseudomonas aeruginosa), which were 2.9-fold and 3.9-fold higher than that of the standard treatment with 2% glutaraldehyde (GA) solution, respectively. The proposed opto-chemical disinfection method can help reduce multi-drug resistant bacteria and prevent cross-infection during the clinical usage of a flexible endoscope.

Medical societies and public health agencies rigorously emphasize the importance of adequate disinfection of flexible endoscopes. The aim of this work was to propose a novel opto-chemical disinfection treatment against Staphylococcus aureus grown in mature biofilm on Teflon-based endoscope channel models. Laser irradiation using near-infrared and blue wavelengths combined with a low concentration of chemical disinfectant induced both irreversible thermal denaturation and intercellular oxidative stress as a combined mechanism for an augmented antimicrobial effect. The opto-chemical method yielded a 6.7–log10 reduction of the mature Staphylococcus aureus biofilms (i.e., approximately 1.0-log10 higher than current requirement of standard treatment). The proposed technique may be a feasible disinfection method for mitigating the risk associated with infection transmission.

The aim of the present study is to fabricate hydrogel as a photosensitizer (PS) for photodynamic therapy. Chlorin e6 (Ce6)-fucoidan/alginates@gellam gum (Ce6-Fu/AL@GG)-based hydrogel was fabricated and characterised in terms of morphology and functional groups. MTT assay was used to check toxicity and also performed scratch assay for wound healing property of Ce6-Fu/AL@GGH. Fourier transform infrared spectroscopy (FT-IR) confirmed the existence of physical interactions between polysaccharides. Thermogravimetric analysis (TGA) and Differential scanning calorimetry (DSC) analysis confirmed a decrease in the thermal stability of the fabricated hydrogel. Scanning electron microscope (SEM) and Transmission electron microscope (TEM) images demonstrated porous matrixes representing homogeneous dispersion of nanoparticles in the hydrogel. Cytotoxicity tests revealed that a decrease in the cell viability occurred in PDT after 48 h treatment. Both Ce6 and laser irradiation induced the HT-29 apoptotic effect that was mediated by intracellular ROS generation and mitochondrial damage. The laser-treated hydrogel was effective in inhibiting HT-29 cell growth. Ce6-Fu/AL@GG hydrogel can be a promising platform for PDT on cancer treatment.

Primary hepatocellular carcinoma (HCC) and colon carcinoma are two of the most common clinical malignancies along with high morbidity and mortality. As low-power laser irradiation (LPLI) can induce cytotoxicity or cell apoptosis on several types of hyperplasia, LPLI may be a potential alternative treatment for gastroenterological cancers. The current in vitro study focused on LPLI-induced apoptosis and mechanism after 532-nm laser irradiation on two different carcinoma cells. Squamous cell carcinoma (VX2) and murine colon carcinoma (CT26) cells were cultured to test the feasibility of LPLI. The applied fluence varied from 0 to 600 J/cm2. 3-(4,5-dimethyl-2-thiazolyl)-2,5-diphenyl-2H-tetrazolium bromide analysis, fluorescence imaging, wound healing assay, and cell apoptosis tests were performed 24 h post-irradiation to monitor cellular responses. The current results demonstrated a dose-dependent stimulatory effect of LPLI on the cell viability, migration, and apoptosis of VX2 and CT26 cells. The therapeutic fluence of 600 J/cm2 induced statistically significant inhibition in cell viability. Both the wound healing assay and the cell apoptosis tests confirmed that LPLI with high fluences could inhibit cell migration as well as induce cell apoptosis. The current findings demonstrate that LPLI might be a potential treatment for the carcinoma cells. Further studies will be performed to evaluate the feasibility of LPLI in in vivo tumor models.

