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such as alexandrite&#44; neodymium-YAG&#44; dual wavelength lasers<a class="elsevierStyleCrossRef" href="#bib0170"><span class="elsevierStyleSup">8</span></a> and&#44; more recently intense pulsed light &#40;IPL&#41; sources&#46;<a class="elsevierStyleCrossRef" href="#bib0145"><span class="elsevierStyleSup">3</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">IPL systems emit non-coherent broadband light with wavelengths in the 515&#8211;1200<span class="elsevierStyleHsp" style=""></span>nm range<a class="elsevierStyleCrossRef" href="#bib0160"><span class="elsevierStyleSup">6</span></a> and&#44; theoretically&#44; this spectrum matches the absorption coefficient and thermal relaxation time of a broader range of vessels within CM&#46;<a class="elsevierStyleCrossRef" href="#bib0175"><span class="elsevierStyleSup">9</span></a> Similar to laser systems &#40;though less selective than them&#41;&#44; this technology seems to respect the principle of selective photothermolysis &#40;SP&#41;&#44;<a class="elsevierStyleCrossRefs" href="#bib0145"><span class="elsevierStyleSup">3&#44;10</span></a> which consists in the preferential absorption of light by oxy&#47;deoxy-hemoglobin and the subsequent conversion into thermal energy&#44; leading to the selective coagulation of blood vessels&#46;<a class="elsevierStyleCrossRef" href="#bib0185"><span class="elsevierStyleSup">11</span></a> Specific output wavelengths depend on the cutoff filters used&#44;<a class="elsevierStyleCrossRef" href="#bib0160"><span class="elsevierStyleSup">6</span></a> which optimize absorption of the target chromophores&#44; reduce the strong absorption of melanin and prevent adverse effects such as erythema&#44; blistering and crusting&#46;<a class="elsevierStyleCrossRef" href="#bib0190"><span class="elsevierStyleSup">12</span></a> Recently&#44; the optimized pulsed light sources &#40;OPL&#41; have been developed&#44; providing a dual-band output spectrum from 500 to 670<span class="elsevierStyleHsp" style=""></span>nm and 870 to 1200<span class="elsevierStyleHsp" style=""></span>nm&#44; which are even more selective to oxy&#47;deoxy-hemoglobin&#46; Theoretically&#44; the use of OPL reduces the risk of epidermal damage&#44; by displacing the interval between 610 and 870<span class="elsevierStyleHsp" style=""></span>nm&#44; characterized by melanin&#39;s absorption peak&#46;<a class="elsevierStyleCrossRef" href="#bib0195"><span class="elsevierStyleSup">13</span></a></p><p id="par0020" class="elsevierStylePara elsevierViewall">IPL systems allow the individual selection of multiple parameters&#44; such as&#58; wavelength&#44; pulse duration&#44; fluence&#44; multipulse mode and intrapulse time delay&#46;<a class="elsevierStyleCrossRef" href="#bib0190"><span class="elsevierStyleSup">12</span></a> On the other hand&#44; we can also use only one pulse or multiple pulses&#44; with different delays&#44; creating a multiplicity of possible combinations&#46;</p><p id="par0025" class="elsevierStylePara elsevierViewall">Although IPL sources have been increasingly used in the treatment of CM&#44; there are very few clinical studies regarding their effectiveness&#46;<a class="elsevierStyleCrossRefs" href="#bib0155"><span class="elsevierStyleSup">5&#44;11</span></a> Furthermore&#44; we have not found any published histochemical studies describing the histological effects of IPL treatment of CM&#46; We aim to describe the vascular&#44; epidermal and dermal tissue damage in CM treated with IPL with variations in multiple parameters using nitroblue-tetrazolium chloride &#40;NBTC&#41; histochemical staining of biopsies taken from the CM immediately after treatment&#46;<a class="elsevierStyleCrossRefs" href="#bib0150"><span class="elsevierStyleSup">4&#44;14&#8211;17</span></a></p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Material and methods</span><p id="par0030" class="elsevierStylePara elsevierViewall">Fifteen adult patients with CM were enrolled in this study&#46; Four men and eleven women were treated with the Ellipse Flex &#40;Ellipse<span class="elsevierStyleSup">&#174;</span>&#44; Denmark&#41; IPL device that can provide two different spectrums of polychromatic light&#44; according to the different cut-off filters used&#58; between 555 and 950<span class="elsevierStyleHsp" style=""></span>nm &#40;VL-2<span class="elsevierStyleSup">&#174;</span>&#41; and 530 and 750<span class="elsevierStyleHsp" style=""></span>nm &#40;PR<span class="elsevierStyleSup">&#174;</span>&#41;&#46; For epidermal protection&#44; a cold-air cooling system &#40;Cryos5&#8482;&#44; Zimmer Medizinsysteme GMbH&#44; Neu-Ulm&#44; Germany&#41; and an ultrasound gel were used&#46; Different wavelengths&#44; fluences&#44; pulse durations&#44; inter- and intradelay times with stacking pulses<a class="elsevierStyleCrossRefs" href="#bib0220"><span class="elsevierStyleSup">18&#44;19</span></a> and multiple passes were used to treat an average of four CM test areas per patient &#40;range 2&#8211;7&#41;&#46; The hospital&#39;s ethics committee approved the study&#46; Fully informed written consent was obtained from all patients before the first treatment&#46; A technical description of the IPL device and the parameters used in the study are shown in <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0035" class="elsevierStylePara elsevierViewall">Post-treatment biopsies of each of the 55 test areas were performed&#44; 10<span class="elsevierStyleHsp" style=""></span>min after a single IPL treatment using a 3-mm punch&#46; We chose slightly sun-exposed skin areas in order to minimize epidermal damage and hair-free areas to avoid melanin light absorption&#44; since melanin behaves as a competitive chromophore to oxyhemoglobin&#46;<a class="elsevierStyleCrossRefs" href="#bib0175"><span class="elsevierStyleSup">9&#44;20</span></a> Biopsies were frozen in liquid nitrogen and the tissue sections were stained with NBTC&#44; as described in previous studies&#46;<a class="elsevierStyleCrossRefs" href="#bib0150"><span class="elsevierStyleSup">4&#44;14&#44;16</span></a> This enzyme is a redox indicator that is reduced by NADPH-diaphorase&#46; This enzymatic activity stops immediately after cell death and is present in endothelial cells&#44; fibroblasts and smooth muscle fibers but not in the dermal connective matrix&#46; Therefore&#44; only the viable tissue stains blue&#44; allowing an easy differentiation from thermally damaged tissue&#46;</p><p id="par0040" class="elsevierStylePara elsevierViewall">Three parameters were evaluated&#58; vessel wall destruction&#44; epidermal and dermal damage&#44; using a semiquantitative score&#58; 0&#44; absent&#59; 1&#44; minimal&#59; 2&#44; moderate&#59; and 3&#44; extensive tissue damage&#46; Two dermatologists and one dermatopathologist evaluated all slides blindly&#46; We always chose the majority agreement among the three observers&#44; and in case of total disagreement&#44; we suited the particular case to achieve a consensus agreement&#46;</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Results</span><p id="par0045" class="elsevierStylePara elsevierViewall">The median age of the 15 patients was 39 years-old &#40;21&#8211;80 years&#41; and most biopsies were taken from the retroauricular area &#40;47&#37;&#41; and back &#40;33&#37;&#41;&#46; The areas within the treated CM were all flat&#44; their color varied from pink to purple and the vessels had varying diameters &#40;<a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>&#41;&#46; The histochemical findings are illustrated in <a class="elsevierStyleCrossRef" href="#tbl0015">Table 3</a>&#44; showing how variations in each IPL parameter can modify the capacity of vessel wall destruction and production of epidermal and dermal collateral damage&#46;</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><elsevierMultimedia ident="tbl0015"></elsevierMultimedia><p id="par0050" class="elsevierStylePara elsevierViewall">In this series&#44; the patients with the most severe epidermal damage were those with a darker phototype &#40;patients 2&#44; 5 and 7&#41;&#46; In both cases&#44; in spite of intense epidermal cooling&#44; severe epidermal damage was noted with high fluences &#40;around 19<span class="elsevierStyleHsp" style=""></span>J&#47;cm<span class="elsevierStyleSup">2</span>&#41;&#44; but also with lower fluences &#40;11 and 13<span class="elsevierStyleHsp" style=""></span>J&#47;cm<span class="elsevierStyleSup">2</span>&#41; and a long pulse duration &#40;8<span class="elsevierStyleHsp" style=""></span>ms&#41; in case 7&#46; Indeed&#44; a significant proportion of the applied energy was absorbed by melanin in the basal layer of the epidermis&#44; and the amount of energy that reached the dermis was insufficient to achieve enough heat to cause vessel wall destruction &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>&#41;&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0055" class="elsevierStylePara elsevierViewall">Patients with pink lesions were difficult to treat&#44; as expected&#46; In case 15&#44; stacking a multipulse train of short pulses with high fluences obtained more vessel wall damage but with intense epidermal &#40;but not dermal&#41; damage&#46; In case 4&#44; using the shorter pulse duration &#40;2&#46;5<span class="elsevierStyleHsp" style=""></span>ms&#41; and a total energy of 9<span class="elsevierStyleHsp" style=""></span>J&#47;cm<span class="elsevierStyleSup">2</span> per pulse&#44; even with seven stacking pulses&#44; we could not obtain the necessary heating to cause any vascular or tissular alteration &#40;<a class="elsevierStyleCrossRef" href="#fig0010">Fig&#46; 2</a>&#41;&#46; However&#44; in case 12 both multiple and stacking pulses obtained more intense vessel wall damage than using only one pulse&#44; without significant collateral damage&#46;</p><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0060" class="elsevierStylePara elsevierViewall">On the other hand&#44; in a purple CM lesion treated with a fluence of 15<span class="elsevierStyleHsp" style=""></span>J&#47;cm<span class="elsevierStyleSup">2</span> and a pulse duration of 8<span class="elsevierStyleHsp" style=""></span>ms&#44; we found complete vessel wall destruction with less dermo-epidermal damage using multiple passes &#40;interdelay time&#58; 30<span class="elsevierStyleHsp" style=""></span>s&#41; instead of stacking pulses &#40;case 3&#41;&#46;</p><p id="par0065" class="elsevierStylePara elsevierViewall">In some patients&#44; using multiple pulses instead of a single pulse&#44; improved treatment efficacy in CM with thin vessels&#46; This happened in case 12 &#40;fluence of 19<span class="elsevierStyleHsp" style=""></span>J&#47;cm<span class="elsevierStyleSup">2</span> and pulse duration of 8<span class="elsevierStyleHsp" style=""></span>ms&#41; and case 15 &#40;fluence of 19&#46;2<span class="elsevierStyleHsp" style=""></span>J&#47;cm<span class="elsevierStyleSup">2</span> and pulse duration of 2&#46;5<span class="elsevierStyleHsp" style=""></span>ms&#41;&#44; where two pulses achieved a selective destruction of the vessel wall&#46; In case 15&#44; when we used 3 pulses &#40;with the same referred parameters&#41;&#44; the same level of vessel walls destruction was obtained &#40;as with two pulses&#41;&#44; but with more dermo-epidermal damage&#46;</p><p id="par0070" class="elsevierStylePara elsevierViewall">Intrapulse delay adjustments may also become extremely important to achieve complete destruction of vessel walls&#44; with less collateral damage&#46; Decreasing the intrapulse delay time&#44; we obtained more efficient vessel walls destruction&#44; without substantial increase of the dermo-epidermal damage &#40;cases 8 and 13&#41;&#46; Both patients had CM with medium caliber vessels&#46; They were treated with high fluences &#40;19&#46;4<span class="elsevierStyleHsp" style=""></span>J&#47;cm<span class="elsevierStyleSup">2</span> in case 8 and 17&#46;5<span class="elsevierStyleHsp" style=""></span>J&#47;cm<span class="elsevierStyleSup">2</span> in case 13&#41; and intrapulse delay times were reduced from 50 to 5<span class="elsevierStyleHsp" style=""></span>ms &#40;case 8&#41; and from 200 to 5<span class="elsevierStyleHsp" style=""></span>ms &#40;case 13&#41;&#46; In case 8&#44; however&#44; an even more selective result was acquired&#44; maintaining the referred parameters &#40;including the 5<span class="elsevierStyleHsp" style=""></span>ms intrapulse delay&#41; and decreasing the total fluence &#40;from 19&#46;4 to 13&#46;4<span class="elsevierStyleHsp" style=""></span>J&#47;cm<span class="elsevierStyleSup">2</span>&#41;&#44; without any dermo-epidermal damage&#46;</p><p id="par0075" class="elsevierStylePara elsevierViewall">In some purple CM containing vessels with a medium to large vessel caliber&#44; increased intrapulse delay times led to complete destruction of vessel walls&#44; with less collateral damage&#46; In cases 9 and 11&#44; for example&#44; increasing intrapulse delay times from 1&#46;5 to 200<span class="elsevierStyleHsp" style=""></span>ms resulted in complete vessel wall destruction with slightly less epidermal and dermal tissue damage &#40;<a class="elsevierStyleCrossRef" href="#fig0015">Fig&#46; 3</a>&#41;&#46;</p><elsevierMultimedia ident="fig0015"></elsevierMultimedia><p id="par0080" class="elsevierStylePara elsevierViewall">In patients 1&#44; 4&#44; 8 and 14&#44; who were treated with the PR<span class="elsevierStyleSup">&#174;</span> handpiece &#40;530&#8211;750<span class="elsevierStyleHsp" style=""></span>nm&#41;&#44; the settings used seemed insufficient to destroy the vessel walls effectively&#44; even when using a shorter pulse duration &#40;2&#46;5<span class="elsevierStyleHsp" style=""></span>ms&#41; with the highest fluences allowed by the device&#46; As mentioned above&#44; no vascular damage was observed in patient 4&#44; even when stacking pulses&#46;</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Discussion</span><p id="par0085" class="elsevierStylePara elsevierViewall">Although PDL is still the first choice for the treatment of CM&#44; second generation IPL devices have improved their selectivity and have been increasingly used&#46;<a class="elsevierStyleCrossRefs" href="#bib0155"><span class="elsevierStyleSup">5&#44;9&#44;21</span></a> Currently reported clearing rates range between 6&#37; and more than 90&#37;&#44;<a class="elsevierStyleCrossRefs" href="#bib0235"><span class="elsevierStyleSup">21&#8211;24</span></a> which may be due to the IPL devices&#8217; wide wavelength spectrum &#40;a second absorbance peak of oxyhemoglobin at 555<span class="elsevierStyleHsp" style=""></span>nm and a third around 900<span class="elsevierStyleHsp" style=""></span>nm&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0155"><span class="elsevierStyleSup">5</span></a> IPL is a less studied technique&#44; in which multiple parameters &#40;fluence&#44; wavelength spectrum&#44; pulse duration&#44; intra- and interpulse delay times&#41; may be adjusted&#44; conditioning an endless amount of therapeutic options&#46;</p><p id="par0090" class="elsevierStylePara elsevierViewall">In the present study we have been able to show the histochemical SP of IPL&#44; even with multipulse treatments&#44; according to the Verkruysse model<a class="elsevierStyleCrossRef" href="#bib0255"><span class="elsevierStyleSup">25</span></a> first demonstrated with PDL treatments&#46; Using multipulses of IPL&#44; higher energy thresholds are reached in the vessel walls with less collateral damage&#46;<a class="elsevierStyleCrossRefs" href="#bib0215"><span class="elsevierStyleSup">17&#44;18&#44;25</span></a></p><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Single and multiple pulses</span><p id="par0095" class="elsevierStylePara elsevierViewall">Multiples pulses produce an accumulative increase in temperature in blood vessels&#44; leading to thermal coagulation&#46;<a class="elsevierStyleCrossRef" href="#bib0220"><span class="elsevierStyleSup">18</span></a> In order to maintain SP the caliber and density of the vessel walls must be taken into account&#46;</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">Interpulse delay times &#40;multiple passes and stacking pulses&#41;</span><p id="par0100" class="elsevierStylePara elsevierViewall">Multiple passes with large interpulse delays &#40;30&#8211;60<span class="elsevierStyleHsp" style=""></span>s&#41; seem to heat the vessel walls slowly&#44; being less aggressive than stacking pulses&#46; This may be an advantage for patients who did not respond to a single-pulsed treatment&#46; This treatment modality is especially useful in CM in the presence of clusters of vessels with a larger caliber&#44; which have a longer thermal relaxation