62 new papers in the November 2009 LLLT literature watch

62 LLLT abstracts for you this month and of course we have to start with the Lancet paper on laser for neck pain. You can see a TV interview with the primary author Roberta Chow on the front page of our web site and an audio interview I did back in September is here. ┬áThere are as usual more papers showing how important dose and dose-rate-effects are. If you are unsure what W/cm2 are and how many you need then then it’s time you came on our “3 x 3 knowledge matrix” training course. There are trials on myofascial pain,lymphedema, plantar fasciitis, oral mucositis, psoriasis and more. read on

Efficacy of low-level laser therapy in the management of neck pain: a systematic review and meta-analysis of randomised placebo or active-treatment controlled trials.

Chow RT, Johnson MI, Lopes-Martins RA, Bjordal JM

Nerve Research Foundation, Brain and Mind Research Institute, University of Sydney, Sydney, NSW, Australia.

BACKGROUND: Neck pain is a common and costly condition for which pharmacological management has limited evidence of efficacy and side-effects. Low-level laser therapy (LLLT) is a relatively uncommon, non-invasive treatment for neck pain, in which non-thermal laser irradiation is applied to sites of pain. We did a systematic review and meta-analysis of randomised controlled trials to assess the efficacy of LLLT in neck pain. METHODS: We searched computerised databases comparing efficacy of LLLT using any wavelength with placebo or with active control in acute or chronic neck pain. Effect size for the primary outcome, pain intensity, was defined as a pooled estimate of mean difference in change in mm on 100 mm visual analogue scale. FINDINGS: We identified 16 randomised controlled trials including a total of 820 patients. In acute neck pain, results of two trials showed a relative risk (RR) of 1.69 (95% CI 1.22-2.33) for pain improvement of LLLT versus placebo. Five trials of chronic neck pain reporting categorical data showed an RR for pain improvement of 4.05 (2.74-5.98) of LLLT. Patients in 11 trials reporting changes in visual analogue scale had pain intensity reduced by 19.86 mm (10.04-29.68). Seven trials provided follow-up data for 1-22 weeks after completion of treatment, with short-term pain relief persisting in the medium term with a reduction of 22.07 mm (17.42-26.72). Side-effects from LLLT were mild and not different from those of placebo. INTERPRETATION: We show that LLLT reduces pain immediately after treatment in acute neck pain and up to 22 weeks after completion of treatment in patients with chronic neck pain. FUNDING: None.

Lancet 2009 Nov 12

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=19913903

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Evaluation of low intensity laser therapy in myofascial pain syndrome.

Carrasco TG, Guerisoli LD, Guerisoli DM, Mazzetto MO

Faculty of Dentistry of Ribeirao Preto, University of Sao Paulo, Brazil.

Limited studies have demonstrated that low intensity laser therapy (LILT) may have a therapeutic effect on the treatment of myofascial pain syndrome (MPS). Sixty (60) patients with MPS and having one active trigger point in the anterior masseter and anterior temporal muscles were selected and assigned randomly to six groups (n=10): Groups I to Ill were treated with GaAIAS (780 nm) laser, applied in continuous mode and in a meticulous way, twice a week, for four weeks. Energy was set to 25 J/cm2, 60 J/cm2 and 105 J/cm2, respectively. Groups IV to VI were treated with placebo applications, simulating the same parameters as the treated groups. Pain scores were assessed just before, then immediately after the fourth application, immediately after the eighth application, at 15 days and one month following treatment. A significant pain reduction was observed over time (p<0.001). The analgesic effect of the LILT was similar to the placebo groups. Using the parameters described in this experiment, LILT was effective in reducing pain experienced by patients with myofascial pain syndrome. Thus, it was not possible to establish a treatment protocol. Analyzing the analgesic effect of LILT suggests it as a possible treatment of MPS and may help to establish a clinical protocol for this therapeutic modality.

Cranio 2009 Oct 27(4) 243-7

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=19891258

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Managing postmastectomy lymphedema with low-level laser therapy.

Lau RW, Cheing GL

Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong SAR, China.

OBJECTIVE: We aimed to investigate the effects of low-level laser therapy (LLLT) in managing postmastectomy lymphedema. BACKGROUND DATA: Postmastectomy lymphedema (PML) is a common complication of breast cancer treatment that causes various symptoms, functional impairment, or even psychosocial morbidity. A prospective, single-blinded, controlled clinical trial was conducted to examine the effectiveness of LLLT on managing PML. METHODS: Twenty-one women suffering from unilateral PML were randomly allocated to receive either 12 sessions of LLLT in 4 wk (the laser group) or no laser irradiation (the control group). Volumetry and tonometry were used to monitor arm volume and tissue resistance; the Disabilities of Arm, Shoulder, and Hand (DASH) questionnaire was used for measuring subjective symptoms. Outcome measures were assessed before and after the treatment period and at the 4 wk follow-up. RESULTS: Reduction in arm volume and increase in tissue softening was found in the laser group only. At the follow-up session, significant between-group differences (all p < 0.05) were found in arm volume and tissue resistance at the anterior torso and forearm region. The laser group had a 16% reduction in the arm volume at the end of the treatment period, that dropped to 28% in the follow-up. Moreover, the laser group demonstrated a cumulative increase from 15% to 33% in the tonometry readings over the forearm and anterior torso. The DASH score of the laser group showed progressive improvement over time. CONCLUSION: LLLT was effective in the management of PML, and the effects were maintained to the 4 wk follow-up.

Photomed Laser Surg 2009 Oct 27(5) 763-9

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=19878027

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Ultrasonographic evaluation of plantar fasciitis after low-level laser therapy: results of a double-blind, randomized, placebo-controlled trial.

Kiritsi O, Tsitas K, Malliaropoulos N, Mikroulis G

Prognosis, Diagnostic Center, Larnaca, Zaka 56, 56727, Thessaloniki, Greece, kirolga@hotmail.com.

