קרן הלייזר היא קרן אור מונוכרומטית [מורכבת מאורך גל אחד (צבע אחד)], שלא כמו האור הרגיל שבאמצעות מנסרה משולשת מתפרק לכל רכיביו על פי הצבעים השונים. בהיותה כזאת היא ישרה ואינה מתפזרת ולכן כה מדוייקת. ברפואה קרן הלייזר משמשת לחיתוך (CUTTING) ולאידוי (EVAPORATION), למטרת סילוק נגעים גידוליים, שפירים וממאירים, ונגעים דלקתיים.
" טיפול בלייזר CO2 מחסל לחלוטין CIN ב 90% מהמקרים. ..בכל מקרה בגלל הפתופיזיולוגיה של ה HPV פרוצדורה ניתוחית (כמו הלייזר) מורידה את העומס הנגיפי…
בנשים בריאות מבחינה אימונולוגית עם דיספלזיות – הטיפול בלייזר עשוי להסתיים בסילוק מוחלט של הגנום של HPV."
"… בנשים עם דיספלזיות קלות עד חמורות, שכיחות PCR חיובי ל HPV היה 73.2% ולאחר טיפול בלייזר אצל כל הנשים פרט ל 3 לא נמצאו יותר נגיפי HPV. אצל ה 3 הזנים שנמצאו היו שונים מהזנים המקוריים."
שיעור החזרות של הגידול בקבוצת הלייזר היה נמוך משמעותית משבקבוצת הכריתה הכירורגית.
מסקנת החוקר היא שהדכוי של ההתנגדות החיסונית של תאי הגידול נגרם ע"י הטיפול בלייזר.
ב "מעבדות חי" בפארק המדע ברחובות.
מ.ר. 3904 19/1/2010 זן 16: 4092 16/2/2010 לא נמצאה עדות לנוכחות HPV
ב.ת. 4265 7/3/2010 זן 82: 4560 22/4/2010 לא נמצאה עדות לנוכחות HPV
ס.א. 3947 26/1/2010 זן 59: 4915 13/6/2010 לא נמצאה עדות לנוכחות HPV
ע.מ. 4770 20/5/2010 זן 18: 4911 13/6/2010 לא נמצאה עדות לנוכחות HPV
כל הזנים שהוזכרו לעיל הם HIGH RISK HPV
eMedicine Specialties > Obstetrics and Gynecology > Gynecologic Surgery
Carbon Dioxide Laser Surgery in Gynecology
Janice L Bacon, MD, Professor and Chair, Department of Obstetrics and Gynecology, University of South Carolina School of Medicine
Updated: Mar 10, 2010
Carbon dioxide laser procedures eradicate CIN in up to 90% of cases.[22 ]…. However, because of the pathophysiology of HPV, an operative procedure results in a reduced viral load …
immunologically intact women, appropriate dysplasias treated with carbon dioxide laser procedures may result in complete eradication of the HPV genome.
Future and Controversies
The appropriate long-term follow-up protocol for women with high-risk HPV types and those with unclassified HPV types remains unknown. The most reasonable course of long-term follow-up is not yet determined.
27.Kjellberg L, Wadell G, Bergman F, et al. Regular disappearance of the human papillomavirus genome after conization of cervical dysplasia by carbon dioxide laser. Am J Obstet Gynecol. Nov 2000;183(5):1238-42. [Medline].
Nippon Seikeigeka Gakkai Zasshi. 1987 Nov;61(11):1265-71.
[Experimental study of the fibrosarcoma (S1509a) widely resected by CO2 laser–local recurrence and anti-tumor immunity] [Article in Japanese]
Department of Orthopaedic Surgery, Gunma University School of Medicine, Japan.
Sarcoma 1509a cells (1 X 10(6] were inoculated into the right dorsum of A/Jackson mice. Laser or surgical resection was performed on the 8th or 11th day after tumor inoculation. Twenty days later, the same number of S1509a was inoculated into the contralateral side of the primary tumor. The local recurrence rate of the tumor resected by the laser was lower than that with the surgical method. Fewer mice rejected the reinoculated tumor after resection using laser method than after surgical resection. A/Jackson mice, hyperimmuned with S1509a, were inoculated with 3 X 10(6) cells of the S1509a on the 2nd, 5th, 10th and 21st days after laser irradiation. Hyperimmunized mice inoculated with the sarcoma cells on the 2nd day after laser irradiation showed higher acceptability of the tumor than immune mice without irradiation. However, other groups of mice rejected the inoculated sarcoma cells. These results suggest that suppression of tumor specific immunity was induced by laser irradiation.