time &#40;TRT&#41;&#44; because it allows cooling between pulses&#46;<a class="elsevierStyleCrossRef" href="#bib0215"><span class="elsevierStyleSup">17</span></a> In these cases&#44; stacking pulses may lead to overheating and consequent collateral dermal damage&#46;</p><p id="par0105" class="elsevierStylePara elsevierViewall">On the other hand&#44; in patients with CM with sparse and thin vessels&#44; short interpulse delay times or stacking pulses could be safer in fair-skinned patients and allow the necessary temperature increase to achieve thermal coagulation and consequent vessel wall destruction&#44; without collateral damage&#46;</p></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0105">Intrapulse delay times</span><p id="par0110" class="elsevierStylePara elsevierViewall">Managing intrapulse delays is also extremely important&#44; taking into account the color of the CM&#44; which depends on the vessel density and caliber&#46;<a class="elsevierStyleCrossRef" href="#bib0205"><span class="elsevierStyleSup">15</span></a> Again&#44; long intrapulse delays are safer in the presence of high vessel density and larger caliber&#46; Short intrapulse delays are appropriate to treat CM lesions with low vessels¿ density and small diameter and therefore with less chromophore to absorb light energy&#46;<a class="elsevierStyleCrossRef" href="#bib0215"><span class="elsevierStyleSup">17</span></a></p></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0110">Darker phototypes and epidermal damage</span><p id="par0115" class="elsevierStylePara elsevierViewall">The risk of epidermal injury is especially seen in patients with darker phototypes&#44; due to considerable melanin absorption of IPL light&#44; mainly in the basal layer&#46;<a class="elsevierStyleCrossRef" href="#bib0155"><span class="elsevierStyleSup">5</span></a> Besides epidermal damage&#44; these patients also showed a poor response to treatment&#44; with insufficient vessel heating and thermal coagulation because most of the energy was retained in the epidermis&#46; Intense epidermal cooling is extremely important in these patients to allow light energy penetration in the dermis&#46;<a class="elsevierStyleCrossRef" href="#bib0260"><span class="elsevierStyleSup">26</span></a></p><p id="par0120" class="elsevierStylePara elsevierViewall">The therapeutic approach to the CM depends on the caliber&#44; capillary density and depth of the vessels as well as the patient&#39;s skin type &#40;<a class="elsevierStyleCrossRef" href="#fig0020">Fig&#46; 4</a>&#41;&#46;</p><elsevierMultimedia ident="fig0020"></elsevierMultimedia><p id="par0125" class="elsevierStylePara elsevierViewall">This study has many limitations&#44; such as the heterogeneity of the selected patients &#40;regarding the skin phototype of the patients or the color and location of the CM&#41; and&#44; above all&#44; the amount of different IPL setting combinations used&#46; However&#44; our aim was only to start to understand the potential improvements we could achieve with the IPL device by individualizing the selection of parameters through these first histochemical observations&#46; These observations may allow for a future comparative and controlled study in which a single or only a small number of parameters are changed when treating comparable lesions&#47;patients in regards to the color and location of the CM and the patient&#39;s skin phototype&#46;</p><p id="par0130" class="elsevierStylePara elsevierViewall">In IPL treatment of CM&#44; the goal is to take full advantage of the energy of the emitted light to selectively damage only the vessels without collateral damage&#46; The final outcomes are conditioned by many factors&#46; With regard to the patient&#44; physicians should consider&#58; the vessel size&#44; density and depth&#59; the quantity of red blood cells inside the vessels &#40;i&#46;e&#46;&#44; the target chromophore&#41;&#59; and the epidermal pigmentation of the patient&#46;<a class="elsevierStyleCrossRefs" href="#bib0175"><span class="elsevierStyleSup">9&#44;18</span></a> Regarding the IPL device and the operator&#44; factors that influence our results are&#58; the wavelength spectrum of the IPL device&#44; the light energy&#44; the pulse duration&#44; the possibility of using single or multiple pulses with variable inter- and intrapulse delay times and choosing adequate cooling strategies&#46;<a class="elsevierStyleCrossRef" href="#bib0220"><span class="elsevierStyleSup">18</span></a></p></span></span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0115">Conclusions</span><p id="par0135" class="elsevierStylePara elsevierViewall">In this study we explored the potential of an IPL device in treating CM and the huge number of possible treatment parameter combinations that can be used&#46; IPL intra- and interpulse delay changes produce very different final results&#46; Our findings suggest that patients with thin vessels should be treated in a more aggressive way&#46; Perhaps with the recent introduction of next-generation intensed pulsed lights with shorter pulses can improve the treatment of this group of lesions&#46; On the other hand&#44; physicians treating CM in patients with darker phototypes should choose an adequate cooling strategy to avoid epidermal damage&#46;</p></span><span id="sec0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0120">Ethical responsibilities</span><span id="sec0055" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0125">Protection of people and animals</span><p id="par0140" class="elsevierStylePara elsevierViewall">The authors declare that this research has not been conducted experiments on humans or animals&#46;</p></span><span id="sec0060" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0130">Confidentiality of data</span><p id="par0145" class="elsevierStylePara elsevierViewall">The authors declare that they have followed the protocols of the workplace on the publication of patient data&#46;</p></span><span id="sec0065" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0135">Right to privacy and informed consent</span><p id="par0150" class="elsevierStylePara elsevierViewall">The authors have obtained the informed consent of patients and&#47;or subjects referred to in Article consent&#46; This document is in the possession of the corresponding author&#46;</p></span></span><span id="sec0070" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0140">Conflict of interests</span><p id="par0155" class="elsevierStylePara elsevierViewall">The authors declare no conflict of interest&#46;</p></span></span>"
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        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Background</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Among the different approaches for improving the effectiveness in the treatment of Capillary Malformations type Port Wine Stain &#40;CM type PWS&#41; are the intense pulsed light sources&#46; There are few clinical studies prove useful in the treatment of CM&#46; Furthermore&#44; no studies have been published yet demonstrating the histological effects of IPL in CM&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Objectives</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">To assess the histological effects of pulsed light in capillary malformations type port wine stain&#46; We wanted to compare epidermal&#44; dermal and vessel wall damage after treatment with different combinations of IPL parameters&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Material and methods</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Fifty-five post-treatment biopsies were performed in 15 consenting patients with CM and stained with nitroblue-tetrazolium chloride &#40;NBTC&#41;&#46; Patients had not been treated previously&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Results</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Fifteen patients with CM&#44; with a median age of 39 years-old were enrolled in this study&#46; In this series&#44; the patients with the most severe epidermal damage were those with a darker phototype&#46; Pink CM were especially resistant to treatment&#44; even using high fluences&#44; short pulse durations and stacking pulses&#46; Longer intra- and interpulse delays were effective in purple CM&#44; achieving adequate vessel destruction&#46;</p></span> <span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0030">Conclusions</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">IPL devices provide a vast amount of treatment possibilities and further studies are necessary to optimize therapeutic approaches to CM&#46; In this study we have observed the histological effects of different pulses on the MC type PWS&#46;</p></span>"
        "secciones" => array:5 [
          0 => array:2 [
            "identificador" => "abst0005"
            "titulo" => "Background"
          ]
          1 => array:2 [
            "identificador" => "abst0010"
            "titulo" => "Objectives"
          ]
          2 => array:2 [
            "identificador" => "abst0015"
            "titulo" => "Material and methods"
          ]
          3 => array:2 [
            "identificador" => "abst0020"
            "titulo" => "Results"
          ]
          4 => array:2 [
            "identificador" => "abst0025"
            "titulo" => "Conclusions"
          ]
        ]
      ]
      "es" => array:3 [
        "titulo" => "Resumen"
        "resumen" => "<span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Antecedentes</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Entre las distintas estrategias para intentar mejorar la eficacia en el tratamiento de las malformaciones capilares tipo mancha en vino de Oporto &#40;MC tipo MVO&#41; est&#225;n las fuentes de luz pulsada intensa&#46; Existen hasta la fecha pocos estudios cl&#237;nicos que avalen su utilidad en el tratamiento de las MC&#46; Adem&#225;s&#44; no disponemos de estudios histol&#243;gicos que objetiven los efectos de la luz pulsada en la coagulaci&#243;n de estos vasos an&#243;malos&#46;</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Objetivos</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Evaluar los efectos histol&#243;gicos de la luz pulsada en las MC tipo MVO&#46; Intentamos comparar el da&#241;o epid&#233;rmico&#44; d&#233;rmico y de la pared de los vasos despu&#233;s del tratamiento con distintos par&#225;metros de IPL&#46;</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Material y m&#233;todos</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Fueron realizadas 55 biopsias postratamiento en las MC de 15 pacientes&#46; Las muestras fueron te&#241;idas con cloruro de nitroblue tetrazolium&#46;</p></span> <span id="abst0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0055">Resultados</span><p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Quince pacientes &#40;edad media&#58; 39 a&#241;os&#41; fueron inscritos en este estudio&#46; En esta serie los pacientes con mayor da&#241;o epid&#233;rmico fueron aquellos con un fototipo m&#225;s alto &#40;&#62;<span class="elsevierStyleSmallCaps">iv</span>&#41;&#46; Las malformaciones de color rosa p&#225;lido eran especialmente resistentes al tratamiento&#44; incluso con altas <span class="elsevierStyleItalic">fluencias</span>&#44; duraciones de pulso corto y pulsos repetidos&#46; Los pulsos de una mayor duraci&#243;n fueron especialmente eficaces en malformaciones capilares viol&#225;ceas&#46;</p></span> <span id="abst0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0060">Conclusiones</span><p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Los equipos de IPL ofrecen una gran cantidad de opciones de tratamiento en las MC&#44; sin embargo necesitamos conocer mejor sus efectos para realizar abordajes m&#225;s eficaces y seguros&#46; En este estudio hemos podido observar los efectos histol&#243;gicos de los distintos pulsos sobre las MC tipo MVO&#46;</p></span>"
        "secciones" => array:5 [
          0 => array:2 [
            "identificador" => "abst0030"
            "titulo" => "Antecedentes"
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          1 => array:2 [
            "identificador" => "abst0035"
            "titulo" => "Objetivos"
          ]
          2 => array:2 [
            "identificador" => "abst0040"
            "titulo" => "Material y m&#233;todos"
          ]
          3 => array:2 [
            "identificador" => "abst0045"
            "titulo" => "Resultados"
          ]
          4 => array:2 [
            "identificador" => "abst0050"
            "titulo" => "Conclusiones"
          ]
        ]
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          "en" => "<p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">In patients with a darker phototype&#44; severe epidermal damage with full epidermal necrosis &#40;&#167;&#41; was noted with &#40;1a&#41; high fluences &#40;19&#46;4<span class="elsevierStyleHsp" style=""></span>J&#47;cm<span class="elsevierStyleSup">2</span>&#41; in patient 2 and &#40;1b&#41; lower fluences&#58; 13<span class="elsevierStyleHsp" style=""></span>J&#47;cm<span class="elsevierStyleSup">2</span> in patient 7&#46; In these patients&#44; focal intravascular coagulation was also seen &#40;&#165;&#41;&#46; No dermal damage was observed&#46;</p>"
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      1 => array:7 [
        "identificador" => "fig0010"
        "etiqueta" => "Figure 2"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
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        "descripcion" => array:1 [
          "en" => "<p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">A pink CM &#40;patient 4&#41; was treated using a short pulse duration &#40;2&#46;5<span class="elsevierStyleHsp" style=""></span>ms&#41; and a total energy of 9<span class="elsevierStyleHsp" style=""></span>J&#47;cm<span class="elsevierStyleSup">2</span> per pulse without causing any vascular or dermal&#8211;epidermal damage neither with &#40;2a&#41; one pulse nor after &#40;2b&#41; seven stacking pulses&#46;</p>"
        ]
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      2 => array:7 [
        "identificador" => "fig0015"
        "etiqueta" => "Figure 3"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
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            "imagen" => "gr3.jpeg"
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        "descripcion" => array:1 [
          "en" => "<p id="spar0065" class="elsevierStyleSimplePara elsevierViewall">A purple CM &#40;patient 9&#41; was treated with a fluence of 19&#46;3<span class="elsevierStyleHsp" style=""></span>J&#47;cm<span class="elsevierStyleSup">2</span> and a pulse duration of 2&#46;5<span class="elsevierStyleHsp" style=""></span>ms with delay times of &#40;a&#41; 1&#46;5<span class="elsevierStyleHsp" style=""></span>ms and &#40;3b&#41; 200<span class="elsevierStyleHsp" style=""></span>ms&#46; Intense destruction of the vessel walls &#40;&#8224;&#41; was achieved with both delay times&#46; The shorter delay time &#40;2a&#41; lead to intense epidermal &#40;&#167;&#41; and dermal &#40;&#42;&#41; tissue damage in comparison to the moderate epidermal and dermal damage observed with the longer delay time &#40;b&#41;&#46; &#40;c&#41; Note the permanent gray in the central area &#40;&#42;&#41; following treatment with high fluences &#40;19&#46;3<span class="elsevierStyleHsp" style=""></span>J&#47;cm<span class="elsevierStyleSup">2</span>&#41; and short pulse &#40;2&#46;5<span class="elsevierStyleHsp" style=""></span>ms&#41;&#46; &#40;d&#41; In dermoscopy we observe intense vessel coagulation&#46;</p>"
        ]
      ]
      3 => array:7 [
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          "en" => "<p id="spar0070" class="elsevierStyleSimplePara elsevierViewall">Treatment algorithm with intense pulsed light in capillary malformations type Port wine stain according to the caliber and depth of their vessels&#46;</p>"
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        "identificador" => "tbl0005"
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        "tabla" => array:2 [