The aim of this study was to investigate the effect of low-level laser therapy (LLLT) on plantar fasciitis documented by the ultrasonographic appearance of the aponeurosis and by patients’ pain scores. Thirty individuals with diagnosis of unilateral plantar fasciitis were enrolled in a randomized, double-blind, placebo-controlled trial, but 25 participants completed the therapeutic protocol. The contralateral asymptomatic fascia was used as control. After enrolment, symptomatic individuals were randomly assigned to receive LLLT, or identical placebo, for 6 weeks. Ultrasonography was performed at baseline and after completion of therapy. The subjective subcalcaneal pain was recorded at baseline and after treatment on a visual analogue scale (VAS). After LLLT, plantar fascia thickness in both groups showed significant change over the experimental period and there was a difference (before treatment and after treatment) in plantar fascia thickness between the two groups. However, plantar fascia thickness was insignificant (mean 3.627 +/- 0.977 mm) when compared with that in the placebo group (mean 4.380 +/- 1.0042 mm). Pain estimation on the visual analogue scale had improved significantly in all test situations (after night rest, daily activities) after LLLT when compared with that of the placebo group. (P = 0.006 and P = 0.01, respectively). Additionally, when the difference in pain scores was compared between the two groups, the change was statistically significant (after night rest P = 0.000; daily activities P = 0.001). In summary, while ultrasound imaging is able to depict the morphologic changes related to plantar fasciitis, 904 nm gallium-arsenide (GaAs) infrared laser may contribute to healing and pain reduction in plantar fasciitis.

Lasers Med Sci 2009 Oct 20

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=19841862

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Salivary Levels of TNF-alpha and IL-6 in Patients with Denture Stomatitis Before and After Laser Phototherapy.

Simunovic-Soskic M, Pezelj-Ribaric S, Brumini G, Glazar I, Grzic R, Miletic I

1 Department of Prosthodontics, School of Dentistry, Medical Faculty, University of Rijeka , Croatia .

Abstract Objective: The aim of this study was to monitor therapeutic response by determining the level of proinflammatory cytokines TNF-alpha and IL-6 in whole unstimulated saliva in patients with denture stomatitis (DS), before and after laser phototherapy (LPT). Background: DS is an inflammatory condition that occurs in subjects who wear dentures, and it is a common oral mucosal lesion. A potential noninvasive treatment for DS patients is LPT. Materials and Methods: A sample consisting of 40 consecutive subjects was selected on a voluntary basis from patients who presented for the diagnosis and treatment of DS at the Oral Medicine Unit of the Medical Faculty at the University of Rijeka. A clinical examination was performed according to the standard clinical criteria. Lesions described as palatal inflammation were diagnosed as Newton type II denture stomatitis. The patients were randomly assigned to either an experimental group (20 patients receiving real LPT) or a control group (20 patients receiving inactive/placebo laser treatment). In order to determine the salivary levels of TNF-alpha and IL-6, ELISA (Sigma Immunochemicals, St Louis, MO) was performed. Results: Following treatment with LPT for 4 wk, the levels of TNF-alpha and IL-6 decreased significantly (p < 0.001) and were significantly different from controls (p < 0.001). Conclusion: The results of this study suggest that LPT may be an efficacious choice of therapy.

Photomed Laser Surg 2009 Oct 1

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=19795993

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Use of therapeutic laser for prevention and treatment of oral mucositis.

Khouri VY, Stracieri AB, Rodrigues MC, Moraes DA, Pieroni F, Simoes BP, Voltarelli JC

University Hospital, University of Sao Paulo, Ribeirao Preto, SP, Brazil. vivikhouri@usp.br

Oral mucositis (OM) affects patients who are submitted to hematopoietic stem cell transplantation (HSCT) due to high doses of chemotherapy and/or radiotherapy. The purpose of this investigation was to perform a comparative study of the frequency and evolution of OM among patients subjected to therapeutic laser and to the conventional therapy (use of mouthwash called ‘Mucositis Formula’). The patients were subjected to a myeloablative conditioning regimen before the allogeneic HSCT. Twenty-two patients were selected and divided into 2 groups: group I was irradiated with InGaAlP laser (660 nm) and GaAlAs laser (780 nm), 25 mW potency, 6.3J/cm(2) dose, in 10-s irradiation time, followed to conventional treatment; group II was subjected only to the conventional treatment. Both World Health Organization (WHO) scale and the Oral Mucositis Assessment Scale (OMAS) were used to evaluate the results. Data were analyzed by the non-parametric Wilcoxon test, with p<0.05 considered as statistically significant. Group I presented a lower frequency of OM (p=0.02) and lower mean scores, according to WHO and OMAS scales (p<0.01 and p=0.01, respectively). In conclusion, laser reduced the frequency and severity of OM, suggesting that therapeutic laser can be used both as a new form of prevention and treatment of OM.

Braz Dent J 2009 20(3) 215-20

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=19784467

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Combination 830-nm and 633-nm Light-Emitting Diode Phototherapy Shows Promise in the Treatment of Recalcitrant Psoriasis: Preliminary Findings.

Ablon G

Ablon Skin Institute , Los Angeles, California .

Abstract Background and Objectives: Psoriasis is one of the major problems facing dermatologists worldwide. Planar arrays of light-emitting diodes (LEDs) have recently attracted attention in the treatment of difficult dermatological entities, 830 nm in near infrared (near-IR) and 633 nm in visible red. This study was designed to assess the efficacy of combination 830-nm and 633-nm LED phototherapy in the treatment of recalcitrant psoriasis. Subjects and Methods: Nine informed and consenting patients with psoriasis were enrolled in this preliminary study, (3 men, 6 women, mean age 34.3, skin types I to IV). All had chronic psoriasis, which in most cases had proved resistant to conventional treatments. They were treated sequentially with LED arrays delivering continuous-wave 830 nm (near-IR) and 633 nm (red) in two 20-min sessions over 4 or 5 weeks, with 48 h between sessions (830 nm, 60 J/cm(2); 633 nm, 126 J/cm(2)). Results: All patients completed their LED regimens (4 requiring 1 regimen, 5 requiring a second). Follow-up periods were from 3 to 8 months, except in two patients who were lost to follow-up. Clearance rates at the end of the follow-up period ranged from 60% to 100%. Satisfaction was universally very high. Conclusions: The antiinflammatory effects of LED energy at 830 nm and 633 nm have been well documented, as has their use in wound healing. LED phototherapy is easy to apply, pain free and side-effect free, and is well tolerated by patients of all skin types. The promising results of this preliminary study warrant a proper controlled double-blind study with a larger patient population.

Photomed Laser Surg 2009 Sep 21

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=19764893

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Photodynamic therapy for the treatment of recurrent herpes labialis: Preliminary results.

Sperandio FF, Marotti J, Aranha AC, Eduardo Cde P

This study sought to evaluate the clinical outcome of patients who had been diagnosed with recurrent herpes labialis (RHL) after treatment with photodynamic therapy (PDT) associated with low-level laser therapy (LLLT). PDT has shown great effectiveness for treating already-established RHL vesicles, compared to ordinary treatments involving antiviral compounds. Two patients with vesicles on their lips were treated with PDT, followed by irradiation with LLLT. Both patients reported pain relief immediately after the procedure; at a six-month follow-up, neither patient showed signs or symptoms that related to RHL.