Prolonged endotracheal intubation is the most common cause of tracheal stenosis, which may lead to serious airway obstruction. Development of an endotracheal tube coated with biomaterials that exhibit anti-inflammatory or anti-fibrogenic effects may prevent tracheal stenosis. This study demonstrates that an endotracheal tube coated with phlorotannin, which is present in extracts of the brown alga Ecklonia cava, can prevent tracheal stenosis in a rabbit model. An in vitro study shows that phlorotannin inhibits proliferation of human tracheal fibroblasts treated with transforming growth factor β1. Phlorotannin-coated endotracheal tubes show steady release of phlorotannin for up to 7 days, and removal of the tube 1 week after insertion reveals a reduction in both fibrogenesis and thickening of tracheal submucosa. Western blot analysis of tracheal tissues after removal of the phlorotannin-coated tube shows decreased protein expression levels of phenotypic markers of fibrosis such as collagen type I and α-smooth muscle actin. The ability of phlorotannin-coated endotracheal tube to prevent tracheal stenosis caused by endotracheal intubation indicates that phlorotannin may be considered as a candidate biomaterial for coating the cuff of endotracheal tubes to prevent tracheal stenosis.

Background and objectives Fibrosis is a highly prevalent disease, which is responsible for 45% of deaths through pathological effects in developed countries. Previous studies have reported that low-level laser therapy (LLLT) can modulate fibrotic activity, but significant enhancement of therapeutic efficacy is still required for clinical translation. The aim of this study is to evaluate the feasible effect of LLLT combined with phloroglucinol (PHL) on the inhibition of fibrosis in vitro. Study design/materials and methods NIH/3T3 murine embryonic fibroblasts cells were cultured and transforming growth factor-β1 (TGF-β1) was treated for transition of fibroblasts. After TGF-β1 treatment, LLLT and PHL were used, respectively, and in combination to suppress fibrosis. 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide and BrdU assays were performed to estimate the cell viability and proliferation. To evaluate the expression of fibrotic markers, we used confocal immunofluorescence and western blot. Results When compared with respectively treated groups, the group with the combined treatment of LLLT and PHL significantly reduced cell viability and proliferation. Immunofluorescence staining showed that the combined group minimized more α-smooth muscle actin (α-SMA) and type I collagen than the other groups. Western blot analysis showed that the combined treatment had significant decreases in α-SMA, TGF-β1, and type I collagen. Conclusions PHL-assisted LLLT may be an effective treatment to inhibit fibrosis due to its additive effects. The combined treatment has a potential to be an alternative treatment for fibrosis. Lasers Surg. Med. © 2019 Wiley Periodicals, Inc.

Astaxanthin and alpha-tocopherol have various biological potential with induction of intracellular ROS production in cytosol, endoplasmic reticulum and mitochondrial site. The present study was performed to prepare nanoemulsion (NEs) formulation of astaxanthin and alpha-tocopherol with sodium caseinate (AS-AT/SC NEs) using spontaneous emulsification and ultrasonication for analyzing intracellular ROS production in apoptosis. NEs was characterized with standard analysis, which revealed a high stability of normal pH with a small size and unique zeta potential of spherical structure droplets with no toxicity and faster cell migration. It induced ROS production and confirmed using fluorescent stains due to their unique physicochemical and functional properties. Therefore, it played a significant role in the induction of oxidative stress inside the cell as dose-dependent cytotoxicity at different concentrations. AS-AT/SC NEs with protective effect in maintaining intracellular ROS, oxidative stress and mitochondrial membrane potential to reduced apoptosis morphology in cancer cells through mitochondria-mediated apoptosis that inhibits cell death, thus cell survival was initiated at greater extent. Thereby exhibiting a significant remarkable therapeutic effect in cancer field. To best of our knowledge, this is first study concluded that induction of apoptosis potential by AS-AT/SC NEs emerged as a potential way to eradicate cancer cells.

