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surgical sapphire

Gabrielle A Murashova, Christopher A Mancuso, Jacob L Canfield, Sanae Sakami, Krzysztof Palczewski, Grazyna Palczewska, Marcos Dantus
Ultrafast lasers have potential use in ophthalmology for diagnoses through non-invasive imaging as well as for surgical therapies or for evaluating pharmacological therapies. New ultrafast laser sources, operating at 1.07 μm and sub-40 fs pulse durations, offer exciting possibilities in multiphoton imagining of the retina as the bulk of the eye is relatively transparent to this wavelength, three-photon excitation is not absorbed by DNA, and this wavelength has a greater penetration depth compared to the commonly used 800 nm Ti:Sapphire laser...
November 1, 2017: Biomedical Optics Express
Kyle J Gunnerson, Andrew D Shaw, Lakhmir S Chawla, Azra Bihorac, Ali Al-Khafaji, Kianoush Kashani, Matthew Lissauer, Jing Shi, Michael G Walker, John A Kellum
BACKGROUND: Acute kidney injury (AKI) is an important complication in surgical patients. Existing biomarkers and clinical prediction models underestimate the risk for developing AKI. We recently reported data from two trials of 728 and 408 critically ill adult patients in whom urinary TIMP2•IGFBP7 (NephroCheck, Astute Medical) was used to identify patients at risk of developing AKI. Here we report a preplanned analysis of surgical patients from both trials to assess whether urinary tissue inhibitor of metalloproteinase 2 (TIMP-2) and insulin-like growth factor-binding protein 7 (IGFBP7) accurately identify surgical patients at risk of developing AKI...
February 2016: Journal of Trauma and Acute Care Surgery
Sasko Kedev, Danica Petkoska, Biljana Zafirovska, Ivan Vasilev, Olivier F Bertrand
We aimed to evaluate the feasibility and safety of performing percutaneous carotid stent implantation with a newly designed double-layer stent using transradial slender 5Fr techniques. We recruited 10 consecutive patients who underwent percutaneous carotid stenting using nitinol double-layer micromesh (Roadsaver) stents. Mean age of patients was 66 years. Seven patients had ≥2 high-risk criteria according to SAPPHIRE classification. Indication was neurologic symptoms in 7 and severe lesion without symptoms in 3 cases...
September 15, 2015: American Journal of Cardiology
Jessica J Jalbert, Louis L Nguyen, Marie D Gerhard-Herman, Michael R Jaff, Christopher J White, Andrew T Rothman, John D Seeger, Hiraku Kumamaru, Lauren A Williams, Chih-Ying Chen, Jun Liu, Thomas T Tsai, Herbert D Aronow, Joseph A Johnston, Thomas G Brott, Soko Setoguchi
IMPORTANCE: Despite increased carotid artery stenting (CAS) dissemination following the 2005 National Coverage Determination, to our knowledge, periprocedural and long-term outcomes have not been described among Medicare beneficiaries. OBJECTIVE: To describe the incidence of outcomes during and after the periprocedural period among Medicare beneficiaries undergoing CAS. DESIGN, SETTING, AND PARTICIPANTS: Observational study with a mean follow-up time of approximately 2 years among 22,516 fee-for-service Medicare beneficiaries at least 66 years old undergoing CAS (2005-2009) who were linked to the Centers for Medicare & Medicaid Services' CAS database...
March 2015: JAMA Neurology
Erica Su, Hui Sun, Tibor Juhasz, Brian J F Wong
Microfracture surgery is a bone marrow stimulation technique for treating cartilage defects and injuriesin the knee. Current methods rely on surgical skill and instrumentation. This study investigates the potential useof laser technology as an alternate means to create the microfracture holes. Lasers investigated in this study include an erbium:YAG laser (λ = 2.94 μm), titanium:sapphire femtosecond laser system (λ = 1700 nm), and Nd:glass femtosecond laser (λ = 1053 nm). Bovine samples were ablated at fluences of 8 to 18 J∕cm2 with the erbium:YAG laser, at a power of 300 ± 15 mW with the titanium:sapphire femtosecond system, and at an energy of 3 μJ∕pulse with the Nd:glass laser...
September 2014: Journal of Biomedical Optics
Christopher J White
Carotid artery stenting (CAS) has achieved clinical equipoise with carotid endarterectomy (CEA), as evidenced by 2 large U.S. randomized clinical trials, multiple pivotal registry trials, and 2 multispecialty guideline documents endorsed by 14 professional societies. The largest randomized trial conducted in patients at average surgical risk of CEA, CREST (Carotid Revascularization Endarterectomy Versus Stenting Trial) found no difference between CAS and CEA for the combined endpoint of stroke, death, and myocardial infarction (MI) after 4 years of follow-up...