Gen Dent 2009 Jul-Aug 57(4) 415-9

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=19903625

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Low-level laser therapy for pain caused by placement of the first orthodontic archwire: a randomized clinical trial.

Tortamano A, Lenzi DC, Haddad AC, Bottino MC, Dominguez GC, Vigorito JW

Department of Orthodontics, School of Dentistry, University of Sao Paulo, Sao Paulo, Brazil.

INTRODUCTION: The purpose of this study was to clinically evaluate the effect of low-level laser therapy (LLLT) as a method of reducing pain reported by patients after placement of their first orthodontic archwires. METHODS: The sample comprised 60 orthodontic patients (ages, 12-18 years; mean, 15.9 years). All patients had fixed orthodontic appliances placed in 1 dental arch (maxillary or mandibular), received the first archwire, and were then randomly assigned to the experimental (laser), placebo, or control group. This was a double-blind study. LLLT was started in the experimental group immediately after placement of the first archwire. Each tooth received a dose of 2.5 J per square centimeter on each side (buccal and lingual). The placebo group had the laser probe positioned into the mouth at the same areas overlying the dental root and could hear a sound every 10 seconds. The control group had no laser intervention. All patients received a survey to be filled out at home describing their pain during the next 7 days. RESULTS: The patients in the LLLT group had lower mean scores for oral pain and intensity of pain on the most painful day. Also, their pain ended sooner. LLLT did not affect the start of pain perception or alter the most painful day. There was no significant difference in pain symptomatology in the maxillary or mandibular arches in an evaluated parameter. CONCLUSIONS: Based on these findings, we concluded that LLLT efficiently controls pain caused by the first archwire.

Am J Orthod Dentofacial Orthop 2009 Nov 136(5) 662-7

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=19892282

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Investigation of the Effect of GaAs Laser Therapy on Lateral Epicondylitis.

Emanet SK, Altan LI, Yurtkuran M

Uludag University Medical Faculty , Ataturk Rehabilitation Center, Rheumatic Disease and Hydrotherapy Section, Bursa, Turkey .

Abstract Background and Objective: There are conflicting reports regarding the efficacy of low energy laser therapy in treatment of lateral epicondylitis (LE). Contradictory results are considered to be due to different joint treatment protocols regarding variables such as dose, duration, and frequency. The aim of this study was to investigate the efficacy of gallium-arsenide (GaAs) laser therapy, which was performed with the dose regimen recommended by the World Association for Laser Therapy, in relieving pain and improving functional activities in patients with LE. Patients and Methods: Forty-nine patients (50 elbows) evaluated in our outpatient clinic were included in the study. Elbows were randomized into two groups: laser (n = 25) and placebo laser (n = 25). Either laser or placebo laser therapy was applied to patients for 15 sessions (5 d per week for 3 weeks). Main outcome measures were visual analog scale, tenderness, Disability of the Arm Shoulder and Hand (DASH) questionnaire, the Patient-Related Lateral Epicondylitis Evaluation (PRTEE) test, pain-free grip strength, and the Nottingham Health Profile (NHP) questionnaire. Evaluations were performed before treatment, at the end of 3 weeks of treatment, and after the 12th week of treatment ended. Results: Upon post-treatment evaluation, a significant improvement in all parameters was observed for both groups (p < 0.05). No significant difference was found when the laser and placebo groups were compared. At the 12 week evaluation, a significant sustained improvement in all parameters was observed. On intergroup evaluation, a significant improvement was observed in favor of the active treatment group regarding pain with resisted extension of the wrist, tenderness with pressure, and for both the total and subgroup scores of the DASH questionnaire and PRTEE test, as well as for the pain subgroup of the NHP questionnaire (p < 0.05). Conclusion: Although low energy laser therapy had no advantage compared to placebo in patients with LE for the short term, a significant improvement, particularly in functional parameters, was achieved in the long term. Laser, which has relatively no side effects, might be included among long-term treatment options for LE.

Photomed Laser Surg 2009 Oct 30

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=19877824

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Therapeutic Effects of Low-Level Laser on Lateral Epicondylitis from Differential Interventions of Chinese-Western Medicine: Systematic Review.

Chang WD, Wu JH, Yang WJ, Jiang JA

1 Department of Rehabilitation Medicine, Da Chien General Hospital , Miaoli City, Taiwan .

Abstract Background: Low-level laser therapy (LLLT) is a conservative treatment for lateral epicondylitis (LE), but it is also an alternative intervention between the very different approaches of Chinese and Western medicine. Objective: The purpose of this study was to systematically review and meta-analyze the therapeutic effects of LLLT on LE. Methods: We searched several electronic databases, including Medline, PubMed, and CINAHL, and explored studies that were randomized controlled trials on the therapeutic effects of LLLT on LE from 1990 to February 2009. These studies were systematically reviewed for the difference in therapeutic effects among various LLLTs on acupuncture points and on tender and myofascial trigger points (MTrPs). The reviewed therapeutic effects included pain, grip strength, range of motion (ROM), and weight tests, and were compared by meta-analysis. Results: We selected ten articles, and in seven of them the irradiation was conducted on tender points or MTrPs in the experimental groups. In two other articles, the irradiation was conducted on acupuncture points, and the last one was conducted on both kinds of points. Only three articles provided sufficient data for meta-analysis. The results revealed that applying LLLT on tender points or MTrPs is an effective means to improve the effect size (ES) of pain release after treatment (pooled ES: 0.71, 95% CI: 0.82- approximately 0.60) and follow-up (pooled ES: 1.05, 95% CI: 1.16- approximately 0.94). LLLT application was also able to increase the grip force, ROM, and weight test (p < 0.05). Conclusions: We suggest that using LLLT on tender points or MTrPs of LE could effectively improve therapeutic effects.

Photomed Laser Surg 2009 Oct 30

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=19874256

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Analysis of Low-Level Laser Radiation Transmission in Occlusive Dressings.

de Jesus Guirro RR, de Oliveira Guirro EC, Martins CC, Nunes FR

1 Department of Biomechanics, Medicine and Rehabilitation of the Locomotor System, School of Medicine of Ribeirao Preto, University Sao Paulo , Brazil .

