Surgical treatment of ranula with carbon dioxide laser radiation

Ranula is a mucous extravasation cyst which appears as a swelling in the submental and submandibular regions. Several surgical techniques to manage ranula have been described in the literature, these techniques include the CO2 laser radiation excision. Four patients were treated for intraoral ranula in the floor of the mouth by marsupialization with carbon dioxide laser radiation with defocused beam, continuous mode and 4 watts of power. There were no complications and no recurrences have occurred to date. The results showed that carbon dioxide laser radiation gives optimal results with no need for suture and good wound healing.

Removal of epulis fissuratum associated to vestibuloplasty with carbon dioxide laser

There have been numerous surgical techniques developed for removing the epulis fissuratum lesions in order to improve alveolar ridge contour and improving adaptation of full prostheses. Most of these techniques can cause postoperative complications, such as oedema, pain, difficulty in swallowing and jaw movements, haemorrhage, infections and slow placement of final prostheses. The use of carbon dioxide (CO2) laser for the surgical removal of epulis lesions has resulted in many significant improvements including convenient mucosa removal, no bleeding or need for sutures, and minimal postoperative pain and oedema. This study is of 15 cases of removal of extensive epulis with vestibuloplasty in the maxilla and mandible that was carried out with CO2 laser, with no postoperative complications, rapid healing, and excellent aesthetic and functional outcome, all of which allowed for more rapid placement of final prosthesis.

DIODE-LASER AND FOURIER-TRANSFORM SPECTROSCOPY OF THE (CH3OH)-C-13 C-O STRETCHING MODE

In this work we present high resolution Doppler limited absorption spectra measurements of the C-O stretching mode of (CH3OH)-C-13, obtained from diode laser spectroscopy, and the Fourier Transform spectrum obtained at 0. 12 cm-1 resolution. By using these data and previously known spectroscopic information, we determined the frequency and the J quantum number for the multiplets of the P and R(J) branches of the C-O stretching fundamental band. Infrared transitions in coincidence with emission lines of the regular CO2 laser and some of its isotope parents are pointed out.

Clinical comparison between conventional suture and vaporization with carbon dioxide laser in rat's skin

Objective: This study compares wound healing efficiency on a rat's skin when the incision was closed with a conventional suture versus vaporized with a CO2 laser. Materials and Methods: In this study, 24 rats were used, and two longitudinal incisions were made with a conventional scalpel in the dorsum of each rat. The left incision was sutured with nylon thread, and the right incision was closed by vaporization with a defocused CO2 laser in continuous mode with an 8-watt power density. Clinical photographs were taken immediately after the procedure, 24 h later, and after 3, 7, 14, and 21 days, documenting the healing of the incision. Results: the results showed that there was an initial delay in wound repair in the vaporized incision as compared to the scalpel incision, but after 21 days, both incisions showed the same clinical characteristics. However, the vaporized incision showed no trauma of the tissue, as opposed to the sutured incision, and no hemorrhagic complications. Conclusion: These results suggest that the CO2 laser can eventually replace the use of sutures.

NEW FIR LASER LINES AND FREQUENCY MEASUREMENTS FROM OPTICALLY PUMPED CD-13(3)OH-3

We report the discovery of 57 new fir laser lines from (CD3OH)-C-13 molecule optically pumped by a waveguide CO2 laser of 300 MHz tunability. For all lines, precise frequency offset measurements between the CO2 line center and the center of the absorbing (CD3OH)-C-13 line were performed using the transferred Lamb-Dip technique. We have also measured directly the frequency of seven FIR laser lines by heterodyning with already known laser lines.We present a complete list of all known laser lines (134) and frequency measurements (24) for this molecule.

Investigation for long wavelength FIR laser lines for EPR studies: New lines from CH2=CF2

The results described in this work are part of a systematic search for long wavelength laser lines to be used in high magnetic field EPR applications and in plasma diagnostic. Four new far-infrared laser lines of CH2 = CF2 (1,1 difluoroethylene), optically pumped by a waveguide CO2 laser, have been discovered and characterized in wavelength, polarization relative to the pumping radiation and offset relative to the CO2 center frequency. New measurements of polarization and offset of 5 already known laser lines are also reported. A table of all of the known CO2 pumped FIR laser lines from this molecule is given.