Poly(lactide-co-glycolide) (PLGA) is one of the most widely used bioplastics in bioengineering and has been actively applied to fused deposition modeling (FDM)-based 3D printing. However, the brittleness of PLGA remains a major obstacle to its application in FDM systems, because these systems can only process flexible materials. Here, we developed a new technique to enhance the flexibility of PLGA. A polymer drawing process involving bidirectional extension was applied to induce molecular alignment, which affects the flexibility of the material. Filamentous forms of PLGA with various draw ratios were prepared and their material properties were investigated in detail. The results showed that PLGA flexibility was markedly increased at the draw ratio of 3, which was identified as the brittle-to-ductile transition point. The elongation at break of the drawn PLGA at this draw ratio was approximately 14 times greater than that of the raw material. Printability tests showed that various complex 3D structures could be fabricated with the drawn PLGA using a FDM system. In addition, the drawn PLGA showed no cytotoxicity in culturing. The technique developed here shows potential for the preparation of long and flexible PLGA filaments for use in FDM technology with biological applicability.

Laser ablation may provide a minimally invasive palliative treatment for pancreatic cancer. The aim of the current study was to assess the feasibility of a 532-nm laser equipped with a cylindrical light diffuser for the treatment of pancreatic cancer. Monolayers of BxPC-3 human pancreatic cancer cell were exposed to 532 nm laser light. Power levels of 5 - 7 W were used to uniformly target the entire cell colonies for 60 and 120 seconds. The cells were incubated for 24 hours after treatment and viabilities were determined by using a MTT assay. Laser ablation was performed by using the cylindrical light diffuser on six pancreatic tumor tissues obtained from pancreatic cancer xenograft mouse models, which were exposed to the 532 nm light at 5W or 7W for 10 to 30 seconds. In the in vitro study, the survival rates of the pancreatic cancer cells were reduced by 6.6% to 98.9% after the treatment, and the survival rates were reduced by increasing laser power and/or irradiation time. In the pancreatic tumor tissues, a homogenous circular ablation zone was observed in all tumors and the ablation distance induced by the laser irradiation showed to be constant from the diffuser to all directions (standard deviation, 0.3 - 1.3 mm). Ablation distance and area increased with increasing laser power and/or irradiation time. The 532 nm laser effectively killed pancreatic cancer cells, and the cylindrical light diffuser was found to be suitable for laser ablation as it provided uniform ablation in pancreatic cancer.

Holmium:YAG laser has been the lithotrite of choice for around 30 years in kidney stone surgery. Lasers have evolved over the years to offer higher power, increased pulse frequencies and longer pulse durations. The drivers for change have been to improve stone ablation and to minimise retropulsion. We report on a new prototype Holmium laser that fires multiple “micro-pulses” in “pulse packets” and discuss the stone phantom ablation rate results utilizing a bench model. The prototype laser demonstrated impressive stone ablation rates in our bench testing across a range of power settings. We will discuss the details of these results supporting that pulse-modulation with packets of micro-pulses are a promising technological development. (Disclaimers: Bench Test results may not necessarily be indicative of clinical performance. The testing was performed by or on behalf of BSC.

Stone retropulsion during laser lithotripsy results from various physical phenomena such as recoil momentum, bubble dynamics, and subsequent jet formation. Considerable stone retropulsion has been observed whereby the optical energy is converted into both mechanical and thermal energy as a distinctive bubble generation and collapse. It is hypothesized that by reducing the peak power and lengthening the pulse duration, we can reduce this conversion of optical energy into mechanical energy. This should maximize the thermal effects on the stone leading to enhanced ablation efficiency as well as less stone “chasing”. We are reporting on a new prototype Holmium laser with low pulse power and long temporal pulse durations in an attempt to minimize stone retropulsion.