Abstract Objective: The purpose of this study is to analyze the power transmitted by low-level laser therapy (LLLT) into occlusive dressings using different wavelengths for the treatment of cutaneous lesions. Background Data: LLLT has been largely used to treat several cutaneous lesions commonly associated with occlusive dressings to accelerate the healing process. Materials and Methods: Radiation transmission was measured by a digital power analyzer connected to a laser emitter with wavelengths of 660, 830, and 904 nm and mean levels of 30, 30, 6.5 mW, respectively, previously calculated. Thirteen different occlusive dressings were analyzed and interposed between the laser emitter and the power analyzer sensor, with 15 measurements made for each dressing. Statistics were provided by the analysis of variance (ANOVA), followed by Student’s t-test (p < 0.05). Results: The power transmitted ranged between 98.6% and 0%, depending on the material and wavelength. The dressings tested were BioFill, Hydrofilm, Confeel Plus 3533, Confeel 3218, DuoDERM Extra Thin, Hydrocoll, Micropore Nexcare, CIEX tape, Emplasto Sabia, CombiDERM, Band-aid, Actisorb Plus, in addition to polyvinylchloride (PVC) film, and transmitted power higher than 40% of the incident power, independently from the wavelength indicated for the association with LLLT. Conclusion: The results showed that LLLT transmission depends on the occlusive dressing material and the wavelength irradiated.

Photomed Laser Surg 2009 Oct 9

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=19817516

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Sexual Functions and Depressive Symptoms after Photodynamic Therapy for Vulvar Lichen Sclerosus in Postmenopausal Women from the Upper Silesian Region of Poland.

Skrzypulec V, Olejek A, Drosdzol A, Nowosielski K, Kozak-Darmas I, Wloch S

Department of Women’s Disease Control and Prevention, School of Health Care, Medical University of Silesia, Katowice, Poland.

Introduction. Although lichen sclerosus (LS) may affect women’s physical functioning, mood, and quality of life, restricting their physical activities, sexual, and non-sexual contacts, there are limited data on the sexual functioning of women diagnosed with LS. Aims. The aim of the study was to evaluate the influence of photodynamic therapy for vulvar LS on sexual functions and depressive symptoms in postmenopausal women from the Upper Silesian Region of Poland. Methods. A total of 65 women aged 50-70 visiting an outpatient clinic for assessment of vulvar dermatoses were screened for the clinical trial. Finally, 37 women who met all the inclusion/exclusion criteria were included in the study. All the subjects were treated by topical laser therapy (photodynamic therapy). Sexual functions and depressive symptoms were assessed before and after the therapy using Female Sexual Function Index and Beck Depression Inventory, respectively. Main Outcome Measures. Sexual behaviors, sexual functions, and depressive symptoms in females after photodynamic therapy for vulvar LS. Results. The total FSFI score was significantly lower after the treatment of vulvar LS as compared with the baseline (median 24.6 vs. 15.9). However, the prevalence of clinically significant FSD was stable throughout the medical intervention except lubrication disorders (higher prevalence after the treatment: 40% vs. 68.57%). Although the scores of BDI at the baseline dropped significantly after the photodynamic therapy (median 12.0 and 9.0, respectively), there were no significant differences in the prevalence of depressive symptoms (48.65% vs. 45.94%). Conclusions. Topical laser therapy for vulvar LS has a good clinical outcome, especially in the context of no major negative effects on sexual functioning and the positive impact on the severity of depressive symptoms in postmenopausal women. However, patients should be informed about the possible lubrication disorders following the treatment.

J Sex Med 2009 Sep 29

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=19796058

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Use of 660-nm Diode Laser in the Prevention and Treatment of Human Oral Mucositis Induced by Radiotherapy and Chemotherapy.

Zanin T, Zanin F, Carvalhosa AA, de Souza Castro PH, Pacheco MT, Zanin IC, Junior AB

1 Photobiology and Lasertherapy Center, Vale do Paraiba University , Sao Jose dos Campos, SP, Brazil .

Abstract Objective: The aim of this multidisciplinary study was to evaluate quantitatively and qualitatively the effect of a 660-nm diode laser in the prevention and treatment of human oral mucositis (OM) in patients suffering from head and neck cancer who had undergone radiotherapy and chemotherapy. Background Data: OM is a severe oral lesion resulting from the toxic effects of treatment for cancer in the head and neck region. Low-level laser therapy is indicated to prevent and treat this oral complication and may be used alone or in association with conventional drug treatment, producing pain relief and wound repair. Methods: This study included 72 patients with head and neck cancer treated at the Cancer Hospital of Mato-Grosso, Brazil, and divided into a control group (C; n = 36) and a laser group (L; n = 36). Laser therapy was performed in combination with radiotherapy and chemotherapy twice a week using a diode laser (lambda = 660 nm, power = 30 mW, spot size = 2 mm, energy = 2 J per point). Results: Statistically significant differences were observed between the two groups. Patients in group L usually did not present with OM or pain, but all patients in group C presented with OM ranging from Level I to III associated with pain. This difference was significant from week 1 on, increased until week 4 and remained stable up to week 7. Conclusion: Laser therapy was effective in preventing and treating oral effects induced by radiotherapy and chemotherapy, thus improving the patient’s quality of life.

Photomed Laser Surg 2009 Sep 21

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=19764899

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Laser Therapy in the Tissue Repair Process: A Literature Review.

da Silva JP, da Silva MA, Almeida AP, Junior IL, Matos AP

1 Physiotherapy Department, Faculdade de Tecnologia e Ciencias , Vitoria da Conquista, Brazil .

Abstract Objective: Carry out a literature review on the use of laser therapy in the tissue repair process and address the different lasers and parameters used by the authors. Methods: A review was carried out of the literature from 1960 to 2008 in the Lilacs, Medline, and PubMed databases using the following key words: Laser Therapy, Wound Healing, and Tissue repair. Results: The most frequently used types of laser are helium neon (HeNe) lasers and diode lasers, including gallium-aluminum-arsenium (GaAlAs), arsenium-gallium (AsGa), and indium-gallium-aluminum-phosphide (InGaAlP) lasers. However, implementation of different protocols was found, with different materials and different activating wavelengths, thus making it difficult to compare results and choose the parameters of treatment. Conclusions: The majority of authors report that laser therapy speeds up the process of tissue repair, but further studies are suggested to determine the best parameters to be used.

Photomed Laser Surg 2009 Sep 21

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=19764898

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[Less need for insulin, a surprising effect of phototherapy in insulin-dependent diabetes mellitus]

Nieuwenhuis RF, Spooren PF, Tilanus JJ

opleiding tot psychiater verbonden aan deGGZ Breburg Groep en was werkzaam in het St. Elisabeth Ziekenhuis te Tilburg.