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                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " colspan="2" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Technical characteristics</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Wavelength&#47;emission spectrum&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">555&#8211;950<span class="elsevierStyleHsp" style=""></span>nm<br>530&#8211;750<span class="elsevierStyleHsp" style=""></span>nm&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Light characteristics&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Polychromatic&#44; incoherent&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Shape of spot&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Rectangular&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Spot size &#40;cm<span class="elsevierStyleSup">2</span>&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">5&#46;0 &#40;10<span class="elsevierStyleHsp" style=""></span>&#215;<span class="elsevierStyleHsp" style=""></span>48<span class="elsevierStyleHsp" style=""></span>mm&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Cooling&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Cold-air cooling and ultrasound gel&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Pulse duration &#40;ms&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2&#46;5&#8211;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Fluence range &#40;J&#47;cm<span class="elsevierStyleSup">2</span>&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">5&#46;3&#8211;19&#46;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Number of minipulses in one pulse&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#8211;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Number of pulses&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#8211;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Delay &#40;inter-&#47;intrapulses&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a>&#8211;60<span class="elsevierStyleHsp" style=""></span>s&#47;1&#46;5&#8211; 200<span class="elsevierStyleHsp" style=""></span>ms&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
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              ]
              "imagenFichero" => array:1 [
                0 => "xTab1384153.png"
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          "notaPie" => array:1 [
            0 => array:3 [
              "identificador" => "tblfn0005"
              "etiqueta" => "a"
              "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Interpulse delays of 1<span class="elsevierStyleHsp" style=""></span>s correspond to stacking pulses&#46;</p>"
            ]
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0075" class="elsevierStyleSimplePara elsevierViewall">Characteristics of the IPL device and the parameters used&#46;</p>"
        ]
      ]
      5 => array:7 [
        "identificador" => "tbl0010"
        "etiqueta" => "Table 2"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "tabla" => array:2 [
          "leyenda" => "<p id="spar0085" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleSup">&#42;</span>Color of capillary malformation &#40;colorimetric scale&#41;<span class="elsevierStyleSup">28</span>&#58; pink &#40;1&#41;&#59; red-violaceous &#40;2&#41; or purple &#40;3&#41;&#46;</p><p id="spar0090" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleSup">&#42;&#42;</span>Vessel caliber&#58; thin 10&#8211;50<span class="elsevierStyleHsp" style=""></span>&#956;m &#40;1&#41;&#59; medium 50&#8211;200<span class="elsevierStyleHsp" style=""></span>&#956;m &#40;2&#41; or large &#8805;200<span class="elsevierStyleHsp" style=""></span>&#956;m &#40;3&#41;&#46;</p>"
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " colspan="3" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Patients</th><th class="td" title="table-head  " colspan="4" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Capillary malformations</th></tr><tr title="table-row"><th class="td" title="table-head  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Sex&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Age&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Location&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Color&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Vessels caliber&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Phototypes &#40;Fitzpatrick&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Female&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">53&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Shoulder&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">III&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="char" valign="top">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Female&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">45&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Back&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">IV&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="char" valign="top">3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Female&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">80&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Retroauricular&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">III&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="char" valign="top">4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Female&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">29&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Arm&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">II&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="char" valign="top">5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Male&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">27&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Retroauricular&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">IV&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="char" valign="top">6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Male&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">42&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Retroauricular&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">III&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="char" valign="top">7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Female&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">38&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Face&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">IV&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="char" valign="top">8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Female&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">38&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Retroauricular&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">II&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="char" valign="top">9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Male&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">59&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Back&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">III&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="char" valign="top">10&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Female&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">57&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Retroauricular&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">III&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="char" valign="top">11&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Female&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">54&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Back&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">II&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="char" valign="top">12&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Female&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">31&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Back&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">II&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="char" valign="top">13&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Female&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">21&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Retroauricular&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">II&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="char" valign="top">14&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Female&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">39&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Back&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">III&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="char" valign="top">15&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Male&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">38&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Back&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">III&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab1384155.png"
              ]
            ]
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0080" class="elsevierStyleSimplePara elsevierViewall">Characteristics of the patients and capillary malformations treated&#46;</p>"
        ]
      ]
      6 => array:7 [
        "identificador" => "tbl0015"
        "etiqueta" => "Table 3"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "tabla" => array:2 [
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td-with-role" title="table-head ; entry_with_role_rowhead " align="left" valign="top" scope="col">Patients&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " colspan="5" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">IPL Parameters</th><th class="td" title="table-head  " colspan="3" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Histopathological findings</th></tr><tr title="table-row"><th class="td" title="table-head  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Wavelengths &#40;nm&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Pulses<a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">a</span></a> &#40;number&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Fluence &#40;J&#47;cm<span class="elsevierStyleSup">2</span>&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Pulse duration &#40;ms&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Delay time&#58; inter-&#47;intrapulses&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Vessel wall damage&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Epidermal damage&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Dermal damage&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry  " rowspan="5" align="left" valign="top">1</td><td class="td" title="table-entry  " align="char" valign="top">555&#8211;950&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">19&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#8211;&#47;&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="char" valign="top">555&#8211;950&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">19&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">60<span class="elsevierStyleHsp" style=""></span>s&#47;&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="char" valign="top">530&#8211;750&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">8&#46;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#8211;&#47;&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="char" valign="top">530&#8211;750&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">5&#46;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&#46;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#8211;&#47;&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="char" valign="top">555&#8211;950&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">7&#46;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&#46;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#8211;&#47;&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="9" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " rowspan="3" align="left" valign="top">2</td><td class="td" title="table-entry  " align="char" valign="top">555&#8211;950&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1 &#40;3 mp&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">19&#46;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&#46;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#8211;&#47;200<span class="elsevierStyleHsp" style=""></span>ms&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="char" valign="top">555&#8211;950&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1 &#40;3 mp&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">19&#46;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&#46;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#8211;&#47;100<span class="elsevierStyleHsp" style=""></span>ms&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="char" valign="top">555&#8211;950&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1 &#40;3 mp&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">19&#46;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&#46;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#8211;&#47;50<span class="elsevierStyleHsp" style=""></span>ms&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="9" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " rowspan="6" align="left" valign="top">3</td><td class="td" title="table-entry  " align="char" valign="top">555&#8211;950&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">15&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#8211;&#47;&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="char" valign="top">555&#8211;950&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">15&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1<span class="elsevierStyleHsp" style=""></span>s&#47;&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="char" valign="top">555&#8211;950&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">15&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">30<span class="elsevierStyleHsp" style=""></span>s&#47;&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="char" valign="top">555&#8211;950&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">13&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#8211;&#47;&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="char" valign="top">555&#8211;950&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">13&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1<span class="elsevierStyleHsp" style=""></span>s&#47;&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="char" valign="top">555&#8211;950&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">13&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">30<span class="elsevierStyleHsp" style=""></span>s&#47;&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="9" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " rowspan="2" align="left" valign="top">4</td><td class="td" title="table-entry  " align="char" valign="top">530&#8211;750&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1 &#40;3 mp&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&#46;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#8211;&#47;1&#46;5<span class="elsevierStyleHsp" style=""></span>ms&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="char" valign="top">530&#8211;750&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">7 &#40;3 mp&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&#46;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1<span class="elsevierStyleHsp" style=""></span>s&#47;1&#46;5<span class="elsevierStyleHsp" style=""></span>ms&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="9" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">555&#8211;950&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">19&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#8211;&#47;&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">555&#8211;950&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">19&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">60<span class="elsevierStyleHsp" style=""></span>s&#47;&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">555&#8211;950&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">14&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#8211;&#47;&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">555&#8211;950&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">14&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">60<span class="elsevierStyleHsp" style=""></span>s&#47;&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="9" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " rowspan="2" align="left" valign="top">6</td><td class="td" title="table-entry  " align="char" valign="top">555&#8211;950&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1 &#40;4 mp&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">19&#46;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&#46;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#8211;&#47;1&#46;5<span class="elsevierStyleHsp" style=""></span>ms&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="char" valign="top">555&#8211;950&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1 &#40;4 