Low-level laser therapy for pain relief after episiotomy: a double-blind randomised clinical trial

Aims and objectives. To evaluate the effectiveness of a low-level laser therapy for pain relief in the perineum following episiotomy during childbirth. Background. Laser irradiation is a painless and non-invasive therapy for perineal pain treatment and its effects have been investigated in several studies, with no clear conclusion on its effectiveness. Design. A double-blind randomised controlled clinical trial. Method. One hundred and fourteen women who underwent right mediolateral episiotomies during vaginal birth in an in-hospital birthing centre in Sao Paulo, Brazil and reported pain =3 on a numeric scale (010) were randomised into three groups of 38 women each: two experimental groups (treated with red and infrared laser) and a control group. The experimental groups were treated with laser applied at three points directly on the episiotomy after suturing in a single session between 656 hours postpartum. We used a diode laser with wavelengths of 660 nm (red laser) and 780 nm (infrared laser). The control group participants underwent all laser procedures, excluding the emission of irradiation. The participants and the pain scores evaluator were blinded to the type of intervention. The perineal pain scores were assessed at three time points: before, immediately after and 30 minutes after low-level laser therapy. Results. The comparison of perineal pain between the three groups showed no significant differences in the three evaluations (p = 0.445), indicating that the results obtained in the groups treated with low-level laser therapy were equivalent to the control group. Conclusions. Low-level laser therapy did not decrease the intensity of perineal pain reported by women who underwent right mediolateral episiotomy. Relevance to clinical practice. The effect of laser in perineal pain relief was not demonstrated in this study. The dosage may not have been sufficient to provide relief from perineal pain after episiotomy during a vaginal birth.

A 12-month follow-up of hypopigmentation after laser hair removal

Introduction: Laser hair removal is becoming an increasingly popular alternative to traditional methods such as shaving, waxing, among other methods. Semiconductor diode lasers are considered the most efficient light sources available and are especially well suited for clinical applications including hair reduction. The effectiveness of laser hair reduction depends on many variables, including the skin type of the patient. Material and Methods: A patient with Fitzpatrick Skin Type IV was submitted to laser hair removal of the arms with a high-power diode laser system with long pulses with a wavelength of 800 nm, a fluence of 40 J/cm2 and a pulse width of 20 ms. A 12-month follow-up assessment was performed and included photography and questionnaire. Results: Hypopigmentation was observed after a single laser hair removal section. After 6 months with the area totally covered, a gradual suntan with a sun screen lotion with an SPF of 15 was prescribed by the dermatologist. After 12 months of the initial treatment, a complete recovery of the hypopigmentation was achieved. Conclusion: Although a safe procedure, lasers for hair removal may be associated with adverse side effects including undesired pigment alterations. Before starting a laser hair removal treatment, patients seeking the eradication of hair should be informed that temporary, and possibly permanent, pigmentary changes may occur.

Resonante Laserionisations-Massenspektrometrie an Gadolinium zur Isotopenhäufigkeitsanalyse mit geringsten Mengen

Resonante Laserionisations-Massenspektrometrie an Gadolinium zur Isotopenhäufigkeitsanalyse mit geringsten Mengen Die selektive Spuren- und Ultraspurenanalyse des Erdalkalielements Gadolinium eröffnet eine Vielzahl von Anwendungen in der Biomedizin und Kosmochemie. Zum Erreichen der hohen Anforderungen bezüglich Isotopen- und Isobarenselektivität von S>10^7 sowie Gesamteffizienz von e>10^-6 wurde der Einsatz der resonanten Laserionisations-Massenspektrometrie untersucht. Dazu erfolgte die Weiterentwicklung und Anpassung des existierenden Diodenlaser-Quadrupolmassenspektrometersystems. Durch Ionenflugbahn-Simulationsrechnungen wurde für das Quadrupol-Massenspektrometer die erreichbare Nachbarmassenunterdrückung und Transmission in Abhängigkeit von der Auflösung theoretisch vorhergesagt. Die Werte wurden experimentell bestätigt. Aus der beobachteten Peakstruktur erfolgte die Ableitung einer Methode zur Bestimmung der Energieunschärfe des eingesetzten Ionisationsprozesses. Zum Auffinden eines effizienten dreifach resonanten Anregungsschemas wurden die Isotopieverschiebungen und Hyperfeinstrukturen aller stabilen Gadoliniumisotope in zahlreichen Übergängen für die einfach, zweifach und dreifach resonante Ionisation präzise vermessen. Das aufgenommene Spektrum autoionisierender Resonanzen zeigte etwa 150 bislang unbekannter Zustände mit Resonanzüberhöhungen von bis zu fünf Größenordnungen im Ionisationswirkungsquerschnitt. Die entwickelte Methode der Hyperfeinzustandsselektion ermöglichte die Bestimmung der Drehimpulsquantenzahl J der autoionisierenden Resonanzen. Die analytische Charakterisierung der dreistufig resonanten Ionisation von Gadolinium ergab eine Isotopen- und Isobarenselektivität von S(Isotop)>10^12 und S(Isobar)>10^7. Die mit dem Diodenlasersystem erreichte Nachweiseffizienz von e=1-3x10^-6 mit einer untergrundlimitierten Nachweisgrenze von wenigen 10^9 Atomen Gd-158 erlaubte erste Demonstrationsmessungen an medizinischen Gewebeproben.