A 40-year-old woman with insulin-dependent diabetes mellitus was treated successfully with phototherapy for a seasonal affective disorder. Following sessions of phototherapy she developed hypoglycaemias and required less insulin. A review of the literature showed that melatonin has an inhibiting effect on insulin sensitivity. The melatonin secretion, which is suppressed by phototherapy, may cause an immediate decrease in the plasma glucose levels. This decrease may well be important for patients with insulin-resistant diabetes mellitus and seasonal affective disorder.

Tijdschr Psychiatr 2009 51(9) 693-7

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=19760569

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The Effect of Equal Daily Dose Achieved by Different Power Densities of Low-Level Laser Therapy at 635 and 670 nm on Wound Tensile Strength in Rats: A Short Report.

Vasilenko T, Slezak M, Kovac I, Bottkova Z, Jakubco J, Kostelnikova M, Tomori Z, Gal P

1 Department of Medical Biophysics, Pavol Jozef Safarik University , Kosice, Slovak Republic.

Abstract Objective: The aim of our study was to compare the effects of different power densities of LLLT at 635 and 670 nm achieving a daily dose of 5 J/cm(2) on wound tensile strength (TS) in rats. Background Data: Optimal parameters of low-level laser therapy (LLLT) are still unknown. Materials and Methods: Under general anesthesia, one full-thickness skin incision was performed on the back of each rat (n = 40) and immediately closed using an intradermal running suture. Rats were separated into five groups depending on treatment parameters: (1) sham irradiated control group (SIC); (2) 635 nm laser-treated group at 4 mW/cm(2) (L-635/4); (3) 635 nm laser-treated group at 15 mW/cm(2) (L-635/15); (4) 670 nm laser-treated group at 4 mW/cm(2) (L-670/4); and (5) 670 nm laser-treated group at 15 mW/cm(2) (L-670/15). The total daily dose was 5 J/cm(2). Seven days after surgery each wound was removed for wound TS measurement. Results: The lowest wound TS results were measured in the SIC rats (10.5 +/- 2.8 g/mm(2)). Higher wound TS results were measured in group L-670/15 (11.5 +/- 2.5 g/mm(2)) and group L-635/4 (11.7 +/- 4.3 g/mm(2)) rats, while significantly higher results were found in group L-670/4 (15.8 +/- 4.4 g/mm(2)) and group L-635/15 (15.9 +/- 4.8 g/mm(2)). The differences were significant between certain groups (p < 0.01: SIC vs. L-635/15, SIC vs. L-670/4; p < 0.05: L-635/4 vs. L-635/15, L-635/4 vs. L-670/4, L-635/15 vs. L-670/15, L-670/4 vs. L-670/15). Conclusion: Both red lasers significantly increased wound TS at selected parameters. Whereas the 635 nm laser significantly improved wound healing by using the higher power density, the 670 nm laser improved healing using a lower power density.

Photomed Laser Surg 2009 Sep 11

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=19743962

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Laser Photobiomodulation of Wound Healing in Diabetic and Non-Diabetic Mice: Effects in Splinted and Unsplinted Wounds.

Chung TY, Peplow PV, Baxter GD

1 Department of Anatomy & Structural Biology, University of Otago , Dunedin, New Zealand .

Abstract Objective: The aim of this investigation was to compare the healing of laser-irradiated and non-irradiated wounds covered by an occlusive dressing in mice. Background data: Many previous studies of the effects of laser irradiation of experimental wounds in mice and rats did not cover the wounds so that healing occurred mainly by contraction. Healing of covered wounds is slower and mimics more closely wound healing in humans. Materials and Methods: Forty-seven diabetic and twenty non-diabetic mice were used. A single wound (5 mm diameter) was created on the left flank of each animal and covered by Tegaderm HP dressing (Day 1). Wounds were irradiated (660 nm) for 20 s using a lower power (18 mW) or higher power (80 mW) laser starting immediately post-wounding for seven consecutive days (0.36 or 1.6 J/day); untreated wounds served as controls. Animals were euthanized on Day 8, 10, or 14. Wound specimens were cut and stained using haematoxylin and eosin, and picrosirius red, and examined by microscopy. Results: Results confirmed that wound healing was impaired in diabetic mice. Analysis of the data demonstrated that Tegaderm HP dressing had retarded contraction (splinted the wounds) in a large proportion of diabetic mice and, to a lesser extent, in non-diabetic mice. Healing of splinted wounds was delayed compared to unsplinted wounds, but laser irradiation (1.6 J/day, 7 days) stimulated healing by re-epithelization and granulation tissue formation. Conclusion: These are the first findings of laser-mediated stimulation of healing in splinted wounds. Further studies are needed to assess the effects of different constellation sets of laser parameters in this wound model.

Photomed Laser Surg 2009 Nov 16

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=19916792

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Laser-aided circumferential supracrestal fiberotomy and low-level laser therapy effects on relapse of rotated teeth in beagles.

Kim SJ, Paek JH, Park KH, Kang SG, Park YG

a Assistant Professor, Department of Orthodontics, Oral Biology Research Institute, College of Dentistry, Kyung-Hee University, Seoul, Korea.

ABSTRACT Objective: To investigate the effectiveness and periodontal side effects of laser circumferential supracrestal fiberotomy (CSF) and low-level laser therapy (LLLT) on orthodontically rotated teeth in beagles. Materials and Methods: Eighteen mandibular incisors from nine dogs were divided into three groups by treatment (n = 6/group): A, orthodontic couple force application only (control); B, laser CSF following orthodontic couple force application; and C, LLLT following orthodontic couple force application. Both mandibular lateral incisors were rotated for 4 weeks, and the relapse tendency was observed for 4 weeks more without any retainers. The amount of relapse, sulcus depth, and gingival recession were measured at weeks 4 and 8. One-way analysis of variance (ANOVA) and Scheffe’s post hoc test were used for data analysis. Tissue specimens were examined at week 8 under light microscopy after hematoxylin-eosin (H&E) and Masson’s trichrome staining. Results: The mean percentage of relapse was 41.29% in group A, 14.52% in group B, and 56.80% in group C (P < .001). Four weeks after laser CSF, the sulcus depth increased by 0.67 mm, but no gingival recession was observed. There was no significant difference between groups A and C in terms of sulcus depth and gingival recession. Conclusions: Laser CSF is an effective procedure to decrease relapse after tooth rotation, causing no apparent damage to the supporting periodontal structures, whereas LLLT on orthodontically rotated teeth without retainers appears to increase the relapse tendency.

Angle Orthod 2010 Mar 80(2) 385-90

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=19905867

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Effects of Chinese herbal medicine combined with He-Ne laser on lipoperoxide and superoxide dismutase in chloasma patients.