mp&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">19&#46;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&#46;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#8211;&#47;200<span class="elsevierStyleHsp" style=""></span>ms&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="9" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " rowspan="5" align="left" valign="top">7</td><td class="td" title="table-entry  " align="char" valign="top">555&#8211;950&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">19&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#8211;&#47;&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="char" valign="top">555&#8211;950&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">19&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1<span class="elsevierStyleHsp" style=""></span>s&#47;&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="char" valign="top">555&#8211;950&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">19&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">60<span class="elsevierStyleHsp" style=""></span>s&#47;&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="char" valign="top">555&#8211;950&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">13&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#8211;&#47;&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="char" valign="top">555&#8211;950&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">11&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">60<span class="elsevierStyleHsp" style=""></span>s&#47;&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="9" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " rowspan="7" align="left" valign="top">8</td><td class="td" title="table-entry  " align="char" valign="top">530&#8211;750&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">5&#46;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&#46;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#8211;&#47;&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="char" valign="top">555&#8211;950&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">7&#46;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&#46;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#8211;&#47;&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="char" valign="top">555&#8211;950&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1 &#40;3 mp&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">19&#46;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&#46;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#8211;&#47;50<span class="elsevierStyleHsp" style=""></span>ms&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="char" valign="top">555&#8211;950&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1 &#40;3 mp&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">19&#46;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&#46;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#8211;&#47;200<span class="elsevierStyleHsp" style=""></span>ms&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="char" valign="top">555&#8211;950&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">7&#46;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&#46;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1<span class="elsevierStyleHsp" style=""></span>s&#47;&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="char" valign="top">555&#8211;950&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1 &#40;2 mp&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">13&#46;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&#46;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#8211;&#47;5<span class="elsevierStyleHsp" style=""></span>ms&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="char" valign="top">555&#8211;950&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1 &#40;3 mp&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">19&#46;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&#46;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#8211;&#47;5<span class="elsevierStyleHsp" style=""></span>ms&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="9" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " rowspan="2" align="left" valign="top">9</td><td class="td" title="table-entry  " align="char" valign="top">555&#8211;950&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1 &#40;3 mp&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">19&#46;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&#46;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#8211;&#47;1&#46;5<span class="elsevierStyleHsp" style=""></span>ms&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="char" valign="top">555&#8211;950&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1 &#40;3 mp&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">19&#46;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&#46;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#8211;&#47;200<span class="elsevierStyleHsp" style=""></span>ms&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="9" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " rowspan="4" align="left" valign="top">10</td><td class="td" title="table-entry  " align="char" valign="top">555&#8211;950&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">19&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#8211;&#47;&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="char" valign="top">555&#8211;950&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">19&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">60<span class="elsevierStyleHsp" style=""></span>s&#47;&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="char" valign="top">555&#8211;950&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">16&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#8211;&#47;&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="char" valign="top">555&#8211;950&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">16&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">60<span class="elsevierStyleHsp" style=""></span>s&#47;&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="9" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " rowspan="2" align="left" valign="top">11</td><td class="td" title="table-entry  " align="char" valign="top">555&#8211;950&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1 &#40;4 mp&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">19&#46;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&#46;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#8211;&#47;1&#46;5<span class="elsevierStyleHsp" style=""></span>ms&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="char" valign="top">555&#8211;950&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1 &#40;4 mp&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">19&#46;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&#46;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#8211;&#47;200<span class="elsevierStyleHsp" style=""></span>ms&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="9" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " rowspan="3" align="left" valign="top">12</td><td class="td" title="table-entry  " align="char" valign="top">555&#8211;950&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">19&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#8211;&#47;&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="char" valign="top">555&#8211;950&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">19&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1<span class="elsevierStyleHsp" style=""></span>s&#47;&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="char" valign="top">555&#8211;950&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">19&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">60<span class="elsevierStyleHsp" style=""></span>s&#47;&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="9" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " rowspan="3" align="left" valign="top">13</td><td class="td" title="table-entry  " align="char" valign="top">555&#8211;950&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1 &#40;4 mp&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">17&#46;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&#46;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#8211;&#47;5<span class="elsevierStyleHsp" style=""></span>ms&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="char" valign="top">555&#8211;950&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2 &#40;4 mp&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">17&#46;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&#46;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1<span class="elsevierStyleHsp" style=""></span>s&#47;5<span class="elsevierStyleHsp" style=""></span>ms&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="char" valign="top">555&#8211;950&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1 &#40;4 mp&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">17&#46;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&#46;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#8211;&#47;200<span class="elsevierStyleHsp" style=""></span>ms&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="9" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " rowspan="4" align="left" valign="top">14</td><td class="td" title="table-entry  " align="char" valign="top">555&#8211;950&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">14&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#8211;&#47;&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="char" valign="top">555&#8211;950&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">19&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#8211;&#47;&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="char" valign="top">555&#8211;950&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">19&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">60<span class="elsevierStyleHsp" style=""></span>s&#47;&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="char" valign="top">530&#8211;750&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">9&#46;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#8211;&#47;&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="9" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " rowspan="3" align="left" valign="top">15</td><td class="td" title="table-entry  " align="char" valign="top">555&#8211;950&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1 &#40;3 mp&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">19&#46;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&#46;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#8211;&#47;2&#46;5<span class="elsevierStyleHsp" style=""></span>ms&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="char" valign="top">555&#8211;950&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2 &#40;3 mp&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">19&#46;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&#46;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1<span class="elsevierStyleHsp" style=""></span>s&#47;2&#46;5<span class="elsevierStyleHsp" style=""></span>ms&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="char" valign="top">555&#8211;950&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">3 &#40;3 mp&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">19&#46;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&#46;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1<span class="elsevierStyleHsp" style=""></span>s&#47;2&#46;5<span class="elsevierStyleHsp" style=""></span>ms&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
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                0 => "xTab1384154.png"
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            0 => array:3 [
              "identificador" => "tblfn0010"
              "etiqueta" => "a"
              "nota" => "<p class="elsevierStyleNotepara" id="npar0010">1<span class="elsevierStyleHsp" style=""></span>s&#44; Interpulse delays of 1<span class="elsevierStyleHsp" style=""></span>s correspond to stacking pulses&#59; mp&#44; minipulses&#46; The histopathological findings are described using a semiquantitative scale &#40;0&#8211;3&#41;&#44; regarding&#58; vessel wall damage &#40;0&#44; absent&#59; 1&#44; focal intravascular coagulation&#59; 2&#44; moderate destruction of vessel walls&#59; 3&#44; intense destruction of vessel walls&#41;&#44; epidermal damage &#40;0&#44; absent&#59; 1&#44; focal epidermal damage&#59; 2&#44; moderate epidermal damage&#59; 3&#44; full epidermal necrosis&#41; and dermal damage &#40;0&#44; absent&#59; 1&#44; focal dermal damage with perivascular collagen denaturation&#59; 2&#44; moderate dermal damage with a limited coagulation area&#59; 3&#44; intense dermal damage with an extensive coagulation area&#41;&#46;</p>"
            ]
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0095" class="elsevierStyleSimplePara elsevierViewall">IPL parameters used and histopathological findings seen with the NTBC histochemical stained biopsies&#46;</p>"
        ]
      ]
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    "bibliografia" => array:2 [
      "titulo" => "References"
      "seccion" => array:1 [
        0 => array:2 [
          "identificador" => "bibs0005"
          "bibliografiaReferencia" => array:26 [
            0 => array:3 [
              "identificador" => "bib0135"
              "etiqueta" => "1"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Vascular malformations&#58; part I"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "M&#46;C&#46; Garzon"
                            1 => "J&#46;T&#46; Huang"
                            2 => "O&#46; Enjolras"
                            3 => "I&#46;J&#46; Frieden"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.jaad.2006.05.069"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Am Acad Dermatol"
                        "fecha" => "2007"
                        "volumen" => "56"
                        "paginaInicial" => "353"
                        "paginaFinal" => "370"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17317485"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            1 => array:3 [
              "identificador" => "bib0140"
              "etiqueta" => "2"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Clinical testing of a photoacoustic probe for port wine stain depth determination"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "J&#46;A&#46; Viator"
                            1 => "G&#46; Au"
                            2 => "G&#46; Paltauf"
                            3 => "S&#46;L&#46; Jacques"
                            4 => "S&#46;A&#46; Prahl"
                            5 => "H&#46; Ren"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Lasers Surg Med"
                        "fecha" => "2002"
                        "volumen" => "30"
                        "paginaInicial" => "141"
                        "paginaFinal" => "148"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11870794"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            2 => array:3 [
              "identificador" => "bib0145"
              "etiqueta" => "3"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Laser and IPL treatment of port-wine stains&#58; therapy options&#44; limitations&#44; and practical aspects"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "A&#46; Klein"
                            1 => "W&#46; B&#228;umler"
                            2 => "M&#46; Landthaler"
                            3 => "P&#46; Babilas"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1007/s10103-011-0903-4"
                      "Revista" => array:6 [
                        "tituloSerie" => "Lasers Med Sci"
                        "fecha" => "2011"
                        "volumen" => "26"
                        "paginaInicial" => "845"
                        "paginaFinal" => "859"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21390514"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            3 => array:3 [
              "identificador" => "bib0150"
              "etiqueta" => "4"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Treatment of resistant port-wine stains with a pulsed dual wavelength 595 and 1064<span class="elsevierStyleHsp" style=""></span>nm laser&#58; a histochemical evaluation of the vessel wall destruction and selectivity"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "J&#46; Borges da Costa"
                            1 => "P&#46; Boixeda"
                            2 => "C&#46; Moreno"
                            3 => "J&#46; Santiago"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Photomed Laser Surg"
                        "fecha" => "2009"