Spektroskopie und Ultraspurenanalyse von Plutonium mittels Resonanzionisations-Massenspektrometrie

Die Resonanzionisations-Massenspektrometrie (RIMS) ist sowohl für spektroskopische Untersuchungen seltener Isotope als auch für den Ultraspurennachweis langlebiger radioaktiver Elemente einsetzbar. Durch die mehrstufige resonante Anregung atomarer Energieniveaus mit anschließender Ionisation mit Laserlicht wird eine sehr hohe Elementselektivität und Ionisationseffizienz erreicht. Der nachfolgende massenselektive Ionennachweis liefert eine gute Isotopenselektivität zusammen mit einer effektiven Untergrundunterdrückung. Ein wichtiger Bestandteil der RIMS-Apparatur ist ein zuverlässig arbeitendes, leistungsstarkes Lasersystem für die Resonanzionisation. Im Rahmen dieser Arbeit wurde ein von einem hochrepetierenden Nd:YAG-Laser gepumptes, aus drei Titan-Saphir-Lasern bestehendes System fertig aufgebaut und in den Routinebetrieb überführt. Die Titan-Saphir-Laser liefern im Durchstimmbereich von 730 - 880 nm eine mittlere Leistung von bis zu 3 W pro Laser bei einer Linienbreite von 2 - 3 GHz. Sie lassen sich computergesteuert in ihren Wellenlängen durchstimmen. Die mittels Resonanzionisation erzeugten Ionen werden dann in einem Flugzeit-Massenspektrometer entsprechend ihrer Masse aufgetrennt und mit einem Kanalplattendetektor nachgewiesen.Als Voraussetzung für die isotopenselektive Ultraspurenanalyse von Plutonium wurden mit diesem Lasersystem die Isotopieverschiebungen eines effizienten, dreistufigen Anregungsschema für Plutonium bestimmt. Die Laserleistungen reichen zur vielfachen Sättigung der ersten beiden Anregungsschritte und zur zweifachen Sättigung des dritten Anregungsschritts aus.Außerdem wurden die Ionisationsenergien von Pu-239 und Pu-244 zur Untersuchung ihrer Isotopenabhängigkeit bestimmt. Die beiden Ionisationsenergien sind im Rahmen der erreichten Genauigkeit bei einem Meßwert von IP239-IP244 = 0,24(82) cm^-1 gleich.Die Nachweiseffizienz der RIMS-Apparatur für Plutonium wurde in Effizienzmessungen zu 10^-5 bestimmt. Durch die gute Untergrundunterdrückung ergab sich daraus eine Nachweisgrenze von 10^6 Atomen bei der Messung eines Plutoniumisotops. Die Bestimmung der Isotopenverhältnisse von Proben mit einer zertifizierten Isotopenzusammensetzung lieferte eine gute Übereinstimmung der Meßwerte mit den angegebenen Zusammensetzungen.Die RIMS-Apparatur wurde zur Bestimmung des Gehalts und der Isotopenzusammensetzung von Plutonium in Meerwasser- und Staubproben eingesetzt.Auf Grund der Isotopenzusammensetzung konnte gezeigt werden, daß das Plutonium bei den meisten Proben aus dem Fallout von oberirdischen Kernwaffentests stammte. Des weiteren wurde Plutonium in Urinproben bestimmt. Die Nachweisgrenzen lagen bei diesen Umweltproben bei 10^6 bis 10^7 Atomen Plutonium und damit um zwei Größenordnungen niedriger als die Nachweisgrenze für Pu-239 bei der alpha-Spektroskopie, der Standardmethode für den Plutoniumnachweis.

