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Photodynamic Therapy Combined with 1064-nm Nd:YAG Laser Therapy and Topical Efinaconazole for Refractory Onychomycosis: Case Series

  • Park, Jae Wan;Koh, Young Gue;Seo, Seong Jun;Park, Kui Young
    • Medical Lasers
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    • 제10권3호
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    • pp.185-188
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    • 2021
  • Onychomycosis is the most common disease of the nail, with a worldwide prevalence of 5.5%. It causes local pain, paresthesia, and cosmetic problems and decreases the patients' quality of life. Conventional treatments include the administration of topical and systemic agents. However, factors such as subungual hyperkeratosis and biofilm formation may affect the efficacy of these treatments. Moreover, side effects associated with systemic agents are a major concern for patients. Therefore, various novel treatments are being developed; among them, photodynamic therapy (PDT) and Nd:YAG laser are promising, and several studies have demonstrated the efficacy and safety of PDT and laser therapy. Here, we report the efficacy and tolerability of PDT combined with 1064-nm Nd:YAG laser therapy and topical efinaconazole for the treatment of three patients with refractory onychomycosis.

사출성형용 Nylon 6계 Nd-Fe-Co-Zr-B 펠렛의 자기특성 (Magnetic Properties of Nylon 6 based Nd-Fe-Co-Zr-B Pellets for Injection Molding)

  • 최승덕;이우영;양충진
    • 한국자기학회지
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    • 제3권1호
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    • pp.34-40
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    • 1993
  • 급속냉각기술로 제조된 $Nd_{10.5}Fe_{79}Co_{2}Zr_{1.5}B_{7}$ 합금분말을 사용하여 사출성형용 자성 펠렛을 제조하였다. 입도분포가 다른 두 종류의 분말($38~75\;\mu\textrm{m}$$75~50\;\mu\textrm{m}$)을 사용하여 열가소성(Nylon 6) 펠렛을 제조한 후 자성분말의 임계분율(critical volume fraction) 을 결정하고 수지자석의 성형밀도에 따른 자기특성을 고찰하였다. Nylon 6 수지를 사용한 Nd-Fe-Co-Zr-B계 펠렛은 분말입도가 $38~75\;\mu\textrm{m}$인 경우 임계 부피분율은 70%로 나타났고, 그때의 성형밀도는 이론밀도 의 90%를 상회 했으나 $75~150\;\mu\textrm{m}$ 분말의 경우는 같은 분율에서 이론밀도의 87% 수준에 머물렀다. 최적의 자기특성은 분말에 윤활제로서 silicone oil만을 0.5wt.% 첨가한 경우이며 이때의 자기특성으로, $(BH)_{max}=5.2\;MGOe,\;B_{r}=5.1\;kG$ 그리고 $_{i}H_{c}=8.8\;kOe$의 높은 수준을 보였다. Nylon 6수지자석의 성형밀도를 예측할 수 있는 경험식으로서, ${\rho}(g/cm^{3})=1.1+K.V_{s}$을 얻었으며 K(5.3~5.6)는 자성분말 입도에 따른 기울기 상수이고 $V_{s}$는 분말의 부피분율이다.

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Nd:YAG레이저조사가 경화상아질에 미치는 영향에 관한 주사전자현미경적 연구 (A Scanning Electron Microscopic Study on the Effect of Nd:YAG Laser Irradiation on the Sclerotic Dentin)