Endoscopic submucosal dissection (ESD) is clinically used to remove early gastric cancer in stomach. The aim of the current study is to examine a therapeutic capacity of pulsed Ho:YAG laser for the development of laser-assisted ESD under various surgical parameters. Ex vivo porcine stomach tissue was ablated with 1-J Ho:YAG pulses at 10 Hz at different number of treatments (NT = 1, 2, and 3) and treatment speeds (TS = 0.5, 1, and 2 mm/s) without and with saline injection. Regardless of saline injection, straight tissue ablation showed that ablation depth increased with increasing NT and decreasing TS. At NT = 3 and TS = 0.5 mm/s, no saline injection yielded the maximum ablation depth (3.4 ± 0.3 mm), partially removing muscularis propria. However, saline injection confined the tissue ablation within a submucosal layer (2.1 ± 0.3 mm). Thermal injury was found to be 0.7~1.1 mm in the adjacent tissue with superficial carbonization. Circular tissue ablation (2 cm in diameter) at NT = 3 and TS = 0.5 mm/s presented that no saline injection yielded a reduction in the lesion area, whereas saline injection maintained the ablated lesion area. Histological analysis revealed that unlike no saline injection, saline injection ablated the entire mucosal layer without perforation in the muscular propria. The pulsed Ho:YAG laser can be a potential surgical tool for clinical ESD to incise a target lesion without adverse perforation. Further investigations will validate the efficacy and safety of the Ho:YAG laser-assisted ESD in in vivo porcine stomach models for clinical translation.

Colorectal cancer is the third most common malignancy all over the world, along with high morbidity and mortality. As a treatment, high-fluence low-power laser irradiation (HF-LPLI) has reported that its biostimulatory activity can suppress or even destruct tumor growth in neoplastic diseases. The aim of the present study is to examine a therapeutic capacity of HF-LPLI for colorectal cancer treatment by using human colon cancer cell (HT29) model. The in vitro cancer cell model was used to analyze the underlying mechanism of laser-induced apoptosis. Laser irradiation was performed five times (once a day for five consecutive days) with 635 nm laser light for 8 and 16 min (fluence = 128 and 256 J/cm2), respectively. The efficiency of the HF-LPLI treatment was evaluated by MTT, fluorescence staining, cell wound healing, and western blot test during the 5-day period. Experiment data showed that HF-LPLI had a dose-dependent stimulating effect on cell viability, migration, and apoptosis of HT29 cells. The inhibition effect of laser treatment at 256 J/cm2 on cell viability was statistically significant. Meanwhile, the wound healing and western blot tests also confirmed that HF-LPLI could inhibit cell migration and induce cell apoptosis. The current research results demonstrate that 635 nm HF-LPLI can be an alternative treatment option for colorectal cancer by increasing the expression of caspase-3 and inducing HT29 tumor cell apoptosis through activation of the mitochondrial pathway.

Laser lights have been used by dermatologists for tattoo removal through photothermal interactions. However, most clinical studies used a visual scoring method to evaluate the tattoo removal process less objectively, leading to unnecessary treatments. This study aimed to develop a simple and quantitative imaging method to monitor the degree of tattoo removal in in vivo skin models. Sprague Dawley rat models were tattooed with four different concentrations of black inks. Laser treatment was performed weekly on the tattoos using a wavelength of 755 nm over six weeks. Images of non-treated and treated samples were captured using the same method after each treatment. The intensities of the tattoos were measured to estimate the contrast for quantitative comparison. The results demonstrated that the proposed monitoring method quantified the variations in tattoo contrast after the laser treatment. Histological analysis validated the significant removal of tattoo inks, no thermal injury to adjacent tissue, and uniform remodeling of epidermal and dermal layers after multiple treatments. This study demonstrated the potential of the quantitative monitoring technique in assessing the degree of clearance level objectively during laser treatments in clinics.