August 19, 2014: Journal of the American College of Cardiology
Nir Katchinskiy, Roseline Godbout, Helly R Goez, Abdulhakem Y Elezzabi
BACKGROUND AND OBJECTIVE: Laser-induced cell-cell surgical attachment using femtosecond laser pulses is reported. STUDY DESIGN/MATERIALS AND METHODS: We have demonstrated the ability to attach single cells using sub-10 femtosecond laser pulses, with 800 nm central wavelength delivered from a Ti:Sapphire laser. To check that the cells did not go through a cell-fusion process, a fluorescent dye Calcein AM was used to verify that the fluorescent dye did not migrate from a dyed cell to a non-dyed cell...
April 2014: Lasers in Surgery and Medicine
G Carrafiello, M L De Lodovici, G Piffaretti, N Rivolta, A M Ierardi, M Petrillo, A Facchinetti, F Carimati, E P Verrengia, M Mauri, D Tsetis
AIM: To evaluate technical success, complications and the influence of the learning curve on outcome in carotid artery stenting (CAS) performed in patients not suitable for surgery. PATIENTS AND METHODS: One hundred and nine procedures of protected carotid stenting in 103 high risk patients were performed. All patients presented at least one factor that potentially increased the surgical risk of carotid endoarterectomy (CEA), according to SAPPHIRE criteria. Neurologic complications were quantified by the National Institutes of Health Stroke Scale (NIHSS) and were evaluated by median Rankin Scale (mRS)...
April 2014: Diagnostic and Interventional Imaging
Thomas C Hutchens, Arash Darafsheh, Amir Fardad, Andrew N Antoszyk, Howard S Ying, Vasily N Astratov, Nathaniel M Fried
Vitreoretinal surgery is performed using mechanical dissection that sometimes results in iatrogenic complications, including vitreous hemorrhage, retinal breaks, incomplete membrane delamination, retinal distortion, microscopic damage, etc. An ultraprecise laser probe would be an ideal tool for cutting away pathologic membranes; however, the depth of surgery should be precisely controlled to protect the sensitive underlying retina. The ultraprecise surgical microprobe formed by chains of dielectric spheres for use with the erbium:YAG laser source (λ=2940  nm), with extremely short optical penetration depth in tissue, was optimized...
January 2014: Journal of Biomedical Optics
Mingtao Zhao, Yong Huang, Jin U Kang
We describe a novel common-path optical coherence tomography (CP-OCT) fiber probe design using a sapphire ball lens for cross-sectional imaging and sensing in retina vitrectomy surgery. Single mode Gaussian beam (TEM(00)) simulation was used to optimize lateral resolution and working distance (WD) of the common-path probe. A theoretical sensitivity model for CP-OCT was prosed to assess its optimal performance based an unbalanced photodetector configuration. Two probe designs with working distances (WD) 415μm and 1221μm and lateral resolution 11μm and 18μm, respectively were implemented with sensitivity up to 88dB...
March 26, 2013: Proceedings of SPIE
M Fiek, F Gindele, C von Bary, D Muessig, A Lucic, E Hoffmann, C Reithmann, G Steinbeck
PURPOSE: For the treatment of increasingly complex cardiac arrhythmias, new catheter designs as well as alternative energy sources are constantly being developed. However, there is presently no in vitro method available for assessment of the temperature changes induced at various myocardial levels during energy delivery. Therefore, our study was aimed at developing an in vitro model to record and display the temperature kinetics during ablation in the entire muscle cross section. METHODS AND RESULTS: A sapphire glass pane was inserted into one wall of the in vitro experimental set-up...
October 2013: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
Christian Stetter, Markus Hirschberg, Bernhard Nieswandt, Ralf-Ingo Ernestus, Manfred Heckmann, Anna-Leena Sirén
INTRODUCTION: Structural plasticity with synapse formation and elimination is a key component of memory capacity and may be critical for functional recovery after brain injury. Here we describe in detail two surgical techniques to create a cranial window in mice and show crucial points in the procedure for long-term repeated in vivo imaging of synaptic structural plasticity in the mouse neocortex. METHODS: Transgenic Thy1-YFP(H) mice expressing yellow-fluorescent protein (YFP) in layer-5 pyramidal neurons were prepared under anesthesia for in vivo imaging of dendritic spines in the parietal cortex either with an open-skull glass or thinned skull window...
2013: Experimental & Translational Stroke Medicine
Ansgar C Cheng, Alvin G Wee, Sapphire Gan
Functional rehabilitation of fully edentulous maxillary defects is always regarded as a prosthodontic challenge. Surgical augmentation does not always offer value addition in the functional treatment outcome. This article describes the maxillofacial prosthodontic treatment of an edentulous patient who received an abdominus microvascular free flap surgical augmentation of a large acquired maxillary defect.