Development of Robotized Laser Welding Applications for Joining Thin Sheets

Laser Welding (LW) is more often used in manufacturing due to its advantages, such as accurate control, good repeatability, less heat input, opportunities for joining of special materials, high speed, capability to join small dimension parts etc. LW is dedicated to robotized manufacturing, and the fabrication cells are using various level of flexibility, from specialized robots to very flexible setups. This paper features several LW applications using two industrially-scaled manufacturing cells at UPM Laser Centre (CLUPM) of Polytechnical University of Madrid (Universidad Politécnica de Madrid). The one dedicated to Remote Laser Welding (RLW) of thin sheets for automotive and other sectors uses a CO2 laser of 3500 W. The second has a high flexibility, is based on a 6-axis ABB robot and a Nd:YAG laser of 3300 W, and is meant for various laser processing methods, including welding. After a short description of each cell, several LW applications experimented at CLUPM and recently implemented in industry are briefly presented: RLW of automotive coated sheets, LW of high strength automotive sheets, LW vs. laser hybrid welding (LHW) of Double Phase steel thin sheets, and LHW of thin sheets of stainless steel and carbon steel (dissimilar joints). The main technological issues overcame and the critical process parameters are pointed out. Conclusions about achievements and trends are provided.

Mast cell concentration in the wound healing process of incisions made by different instruments

The aim of this study was to compare the concentration of mast cells (MCs) in the healing process of incisions. Thirty rats were submitted to six linear incisions each, performed in the dorsal skin by carbon dioxide (CO(2)) and diode lasers, electrocautery and conventional scalpel. The animals were euthanized at intervals of 0 h, 24 h, 48 h, 72 h, 7 days and 14 days after the incisions had been made. Histological sections were obtained and stained with toluidine blue for identification of MCs, which were manually counted by conventional microscopy in 20 microscopic fields in the border of the incision, near the granulation tissue, or in the area of new collagen formation, depending on intervals. The concentration of MCs was significantly higher in the wounds made by scalpel than in those made by other techniques at 48 h and 72 h. After 72 h the number of MCs was also significantly higher after electrocautery than after incisions made by 4 W CO(2) laser. On days 7 and 14, there was no significant difference in the MC count among the different types of incisions. In summary, the MC concentration varied after different surgical incisions at early phases of wound healing. At the end of the healing process, however, there were similar MC concentrations around the incisions, suggesting that, in standard incisions in the surgical techniques studied, the wound healing process ultimately occurred in a similar pattern.

Conservative Treatment of Chondrodermatitis Nodularis Chronica Helicis with Topical Nitroglycerin

Background: Chondrodermatitis nodularis chronica helicis (CNCH) is a benign, painful, indurated inflammatory nodule arising on the pinna. Different treatment modalities have been used with varying efficacy rates. Despite lower efficacy, conservative methods are most desirable. Case reports: Three patients diagnosed with CNCH were treated with 0.4% topical nitroglycerin ointment, twice daily. These included two women and one man, aged 66, 86, and 60-years-old, respectively. Two painful nodules were located on the antihelix, and one on the helix. One patient had been previously treated with intralesional corticosteroids, and another with intralesional corticosteroids, CO2 laser and photodynamic therapy. All three patients experienced significant clinical and symptomatic improvement with topical nitroglycerin. No side effects were reported. Discussion: The etiology of CNCH is uncertain. Dermal and chondral ischemia arising from perichondrial arterial narrowing has been recently described as a possible cause for this benign condition, hence the potential of nitroglycerin as a smooth muscle relaxant and vasodilator. A previous report described significant improvement in twelve patients treated with 2% topical nitroglycerin. Conclusion: Topical nitroglycerin ointment appears to be a noninvasive alternative for the treatment of CNCH. A lower concentration (0.4%) may be as effective and with fewer side effects, but more studies are warranted.

Gas emission during laparoscopic colorectal surgery using a bipolar vessel sealing device: A pilot study on four patients.