Resonanzionisation zum Nachweis und zur Erzeugung radioaktiver Ionenstrahlen

Die resonante Laserionisation hat sich als ein universales Verfahren für eine Vielzahl von Anwendungen etabliert, die eine selektive Ionisation bei hoher Effizienz erfordern. Hierzu wurden zwei Lasersysteme mit unterschiedlichen Zielsetzungen und Schwerpunkten entwickelt und in dieser Arbeit angewendet. Im ersten Teil der Arbeit wird die Entwicklung der hochauflösenden Resonanzionisations-Massenspektrometrie zum Ultraspurennachweis von 41Ca vorgestellt. Hierzu wurden drei kontinuierliche Diodenlaser mit einem Quadrupolmassenspektrometer kombiniert. Bei einer Nachweiseffizienz von 1 × 10^−5 konnte eine Nachweisgrenze von 2 × 10^-13 41Ca/totCa erreicht werden. Das in den Routinebetrieb überführte Meßverfahren ermöglichte die Teilnahme an einem interdisziplinären Netzwerk zur Osteoporose-Forschung. In Vergleichsmessungen der Resonanzionisations-Massenspektrometrie mit allen derzeit existierenden Meßverfahren zum 41Ca-Ultraspurennachweis konnte eine sehr gute Übereinstimmung erzielt werden. Der zweite Teil der Arbeit beinhaltet die Adaption eines durchstimmbaren, hochrepetierenden Titan:Saphir-Lasersystem für den Einsatz an Laserionenquellen zur selektiven Erzeugung radioaktiver Ionenstrahlen. Das entwickelte Lasersystem ermöglicht eine effiziente, resonante Anregung des Großteils der Elemente im Periodensystem. Hierzu wurde eine kombinierte Frequenzverdopplungs- und Frequenzverdreifachungseinheit zur Erzeugung höherer Harmonischer aufgebaut. Die Anwendbarkeit eines solchen reinen Festkörper-Lasersystems wurde in zahlreichen off-line Testmessungen sowohl in Mainz als auch an den ISOL Einrichtungen am TRIUMF und ORNL gezeigt und führte zum ersten on-line Einsatz am TRIUMF.

Optical power stabilization of a laser diode for qnd measurement

La realizzazione di stati non classici del campo elettromagnetico e in sistemi di spin è uno stimolo alla ricerca, teorica e sperimentale, da almeno trent'anni. Lo studio di atomi freddi in trappole di dipolo permette di avvicinare questo obbiettivo oltre a offrire la possibilità di effettuare esperimenti su condesati di Bose Einstein di interesse nel campo dell'interferometria atomica. La protezione della coerenza di un sistema macroscopico di spin tramite sistemi di feedback è a sua volta un obbiettivo che potrebbe portare a grandi sviluppi nel campo della metrologia e dell'informazione quantistica. Viene fornita un'introduzione a due tipologie di misura non considerate nei programmi standard di livello universitario: la misura non distruttiva (Quantum Non Demolition-QND) e la misura debole. Entrambe sono sfruttate nell'ambito dell'interazione radiazione materia a pochi fotoni o a pochi atomi (cavity QED e Atom boxes). Una trattazione delle trappole di dipolo per atomi neutri e ai comuni metodi di raffreddamento è necessaria all'introduzione all'esperimento BIARO (acronimo francese Bose Einstein condensate for Atomic Interferometry in a high finesse Optical Resonator), che si occupa di metrologia tramite l'utilizzo di condensati di Bose Einstein e di sistemi di feedback. Viene descritta la progettazione, realizzazione e caratterizzazione di un servo controller per la stabilizzazione della potenza ottica di un laser. Il dispositivo è necessario per la compensazione del ligh shift differenziale indotto da un fascio laser a 1550nm utilizzato per creare una trappola di dipolo su atomi di rubidio. La compensazione gioca un ruolo essenziale nel miglioramento di misure QND necessarie, in uno schema di feedback, per mantenere la coerenza in sistemi collettivi di spin, recentemente realizzato.