                        "volumen" => "27"
                        "paginaInicial" => "599"
                        "paginaFinal" => "605"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            4 => array:3 [
              "identificador" => "bib0155"
              "etiqueta" => "5"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Comparison of intense pulse light &#40;IPL&#41; and pulse dye laser &#40;PDL&#41; in port-wine stain treatment"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "M&#46; Drosner"
                            1 => "J&#46; Ellwanger"
                            2 => "K&#46; Sc&#246;ttle"
                            3 => "M&#46; Stockmeier"
                            4 => "F&#46; Gatty"
                            5 => "G&#46; Hellbr&#252;gge"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Med Laser Appl"
                        "fecha" => "2008"
                        "volumen" => "23"
                        "paginaInicial" => "133"
                        "paginaFinal" => "140"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            5 => array:3 [
              "identificador" => "bib0160"
              "etiqueta" => "6"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "M Pulsed dye laser vs&#46; intense pulsed light for port-wine stains&#58; a randomized side-by-side trial with blinded response evaluation"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "A&#46; Faurschou"
                            1 => "K&#46; Togsverd-Bo"
                            2 => "C&#46; Zachariae"
                            3 => "Haedersdal"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1111/j.1365-2133.2008.08993.x"
                      "Revista" => array:6 [
                        "tituloSerie" => "Br J Dermatol"
                        "fecha" => "2009"
                        "volumen" => "160"
                        "paginaInicial" => "359"
                        "paginaFinal" => "364"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19120324"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            6 => array:3 [
              "identificador" => "bib0165"
              "etiqueta" => "7"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Treatment of pulsed dye laser-resistant port wine stain birthmarks"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "Z&#46;F&#46; Jasim"
                            1 => "J&#46;M&#46; Handley"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.jaad.2007.01.019"
                      "Revista" => array:7 [
                        "tituloSerie" => "J Am Acad Dermatol"
                        "fecha" => "2007"
                        "volumen" => "57"
                        "paginaInicial" => "677"
                        "paginaFinal" => "682"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17658196"
                            "web" => "Medline"
                          ]
                        ]
                        "itemHostRev" => array:3 [
                          "pii" => "S0735109710002792"
                          "estado" => "S300"
                          "issn" => "07351097"
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            7 => array:3 [
              "identificador" => "bib0170"
              "etiqueta" => "8"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Advances in treatment of cutaneous and subcutaneous vascular anomalies by pulsed dual wavelength 595- and 1064<span class="elsevierStyleHsp" style=""></span>nm application"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "P&#46; Boixeda"
                            1 => "C&#46;L&#46; P&#233;rez"
                            2 => "S&#46; Vano-Galvan"
                            3 => "P&#46; Ja&#233;n"
                            4 => "W&#46; Lanigan"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Med Laser Appl"
                        "fecha" => "2008"
                        "volumen" => "23"
                        "paginaInicial" => "121"
                        "paginaFinal" => "126"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            8 => array:3 [
              "identificador" => "bib0175"
              "etiqueta" => "9"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Intense pulsed light source for the treatment of dye laser resistant port-wine stains"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "P&#46; Bjerring"
                            1 => "K&#46; Christiansen"
                            2 => "A&#46; Troilius"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "J Cosmet Laser Ther"
                        "fecha" => "2003"
                        "volumen" => "5"
                        "paginaInicial" => "7"
                        "paginaFinal" => "13"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            9 => array:3 [
              "identificador" => "bib0180"
              "etiqueta" => "10"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Selective photothermolysis&#58; precise microsurgery by selective absorption of pulsed radiation"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "R&#46;R&#46; Anderson"
                            1 => "J&#46;A&#46; Parrish"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Science"
                        "fecha" => "1983"
                        "volumen" => "220"
                        "paginaInicial" => "524"
                        "paginaFinal" => "527"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/6836297"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            10 => array:3 [
              "identificador" => "bib0185"
              "etiqueta" => "11"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Split-face comparison of intense pulsed light with short- and long-pulsed dye lasers for the treatment of port-wine stains"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "P&#46; Babilas"
                            1 => "S&#46; Schreml"
                            2 => "T&#46; Eames"
                            3 => "U&#46; Hohenleutner"
                            4 => "R&#46;M&#46; Szeimies"
                            5 => "M&#46; Landthaler"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1002/lsm.20964"
                      "Revista" => array:6 [
                        "tituloSerie" => "Lasers Surg Med"
                        "fecha" => "2010"
                        "volumen" => "42"
                        "paginaInicial" => "720"
                        "paginaFinal" => "727"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20886506"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            11 => array:3 [
              "identificador" => "bib0190"
              "etiqueta" => "12"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Intense pulsed light"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "N&#46;L&#46; Schoenewolf"
                            1 => "M&#46;J&#46; Barysch"
                            2 => "R&#46; Dummer"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1159/000328446"
                      "Revista" => array:6 [
                        "tituloSerie" => "Curr Probl Dermatol"
                        "fecha" => "2011"
                        "volumen" => "42"
                        "paginaInicial" => "166"
                        "paginaFinal" => "172"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21865810"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            12 => array:3 [
              "identificador" => "bib0195"
              "etiqueta" => "13"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Characterization of an optimized light source and comparison to pulsed dye laser for superficial and deep vessel clearance"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "R&#46;A&#46; Weiss"
                            1 => "E&#46;V&#46; Ross"
                            2 => "E&#46;A&#46; Tanghetti"
                            3 => "D&#46;B&#46; Vasily"
                            4 => "J&#46;J&#46; Childs"
                            5 => "M&#46;Z&#46; Smirnov"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1002/lsm.21032"
                      "Revista" => array:6 [
                        "tituloSerie" => "Lasers Surg Med"
                        "fecha" => "2011"
                        "volumen" => "43"
                        "paginaInicial" => "92"
                        "paginaFinal" => "98"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21384389"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            13 => array:3 [
              "identificador" => "bib0200"
              "etiqueta" => "14"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Epidermal damage and limited coagulation depth with the flashlamp-pumped pulsed dye laser&#58; a histochemical study"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "U&#46; Hohenleutner"
                            1 => "M&#46; Hilbert"
                            2 => "U&#46; Wlotzke"
                            3 => "M&#46; Landthaler"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "J Invest Dermatol"
                        "fecha" => "1995"
                        "volumen" => "104"
                        "paginaInicial" => "798"
                        "paginaFinal" => "802"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/7738359"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            14 => array:3 [
              "identificador" => "bib0205"
              "etiqueta" => "15"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Photothermally induced vessel-wall necrosis after pulsed dye laser treatment&#58; lack of response in port-wine stains with small sized or deeply located vessels"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "E&#46;J&#46; Fiskerstrand"
                            1 => "L&#46;O&#46; Svaasand"
                            2 => "G&#46; Kopstad"
                            3 => "K&#46; Ryggen"
                            4 => "S&#46; Aase"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "J Invest Dermatol"
                        "fecha" => "1996"
                        "volumen" => "107"
                        "paginaInicial" => "671"
                        "paginaFinal" => "675"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8875947"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            15 => array:3 [
              "identificador" => "bib0210"
              "etiqueta" => "16"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Comparative histochemistry of port-wine stains after copper vapor laser &#40;578<span class="elsevierStyleHsp" style=""></span>nm&#41; and &#225;rgon laser treatment"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "R&#46; Neumann"
                            1 => "R&#46; Knobler"
                            2 => "H&#46; Leonhartsberger"
                            3 => "W&#46; Gebhart"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "J Invest Dermatol"
                        "fecha" => "1992"
                        "volumen" => "99"
                        "paginaInicial" => "160"
                        "paginaFinal" => "167"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/1629627"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            16 => array:3 [
              "identificador" => "bib0215"
              "etiqueta" => "17"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Selectividad de la fototerm&#243;lisis en el tratamento de las manchas en vino de Oporto mediante m&#250;ltiples pulses de l&#225;ser de colorante pulsado"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "L&#46; Aldanondo"
                            1 => "P&#46; Boixeda"
                            2 => "M&#46; Fernand&#233;z-Lorente"
                            3 => "A&#46; Marquet"
                            4 => "M&#46; Calvo"
                            5 => "P&#46; Jaen"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Actas Dermosifiliogr"
                        "fecha" => "2008"
                        "volumen" => "99"
                        "paginaInicial" => "546"
                        "paginaFinal" => "554"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18682168"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            17 => array:3 [
              "identificador" => "bib0220"
              "etiqueta" => "18"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Recent advances in laser therapy and other technologies"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "P&#46; Boixeda"
                            1 => "M&#46; Calvo"
                            2 => "L&#46; Bagazgoitia"
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                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Actas Dermosifiliogr"
                        "fecha" => "2008"
                        "volumen" => "99"
                        "paginaInicial" => "262"
                        "paginaFinal" => "268"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18394401"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            18 => array:3 [
              "identificador" => "bib0225"
              "etiqueta" => "19"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Does pulse stacking improve the results of treatment with variable-pulse pulsed dye lasers"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "T&#46;E&#46; Rohrer"
                            1 => "V&#46; Chatrath"
                            2 => "V&#46; Iyengar"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Dermatol Surg"
                        "fecha" => "2004"
                        "volumen" => "30"
                        "paginaInicial" => "163"
                        "paginaFinal" => "167"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/14756644"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            19 => array:3 [
              "identificador" => "bib0230"
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              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Intense pulsed light technology &#40;IPL&#41;"
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                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "K&#46; Kunzi-Rapp"
                            1 => "R&#46; Steiner"
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                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "LibroEditado" => array:4 [
                        "titulo" => "Laser and IPL technology in dermatology and aesthetic medicine"
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                        "paginaFinal" => "42"
                        "serieFecha" => "2010"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            20 => array:3 [
              "identificador" => "bib0235"
              "etiqueta" => "21"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Treatment of port-wine stains with a noncoherent pulsed light source&#58; a retrospective study"
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                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "C&#46; Raulin"
                            1 => "C&#46;A&#46; Schroeter"
                            2 => "R&#46;A&#46; Weiss"
                            3 => "M&#46; Keiner"
                            4 => "S&#46; Werner"
                          ]
                        ]
                      ]
                    ]
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Vol. 107. Núm. 3.
Páginas 215-223 (abril 2016)
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Vol. 107. Núm. 3.
Páginas 215-223 (abril 2016)
Original Article
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Histochemical Evaluation of the Vessel Wall Destruction and Selectivity After Treatment with Intense Pulsed Light in Capillary Malformations
Evaluación histoquímica de la destrucción de la pared del vaso y la selectividad después del tratamiento con luz pulsada intensa en las malformaciones capilares
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E. Grilloa,
Autor para correspondencia
, A. Rita Travassosb, P. Boixedaa, A. Cuevasc, B. Péreza, J. Paolia, P. Jaéna
a Department of Dermatology, Hospital Ramón y Cajal, Madrid, Spain
b Clínica Universitária de Dermatologia, Hospital de Santa Maria–Centro Hospital Norte, Lisboa, Portugal
c Department of Pathology, Hospital Ramón y Cajal, Madrid, Spain
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Table 1. Characteristics of the IPL device and the parameters used.
Table 2. Characteristics of the patients and capillary malformations treated.
Table 3. IPL parameters used and histopathological findings seen with the NTBC histochemical stained biopsies.
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Abstract
Background