  • 김문현;신금백
    • Journal of Oral Medicine and Pain
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    • 제24권4호
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    • pp.397-410
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    • 1999
  • In order to obtain the basic data concerning the optimal parameters in using Nd:YAG laser as a therapeutic modality to dentinal hypersensitivity, the author prepared 3 sections of sound dentin and 10 sections of sclerotic dentin with thickness of $0.5mm{\pm}0.1mm$ from human extracted teeth of anteriors and premolars, and applied the laser energy from a fiberoptic delivered, free running, pulsed Nd:YAG laser (wavelength 1064nm, pulse duration $120{\mu}sec$, fiber diameter $320{\mu}m$) to surfaces of sound and sclerotic dentin sections for 1 second with contact/unidirectional moving mode of the fiber under speed of 3mm~4mm/sec and parameters of 0.5W/10Hz, 1.0W/10Hz, 1.5W/10Hz, 2.0W/10Hz: $62J/cm^2$, $124J/cm^2$, $187J/cm^2$, $249J/cm^2$. The author comparatively evaluated the characteristics of ultrastructural changes on surfaces of sound and sclerotic dentin sections irradiated by the pulsed Nd:YAG laser using the scanning electron microscopy. A fairly ill-defined bordered surface of partially closed and melted dentinal tubules can be seen on the scanning electron microscopic feature of the sound dentin surface irradiated by the pulsed Nd:YAG laser with energy density of $62J/cm^2$. The physical modification of sound dentin surface extensively occurred depended on the increase of energy density from $62J/cm^2$ to $124J/cm^2$, $187J/cm^2$, $249J/cm^2$. While, a fairly well-defined bordered surface of partially closed and melted dentinal tubules with thickened peritubular dentin can be seen on the scanning electron microscopic feature of the sclerotic dentin surface irradiated by the pulsed Nd:YAG laser with energy density of $62J/cm^2$. The physical modification of sclerotic dentin surface of a fairly rough, shallow depression with many cracks, thickened peritubular dentin and structureless dentinal tubules extensively occurred depended on the increase of energy density from $62J/cm^2$ to $124J/cm^2$, $187J/cm^2$, $249J/cm^2$ compared to those of sound dentin surface irradiated by the pulsed Nd:YAG laser under the same parameters. Therefore, it is recommended that the pulsed Nd:YAG laser as a therapeutic modality to dentinal hypersensitivity should be applied with the less energy density than $62J/cm^2$ on the sound dentin surface, and its energy density on the partially sclerotic dentin surface should be lower than that on the sound dentin surface to preserve tooth from unnecessary excessive structural destruction.

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불화나트륨 이온도포와 Nd:YAG laser 조사가 치근면 내마모성에 미치는 영향 (Effect of NaF iontophoresis and Nd:YAG laser irradiation on the abrasion-resistance of root surface)

  • 김진덕;염창엽;김송욱;김병옥;한경윤
    • Journal of Periodontal and Implant Science
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    • 제27권4호
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    • pp.819-828
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    • 1997
  • The purpose of this study was to evaluate the abrasion-resistance of root surface after NaF iontophoresis, Nd:YAG laser irradiation and combined treatment 50 anterior teeth with flat interproximal root surface that had been extracted due to periodontal destruction were selected. All teeth were treated by the same procedure as conventional periodontal root treatment, such as scaling and root planing, root conditioning with tetracycline HCI(lOOmg/ml, 5min). The pre-treatment weight of each tooth was measured by a dial scale(SHIMADEU Co, LIBROR EB-220HU, capacity 220.000 g, Japan). All teeth were divided into 5 groups as follows: Nd:YAG laser irradiation(group 1, 1 W, 100 mJ, 10Hz, fiberoptic-root surface distance=5mm, $10\;sec.{\times}6times$, EL.EN.EN060, Italy): NaF iontophoresis(group 2, $150{\mu}A$, 4 min}: Nd:YAG laser irradiation following NaF iontophoresis(group 3): NaF iontophoresis following Nd:YAG laser irradiation(group 4): No treatment(control group). Electric toothbrushing (Oral-B, Brown Co, Germany) was conducted during 1 hour($lO\;min.{\times}6\;times$). Subsequently post-treatment weight was remeasured by the same method as pre-treatment weight measurement. The difference of abrasion rate among all groups was statistically analyzed by ANOVA(SAS program). Following results were obtained: 1. The abrasion rate was significantly lower in Nd:YAG laser irradiation group than NaF iontophoresis group(p < 0.001). 2. The abrasion rate was significantly lower in combined groups of Nd:YAG laser irradiation and NaF iontophoresis than either Nd:YAG laser irradiation group or NaF iontophoresis group(p < 0.001). 3. There was no significant difference in abrasion rate according to application order in the combined groups(p > 0.05). 4. The abrasion rate was significantly lower in all experimental groups than control group(p < 0.001). The results suggest that combined treatment of Nd:YAG laser irradiation and NaF iontophoresis on exposed root surface after periodontal therapy can enhance the abrasion-resistance of root surface and may inhibit the root caries development.