A bioengineered skeletal muscle tissue as an alternative for autologous tissue flaps, which mimics the structural and functional characteristics of the native tissue, is needed for reconstructive surgery. Rapid progress in the cell-based tissue engineering principle has enabled in vitro creation of cellularized muscle-like constructs; however, the current fabrication methods are still limited to build a three-dimensional (3D) muscle construct with a highly viable, organized cellular structure with the potential for a future human trial. Here, we applied 3D bioprinting strategy to fabricate an implantable, bioengineered skeletal muscle tissue composed of human primary muscle progenitor cells (hMPCs). The bioprinted skeletal muscle tissue showed a highly organized multi-layered muscle bundle made by viable, densely packed, and aligned myofiber-like structures. Our in vivo study presented that the bioprinted muscle constructs reached 82% of functional recovery in a rodent model of tibialis anterior (TA) muscle defect at 8 weeks of post-implantation. In addition, histological and immunohistological examinations indicated that the bioprinted muscle constructs were well integrated with host vascular and neural networks. We demonstrated the potential of the use of the 3D bioprinted skeletal muscle with a spatially organized structure that can reconstruct the extensive muscle defects. Wake Forest Clinical and Translational Science Institute [UL1 TR001420]; Army; Navy; NIH; Air Force; VA; Health Affairs [W81XWH-14-2-0004]; U.S. Army Medical Research Acquisition Activity, Fort Detrick MD [21702-5014]; Basic Science Research Program through the National Research Foundation of Korea (NRF) - Ministry of Education, Science, and Technology [2012R1A6A3A03040684] We thank H. S. Kim, J. S. Lee, and T. Bledsoe for a surgical procedure, Regenerative Medicine Clinical Center (RMCC) for hMPCs isolation, M. Devarasetty for imaging, and Y. M. Ju for technical assistance. The authors thank K. Klein at the Wake Forest Clinical and Translational Science Institute (UL1 TR001420) for editorial assistance. This work was supported by the Army, Navy, NIH, Air Force, VA and Health Affairs to support the AFIRM II effort under Award No. W81XWH-14-2-0004. The U.S. Army Medical Research Acquisition Activity, 820 Chandler Street, Fort Detrick MD 21702-5014 is the awarding and administering acquisition office. Opinions, interpretations, conclusions, and recommendations are those of the author and are not necessarily endorsed by the Department of Defense. J.H.K. was supported by Basic Science Research Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Education, Science, and Technology (2012R1A6A3A03040684).

Purpose: The purpose of this study was to propose and test a conceptual model that explains the interrelationships among perceived social support, loneliness, physical activity (PA), and quality of life (QoL) among active older adults in South Korea. Methods: Data were collected from 332 individuals over the age of 65 using a systematic stratified convenience sampling method. Survey data were collected and analyzed using a structural equation model (SEM). Results: Perceived social support had a significantly positive effect on PA (β = 0.14, p

BACKGROUND AND OBJECTIVE Hypertrophic scar (HTS) results from a connective tissue reaction to trauma, inflammation, surgery, or burn on skin. In spite of various techniques for wound generation, the degree of scar in animal models after healing is still unpredictable and less reproducible. The objective of the current study was to identify the appropriate method to create the maximal HTS tissue in a reliable manner by comparing three different methods in vivo. MATERIALS AND METHODS A 27 ICR mice were tested for the in vivo evaluations. Three different methods were applied to develop wounds on the back of each mice for quantitative evaluations on collagen formation: Group 1 (thermal burn), Group 2 (chemical burn), and Group 3 (physical punch). After injury, each lesion was photographed to examine physical variations in the wound areas. Histological analysis was conducted on days 0, 7, and 28 to assess the extent of the injury in the tissue and to quantitatively compare the amount of collagen formation after wound healing. RESULTS Compared with Groups 1 and 3, Group 2 demonstrated the largest wound area that gradually decreased with healing time. However, the minimal axial damage (along tissue depth) occurred to Group 2 at day 0 (183.7 ± 28.9, 38.1 ± 9.2, and 296.0 ± 81.7 µm for Groups 1, 2, and 3, respectively). After 28 days, all the groups showed the complete healing and accompanied a significant increase in the number of fibroblast and collagen generation with well-oriented and denser collagen fibers, in comparison with normal skin. Group 2 yielded twice thicker skin (both epidermis and dermis) than the other groups (970.8 ± 108.8 µm for Group 2 vs. 381.5 ± 30.8 µm for Group 1 and 442.9 ± 56.3 µm for Group 3; P