BACKGROUND: Dissection during laparoscopic surgery produces smoke containing potentially toxic substances. The aim of the present study was to analyze smoke samples produced during laparoscopic colon surgery using a bipolar vessel sealing device (LigaSuretrade mark). METHODS: Four consecutive patients undergoing left-sided colectomy were enrolled in this pilot study. Smoke was produced by the use of LigaSuretrade mark. Samples (5,5l) were evacuated from the pneumoperitoneum in a closed system into a reservoir. Analysis was performed with CO2-laser-based photoacoustic spectroscopy and confirmed by a Fourier-transform infrared spectrum. The detected spectra were compared to the available spectra of known toxins. RESULTS: Samples from four laparoscopic sigmoid resections were analyzed. No relevant differences were noted regarding patient and operation characteristics. The gas samples were stable over time proven by congruent control measurements as late as 24 h after sampling. The absorption spectra differed considerably between the patients. One broad absorption line at 100 ppm indicating H2O and several unknown molecules were detected. With a sensitivity of alpha min ca 10-5 cm-1 no known toxic substances like phenol or indole were identified. CONCLUSION: The use of a vessel sealing device during laparoscopic surgery does not produce known toxic substances in relevant quantity. Further studies are needed to identify unknown molecules and to analyze gas emission under various conditions.

Control d'un sistema de marcatge làser de caixes

RESUM Avui en dia, l’alta competitivitat que existeix al mercat, fa que les empreses hagin d’esprémer al màxim les seves possibilitats per no quedar-se enrere. Un dels processos en que aquest fet hi és més present és el productiu. L’empresa JCM Technologies també engloba aquest camp i és en un dels seus processos productius on aquest projecte pren part. L’objectiu d’aquest projecte final de carrera ha estat desenvolupar un sistema per poder marcar caixes mitjançant un làser de CO2 i un automatisme manipulador de caixes. D’aquesta manera aquest procés productiu té una durada molt inferior a l’antic procés, que consistia en enganxar una etiqueta al lloc on ara és marcat pel làser. Per satisfer els objectius, s’ha creat una aplicació de Windows que per mitjà d’una interfície gràfica, permet a l’usuari realitzar els passos necessaris per fer el marcatge. Primerament es recullen les dades procedents de la comanda; seguidament es seleccionen les que s’han de marcar a les caixes i s’envien al làser mitjançant comunicació sèrie; una vegada aquesta inicialització ha finalitzat correctament, s’engega la seqüència de marcatge de les caixes, que en marcarà la quantitat indicada. Aquest procés de marcatge consisteix en supervisar l’estat en que es troben certes senyals, procedents de l’automatisme i del làser, i depenent d’aquestes generar-ne unes altres. Aconseguint així realitzar el procés de marcatge de cada caixa. Com a conclusions cal dir, que els objectius s’han complert, ja que s’ha aconseguit un procés de marcatge ràpid i robust. També s’ha aconseguit que les parts de configuració de l’aplicació, i de les caixes siguin de fàcil manipulació. Per tant, amb l’acompliment dels objectius d’aquest projecte, aconseguim completar el sistema de marcatge, i permetre que les caixes siguin marcades de forma correcta, ràpida i eficient.

Papillary cystoadenoma lymphomatosum (Warthin-like) of minor salivary glands

Papillary cystadenoma lymphomatosum is a benign salivary gland tumor most frequently located in the parotid gland (Warthin"s tumor). Its presentation in other major, or in minor, salivary glands is rare. Clinically, it manifests as a slow growing tumor, fluctuant on palpation due to its cystic morphology. The treatment of choice is complete excision with wide tumor-free margins. We present a 73-year-old female patient with an asymptomatic tumor of 8 years evolution in the right posterior area of the hard palate. We performed surgical excision and a biopsy, which was reported as papillary cystadenoma lymphomatosum. During the post-operative examination carried out after 3 weeks, it was observed that the lesion had recurred. The lesion was re-operated, performing the excision with CO2 laser and including the periosteum to ensure complete resection of the tumor. At 10 months follow-up, there was no recurrence of the lesion. This article includes a review of this condition and discusses its most important clinical and pathologic features and therapeutic approaches.

Endoscopic repair of laryngotracheoesophageal clefts: experience in 17 cases.