Wu YH, Li QL, Yang XW

Department of Chinese Medicine, Guangzhou Red Cross Hospital, Guangzhou 510220, China.

OBJECTIVE: To observe the effects of Chinese decoction and ligustrazin hydrochloride injection combined with He-Ne laser on lipoperoxide (LPO) and Superoxide dismutase (SOD) in patients with chloasma. METHODS: 90 cases of chloasma were randomly divided into the following two groups: a treatment group (of 54 cases) treated by a self-prepared prescription for toning the kidneys and relieving the depressed liver to remove blood stasis, ligustrazin hydrochloricde injection and He-Ne laser therapy, and a control group (of 36 cases) treated with oral administration of Vitamin E and Vitamin C plus external application of 20% Azelaic acid cream. RESULTS: The total effective rate in the treatment group was 79.6%, which was significantly higher than that of the control group (P < 0.05). After treatment, the LPO level in the treatment group was significantly lowered (P < 0.01), and the SOD level was significantly elevated (P < 0.05). CONCLUSION: The therapeutic methods adopted in the treatment group may show the action of antioxidation, providing good clinical effects for treating chloasma.

J Tradit Chin Med 2009 Sep 29(3) 163-6

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=19894376

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[Effect of infrared low-intensity laser therapy on orbital circulation in children with progressive short-handedness]

This work was designed to study effect of low-intensity infrared laser radiation (LIIRR) on orbital circulation in children with progressive progressive short-handedness. Parameters of the blood flow in the orbital artery, central retinal artery, and posterior ciliary artery were evaluated in a total of 88 patients at the age from 6 to 14 years. The study group (group 1) comprised 66 children with moderately severe progressive myopia (112 eyes), the control one (group 2) included 22 patients without visual disturbances (44 eyes). Patients of group 1 received physiotherapy for the treatment of significantly deteriorated hemodynamics in the orbital region. Indirect action of LIIRR on the orbital region promoted stabilization of short-handedness in 78.8% of the treated patients. It is concluded that the method described in this paper is clinically efficient and may be recommended for the prevention of progressive myopia in children.

Vopr Kurortol Fizioter Lech Fiz Kult 2009 Sep-Oct (5) 37-9

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=19886021

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Morphological analysis of second-intention wound healing in rats submitted to 16 J/cm 2 lambda 660-nm laser irradiation.

Gonzaga Ribeiro MA, Cavalcanti de Albuquerque RL, Santos Barreto AL, Moreno de Oliveira VG, Santos TB, Freitas Dantas CD

Laboratory of Morphology and Structural Biology, Science and Technology Institute, University Tiradentes, Aracaju/SE, Brazil.

BACKGROUND AND OBJECTIVES: Low-level laser therapy (LLLT) has been extensively applied to improve wound healing due to some biostimulatory properties presented by laser arrays apparently able to accelerate the cicatricial repair of soft tissue injuries. However, many controversial results have been reported in the literature, probably as a result of the wide sort of different protocols of photobiomodulation employed in those experiments. The goal of this study was to investigate the effect of a low-dose protocol of LLT on the intensity of the inflammatory response and the pattern of collagen fibers’ deposition during second-intention wound healing in rodents. MATERIALS AND METHODS: Standard-sized wounds were carried out in the back of 24 male rats. Half of them underwent LLLT treatment (16 J/cm 2 ) at 660 nm delivered for 7 days. Eight and 14 days after the wounds were performed, the repairing area was removed and stained in HE and Masson’s trichrome, and the inflammatory response, epithelization, and collagen fiber depositions were evaluated. RESULTS: We found that LLLT was able to slightly reduce the intensity of the inflammatory reaction as well as to enhance substantially the epithelization process at both 8 th and 14 th days. In addition, it also appeared to stimulate the deposition of collagen fibers at the final stages of wound healing. CONCLUSIONS: The LLLT protocol tested in this study resulted in some improvements in second-intention wound healing in rodents.

Indian J Dent Res 2009 Jul-Sep 20(3) 390

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=19884733

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Low-level laser therapy with pulsed infrared laser accelerates third-degree burn healing process in rats.

Ezzati A, Bayat M, Taheri S, Mohsenifar Z

Shahid Beheshti University, MC, Tehran, Iran.

This study investigated the influence of pulsed low-level laser therapy (LLLT) on the healing of a third-degree burn in a rat model. Two third-degree burns (distal and proximal) were made in the skin of 74 rats. Rats were divided into four groups. In group 1, the distal burn received LLLT with laser switched off; in groups 2 and 3, distal burns were treated with a 3,000 Hz-pulsed infrared diode laser with 2.3 and 11.7 J/cm(2) energy densities, respectively. In group 4, the distal burns were treated topically with 0.2% nitrofurazone. The proximal burn of all groups was considered a control burn. We assessed the response to treatment both microbiologically and macroscopically. The chi-square test showed that the incidence of Staphylococcus epidermidis, Lactobacillus, and diphtheria decreased significantly in laser-treated groups compared with other groups. Independent sample t-test showed that LLLT with 11.7 J/cm(2) energy density significantly increased wound-closure rate at 3 and 4 weeks after burning compared with their relevant control burns (p = 0.018 and p = 0.01, respectively). Pulsed LLLT with 11.7 J/cm(2)/890 nm of a third-degree burn in a rat model significantly increased wound-closure rate compared with control burns.

J Rehabil Res Dev 2009 46(4) 543-54

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=19882488

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Laser light may improve the symptoms of oral lesions of cicatricial pemphigoid: a case report.

Oliveira PC, Reis Junior JA, Lacerda JA, Silveira NT, Santos JM, Vitale MC, Pinheiro AL

Laser Center, School of Dentistry, Federal University of Bahia, Salvador, BA, Brazil.

OBJECTIVE: The aim of this work is to report the handling of a patient suffering from cicatricial pemphigoid (CP) treated with laser phototherapy (LPT) and systemic steroids. BACKGROUND DATA: CP is a group of rare chronic autoimmune blistering diseases that predominately affect the mucous membranes and occasionally the skin. The gingiva is most commonly involved, followed by the palate and the buccal mucosa. High-dosage systemic steroids are widely used for its treatment. LPT has been shown to improve wound healing and relieve pain. Its efficacy depends on the amount of energy delivered to the tissue, exposure time, and delivery method. MATERIALS AND METHODS: A white 47-y-old man with CP who used systemic steroids for the previous 5 y was examined at our clinic. Extra- and intraoral examination revealed classic signs of the condition. LPT (GaAlAs diode laser, 660 nm wavelength, 30 mW, continuous wave, diameter approximately 3 mm, 60 J/cm(2) per session) was used in association with the steroids. LPT was performed in a punctual contact manner every other day on the oral mucosa. Maintenance of the treatment was carried out weekly because interruption of the LPT resulted in the recurrence of the lesions. At the time that this report was written, the patient had been undergoing twice weekly treatments for 6 months without signs of lesion recurrence. CONCLUSION: Concomitant use of systemic steroids and LPT showed a positive effect on controlling oral CP lesions and on improving both oral health and the quality of life of the patient.