2011: Singapore Dental Journal
Julio M Mayol, Carolina Zapata
Different hemostatic methods are available for mild to moderate intraoperative bleeding during open and laparoscopic abdomino-pelvic surgery, but topical hemostats have gained popularity. We sought to review evidence on the use of a gelatin-thrombin matrix (FloSeal®) in elective abdominal and pelvic surgery. A systematic search of PubMed, EMBASE, and Cochrane databases was conducted. The primary endpoints were intraoperative bleeding and number of transfusions. Secondary endpoints included operative time, postoperative complications, re-operation for bleeding, mortality, and duration of hospitalization...
September 2013: Surgical Technology International
George Galyfos, Fragiska Sigala, Konstantinos Tsioufis, Christos Bakoyiannis, Emmanuel Lagoudiannakis, Andreas Manouras, George Zografos, Konstantinos Filis
BACKGROUND: We conducted a comparison of postoperative cardiac damage, defined as cardiac troponin I (cTn-I) elevation, after carotid endarterectomy in low- and high-risk patients. METHODS: The Stenting and Angioplasty with Protection in Patients at High Risk for Endarterectomy (SAPPHIRE) criteria for stratifying patients considered for carotid endarterectomy into low and high surgical risk groups were used prospectively. All patients had preoperative full cardiologic evaluations and cTn-I value assessments that were repeated on postoperative days 1, 3, and 7...
May 2013: Annals of Vascular Surgery
Neil J Wimmer, Robert W Yeh, Donald E Cutlip, Laura Mauri
BACKGROUND AND PURPOSE: The goal of carotid artery stenting is to decrease the risk of stroke or other adverse events from carotid artery disease. Choosing a treatment strategy requires patient-specific information regarding periprocedural risk of adverse neurologic events. The aim of this study was to predict individual patient risk after carotid artery stenting in patients at higher risk for carotid endarterectomy. METHODS: Subjects enrolled in the Stenting and Angioplasty with Protection in Patients at High-Risk for Endarterectomy (SAPPHIRE) worldwide study underwent carotid artery stenting with distal protection...
December 2012: Stroke; a Journal of Cerebral Circulation
J P Rocca, H Raybaud, E Merigo, P Vescovi, C Fornaini
Objective. The aim of this study was to assess the ability of Er:YAG laser to remove by excision torus mandibularis and to smooth torus palatinus exostosis. Materials and Methods. Torus mandibularis (TM) and torus palatinus (TP) were surgically eliminated via the Er:YAG laser using the following parameters: TM: output power ranging from 500 to 1000 mJ, frequency from 20 to 30 Hz, sapphire tips (diameter 0.8 mm), air-water spray (ratio 5/5), pulse duration 150 μsec, fluence ranging from 99592 J/cm(2) to 199044,586 J/cm(2)...
2012: Case Reports in Dentistry
Yao Shi, Xiao-Bo Yang, Neng-Li Dai, Hua Long, Pei-Xiang Lu, Ling Jin, Fa-Gang Jiang
AIM: To experimentally compare the external sclerostomy produced using a femtosecond laser with that made by a surgical knife and to evaluate the healing patterns, efficacy and technical advantages of femtosecond laser sclerostomy. METHODS: In a prospective randomized, controlled, masked-observer study, 10 pigmented rabbits underwent external sclerostomy with a femtosecond laser in the right eye; 10 additional rabbits underwent sclerostomy with a surgical superblade in the right eye...
2012: International Journal of Ophthalmology
Thomas C Hutchens, Arash Darafsheh, Amir Fardad, Andrew N Antoszyk, Howard S Ying, Vasily N Astratov, Nathaniel M Fried
Ophthalmic surgery may benefit from use of more precise fiber delivery systems during laser surgery. Some current ophthalmic surgical techniques rely on tedious mechanical dissection of tissue layers. In this study, chains of sapphire microspheres integrated into a hollow waveguide distal tip are used for erbium:YAG laser ablation studies in contact mode with ophthalmic tissues, ex vivo. The laser's short optical penetration depth combined with the small spot diameters achieved with this fiber probe may provide more precise tissue removal...
June 2012: Journal of Biomedical Optics
Francisco de Assis M G Rego Filho, Maristela Dutra-Corrêa, Gustavo Nicolodelli, Vanderlei S Bagnato, Maria Tereza de Araujo
Since about 40 years, laser-based surgical tools have been used in medicine and dentistry to improve clinical protocols. In dentistry, femtosecond lasers have been claimed to be a potential ablation tool. It would, however, be good to perform a more fundamental investigation to understand ablation interaction mechanisms and possible side effects, depending on different specific components of the target tissue. The goal of this study is to show the changes of ablation characteristics in the femtosecond regime at different levels of structural water within dental hard tissues...
January 2013: Lasers in Medical Science
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