OBJECTIVE: To review the presentation and evaluation of laryngotracheoesophageal clefts as well as their treatment modalities, especially endoscopic closure. STUDY DESIGN: retrospective case series. METHODS: All patients treated for laryngotracheoesophageal clefts in our clinic during the last 15 years were included. Analysis of preoperative data, surgical success and functional outcome was performed. RESULTS: A total of 18 patients were included in our study. Cleft distribution was: type I (n=1), type II (n=3), type IIIa (n=5), type IIIb (n=8) and type IVa (n=1). All clefts were closed endoscopically by CO2 laser repair except for two patients who benfited from open surgery (one type I, one type IIIb). 7 of our 18 patients (39%) experienced a complication necessitating reoperation. Surgical treatment of LTEC allowed cessation of feeding tube assistance and artificial ventilation in 47% and 42% of patients respectively. CONCLUSION: Surgical treatement of laryngotracheoesophageal clefts remains a complex procedure with a high rate of morbidity for high grade clefts. Post-surgical difficulties in feeding and breathing are associated with concomitant congenital anomalies. Endoscopic repair is a successful technique for treating up to grade IIIa laryngeal clefts. Further investigation is needed to assess the best approach for treating longer clefts.

Endoscopic laryngotracheal cleft repair without tracheotomy or intubation.

OBJECTIVES: The objectives of this study are to present the technique and results of endoscopic repair of laryngotracheoesophageal clefts (LTEC) extending caudally to the cricoid plate into the cervical trachea and to revisit the classification of LTEC. METHODS: The authors conducted a retrospective case analysis consisting of four infants with complete laryngeal clefts (extending through the cricoid plate in three cases and down into the cervical trachea in one case) treated endoscopically by CO2 laser incision of the mucosa and two-layer endoscopic closure of the cleft without postoperative intubation or tracheotomy. RESULTS: All four infants resumed spontaneous respiration without support after a mean postoperative period of 3 days with continuous positive airway pressure (CPAP). They accepted oral feeding within 5 postoperative days (range, 3-11 days). No breakdown of endoscopic repair was encountered. After a mean follow up of 48 months (range, 3 mos to 7 y), all children have a good voice, have no sign of residual aspiration, but experience a slight exertional dyspnea. CONCLUSION: This limited experience on the endoscopic repair of extrathoracic LTEC shows that a minimally invasive approach sparing the need for postoperative intubation or tracheotomy is feasible and safe if modern technology (ultrapulse CO2 laser, endoscopic suturing, and postoperative use of CPAP in the intensive care unit) is available.

Kulutus- korroosionkestävien materiaalien laserpinnoitus

Diplomityössä tutkitaan kulutus- ja korrosionkestävien materiaalien laserpinnoitusta. Laserpinnoituksessa sulatetaan uutta materiaalia työkappaleen pintaan lasersäteen avulla. Tarkoituksena on yleensä parantaa pinnan korroosion, kulumisen tai pintapaineen kestävyyttä. Laserpinnoitukseen liittyy useita etuja verrattuna konventionaalisiin päällehitsausprosesseihin. Työssä tutkittavat pinnoitemateriaalit ovat kobolttipohjaiset Stellite 1 ja Stellite 6, työkaluteräkset WR 4 ja WR 6 sekä metallimatriisikomposiitti Anval50/50+30 % Cr3C2. Pinnoitettavat perusaineet ovat hiiliteräs Fe 52, ruostumaton teräs AISI 316 ja valurauta GRP 500. Työn tavoitteena on löytää kunkin pinnoite/perusaine-yhdistelmän pinnoitusparametrit. Pinnoituskokeissa käytettiin LTKK:n 6 kW:n CO2-laseria. Pinnoitetuille koekappeleille tehtiin kovuusmittaukset ja kulutuskokeet. Pinnoitteiden mikrorakenteet analysoitiin ja sekoittumisasteet laskettiin. Virheitä tutkittiin silmämääräisesti sekä radiografisella kuvauksella. Optimiparametreja pinnoitemateriaaleille ei löydetty. Pinnoitteiden sekoittumisasteet muodostuivat suuriksi liiallisen lasertehon ja/tai huonon lisäaineen kohdistuksen vuoksi. Suuri sekoittuminen alensi pinnoitteiden kovuutta ja kulumiskestävyyttä. Pinnoitusparametreja arvioidaan koetulosten perusteella ja niille annetaan korjausehdotuksia. Lopuksi esitetään suosituksia tutkimusprojektin jatkotoimille.