Among the different approaches for improving the effectiveness in the treatment of Capillary Malformations type Port Wine Stain (CM type PWS) are the intense pulsed light sources. There are few clinical studies prove useful in the treatment of CM. Furthermore, no studies have been published yet demonstrating the histological effects of IPL in CM.

Objectives

To assess the histological effects of pulsed light in capillary malformations type port wine stain. We wanted to compare epidermal, dermal and vessel wall damage after treatment with different combinations of IPL parameters.

Material and methods

Fifty-five post-treatment biopsies were performed in 15 consenting patients with CM and stained with nitroblue-tetrazolium chloride (NBTC). Patients had not been treated previously.

Results

Fifteen patients with CM, with a median age of 39 years-old were enrolled in this study. In this series, the patients with the most severe epidermal damage were those with a darker phototype. Pink CM were especially resistant to treatment, even using high fluences, short pulse durations and stacking pulses. Longer intra- and interpulse delays were effective in purple CM, achieving adequate vessel destruction.

Conclusions

IPL devices provide a vast amount of treatment possibilities and further studies are necessary to optimize therapeutic approaches to CM. In this study we have observed the histological effects of different pulses on the MC type PWS.

Keywords:
Capillary malformations
Fluence
Histochemical
Intense pulsed light (IPL)
Multiple pulses
Nitroblue-tetrazolium chloride (NBTC)
Stacking
Selective photothermolysis
Resumen
Antecedentes

Entre las distintas estrategias para intentar mejorar la eficacia en el tratamiento de las malformaciones capilares tipo mancha en vino de Oporto (MC tipo MVO) están las fuentes de luz pulsada intensa. Existen hasta la fecha pocos estudios clínicos que avalen su utilidad en el tratamiento de las MC. Además, no disponemos de estudios histológicos que objetiven los efectos de la luz pulsada en la coagulación de estos vasos anómalos.

Objetivos

Evaluar los efectos histológicos de la luz pulsada en las MC tipo MVO. Intentamos comparar el daño epidérmico, dérmico y de la pared de los vasos después del tratamiento con distintos parámetros de IPL.

Material y métodos

Fueron realizadas 55 biopsias postratamiento en las MC de 15 pacientes. Las muestras fueron teñidas con cloruro de nitroblue tetrazolium.

Resultados

Quince pacientes (edad media: 39 años) fueron inscritos en este estudio. En esta serie los pacientes con mayor daño epidérmico fueron aquellos con un fototipo más alto (>iv). Las malformaciones de color rosa pálido eran especialmente resistentes al tratamiento, incluso con altas fluencias, duraciones de pulso corto y pulsos repetidos. Los pulsos de una mayor duración fueron especialmente eficaces en malformaciones capilares violáceas.

Conclusiones

Los equipos de IPL ofrecen una gran cantidad de opciones de tratamiento en las MC, sin embargo necesitamos conocer mejor sus efectos para realizar abordajes más eficaces y seguros. En este estudio hemos podido observar los efectos histológicos de los distintos pulsos sobre las MC tipo MVO.

Palabras clave:
Malformaciones capilares
Fluencia
Histoquímica
Luz pulsada intensa (IPL)
Múltiples pulsos
Cloruro de nitroazul-tetrazolio (NBTC)
Pulsos consecutivos
Fototermólisis selectiva
Texto completo
Introduction

Capillary malformations type port wine stain (CM type PWS) constitute congenital anomalies that are believed to represent errors in vascular development during embryogenesis.1–4

Currently, pulsed dye laser (PDL) remains the gold standard treatment for CM.1,4–6 However, 25–50% of treated lesions do not demonstrate significant improvement.7 Other options have been used in resistant lesions, such as alexandrite, neodymium-YAG, dual wavelength lasers8 and, more recently intense pulsed light (IPL) sources.3

IPL systems emit non-coherent broadband light with wavelengths in the 515–1200nm range6 and, theoretically, this spectrum matches the absorption coefficient and thermal relaxation time of a broader range of vessels within CM.9 Similar to laser systems (though less selective than them), this technology seems to respect the principle of selective photothermolysis (SP),3,10 which consists in the preferential absorption of light by oxy/deoxy-hemoglobin and the subsequent conversion into thermal energy, leading to the selective coagulation of blood vessels.11 Specific output wavelengths depend on the cutoff filters used,6 which optimize absorption of the target chromophores, reduce the strong absorption of melanin and prevent adverse effects such as erythema, blistering and crusting.12 Recently, the optimized pulsed light sources (OPL) have been developed, providing a dual-band output spectrum from 500 to 670nm and 870 to 1200nm, which are even more selective to oxy/deoxy-hemoglobin. Theoretically, the use of OPL reduces the risk of epidermal damage, by displacing the interval between 610 and 870nm, characterized by melanin's absorption peak.13

IPL systems allow the individual selection of multiple parameters, such as: wavelength, pulse duration, fluence, multipulse mode and intrapulse time delay.12 On the other hand, we can also use only one pulse or multiple pulses, with different delays, creating a multiplicity of possible combinations.

Although IPL sources have been increasingly used in the treatment of CM, there are very few clinical studies regarding their effectiveness.5,11 Furthermore, we have not found any published histochemical studies describing the histological effects of IPL treatment of CM. We aim to describe the vascular, epidermal and dermal tissue damage in CM treated with IPL with variations in multiple parameters using nitroblue-tetrazolium chloride (NBTC) histochemical staining of biopsies taken from the CM immediately after treatment.4,14–17

Material and methods

Fifteen adult patients with CM were enrolled in this study. Four men and eleven women were treated with the Ellipse Flex (Ellipse®, Denmark) IPL device that can provide two different spectrums of polychromatic light, according to the different cut-off filters used: between 555 and 950nm (VL-2®) and 530 and 750nm (PR®). For epidermal protection, a cold-air cooling system (Cryos5™, Zimmer Medizinsysteme GMbH, Neu-Ulm, Germany) and an ultrasound gel were used. Different wavelengths, fluences, pulse durations, inter- and intradelay times with stacking pulses18,19 and multiple passes were used to treat an average of four CM test areas per patient (range 2–7). The hospital's ethics committee approved the study. Fully informed written consent was obtained from all patients before the first treatment. A technical description of the IPL device and the parameters used in the study are shown in Table 1.

Table 1.

Characteristics of the IPL device and the parameters used.