A new double laser pulse pumping scheme for transient collisionally excited plasma soft X-ray lasers

Within this thesis a new double laser pulse pumping scheme for plasma-based, transient collisionally excited soft x-ray lasers (SXRL) was developed, characterized and utilized for applications. SXRL operations from ~50 up to ~200 electron volt were demonstrated applying this concept. As a central technical tool, a special Mach-Zehnder interferometer in the chirped pulse amplification (CPA) laser front-end was developed for the generation of fully controllable double-pulses to optimally pump SXRLs.rnThis Mach-Zehnder device is fully controllable and enables the creation of two CPA pulses of different pulse duration and variable energy balance with an adjustable time delay. Besides the SXRL pumping, the double-pulse configuration was applied to determine the B-integral in the CPA laser system by amplifying short pulse replica in the system, followed by an analysis in the time domain. The measurement of B-integral values in the 0.1 to 1.5 radian range, only limited by the reachable laser parameters, proved to be a promising tool to characterize nonlinear effects in the CPA laser systems.rnContributing to the issue of SXRL pumping, the double-pulse was configured to optimally produce the gain medium of the SXRL amplification. The focusing geometry of the two collinear pulses under the same grazing incidence angle on the target, significantly improved the generation of the active plasma medium. On one hand the effect was induced by the intrinsically guaranteed exact overlap of the two pulses on the target, and on the other hand by the grazing incidence pre-pulse plasma generation, which allows for a SXRL operation at higher electron densities, enabling higher gain in longer wavelength SXRLs and higher efficiency at shorter wavelength SXRLs. The observation of gain enhancement was confirmed by plasma hydrodynamic simulations.rnThe first introduction of double short-pulse single-beam grazing incidence pumping for SXRL pumping below 20 nanometer at the laser facility PHELIX in Darmstadt (Germany), resulted in a reliable operation of a nickel-like palladium SXRL at 14.7 nanometer with a pump energy threshold strongly reduced to less than 500 millijoule. With the adaptation of the concept, namely double-pulse single-beam grazing incidence pumping (DGRIP) and the transfer of this technology to the laser facility LASERIX in Palaiseau (France), improved efficiency and stability of table-top high-repetition soft x-ray lasers in the wavelength region below 20 nanometer was demonstrated. With a total pump laser energy below 1 joule the target, 2 mircojoule of nickel-like molybdenum soft x-ray laser emission at 18.9 nanometer was obtained at 10 hertz repetition rate, proving the attractiveness for high average power operation. An easy and rapid alignment procedure fulfilled the requirements for a sophisticated installation, and the highly stable output satisfied the need for a reliable strong SXRL source. The qualities of the DGRIP scheme were confirmed in an irradiation operation on user samples with over 50.000 shots corresponding to a deposited energy of ~ 50 millijoule.rnThe generation of double-pulses with high energies up to ~120 joule enabled the transfer to shorter wavelength SXRL operation at the laser facility PHELIX. The application of DGRIP proved to be a simple and efficient method for the generation of soft x-ray lasers below 10 nanometer. Nickel-like samarium soft x-ray lasing at 7.3 nanometer was achieved at a low total pump energy threshold of 36 joule, which confirmed the suitability of the applied pumping scheme. A reliable and stable SXRL operation was demonstrated, due to the single-beam pumping geometry despite the large optical apertures. The soft x-ray lasing of nickel-like samarium was an important milestone for the feasibility of applying the pumping scheme also for higher pumping pulse energies, which are necessary to obtain soft x-ray laser wavelengths in the water window. The reduction of the total pump energy below 40 joule for 7.3 nanometer short wavelength lasing now fulfilled the requirement for the installation at the high-repetition rate operation laser facility LASERIX.rn

Diodenlaserbasierte Resonanzionisations-Massenspektrometrie zur Spektroskopie und Ultraspurenanalyse an Uranisotopen