PMID: 3127505 [PubMed – indexed for MEDLINE]
J Gynecol Surg. 1994 Summer;10(2):85-8.
The effect of CO2 laser laparoscopy for treatment of pelvic endometriosis on serum concentrations of antiendometrial antibodies.
Badawy SZ, Cuenca V, Schmitt GA, Herbst LJ, Stefanu C.
Department of Obstetrics and Gynecology, State University of New York, Health Science Center, Syracuse, USA.
This study uses antiendometrial antibodies as an indicator for follow-up of patients with endometriosis after surgical treatment. This is a prospective study of 32 patients with endometriosis. The patients were used as their own controls. Serum samples were obtained before surgery and 1 month, 3 months, and 6-9 months following surgery. All patients were treated with CO2 laser laparoscopy. Serum concentrations of antiendometrial antibodies decreased significantly at 1 month, 3 months, and 6-9 months following treatment in each group. There was no correlation between baseline concentration of antibodies and stage of the disease. This study confirms the value of using antiendometrial antibodies as an indicator for follow-up of endometriosis patients. Surgical treatment with CO2 laser laparoscopy is effective in lowering the antigenic effect of the disease in these patients. This beneficial effect is maintained for up to 9 months after treatment.
Acta Otolaryngol Suppl. 1998;537:38-42.
Changes in nasal responsiveness to histamine and to specific antigen after laser surgery.
Terada N, Hamano N, Terada Y, Shirotori K, Ishikawa K, Togawa K, Konno A.
Department of Otorhinolaryngology, Chiba University, School of Medicine, Japan.
An initial treatment with several kinds of anti-allergic medicines is useful for reducing nasal allergy symptoms in patients suffering from Japanese cedar pollinosis during the pollen season. Since laser surgery before the pollen season seems to have a preventive effect as well, it would be of interest to know the time course of changes in the nasal reactivity to specific and non-specific stimuli after laser surgery. In this study, we investigated the changes in the nasal reactivities to specific antigen and histamine after CO2 laser surgery. The nasal reactivities to both specific antigen and histamine were enhanced 2 weeks after the laser surgery. On the other hand, they were significantly reduced after 4 weeks. Our data strongly suggest. therefore. that laser surgery must be done more than 4 weeks before the start of the pollen season to avoid temporary enhancement of nasal allergy symptoms.
Am J Rhinol. 2002 Jan-Feb;16(1):1-6.
Study of eosinophil activation in nasal mucosa in patients with perennial nasal allergy: effects of CO2 laser surgery.
Furukido K, Takeno S, Osada R, Ishino T, Yajin K.
Department of Otolaryngology, Hiroshima University School of Medicine, Japan.
Carbon dioxide (CO2) laser surgery has been shown to be clinically effective in the treatment of nasal allergy. To investigate the mechanisms of eosinophil infiltration and activation underlying the therapeutic effects of CO2 laser surgery, we examined changes in the cytological profile of nasal mucosa after surgery. Twenty-two patients with perennial nasal allergy against house-dust mites underwent two or three rounds of laser surgery at 1-month intervals on an outpatient basis. The following parameters were evaluated at each visit: (i) improvement of clinical symptoms (nasal obstruction, rhinorrhea, and sneezing), (ii) percentage of infiltrating eosinophils in nasal mucosa, and (iii) the degree of EG2+ cells and intracellular adhesion molecule 1 (ICAM-1) expression by immunocytochemistry. All clinical symptoms significantly decreased after surgery. Significant reductions in eosinophil infiltration (p < 0.01) and the percentage of EG2+ cells (p < .005) were observed also. However, the degree of ICAM-1 expression in epithelial cells was not changed. These results suggest that CO2 laser surgery partially reduced the allergic reactions, leading to improvement of clinical symptoms.