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정상 성인 족부 방사선 사진에서 족근 중족 관절 선열 형성 빈도 및 정상 변이 (Normal Variation and Incidence of Coincided Alignment on Lisfranc Joint on Normal Foot Radiography)

  • 강충남;김종오;고상훈
    • 대한족부족관절학회지
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    • 제1권1호
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    • pp.43-50
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    • 1997
  • The tarsometatarsal joint complex is formed by articulation of the five metatarsal bases with the three cuneiform bones and the cuboid bone. Fracture-dislocation of tarsometatarsal area are difficult to recognize on standard radiographs. The exact diagnosis is occasionally delayed. As a result, improper treatment and late sequelae remains. We decided to make a study of patients with normal foot radiographs on 200 cases. Standard radiographic evaluation was used to study the normal variants of the foot and to evaluate the coincided alignment of the lisfranc joint. Accurate accessment on AP & lateral & $30^{\circ}$ oblique projection of radiographs are very adventageous & important, and next final outcome was detected. : 1. Coincided alignment below 1mm and unfolded lisfranc joint on AP projection was well visalized on 1st cuneiform-metatarsal lateral border and 2nd cuneiform-metatarsal medial border. 2. Coincided alignment below 1mm and unfolded lisfranc joint on oblique projection was well visualized on 2nd cuneiform-metatarsal lateral border and 3rd cuneiform-metatarsal medial border and 3rd cuneform-metatarsal lateral border. 3. More proximal location of 2nd lisfranc joint compared to another joint was 196 cases (98%). It is due to inceleration of 2nd metatarsal base between 3rd & 1st cuneiform. 4. 3rd lisfranc joint was volarward position compared to 2nd listranc on lateral projection at 191 cases (95.5%). It's due to anterior covexity of lisfranc joint. 5. Wide dorsal sided 2nd lisfranc is investigated at 189 cases (94.5%). Because of it. 2nd & 3rd lisfrances are mainly volar dislocated usually. 6. Notching on 5th metatarsal base is visible on 171 cases (85.5%). 7. 4th lisfranc joint had offset normally within $2\sim3mm$ at 98 cases (49%). 8. 5th Lisfranc joint had normally offset within $2\sim3mm$ at 99 cases (49.5%). 9. On lateral projection, slight dorsal location of cuneiform to metatarsal base is investigated at 82 cases (41%).

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Myocardial Coverage and Radiation Dose in Dynamic Myocardial Perfusion Imaging Using Third-Generation Dual-Source CT

  • Masafumi Takafuji;Kakuya Kitagawa;Masaki Ishida;Yoshitaka Goto;Satoshi Nakamura;Naoki Nagasawa;Hajime Sakuma
    • Korean Journal of Radiology
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    • 제21권1호
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    • pp.58-67
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    • 2020
  • Objective: Third-generation dual-source computed tomography (3rd-DSCT) allows dynamic myocardial CT perfusion imaging (dynamic CTP) with a 10.5-cm z-axis coverage. Although the increased radiation exposure associated with the 50% wider scan range compared to second-generation DSCT (2nd-DSCT) may be suppressed by using a tube voltage of 70 kV, it remains unclear whether image quality and the ability to quantify myocardial blood flow (MBF) can be maintained under these conditions. This study aimed to compare the image quality, estimated MBF, and radiation dose of dynamic CTP between 2ndDSCT and 3rd-DSCT and to evaluate whether a 10.5-cm coverage is suitable for dynamic CTP. Materials and Methods: We retrospectively analyzed 107 patients who underwent dynamic CTP using 2nd-DSCT at 80 kV (n = 54) or 3rd-DSCT at 70 kV (n = 53). Image quality, estimated MBF, radiation dose, and coverage of left ventricular (LV) myocardium were compared. Results: No significant differences were observed between 3rd-DSCT and 2nd-DSCT in contrast-to-noise ratio (37.4 ± 11.4 vs. 35.5 ± 11.2, p = 0.396). Effective radiation dose was lower with 3rd-DSCT (3.97 ± 0.92 mSv with a conversion factor of 0.017 mSv/mGy∙cm) compared to 2nd-DSCT (5.49 ± 1.36 mSv, p < 0.001). Incomplete coverage was more frequent with 2nd-DSCT than with 3rd-DSCT (1.9% [1/53] vs. 56% [30/54], p < 0.001). In propensity score-matched cohorts, MBF was comparable between 3rd-DSCT and 2nd-DSCT in non-ischemic (146.2 ± 26.5 vs. 157.5 ± 34.9 mL/min/100 g, p = 0.137) as well as ischemic myocardium (92.7 ± 21.1 vs. 90.9 ± 29.7 mL/min/100 g, p = 0.876). Conclusion: The radiation increase inherent to the widened z-axis coverage in 3rd-DSCT can be balanced by using a tube voltage of 70 kV without compromising image quality or MBF quantification. In dynamic CTP, a z-axis coverage of 10.5 cm is sufficient to achieve complete coverage of the LV myocardium in most patients.