Photomed Laser Surg 2009 Oct 27(5) 825-8

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=19878031

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Effect of Low-Level Laser Therapy on Malondialdehyde Concentration in Random Cutaneous Flap Viability.

Prado R, Neves L, Marcolino A, Ribeiro T, Pinfildi C, Ferreira L, Thomazini J, Piccinato C

1 Department of Surgery and Anatomy, University of Sao Paulo-FMRP-USP , Ribeirao Preto, Brazil .

Abstract Objective: The aim of this study was to assess the effects of 830 nm and 670 nm laser on malondialdehyde (MDA) concentration in random skin-flap survival. Background Data: Low-level laser therapy (LLLT) has been reported to be successful in stimulating the formation of new blood vessels and activating superoxide-dismutase delivery, thus helping the inhibition of free-radical action and consequently reducing necrosis. Materials and Methods: Thirty Wistar rats were used and divided into three groups, with 10 rats in each one. A random skin flap was raised on the dorsum of each animal. Group 1 was the control group; group 2 received 830 nm laser radiation; and group 3 was submitted to 670 nm laser radiation. The animals underwent laser therapy with 36 J/cm(2) energy density immediately after surgery and on the 4 days subsequent to surgery. The application site of the laser radiation was 1 point, 2.5 cm from the flap’s cranial base. The percentage of the skin-flap necrosis area was calculated 7 days postoperative using the paper-template method, and a skin sample was collected immediately after as a way of determining the MDA concentration. Results: Statistically significant differences were found between the necrosis percentages, with higher values seen in group 1 compared with groups 2 and 3. Groups 2 and 3 did not present statistically significant differences (p > 0.05). Group 3 had a lower concentration of MDA values compared to the control group (p < 0.05). Conclusion: LLLT was effective in increasing the random skin-flap viability in rats, and the 670 nm laser was efficient in reducing the MDA concentration.

Photomed Laser Surg 2009 Oct 30

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=19877823

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Low-Level Laser Therapy for Implants Without Initial Stability.

Campanha BP, Gallina C, Geremia T, Loro RC, Valiati R, Hubler R, de Oliveira MG

1 School of Dentistry, Universidade Federal de Minas Gerais , Belo Horizonte, Brazil .

Abstract Objective: This study evaluated the effect of low-level infrared laser on removal torque values of implants with poor initial stability inserted in rabbit tibias. Background Data: It is important to analyze the effects of laser radiation on bone repair when low-quality bone and implants with poor initial stability are used. Materials and Methods: Thirty male white New Zealand rabbits (Oryctolagus Cuniculus) about 2 mo old and weighing 1.5-2.0 kg were used. Machined implants with poor initial stability were inserted in the tibia of each animal. Animals were randomly divided into two groups: laser irradiated and laser nonirradiated. Each group was further divided into three subgroups, according to the day the animals were killed: 15, 30, or 45 d. Torque values were measured with an axial digital torquemeter that applied counter-torque. The Student’s t-test was used to calculate means and standard deviations for the comparisons between laser and control groups. Results: A significant increase (p = 0.050) in removal torque values was found in the group of laser-irradiated implants at 15 and 30 d when compared with the control groups. At 45 d, no significant differences were found. Conclusion: In this study, low-level laser therapy promoted the osseointegration of implants with poor initial stability, particularly in the initial stages of bone healing.

Photomed Laser Surg 2009 Oct 27

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=19860572

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Effect of Biostimulation on Healing of Bone Defects in Diabetic Rats.

Akyol UK, Gungormus M

Ataturk University , Faculty of Dentistry, Department of Oral and Maxillofacial Surgery, Erzurum, Turkey .

Abstract Background and Objective: The aim of this study was to investigate the effects of biostimulation on healing of bone defects in diabetic rats. Study Design/Material and Methods: Twenty-eight Wistar rats weighting 250 to 300 g were used for this study. Diabetes was chemically induced with streptozotocin, and 14 nondiabetic and 14 diabetic rats were included in the study. The distal epiphysis of the right and left femurs of the diabetic rats were perforated with a surgical bone drill. This surgical procedure was performed on the left femurs of normal rats too. The wound on the right side of each diabetic rat received laser stimulation. The left femur of each nondiabetic (normal) rat served as a control. The rats were assigned to three experimental groups: (1) normal bur (control group); (2) diabetic bur; (3) diabetic bur + biostimulation. Results: There was a significant difference among all groups in substantia spongiosa formation on day 10. According to the Mann-Whitney U test, there was a difference between Groups 1 and 2. A significant difference was noted between Groups 2 and 3 as well as between Groups 1 and 3 and between Groups 2 and 3 in union at 20 d of healing. Conclusions: Substantia spongiosa formation was slightly more evident in Groups 1 and 3 than in Group 2. Also, there was more union in Group 3 than in the other groups on day 20. As a result, it can be concluded that low-level laser therapy (808 nm laser at 10 J/cm(2)) can have a beneficial effect on spongiosa in diabetic bone repair when five treatments are administered with 2 d intervals between treatments.

Photomed Laser Surg 2009 Oct 27

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=19860570

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Validating a Nonacupoint Sham Control for Laser Treatment of Knee Osteoarthritis.

Zhao L, Shen X, Cheng K, Deng H, Ding G, Tan M, Lao L

1 Shanghai University of Traditional Chinese Medicine , Shanghai, China .

Abstract Objective: The goals of the present study were to evaluate the effect and safety of combined 10.6 mum and 650 nm laser acupuncture-moxibustion on patients with knee osteoarthritis (OA) and to validate a nonacupoint sham control for assessing the effect of point specificity on the treatment. Materials and Methods: A randomized, sham-controlled clinical trial was conducted in an outpatient clinical setting on patients with knee OA (n = 40). Laser irradiation was performed on acupoint Dubi (ST35) and a sham point three times a week for 4 wk. Outcome measurements were performed at baseline and at wk 2 and 4 using Western Ontario and McMaster Universities’ Osteoarthritis Index (WOMAC). Results: At the 2-wk assessment, i.e., after 6 treatments, improvement in the WOMAC pain score of the acupoint group was significantly greater than that of the control group (49.21% vs. 11.99%, respectively; p = 0.021). However, there were no significant differences between the two groups in the WOMAC physical function score (p = 0.129) or joint stiffness score (p = 0.705). No side effects were found during the trial. Conclusions: Combined 10.6-mum-650-nm laser acupuncture-moxibustion on acupoint ST35 is safe to use and was effective after 2-wk treatment, but not at the 4-wk assessment, in relieving knee OA pain compared to a nonacupoint sham control. A larger clinical trial to verify our findings is warranted.