In dieser Arbeit wird die Erweiterung und Optimierung eines Diodenlasersystems zur hochauflösenden Resonanzionisationsmassenspektrometrie beschrieben. Ein doppelinterferometrisches Frequenzkontrollsystem, welches Absolutstabilisierung auf ca. 1 MHz sowie sekundenschnelle Frequenzverstimmungen um mehrere GHz für bis zu drei Laser parallel ermöglicht, wurde optimiert. Dieses Lasersystem dient zwei wesentlichen Anwendungen. Ein Aspekt waren umfangreiche spektroskopische Untersuchungen an Uranisotopen mit dem Ziel der präzisen und eindeutigen Bestimmung von Energielagen, Gesamtdrehimpulsen, Hyperfeinkonstanten und Isotopieverschiebungen sowie die Entwicklung eines effizienten, mit kommerziellen Diodenlasern betreibbaren Anregungsschemas. Mit diesen Erkenntnissen wurde die Leistungsfähigkeit des Lasermassenspektrometers für die Ultraspurenanalyse des Isotops 236U, welches als Neutronendosimeter und Tracer für radioaktive anthropogene Kontaminationen in der Umwelt verwendet wird, optimiert und charakterisiert. Anhand von synthetischen Proben wurde eine Isotopenselektivität von 236U/238U=4,5(1,5)∙10-9 demonstriert.

Organic lasing: correlation between molecular structure, optical and optoelectronic properties

In this thesis mainly two alternating indenofluorene-phenanthrene copolymers were investigated with a variety of spectroscopic and optoelectronic experiments. The different experimental techniques allowed to retrieve deeper insights into their unique optical as well as optoelectronic properties. The motivation of the research presented in this work was to correlate their photophysical properties with respect to their application in electrically pumped lasing. This thesis begins with the description of optical properties studied by classical absorption and emission spectroscopy and successively describes an overall picture regarding their excited state dynamics occurring after photoexcitation studied by time-resolved spectroscopy. The different spectroscopic methods do not only allow to elucidate the different optical transitions occurring in this class of materials, but also contribute to a better understanding of exciton dynamics and exciton interaction with respect to the molecular structure as well as aggregation and photooxidation of the polymers. Furthermore, the stimulated emission properties were analyzed by amplified spontaneous emission (ASE) experiments. Especially one of the investigated materials, called BLUE-1, showed outstanding optical properties including a high optical gain, a low threshold for ASE and low optical losses. Apart from the optical experiments, the charge carrier mobility was measured with the time-of-flight technique and a comparably high hole mobility on the order of 1 x 10-² cm²/(Vs) was determined for BLUE-1 which makes this material promising for organic lasing. The impact of the high charge carrier mobility in this material class was further analyzed in different optoelectronic devices such as organic LEDs (OLEDs) and organic solar cells.

X-Ray Free-Electron Lasers

Recenti sviluppi nella progettazione di impianti di luce di sincrotrone di quarta generazione riguardano la produzione di fasci di luce nella banda dei raggi X con elevate caratteristiche in termini di brillanza, coerenza e impulsi estremamente brevi ( femtosecondo ) . I principali schemi per la produzione della radiazione XFEL riguardano l’impiego di ondulatori con differenti modalità di seeding. L’utilizzo dei fasci di radiazione XFEL nelle linee di luce per applicazioni di imaging, spettroscopia e diffrazione, ha determinato un costante sforzo sia nello sviluppo di dispositivi ottici in grado di selezionare e focalizzare il fascio su dimensioni nanometriche, che nella sperimentazione di tecniche “lensless” in grado di superare i limiti imposti dall’utilizzo di tali dispositivi . I risultati ottenuti nella produzione dei fasci hanno consentito nuove possibilità di indagine nella struttura dei materiali su distanze atomiche nella definizione, senza precedenti di dettagli su scale temporali del femtosecondo, permettendo lo studio, non solo di strutture atomiche in condizioni di equilibrio stabile quanto di stati della materia velocemente dinamici e di non equilibrio. CXDI e Spettroscopia Strutturale Ultraveloce risolte in tempo sono alcune delle tecniche in cui l’utilizzo della radiazione XFEL apre nuove possibilità di indagine agli stati transienti della materia permettendo la ricostruzione della dinamica di processi chimico –fisici su intervalli temporali finora inaccessibili .