Technical characteristics
Wavelength/emission spectrum  555–950nm
530–750nm 
Light characteristics  Polychromatic, incoherent 
Shape of spot  Rectangular 
Spot size (cm25.0 (10×48mm) 
Cooling  Cold-air cooling and ultrasound gel 
Pulse duration (ms)  2.5–8 
Fluence range (J/cm25.3–19.4 
Number of minipulses in one pulse  1–4 
Number of pulses  1–7 
Delay (inter-/intrapulses)  1a–60s/1.5– 200ms 
a

Interpulse delays of 1s correspond to stacking pulses.

Post-treatment biopsies of each of the 55 test areas were performed, 10min after a single IPL treatment using a 3-mm punch. We chose slightly sun-exposed skin areas in order to minimize epidermal damage and hair-free areas to avoid melanin light absorption, since melanin behaves as a competitive chromophore to oxyhemoglobin.9,20 Biopsies were frozen in liquid nitrogen and the tissue sections were stained with NBTC, as described in previous studies.4,14,16 This enzyme is a redox indicator that is reduced by NADPH-diaphorase. This enzymatic activity stops immediately after cell death and is present in endothelial cells, fibroblasts and smooth muscle fibers but not in the dermal connective matrix. Therefore, only the viable tissue stains blue, allowing an easy differentiation from thermally damaged tissue.

Three parameters were evaluated: vessel wall destruction, epidermal and dermal damage, using a semiquantitative score: 0, absent; 1, minimal; 2, moderate; and 3, extensive tissue damage. Two dermatologists and one dermatopathologist evaluated all slides blindly. We always chose the majority agreement among the three observers, and in case of total disagreement, we suited the particular case to achieve a consensus agreement.

Results

The median age of the 15 patients was 39 years-old (21–80 years) and most biopsies were taken from the retroauricular area (47%) and back (33%). The areas within the treated CM were all flat, their color varied from pink to purple and the vessels had varying diameters (Table 2). The histochemical findings are illustrated in Table 3, showing how variations in each IPL parameter can modify the capacity of vessel wall destruction and production of epidermal and dermal collateral damage.

Table 2.

Characteristics of the patients and capillary malformations treated.

PatientsCapillary malformations
  Sex  Age  Location  Color  Vessels caliber  Phototypes (Fitzpatrick) 
Female  53  Shoulder  III 
Female  45  Back  IV 
Female  80  Retroauricular  III 
Female  29  Arm  II 
Male  27  Retroauricular  IV 
Male  42  Retroauricular  III 
Female  38  Face  IV 
Female  38  Retroauricular  II 
Male  59  Back  III 
10  Female  57  Retroauricular  III 
11  Female  54  Back  II 
12  Female  31  Back  II 
13  Female  21  Retroauricular  II 
14  Female  39  Back  III 
15  Male  38  Back  III 

*Color of capillary malformation (colorimetric scale)28: pink (1); red-violaceous (2) or purple (3).

**Vessel caliber: thin 10–50μm (1); medium 50–200μm (2) or large ≥200μm (3).

Table 3.

IPL parameters used and histopathological findings seen with the NTBC histochemical stained biopsies.

Patients  IPL ParametersHistopathological findings
  Wavelengths (nm)  Pulsesa (number)  Fluence (J/cm2Pulse duration (ms)  Delay time: inter-/intrapulses  Vessel wall damage  Epidermal damage  Dermal damage 
1555–950  19  –/– 
555–950  19  60s/– 
530–750  8.9  –/– 
530–750  5.3  2.5  –/– 
555–950  7.9  2.5  –/– 
2555–950  1 (3 mp)  19.4  2.5  –/200ms 
555–950  1 (3 mp)  19.4  2.5  –/100ms 
555–950  1 (3 mp)  19.4  2.5  –/50ms 
3555–950  15  –/– 
555–950  15  1s/– 
555–950  15  30s/– 
555–950  13  –/– 
555–950  13  1s/– 
555–950  13  30s/– 
4530–750  1 (3 mp)  2.5  –/1.5ms 
530–750  7 (3 mp)  2.5  1s/1.5ms 
555–950  19  –/– 
  555–950  19  60s/– 
  555–950  14  –/– 
  555–950  14  60s/– 
6555–950  1 (4 mp)  19.3  2.5  –/1.5ms 
555–950  1 (4 mp)  19.3  2.5  –/200ms 
7555–950  19  –/– 
555–950  19  1s/– 
555–950  19  60s/– 
555–950  13  –/– 
555–950  11  60s/– 
8530–750  5.3  2.5  –/– 
555–950  7.9  2.5  –/– 
555–950  1 (3 mp)  19.4  2.5  –/50ms 
555–950  1 (3 mp)  19.4  2.5  –/200ms 
555–950  7.9  2.5  1s/– 
555–950  1 (2 mp)  13.4  2.5  –/5ms 
555–950  1 (3 mp)  19.4  2.5  –/5ms 
9555–950  1 (3 mp)  19.3  2.5  –/1.5ms 
555–950  1 (3 mp)  19.3  2.5  –/200ms 
10555–950  19  –/– 
555–950  19  60s/– 
555–950  16  –/– 
555–950  16  60s/– 
11555–950  1 (4 mp)  19.3  2.5  –/1.5ms 
555–950  1 (4 mp)  19.3  2.5  –/200ms 
12555–950  19  –/– 
555–950  19  1s/– 
555–950  19  60s/– 
13555–950  1 (4 mp)  17.5  2.5  –/5ms 
555–950  2 (4 mp)  17.5  2.5  1s/5ms 
555–950  1 (4 mp)  17.5  2.5  –/200ms 
14555–950  14  –/– 
555–950  19  –/– 
555–950  19  60s/– 
530–750  9.9  –/– 
15555–950  1 (3 mp)  19.2  2.5  –/2.5ms 
555–950  2 (3 mp)  19.2  2.5  1s/2.5ms 
555–950  3 (3 mp)  19.2  2.5  1s/2.5ms 
a

1s, Interpulse delays of 1s correspond to stacking pulses; mp, minipulses. The histopathological findings are described using a semiquantitative scale (0–3), regarding: vessel wall damage (0, absent; 1, focal intravascular coagulation; 2, moderate destruction of vessel walls; 3, intense destruction of vessel walls), epidermal damage (0, absent; 1, focal epidermal damage; 2, moderate epidermal damage; 3, full epidermal necrosis) and dermal damage (0, absent; 1, focal dermal damage with perivascular collagen denaturation; 2, moderate dermal damage with a limited coagulation area; 3, intense dermal damage with an extensive coagulation area).

In this series, the patients with the most severe epidermal damage were those with a darker phototype (patients 2, 5 and 7). In both cases, in spite of intense epidermal cooling, severe epidermal damage was noted with high fluences (around 19J/cm2), but also with lower fluences (11 and 13J/cm2) and a long pulse duration (8ms) in case 7. Indeed, a significant proportion of the applied energy was absorbed by melanin in the basal layer of the epidermis, and the amount of energy that reached the dermis was insufficient to achieve enough heat to cause vessel wall destruction (Fig. 1).

Figure 1.

In patients with a darker phototype, severe epidermal damage with full epidermal necrosis (§) was noted with (1a) high fluences (19.4J/cm2) in patient 2 and (1b) lower fluences: 13J/cm2 in patient 7. In these patients, focal intravascular coagulation was also seen (¥). No dermal damage was observed.

(0.36MB).

Patients with pink lesions were difficult to treat, as expected. In case 15, stacking a multipulse train of short pulses with high fluences obtained more vessel wall damage but with intense epidermal (but not dermal) damage. In case 4, using the shorter pulse duration (2.5ms) and a total energy of 9J/cm2 per pulse, even with seven stacking pulses, we could not obtain the necessary heating to cause any vascular or tissular alteration (Fig. 2). However, in case 12 both multiple and stacking pulses obtained more intense vessel wall damage than using only one pulse, without significant collateral damage.

Figure 2.

A pink CM (patient 4) was treated using a short pulse duration (2.5ms) and a total energy of 9J/cm2 per pulse without causing any vascular or dermal–epidermal damage neither with (2a) one pulse nor after (2b) seven stacking pulses.

(0.3MB).

On the other hand, in a purple CM lesion treated with a fluence of 15J/cm2 and a pulse duration of 8ms, we found complete vessel wall destruction with less dermo-epidermal damage using multiple passes (interdelay time: 30s) instead of stacking pulses (case 3).

In some patients, using multiple pulses instead of a single pulse, improved treatment efficacy in CM with thin vessels. This happened in case 12 (fluence of 19J/cm2 and pulse duration of 8ms) and case 15 (fluence of 19.2J/cm2 and pulse duration of 2.5ms), where two pulses achieved a selective destruction of the vessel wall. In case 15, when we used 3 pulses (with the same referred parameters), the same level of vessel walls destruction was obtained (as with two pulses), but with more dermo-epidermal damage.

Intrapulse delay adjustments may also become extremely important to achieve complete destruction of vessel walls, with less collateral damage. Decreasing the intrapulse delay time, we obtained more efficient vessel walls destruction, without substantial increase of the dermo-epidermal damage (cases 8 and 13). Both patients had CM with medium caliber vessels. They were treated with high fluences (19.4J/cm2 in case 8 and 17.5J/cm2 in case 13) and intrapulse delay times were reduced from 50 to 5ms (case 8) and from 200 to 5ms (case 13). In case 8, however, an even more selective result was acquired, maintaining the referred parameters (including the 5ms intrapulse delay) and decreasing the total fluence (from 19.4 to 13.4J/cm2), without any dermo-epidermal damage.

In some purple CM containing vessels with a medium to large vessel caliber, increased intrapulse delay times led to complete destruction of vessel walls, with less collateral damage. In cases 9 and 11, for example, increasing intrapulse delay times from 1.5 to 200ms resulted in complete vessel wall destruction with slightly less epidermal and dermal tissue damage (Fig. 3).

Figure 3.

A purple CM (patient 9) was treated with a fluence of 19.3J/cm2 and a pulse duration of 2.5ms with delay times of (a) 1.5ms and (3b) 200ms. Intense destruction of the vessel walls (†) was achieved with both delay times. The shorter delay time (2a) lead to intense epidermal (§) and dermal (*) tissue damage in comparison to the moderate epidermal and dermal damage observed with the longer delay time (b). (c) Note the permanent gray in the central area (*) following treatment with high fluences (19.3J/cm2) and short pulse (2.5ms). (d) In dermoscopy we observe intense vessel coagulation.

(0.32MB).

In patients 1, 4, 8 and 14, who were treated with the PR® handpiece (530–750nm), the settings used seemed insufficient to destroy the vessel walls effectively, even when using a shorter pulse duration (2.5ms) with the highest fluences allowed by the device. As mentioned above, no vascular damage was observed in patient 4, even when stacking pulses.

