Laser Systems for Photobiology and Photomedicine PDF
Preview Laser Systems for Photobiology and Photomedicine
Laser Systems for Photobiology and Photomedicine NA TO ASI Series Advanced Science Institutes Series A series presenting the results of activities sponsored by the NA TO Science Committee, which aims at the dissemination of advanced scientific and technological knowledge, with a view to strengthening links between scientific communities. The series is published by an international board of publishers in conjunction with the NATO Scientific Affairs Division A Life Sciences Plenum Publishing Corporation B Physics New York and London C Mathematical and Physical Sciences Kluwer Academic Publishers o Behavioral and Social Sciences Dordrecht, Boston, and London E Applied Sciences F Computer and Systems Sciences Springer-Verlag G Ecological Sciences Berlin, Heidelberg, New York, London, H Cell Biology Paris, Tokyo, Hong Kong, and Barcelona I Global Environmental Change Recent Volumes in this Series Volume 248-Lower-Dimensional Systems and Molecular Electronics edited by R. M. Metzger, P. Day, and G. C. Payavassiliou Volume 249-Advances in Nonradiative Processes in Solids edited by B. Di Bartolo Volume 250-The Application of Charge Density Research to Chemistry and Drug Design edited by George A. Jeffrey and Juan F. Piniella Volume 251-Granular Nanoelectronics edited by David K. Ferry, John R. Barker, and Carlo Jacoboni Volume 252-Laser Systems for Photobiology and Photomedicine edited by A. N. Chester, S. Martellucci, and A. M. Scheggi Volume 253-Condensed Systems of Low Dimensionality edited by J. L. Beeby Volume 254-Quantum Coherence in Mesoscopic Systems edited by B. Kramer Series B: Physics Laser Systems for Photobiology and Photomedicine Edited by A. N. Chester Hughes Research Laboratories Malibu, California S. Martellucci The Second University of Rome Rome, Italy and A. M. Scheggi IROE-CNR Florence, Italy Plenum Press New York and London Published in cooperation with NATO Scientific Affairs Division Proceedings of a NATO Advanced Study Institute/15th Course of the International School of Quantum Electronics on Laser Systems for Photobiology and Photomedicine, held May 11-20,1990, in Erice, Sicily, Italy Librarv of Congress Catalog!ng-In-Publlcatlon Oat8 Course of the International Schoel of Ouantus Eleetron!cs on Laser S~ste.s for Photoblalogy and Photonedlelne (15th, 1990 ; Erlee. Iuly) Laser syste.s for photeblology and phota~edic,ne I edlted by A.N. Chester, S. Marte1luccl, and A.M. Schegg,. p. cm. -- (NATO ASI ser,es. Serie. a, Physlcs , v. 252) ·Proceedings of a NATO Advanced Study Instltutef15th Course of TMe International Schael of Ouantu. Eleetronlcs on Laser Syste.s for Phatobialogy and Photomedlclne. held May 11-20. 1990. In Erlee. S1C1lv~ ltaly"--~.p. verso. 'Publlsned ,n caaperatlon .Itn NATO Sclentlfle Af'alrs DiviSion." Includes blbllographleal references and ,ndex. 1. Lasers ,n nediclne--Congresses. 2. Lasers In btology- -Congresses. 3. Lasers--Therapeutlc use--Congresses. 4. Lasers In surgery--Congressas. I. Chester. A. N. 11. Martelluccl, S. 111. Verga Scheggl. A. M. (Anna Marla) IV. North Atlant1e Treat~ Organlzat,on. Sclentlfic Affairs DIVIsIon. V. Title. VI. Ser,.s. [ONLM, 1. Laser Surgery--congresses. 2. Lasers--dlagnOStic use- -congresses. 3. Lasers--therapeutlc use--congresses. 4. Photccheootherapy--congresses. wa 117 C861L 19901 R857.L37C68 1990 610' .28--dc20 DNLM/!lLC For Llbrary of Congress 91-3006 eIP © 1991 Plenum Press, New York A Division of Plenum Publishing Corporation 233 Spring Street, New York, N. Y. 10013 Softcover reprint of the hardcover 1 st edition 1991 All rights reserved No part of this book may be reproduced, stored in a retrieval system, or transmitted in any form or by any means,electronic, mechanical, photocopying, microfilming, recording, or otherwise, without written permission from the Publisher ISBN 978-1-4684-7289-9 ISBN 978-1-4684-7287-5 (eBook) 00110.1007/978-1-4684-7287-5 PREFACE This volume contains the Proceedings of a two-week NATO Advanced Study Institute on "Laser Systems for Photobiology and Photomedicine", conducted from May 11 to 20, 1990 in Erice, Italy. This is the 15th annual course of the International School of Quantum Electronics (ISQE), organized under the auspices of the "Ettore Majorana" Center for Scientific Culture. The application of lasers to medicine and surgery has made amazing progress since the last ISQE Course on this subject in 1983. The present Proceedings give a tutorial