// Hyejin Kim 1, * , Van Phuc Nguyen 1, * , Panchanathan Manivasagan 2, * , Min Jung Jung 3 , Sung Won Kim 4 , Junghwan Oh 1, 2 and Hyun Wook Kang 1, 2 1 Interdisciplinary Program of Biomedical Mechanical and Electrical Engineering, Pukyong National University, Busan, South Korea 2 Department of Biomedical Engineering and Center for Marine-Integrated Biomedical Technology (BK 21 Plus), Pukyong National University, Busan, South Korea 3 Department of Pathology, Kosin University College of Medicine, Busan, South Korea 4 Department of Otolaryngology-Head and Neck Surgery, Kosin University College of Medicine, Busan, South Korea * These authors contributed equally to this work Correspondence to: Sung Won Kim, email: swforyou@gmail.com Junghwan Oh, email: jungoh@pknu.ac.kr Hyun Wook Kang, email: wkang@pukyong.ac.kr Keywords: doxorubicin; gold-nanoparticles; photothermal therapy; chemotherapy; eye tumor Received: October 16, 2017 Accepted: December 01, 2017 Published: December 09, 2017 ABSTRACT The current research demonstrates the feasible biomedical application of AuNPs coated with doxorubicin (Dox)-loaded fucoidan (Fu) for dual-chemotherapy and photothermal treatment (PTT) on eye tumors in vitro and in vivo . Marine-derived Fu was used as a capping agent to achieve high photostability for AuNPs, and Dox as a FDA-approved anti-cancer drug was added to induce chemotherapy. The synthesized Dox-Fu@AuNPs exhibited high cytotoxicity on the tumor cells and strong light absorption for temperature increase in vitro . After intratumoral injection of Dox-Fu@AuNPs in the rabbit eye tumors, PTT-assisted Dox-Fu@AuNPs entailed the complete removal of the eye tumors without recurrence for 14 days after the treatment. Photoacoustic image contrast from the tumor regions was enhanced due to selective light absorption by the administered Dox-Fu@AuNPs. Therefore, the proposed Dox-Fu@AuNPs can be a potential nano-theranostic material for treating and diagnosing the eye tumors.

This study aims to demonstrate the feasibility of cylindrical interstitial laser ablation (CILA) in porcine pancreatic tissue to develop a EUS-guided PC ablation technique with enhanced safety. A diffusing applicator created a uniformly symmetrical laser ablation in pancreatic tissue. Ex vivo tests presented that both ablation thickness and volume increased linearly with the applied power (R2 = 0.96 and 0.90, respectively) without carbonization and fiber degradation. The numerical simulations matched well with the experimental results in terms of temperature development and thermal damage (deviation of ≤ 15%). In vivo tests with EUS confirmed easy insertion and high durability of the diffusing applicator. EUS-guided CILA warranted a feasible therapeutic capacity of ablating in vivo pancreatic tissue. The proposed EUS-guided CILA can be a feasible therapeutic approach to treat PC with predictable thermal ablation and enhanced safety.

Background and objective Bile duct stricture is an uncommon disease in gastroenterology resulting from postoperative trauma. In spite of non-surgical treatments, clinical outcomes for the biliary strictures still encounter high restenosis and stent migration. The objective of the current study was to investigate the feasible application of a balloon catheter-integrated diffing applicator to thermally treat the bile duct stricture. Materials and methods 400-μm optical fibers were micro-machined and then integrated with an inflatable balloon catheter. The fabricated applicator was tested on porcine bile ducts with 20-W 980 nm laser light for 60 s, and a thermal camera was used to measure thermal response of the tissue. Due to mechanical pressure, the inflated balloon was able to expand the tissue lumen up to 6 mm in diameter. Results Compared to control, the inner area of the treated tissue was increased by four fold (i.e., 2.74±0.05 mm2 for treated vs. 0.73±0.14 mm2 for control) during the balloon catheter-assisted laser irradiation. The laser-induced tissue temperature reached up to 80.1±6.4 °C (thermal gradient = 1.2 °C/s). A thin layer of coagulation necrosis (0.5±0.1 mm) consistently formed around the lumen. Conclusion The proposed balloon catheter-integrated diffusing applicator can be a feasible minimally invasive device to photothermally treat the obstructive bile ducts. Lasers Surg. Med. 49:781-786, 2017. © 2017 Wiley Periodicals, Inc.