Light-emitting diode and laser fluorescence-based devices in detecting occlusal caries

The aim of this study was to assess the performance of two light-emitting diode (LED)- and two laser fluorescence-based devices in detecting occlusal caries in vitro. Ninety-seven permanent molars were assessed twice by two examiners using two LED- (Midwest Caries - MID and VistaProof - VP) and two laser fluorescence-based (DIAGNOdent 2095 - LF and DIAGNOdent pen 2190 - LFpen) devices. After measuring, the teeth were histologically prepared and classified according to lesion extension. At D1 the specificities were 0.76 (LF and LFpen), 0.94 (MID), and 0.70 (VP); the sensitivities were 0.70 (LF), 0.62 (LFpen), 0.31 (MID), and 0.75 (VP). At D(3) threshold the specificities were 0.88 (LF), 0.87 (LFpen), 0.90 (MID), and 0.70 (VP); the sensitivities were 0.63 (LF and LFpen), 0.70 (MID), and 0.96 (VP). Spearman's rank correlations with histology were 0.56 (LF), 0.51 (LFpen), 0.55 (MID), and 0.58 (VP). Inter- and intraexaminer ICC values were high and varied from 0.83 to 0.90. Both LF devices seemed to be useful auxiliary tools to the conventional methods, presenting good reproducibility and better accuracy at D(3) threshold. MID was not able to differentiate sound surfaces from enamel caries and VP still needs improvement on the cut-off limits for its use.

Laser-assisted lipolysis in the treatment of gynecomastia: a prospective study in 28 patients

Gynecomastia is the most common breast pathology. Numerous excisions and liposuction techniques have been described to correct bilateral male breast enlargement. Recently, there has been a shift from the open approach to minimally invasive techniques. This article reports a 5-year experience using laser-assisted lipolysis (LAL) to treat gynecomastia, and describes the surgical technique. Between January 2006 and December 2010, a total of 28 patients with bilateral gynecomastia were treated with LAL. Patients had a mean age of 36.5 years (range 24 to 56 years). LAL was performed with a 980-nm diode laser (continuous emission, 15 W power, 8-12 kJ total energy per breast) after tumescent anesthetic infiltration. The breast was evaluated objectively by two physicians who compared chest circumference and photographs. Patients were also asked to score the results using a visual analogue scale: 75 to 100 (very good), 50-74 (good), 25 to 49 (fair) and 0 to 24 (poor). The postoperative period for all patients was incident-free. After 6 months, 18 patients (64.3%) scored the results as "very good", 6 as "good" (21.4%), 3 as "fair" (10.7%) and 1 "poor" (3.6%). Mean chest circumferences pre- and postoperatively were, respectively, 117.4 ± 11.1 cm and 103.3 ± 7.5 cm (p < 0.001), corresponding to a mean difference of 14.1 cm. Physicians scored the photographs as "very good" in 22 patients (78.6%), as "good" in five patients (17.9%), and as "fair" in one patient (3.6%). LAL in gynecomastia is safe and produces significant effects on fatty tissue, with a reduction in breast volume, together with significant skin tightening. Provided an appropriate amount of energy is delivered by an experienced operator, the results are both significant and consistent.

Prospective ex-vivo study on thermal effects in human skin phototypes II, IV and VI: a comparison between the 808, 1064, 1210 and 1320-nm diode laser

Laser Assisted Skin Healing (LASH) was first introduced in 2001 by Capon and Mordon to prevent keloids and hypertrophic scars. LASH requires homogenous heating throughout the full thickness of the skin around the wound. However, LASH therapy with 808-nm diode laser is deemed to be only applicable for phototype I-IV due to melanin absorption. This prospective ex-vivo study aims to evaluate the thermal effects of different wavelengths (808, 1064, 1210 and 1320 nm) on human skin phototype II, IV and VI.

[Blood flow assessment with magnetic resonance imaging after 1.9 μm diode laser assisted arterial micronastomoses]

The most important factor for successful free-flap transfer and replantations is a well-executed anastomosis. The aim of this study is to assess blood flow after laser assisted arterial microanastomosis (LAMA) using a 1.9 μm diode laser.