introduction to today's most important areas, as well as a review of current results by leading researchers. Among the possible approaches to a NATO Advanced Study Institute on Laser Systems for Photobiology and Photomedicine, we chose to emphasize the scientific and technological aspects of advanced laser systems when applied to laboratory and clinical tests. Since it is the policy of the School to stress the advanced scientific and techn·ological achievements in the field of Quantum Electronics, the Course broadly covers performance already achieved and potential applications. Because of the great variety of applications of laser systems in biol- ogy, medicine, chemistry, engineering and related branches of science, this Institute addressed a subject of interdisciplinary interest. The formal sessions were balanced between tutorial presentations and lectures focusing on unsolved problems and "future directions. In addition, considerable time was provided for the participants to meet together informally for additio- nal discussions on the forefront of current work. Therefore the character of the Institute was a blend of current research and tutorial reviews. We have brought together some of the world's acknowledged experts in the field to summarize both the present state of their researches and the background behind them. Most of the lecturers attended all the lectures and devoted their spare hours to stimulating discussions. We would like to thank them all for their admirable contributions. The Institute also has taken advantage of a very active audience; most of the students were active researchers in the field and contributed with discussions and seminars. Some of these student's seminars are also included in these Proceedings. For this book, the lectures have been arranged in sections according to topic, with tutorial and review material placed near the beginning of each section. The papers in these Proceedings give a fairly complete ac- counting of the Course lectures with the exception of the informal discus- sions. In editing this material we did not modify the technical content of the original manuscripts. In the particular case of the Chinese manus- cript, the author does not always use accepted medical terminology; for example, medical authors do not usually speak of "killing" cells, but use other words. We did not change the author's terminology, because the subject matter (laser acupuncture) is not a universally accepted medical procedure anyway. v The topical sections are as follows: A. "Physical and Biological Foundations", providing an overview of the field; B. "Surgical and Ophthalmological Applications", covering the use of a variety of different laser types; C. "Low Power Laser Therapy", presenting several important papers which give a firm scientific foundation to this area of photomedicine; D. "Photodynamic Therapy: Mechanisms and Dosimetry"; E. "Photodynamic Therapy: Experimental Results"; F. "Diagnostic Techniques and Instrumentation"; and, G. "Laser Safety and System Design". These 1990 Proceedings give considerable coverage to "Low Power Laser Therapy" and "Photodynamic Therapy", recognizing the progress in these areas during recent years. The reader may also wish to consult the 1983 Proceedings ("Laser Photobiology and Photomedicine", edited by S. Martel- lucci and A. N. Chester, Plenum, E. Majorana Series N. 22). These earlier papers give more emphasis to "Fundamentals of Lasers and Tissue Interac- tions", "Laser Surgery", and "Photodermatology". Thus, the 1983 and 1990 Proceedings are complementary in their content. This volume would, of course, not be possible without the considerable efforts put forth by the authors represented here; all of them are cordial- ly acknowledged. We also wish to mention with sincere thanks Maria Teresa Petruzzi and Margaret Hayashi, secretaries to the ISQE Directors (S. M. and A. N. C.). We are also grateful to Mrs Vanna Cammelli for her skilful as- sistance in the organization of the course and to Miss Janie Curtis, editor at Plenum Press London, for her outstanding professional support. Before concluding, we acknowledge the organizations who sponsored the School, especially the generous financial support of the NATO A.S.I. programme. The Directors of the NATO Advanced Study Institute: A. N. Chester Vice-President and Director Hughes Research Laboratories Malibu, California, U.S.A. S. Martellucci Professor of Physics The Second University Rome, Italy A. M. Scheggi Director of Research I.R.O.E. - C.N.R. Florence, Italy October 30, 1990 vi CONTENTS PHYSICAL AND BIOLOGICAL FOUNDATIONS Laser Photomedicine - An Overview: Past, Present, and Future •••••• 3 D. H. Sliney and M. L. Wolbarsht Exogenous Chromophores for Laser Non-Surgical Photomedicine .