Macrophages are excellent imaging targets for detecting atherosclerotic plaques as they are involved in all the developmental stages of atherosclerosis. However, no imaging technique is currently capable of visualizing macrophages inside blood vessel walls. The current study develops an intravascular ultrasonic-photoacoustic (IVUP) imaging system combined with indocyanine green (ICG) as a contrast agent to provide morphological and compositional information about the targeted samples. Both tissue-mimicking vessel phantoms and atherosclerotic plaque-mimicking porcine arterial tissues are used to demonstrate the feasibility of mapping macrophages labeled with ICG by endoscopically applying the proposed hybrid technique. A delay pulse triggering technique is able to sequentially acquire photoacoustic (PA) and ultrasound (US) signals from a single scan without using any external devices. The acquired PA and US signals are used to reconstruct 2D cross-sectional and 3D volumetric images of the entire tissue with the ICG-loaded macrophages injected. Due to high imaging contrast and sensitivity, the IVUP imaging vividly reveals structural information and detects the spatial distribution of the ICG-labeled macrophages inside the samples. ICG-assisted IVUP imaging can be a feasible imaging modality for the endoscopic detection of atherosclerotic plaques.

Background and Objective Variable methods of animal model have been introduced to develop tracheal stenosis. However, none of the prior models allow for predictable determination of the grade of stenosis. This study sought to establish an animal model of tracheal stenosis by using a cylindrical diffuser and to evaluate the feasibility of a reproducible model. Study Design/Materials and Methods A cylindrical diffuser was developed to have a 5 mm active segment to emit laser light circumferentially. Twenty one New Zealand white rabbits were enrolled in this study. The cylindrical diffuser was inserted transorally under bronchoscopic view and the diffused light was delivered to tracheal mucosa 2 cm below the level of vocal cord. Input power of irradiation was 10 W, 5 seconds in group A (n = 7), 10 W, 7 seconds in group B (n = 7), and 8 W, 5 seconds in group C (n = 7). The degree of tracheal stenosis was observed weekly and the rabbits were euthanized 4 weeks after the laser irradiation. Results The degree of stenosis in group B (90–98%) was significantly larger than that of group A (75–92%) (P = 0.004), while degree in group C (24–35%) was significantly smaller than that of group A (P

Numerous approaches have been introduced to regenerate artificial dental tissues. However, conventional approaches are limited when producing a construct with three-dimensional patient-specific shapes and compositions of heterogeneous dental tissue. In this research, bioprinting technology was applied to produce a three-dimensional dentin–pulp complex with patient-specific shapes by inducing localized differentiation of human dental pulp stem cells within a single structure. A fibrin-based bio-ink was designed for bioprinting with the human dental pulp stem cells. The effects of fibrinogen concentration within the bio-ink were investigated in terms of printability, human dental pulp stem cell compatibility, and differentiation. The results show that micro-patterns with human dental pulp stem cells could be achieved with more than 88% viability. Its odontogenic differentiation was also regulated according to the fibrinogen concentration. Based on these results, a dentin–pulp complex having patient-specific shape was produced by co-printing the human dental pulp stem cell–laden bio-inks with polycaprolactone, which is a bio-thermoplastic used for producing the overall shape. After culturing with differentiation medium for 15 days, localized differentiation of human dental pulp stem cells in the outer region of the three-dimensional cellular construct was successfully achieved with localized mineralization. This result demonstrates the possibility to produce patient-specific composite tissues for tooth tissue engineering using three-dimensional bioprinting technology.