Discussion

Although PDL is still the first choice for the treatment of CM, second generation IPL devices have improved their selectivity and have been increasingly used.5,9,21 Currently reported clearing rates range between 6% and more than 90%,21–24 which may be due to the IPL devices’ wide wavelength spectrum (a second absorbance peak of oxyhemoglobin at 555nm and a third around 900nm).5 IPL is a less studied technique, in which multiple parameters (fluence, wavelength spectrum, pulse duration, intra- and interpulse delay times) may be adjusted, conditioning an endless amount of therapeutic options.

In the present study we have been able to show the histochemical SP of IPL, even with multipulse treatments, according to the Verkruysse model25 first demonstrated with PDL treatments. Using multipulses of IPL, higher energy thresholds are reached in the vessel walls with less collateral damage.17,18,25

Single and multiple pulses

Multiples pulses produce an accumulative increase in temperature in blood vessels, leading to thermal coagulation.18 In order to maintain SP the caliber and density of the vessel walls must be taken into account.

Interpulse delay times (multiple passes and stacking pulses)

Multiple passes with large interpulse delays (30–60s) seem to heat the vessel walls slowly, being less aggressive than stacking pulses. This may be an advantage for patients who did not respond to a single-pulsed treatment. This treatment modality is especially useful in CM in the presence of clusters of vessels with a larger caliber, which have a longer thermal relaxation time (TRT), because it allows cooling between pulses.17 In these cases, stacking pulses may lead to overheating and consequent collateral dermal damage.

On the other hand, in patients with CM with sparse and thin vessels, short interpulse delay times or stacking pulses could be safer in fair-skinned patients and allow the necessary temperature increase to achieve thermal coagulation and consequent vessel wall destruction, without collateral damage.

Intrapulse delay times

Managing intrapulse delays is also extremely important, taking into account the color of the CM, which depends on the vessel density and caliber.15 Again, long intrapulse delays are safer in the presence of high vessel density and larger caliber. Short intrapulse delays are appropriate to treat CM lesions with low vessels¿ density and small diameter and therefore with less chromophore to absorb light energy.17

Darker phototypes and epidermal damage

The risk of epidermal injury is especially seen in patients with darker phototypes, due to considerable melanin absorption of IPL light, mainly in the basal layer.5 Besides epidermal damage, these patients also showed a poor response to treatment, with insufficient vessel heating and thermal coagulation because most of the energy was retained in the epidermis. Intense epidermal cooling is extremely important in these patients to allow light energy penetration in the dermis.26

The therapeutic approach to the CM depends on the caliber, capillary density and depth of the vessels as well as the patient's skin type (Fig. 4).

Figure 4.

Treatment algorithm with intense pulsed light in capillary malformations type Port wine stain according to the caliber and depth of their vessels.

(0.47MB).

This study has many limitations, such as the heterogeneity of the selected patients (regarding the skin phototype of the patients or the color and location of the CM) and, above all, the amount of different IPL setting combinations used. However, our aim was only to start to understand the potential improvements we could achieve with the IPL device by individualizing the selection of parameters through these first histochemical observations. These observations may allow for a future comparative and controlled study in which a single or only a small number of parameters are changed when treating comparable lesions/patients in regards to the color and location of the CM and the patient's skin phototype.

In IPL treatment of CM, the goal is to take full advantage of the energy of the emitted light to selectively damage only the vessels without collateral damage. The final outcomes are conditioned by many factors. With regard to the patient, physicians should consider: the vessel size, density and depth; the quantity of red blood cells inside the vessels (i.e., the target chromophore); and the epidermal pigmentation of the patient.9,18 Regarding the IPL device and the operator, factors that influence our results are: the wavelength spectrum of the IPL device, the light energy, the pulse duration, the possibility of using single or multiple pulses with variable inter- and intrapulse delay times and choosing adequate cooling strategies.18

Conclusions

In this study we explored the potential of an IPL device in treating CM and the huge number of possible treatment parameter combinations that can be used. IPL intra- and interpulse delay changes produce very different final results. Our findings suggest that patients with thin vessels should be treated in a more aggressive way. Perhaps with the recent introduction of next-generation intensed pulsed lights with shorter pulses can improve the treatment of this group of lesions. On the other hand, physicians treating CM in patients with darker phototypes should choose an adequate cooling strategy to avoid epidermal damage.

Ethical responsibilitiesProtection of people and animals

The authors declare that this research has not been conducted experiments on humans or animals.

Confidentiality of data

The authors declare that they have followed the protocols of the workplace on the publication of patient data.

Right to privacy and informed consent

The authors have obtained the informed consent of patients and/or subjects referred to in Article consent. This document is in the possession of the corresponding author.

Conflict of interests

The authors declare no conflict of interest.

References
[1]
M.C. Garzon, J.T. Huang, O. Enjolras, I.J. Frieden.
Vascular malformations: part I.
J Am Acad Dermatol, 56 (2007), pp. 353-370
[2]
J.A. Viator, G. Au, G. Paltauf, S.L. Jacques, S.A. Prahl, H. Ren, et al.
Clinical testing of a photoacoustic probe for port wine stain depth determination.
Lasers Surg Med, 30 (2002), pp. 141-148
[3]
A. Klein, W. Bäumler, M. Landthaler, P. Babilas.
Laser and IPL treatment of port-wine stains: therapy options, limitations, and practical aspects.
Lasers Med Sci, 26 (2011), pp. 845-859
[4]
J. Borges da Costa, P. Boixeda, C. Moreno, J. Santiago.
Treatment of resistant port-wine stains with a pulsed dual wavelength 595 and 1064nm laser: a histochemical evaluation of the vessel wall destruction and selectivity.
Photomed Laser Surg, 27 (2009), pp. 599-605
[5]
M. Drosner, J. Ellwanger, K. Scöttle, M. Stockmeier, F. Gatty, G. Hellbrügge, et al.
Comparison of intense pulse light (IPL) and pulse dye laser (PDL) in port-wine stain treatment.
Med Laser Appl, 23 (2008), pp. 133-140
[6]
A. Faurschou, K. Togsverd-Bo, C. Zachariae, Haedersdal.
M Pulsed dye laser vs. intense pulsed light for port-wine stains: a randomized side-by-side trial with blinded response evaluation.
Br J Dermatol, 160 (2009), pp. 359-364
[7]
Z.F. Jasim, J.M. Handley.
Treatment of pulsed dye laser-resistant port wine stain birthmarks.
J Am Acad Dermatol, 57 (2007), pp. 677-682
[8]
P. Boixeda, C.L. Pérez, S. Vano-Galvan, P. Jaén, W. Lanigan.
Advances in treatment of cutaneous and subcutaneous vascular anomalies by pulsed dual wavelength 595- and 1064nm application.
Med Laser Appl, 23 (2008), pp. 121-126
[9]
P. Bjerring, K. Christiansen, A. Troilius.
Intense pulsed light source for the treatment of dye laser resistant port-wine stains.
J Cosmet Laser Ther, 5 (2003), pp. 7-13
[10]
R.R. Anderson, J.A. Parrish.
Selective photothermolysis: precise microsurgery by selective absorption of pulsed radiation.
Science, 220 (1983), pp. 524-527
[11]
P. Babilas, S. Schreml, T. Eames, U. Hohenleutner, R.M. Szeimies, M. Landthaler.
Split-face comparison of intense pulsed light with short- and long-pulsed dye lasers for the treatment of port-wine stains.
Lasers Surg Med, 42 (2010), pp. 720-727
[12]
N.L. Schoenewolf, M.J. Barysch, R. Dummer.
Intense pulsed light.
Curr Probl Dermatol, 42 (2011), pp. 166-172
[13]
R.A. Weiss, E.V. Ross, E.A. Tanghetti, D.B. Vasily, J.J. Childs, M.Z. Smirnov, et al.
Characterization of an optimized light source and comparison to pulsed dye laser for superficial and deep vessel clearance.
Lasers Surg Med, 43 (2011), pp. 92-98
[14]
U. Hohenleutner, M. Hilbert, U. Wlotzke, M. Landthaler.
Epidermal damage and limited coagulation depth with the flashlamp-pumped pulsed dye laser: a histochemical study.
J Invest Dermatol, 104 (1995), pp. 798-802
[15]
E.J. Fiskerstrand, L.O. Svaasand, G. Kopstad, K. Ryggen, S. Aase.
Photothermally induced vessel-wall necrosis after pulsed dye laser treatment: lack of response in port-wine stains with small sized or deeply located vessels.
J Invest Dermatol, 107 (1996), pp. 671-675
[16]
R. Neumann, R. Knobler, H. Leonhartsberger, W. Gebhart.
Comparative histochemistry of port-wine stains after copper vapor laser (578nm) and árgon laser treatment.
J Invest Dermatol, 99 (1992), pp. 160-167
[17]
L. Aldanondo, P. Boixeda, M. Fernandéz-Lorente, A. Marquet, M. Calvo, P. Jaen.
Selectividad de la fototermólisis en el tratamento de las manchas en vino de Oporto mediante múltiples pulses de láser de colorante pulsado.
Actas Dermosifiliogr, 99 (2008), pp. 546-554
[18]
P. Boixeda, M. Calvo, L. Bagazgoitia.
Recent advances in laser therapy and other technologies.
Actas Dermosifiliogr, 99 (2008), pp. 262-268
[19]
T.E. Rohrer, V. Chatrath, V. Iyengar.
Does pulse stacking improve the results of treatment with variable-pulse pulsed dye lasers.
Dermatol Surg, 30 (2004), pp. 163-167
[20]
K. Kunzi-Rapp, R. Steiner.
Intense pulsed light technology (IPL).
Laser and IPL technology in dermatology and aesthetic medicine, pp. 37-42
[21]
C. Raulin, C.A. Schroeter, R.A. Weiss, M. Keiner, S. Werner.
Treatment of port-wine stains with a noncoherent pulsed light source: a retrospective study.
Arch Dermatol, 135 (1999), pp. 679-683
[22]
W.S. Ho, S.Y. Ying, P.C. Chan, H.H. Chan.
Treatment of port wine stains with intense pulsed light: a prospective study.
Dermatol Surg, 30 (2004), pp. 887-890
[23]
N. Reynolds, J. Exley, S. Hills, S. Falder, C. Duff, J. Kenealy.
The role of the Lumina intense pulsed light system in the treatment of port wine stains – a case controlled study.
Br J Plast Surg, 58 (2005), pp. 968-980
[24]
H. Stremple, W. Klein.
Laser therapy without laser: a controlled trial comparing the flashlamp-pumped dye laser with the photoderm high-energy gas discharge lamp.
Lasers Med Sci, 11 (1996), pp. 185-187
[25]
W. Verkruysse, M.J. van Gemert, D.J. Smithies, J.S. Nelson.
Modelling multiple laser pulses for port-wine stains treatment.
Phys Med Biol, 45 (2000), pp. 197-203
[26]
P. Boixeda, F. Feltes, J.L. Santiago, J. Paoli.
Future prospects in dermatologic applications of lasers, nanotechnology, and other new technologies.
Actas Dermosifiliogr, 106 (2015), pp. 168-179
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