Saudi Med J. 2007 Apr;28(4):623-7.
Inflammatory myofibroblastic tumor of paranasal sinuses.
Al-Sindi K, Al-Shehabi MH, Al-Khalifa SA.
Department of Pathology, Bahrain Defence Force Hospital, PO Box 28743, Kingdom of Bahrain. firstname.lastname@example.org
Inflammatory myofibroblastic tumors IMTs are clinico-pathologically distinctive but biologically controversial entities; they rarely affect the head and neck region and usually follow a benign clinical course after radical excision. We reviewed the literatures of IMTs and present a rare case of IMT arising from the maxillary paranasal sinus of an 11-year-old girl. Moreover, we elaborate on the morpho-immunophenotypic characteristics of this lesion. Microscopic examination revealed a spindle cell proliferation set in a highly vascular stroma with numerous inflammatory cells. Tumor cells were immunoreactive for vimentin, and smooth muscle actin, negative for desmin, S-100, p53, Cyclin D1, and bcl-2. The potential neoplastic nature of this lesion was substantiated by the strong diffuse immuno-expression of ALK-1 protein, a marker that has been linked to neoplastic transformation. The lesion was excised completely by a CO2 LASER as a new treatment modality and the patient manifested no evidence of disease recurrence at 10-months recall.
J Pediatr Surg. 1989 Feb;24(2):201-3.
Beneficial effects following carbon dioxide laser excision on experimental neuroblastoma.
McCormack CJ, Naim JO, Rogers DW, Ziegler MM, Hinshaw JR.
Department of Surgery, Rochester General Hospital, New York.
Treatment of neuroblastoma in children consists of primary excision with adjuvant radiation and chemotherapy. When the tumor invades surrounding structures that cannot be safely excised or when distant metastasis is present, the patient has a poor prognosis. Because the CO2 laser can be used to excise malignant tumors without seeding the surrounding tissue and because the defocused beam can vaporize malignant cells, we compared partial scalpel excision and partial laser excision of C1300 murine neuroblastoma to the growth rate of residual tumor. In 25 mice, 75% of the tumor was excised with a scalpel, and in another 25, the same percentage was excised with the CO2 laser (10 W). CO2 laser excision significantly decreases the growth of residual neuroblastoma (P less than .01). However, the effect appears to be a function of increased tumor immunogenicity after laser excision rather than the increased tumor kill. We conclude that CO2 laser excision of neuroblastoma may prove to be superior to scalpel excision for primary surgical treatment of neuroblastoma.
Ann Otol Rhinol Laryngol. 1976 Jul-Aug;85(4 Pt 1):508-16.
Acute tympanic membrane perforations and the early immunological response in rats
Authors: Jamel Tahar Aissaa; Malou Hultcrantzab
Affiliations: a Center for Hearing and Communication Research,
b Department of Otorhinolaryngology, Karolinska University Hospital, Stockholm, Sweden
Publication Frequency: 12 issues per year
Published in: Acta Oto-Laryngologica, Volume 129, Issue 11 November 2009 , pages 1192 – 1197
Conclusions: This study showed that macrophages, B cells, and T cells occurred at different frequencies, localizations, and times after acute laser tympanic membrane perforation. Immunological cells were most prevalent in the proliferative mass adjacent to the annulus region. The cellular immunological response in freshly perforated eardrums was unexpectedly aggressive. Objectives: To study the occurrence of immunocompetent cells during the healing process of fresh perforated tympanic membranes. The information could be used to develop alternative outpatient procedures in the cure of chronic perforations, replacing conventional surgery. Materials and methods: A laser myringotomy was carried out in Sprague-Dawley rats, which were sacrificed at 3 and 6 days after the myringotomy. Tympanic membrane sections were stained immunohistochemically according to the avidin-biotin method, targeting macrophages, B cells, and T cells. Semi-quantification was performed; positive cells were counted and mean values were calculated. Results: Macrophages and B cells were most frequent at day 6 and T cells at day 3 after laser myringotomy. B cells were the most prevalent studied cell type. T cells peaked at day 3, after which they decreased in number. Most immunocompetent cells were observed in the proliferative mass at the edge of the perforation
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