Improved Densification and Microwave Dielectric Properties of BaO·Nd2O3·5TiO2 Modified with an Iso-Component Borate Glass

  • Shin, Dong-Joo;Lee, Hyung-Sub;Cho, Yong-Soo
    • 한국재료학회지
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    • 제18권2호
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    • pp.107-111
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    • 2008
  • [ $BaO{\cdot}Nd_2O_3{\cdot}5TiO_2$ ] (BNT) ceramics modified with a borate glass containing Ba, Nd and Ti as glass constituents were investigated with regard to their sintering behavior and microwave dielectric properties. An addition of iso-component glass significantly improved the sinterabilty of the BNT ceramics and lowered the sintering temperature. A maximum density of $5.29\;g/cm^3$ and an x-y shrinkage of 17% were obtained for BNT ceramics containing 10wt.% of the glass sintered at $1100^{\circ}C$. The dielectric composition without the glass additive was only slightly densified at $1100^{\circ}C$. The resulting sample exhibited two crystalline phases, $BaNd_2Ti_5O_{14}$ and $Ba_2Ti_9O_{20}$, regardless of sintering temperature and glass content. When >10wt.% glass was added, exaggerated grain growth with a less uniform microstructure was found, resulting in the subsequent reduction of the fired density and the dielectric properties. BNT ceramics containing 10wt.% of the isocomponent glass sintered at $1100^{\circ}C$ for 4 h showed promising dielectric properties of k = 71.3 and Q = 1,330.

지각과민치아에 대한 Nd:YAG 레이저 조사의 효과 (Desensitizing Effects of a Nd:YAG Laser Irradiation on Hypersensitive Dentine)

  • 정성용;김경희;고명연;안용우;박준상
    • Journal of Oral Medicine and Pain
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    • 제30권4호
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    • pp.465-473
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    • 2005
  • 냉온자극 또는 잇솔질에 불편감을 호소하는 치과 외래 환자를 72명을 대상으로 레이저 조사를 시행한 실험군(45명)과 모의 레이저 조사를 시행한 대조군(27명)으로 나누어 지각 과민 치아의 치경부에 냉자극 및 기계적 자극을 가하여 대상자가 느끼는 불편감을 NPS로 평가하였다. 치아의 통증역치 평가를 위하여 전기치수검사기(EPT)를 사용하였다. 각 치아에 대한 레이저 조사에는 pulsed Nd:YAG 레이저를 사용하였고 조사조건은 1.5W, 20Hz, 75mJ/pulse으로 4분간 비접촉식으로 시행하였다. 대상자의 반응을 레이저 조사 전과 직후, 1주 이내, 2주 이내 각각 평가하여 다음과 같은 결과를 얻었다. 1. 지각 과민 치아에 대한 Nd:YAG 레이저 조사는 지각 과민을 완화시켜 주었으며 대조군에 비해 그 효과가 현저하였다. 2. 심한 지각 과민을 호소하는 치아에 대한 위약 효과는 존재하였으나 중등도의 지각 과민을 호소하는 치아에 대한 위약효과는 배제할 수 있었다. 3. 지각 과민 치아에 대한 Nd:YAG 레이저 조사는 전기치수검사에 의한 통증역치에 영향을 주지 않았다. 4. 지각 과민 치아에 대한 Nd:YAG 레이저 조사의 효과는 최소 2주는 지속되었다. 따라서 지각 과민 치아에 대한 치료법의 하나로 Nd:YAG 레이저 조사가 임상적으로 유용할 것으로 사료된다.