Heat transfer rate at the skin-air interface is of critical importance for the benefits of cryogen spray cooling in combination with laser therapy of shallow subsurface skin lesions, such as port-wine stain birthmarks. With some cryogen spray devices, a layer of liquid cryogen builds up on the skin surface during the spurt, which may impair heat transfer across the skin surface due to relatively low thermal conductivity and potentially higher temperature of the liquid cryogen layer as compared to the spray droplets. While the mass flux of cryogen delivery can be adjusted by varying the atomizing nozzle geometry, this may strongly affect other spray properties, such as lateral spread (cone), droplet size, velocity, and temperature distribution. We present here first experiments with sequential cryogen spraying, which may enable accurate mass flux control through variation of spray duty cycle, while minimally affecting other spray characteristics. The observed increase of cooling rate and efficiency at moderate duty cycle levels supports the above described hypothesis of "isolating" liquid layer, and demonstrates a novel approach to optimization of cryogen spray devices for individual laser dermatological applications.
Flat surfaces produce the most efficient heat transfer, but once indentation exists (as it does in all clinically relevant cases), larger indentations produce a higher maximum heat flux. This suggests that higher momentum sprays (which produce larger skin indentations for identical spurts) than those in current clinical use may improve CSC efficiency.
Epiretinal prostheses used to treat degenerative retina diseases apply stimulus via an electrode array fixed to the ganglion cell side of the retina. Mechanical pressure applied by these arrays to the retina, both during initial insertion and throughout chronic use, could cause sufficient retinal damage to reduce the device's effectiveness. In order to understand and minimize potential mechanical damage, we have used finite element analysis to model mechanical interactions between an electrode array and the retina in both acute and chronic loading configurations. Modeling indicates that an acute tacking force distributes stress primarily underneath the tack site and heel edge of the array, while more moderate chronic stresses are distributed more evenly underneath the array. Retinal damage in a canine model chronically implanted with a similar array occurred in correlating locations, and model predictions correlate well with benchtop eyewall compression tests. This model provides retinal prosthesis researchers with a tool to optimize the mechanical electrode array design, but the techniques used here represent a unique effort to combine a modifiable device and soft biological tissues in the same model and those techniques could be extended to other devices that come into mechanical contact with soft neural tissues.
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