••..•.• 7 L. Goldman Modelling and Measurements of Light Propagation in Tissue for Diagnostic and Therapeutic Applications •..••••..•.•.•..•.•. 13 B. C. Wilson Chemical Laser Interactions with Human Tissues •••.•••.•••.••..•.••. 29 G. L. Valderrama, R. F. Menefee, B. D. Krenek and M. J. Berry SURGICAL AND OPHTHALMOLOGICAL APPLICATIONS Mid-Infrared Laser Surgery ••••••••.•..•.•.•.••.••.••.•..•.•.•••••.• 39 M. L. Wolbarsht and D. Shi The Nd:YAG Laser - Applications in Surgery ..•.••..•.••.•.•..••..... 53 R. A. Kirschner Laser in Plastic Surgery and Dermatology •••.•.••..•.••.•.••.••••.•. 57 J. S. Nelson First Experience with a Laser Clamp in Neurosurgery ..••.••.•..•.•.. 67 V. A. Fasano, W. Cecchetti, S. M. Peirone, R. Urciuoli, G. F. Lombard, M. Fontanella and L. Sansalvadore Excimer Laser Angioplasty in Human Artery Disease .•.••.••••..•..•.. 69 R. Viligiardi, V. Gallucci, R. Pini, R. Salimbeni and S. Galiberti The Efficiency of Laser Panretinal Photocoagulation for Diabetes •.. 73 M. L. Wolbarsht and M. B. Landers III LOW POWER LASER THERAPY Effects of Visible Laser Radiation on Cultured Cells ...••••.•••...• 89 T. I. Karu Medical Applications of Low Power Lasers in China .•.•.......••.••.• 115 Fu-Shou Yang The Use of Low Level Laser Biostimulation for the Treatment of Chronic Pain Syndromes ••••.•..•..•••••••••..•••••••••••• 129 K. C. Moore PHOTODYNAMIC THERAPY: MECHANISMS AND DOSIMETRY Photodynamic Therapy •••••••••••••••••••••••••••••••••••••••.••••••• 139 J. S. Nelson Exogenous Chromophores for Laser Photos urgery (PDT) •...•.••••.••••. 143 L. Goldman Endoscopic Photodynamic Therapy: Clinical Aspects .•••••.••.•.•..••• 149 P. Spinelli, M. Dal Fante and A. Mancini Targets and Mechanisms of Action Associated with Laser Mediated • Photosensi tization •••.••••.•••....••••.•••••.••...•.••..••• 157 A. Ferrario, N. Rucker, A. Wong, M. Luna and C. J. Gomer Photodynamic Therapy of Tumors: A Review of PDT Dosimetry ..•.•...•• 165 W. R. Potter PHOTODYNAMIC THERAPY: EXPERIMENTAL RESULTS Photodynamic Therapy Variation in Biological Activities of HPD and Biological Effectiveness with RIF-1 ...••••••.•••.•••.•• 173 F. A. H. Al-Watban A Comparison of Laser and Arc-Lamp Spectroscopic Systems for In-Vivo Pharmacokinetic Measurements of Photosensitizers Used in Photodynamic Therapy ••••..•.••••..••••.•.••••.•••.. 193 D. A. Russell, P. Nadeau, R. H. Pottier, G. Jori and E. Reddi Experiments on Laser Mediated Photosensitization. Preclinical Evaluation of Mono-1-Aspartyl Chlorin e6 (NPe6) •••...•.•••• 201 A. Ferrario and C. J. Gomer Photodynamic Therapy of Tumors: Definition of PDT Dose and Response •••.•....••••••.•.••.••.••.•••••••....••.•••..••.•• 203 W. R. Potter Laser Excited Fluorescence Lifetimes of Hematoporphyrin IX as a Function of Solution pH: Implication in Photodynamic Therapy ••••.•••.••••.••.••••.••.••.••..••....•••.•..•••..•• 213 P. Nadeau, R. H. Pottier, G. Szabo, D. Brault and C. Vever-Bizet Biological Applications of Time-Gated Fluorescence Spectroscopy .••• 217 R. Cubeddu, R. Ramponi and P. Taroni Instrumentation for Photodynamic Therapy ..••.•.•...••..••.•....•••. 229 D. R. Doiron DIAGNOSTIC TECHNIQUES AND INSTRUMENTATION The Use of Optical Fibers in Biomedical Sensing ••••••••.••••••••••• 233 A. G. Mignani and A. M. Scheggi Laser Holography as a Technique in Experimental Science .••.•••.•... 247 H. Podbielska viii Laser Doppler Flow Measurement for the Evaluation of Cerebral Microcirculation ..........•..•.•........••..•..••••.....•.. 257 v. A. Fasano, R. Urciuoli, P. Bolognese and M. Fontanella LASER SAFETY AND SYSTEM DESIGN Safety Issues in Laser Surgery .•..•..•............................. 263 D. H. Sliney Laser Surgery of the Eye: Phototoxicity Concerns ....•..•.•...•..•.. 273 D. H. Sliney Surgical Endoscopy Units: Room Installation ...............•..•...•. 285 F. Longhi Considerations in the Design of Medical Laser Systems and Instrumentation .•.....•.................................... 289 R. A. Kirschner Radiation Safety of Laser Products: European and Italian Requirements ............•.............................' ..... 293 R. Barbini Index ...•.............•....•.....................................• 303 PHYSICAL AND BIOLOGICAL FOUNDATIONS
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