Photomed Laser Surg 2009 Oct 27

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=19860569

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The Association of Low and High Laser Treatments on Self-Inflicted Lip Injury: A Case Report.

Santos MT, de Souza Merli LA, Guare RO, Ferreira MC

1 Universidade Cruzeiro do Sul , Sao Paulo, Brazil .

Objective: Report a clinical case of surgical lip lesion removal owing to self-injury in a 9-year-old male quadriplegic, spastic cerebral palsy (CP) patient using low and high lasers in association. Background: Various management methods for oral trauma have been suggested, depending on the severity, frequency, and cause of injury, including medication, behavioral techniques, and oral appliances or dental extractions. Methods: Initially, low-level laser therapy (LLLT) was used on the injured labial tissue measuring 2.2 cm externally and 3.4 cm in the internal mucosal, followed by surgical removal using a CO(2) laser. After 30 days, a significant reduction in injury to the oral tissues was observed, and the region presented normal color and good healing conditions. Conclusion: The association of different laser therapies to remove and heal a lip lesion owing to self-injurious behavior was effective and promoted improvement in the patient’s quality of life by establishing painless mastication.

Photomed Laser Surg 2009 Oct 27

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=19860566

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Healing of Surgical Wounds Made with lambda970-nm Diode Laser Associated or Not with Laser Phototherapy (lambda655 nm) or Polarized Light (lambda400-2000 nm).

Medeiros JL, Nicolau RA, Nicola EM, Dos Santos JN, Pinheiro AL

1 Center of Biophotonics, School of Dentistry, Federal University of Bahia , Salvador, Bahia, Brazil .

Abstract Objective: The aim of this study was to analyze the effect of two phototherapies, laser and polarized light, on diode laser (970lambda nm) wounds. Background Data: Lasers have been used in surgery, and some wavelengths may cause thermal damage to the tissue and affect healing. Several studies have shown that some wavelengths are effective in improving healing. Coherent and noncoherent light have been successfully used on the modulation of biological phenomena of several origins. Animals and Methods: Thirty-one Wistar rats were divided into 3 groups (GI to GIII). A 20-mm x 2-mm wound was created on the dorsum of each animal with a diode laser (Sirolaser, Sirona((R)), Bensheim, Germany). Group GI acted as control. On GII, laser light (lambda655 nm, 30 mW, phi approximately 3 mm, 12 J/cm(2)) was used and on GIII illumination with polarized light (lambda400-2000 nm, 40 mW, phi approximately 5.5 cm, 12 J/cm(2)) was used, every other day (GII) or daily (GIII) for 7 days. The animals were killed at 0, 7, and 14 days after surgery. Specimens were taken, routinely processed, stained and imunnomarked [HE (hematoxylin-eosin), sirius red, alpha-smooth muscle actin (SMA)], and underwent histological analysis. Results: GII showed better response at day 14 when re-epithelialization was in a more advanced stage. The number of myofibroblasts was significantly different over the healing time (7 to 14 days); this number was smaller than that observed on G1. On GIII at day 7, the number of myofibroblasts was significantly higher than for GII. At day 14, a more pronounced deposition of collagen matrix was also seen, and inflammation was discrete and more advanced for GIII. Conclusion: The results of the present study showed that the effect of the use of laser light was more evident at early stages of healing and that the use of polarized light improved the resolution of the inflammatory reaction, increased the deposition of collagen, increased the number of myofibroblasts, and quickened re-epithelialization during the experimental time.

Photomed Laser Surg 2009 Oct 26

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=19857050

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Effects of low-level laser therapy and orthodontic tooth movement on dental pulps in rats.

Abi-Ramia LB, Sasso Stuani A, Sasso Stuani A, Sasso Stuani MB, de Moraes Mendes A

Abstract Objectives: To describe the microscopic pulpal reactions resulting from orthodontically induced tooth movement associated with low-level laser therapy (LLLT) in rats. Materials and Methods: Forty-five young male Wistar rats were randomly assigned to three groups. In group I (n = 20), the maxillary right first molars were submitted to orthodontic movement with placement of a coil spring. In group II (n = 20), the teeth were submitted to orthodontic movement plus LLLT at 4 seconds per point (buccal, palatal, and mesial) with a GaAlAs diode laser source (830 nm, 100 mW, 18 J/cm(2)). Group III (n = 5) served as a control (no orthodontic movement or LLLT). Groups I and II were divided into four subgroups according to the time elapsed between the start of tooth movement and sacrifice (12 hours, 24 hours, 3 days, and 7 days). Results: Up until the 3-day period, the specimens in group I presented a thicker odontoblastic layer, no cell-free zone of Weil, pulp core with differentiated mesenchymal and defense cells, and a high concentration of blood vessels. In group II, at the 12- and 24-hour time points, the odontoblastic layer was disorganized and the cell-free zone of Weil was absent, presenting undifferentiated cells, intensive vascularization with congested capillaries, and scarce defense cells in the cell-rich zone. In groups I and II, pulpal responses to the stimuli were more intense in the area underneath the region of application of the force or force/laser. Conclusions: The orthodontic-induced tooth movement and LLLT association showed reversible hyperemia as a tissue response to the stimulus. LLLT leads to a faster repair of the pulpal tissue due to orthodontic movement.

Angle Orthod 2010 Jan 80(1) 116-22

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=19852650

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Effects of 660-nm gallium-aluminum-arsenide low-energy laser on nerve regeneration after acellular nerve allograft in rats.

Zhang LX, Tong XJ, Yuan XH, Sun XH, Jia H

Department of Rehabilitation Medicine, The First Affiliated Hospital, China Medical University, Shenyang, China.

Purpose: The purpose of this study was to explore and discuss the effects of 660-nm gallium-aluminum-arsenide low-energy laser (GaAlAs LEL) irradiation on neural regeneration after acellular nerve allograft repair of the sciatic nerve gap in rats. Methods: Eight male and female Sprague-Dawley rats were used as nerve donors, and 32 healthy Wistar rats were randomly divided into four groups: normal control group, acellular rat sciatic nerve (ARSN) group, laser group, and autograft group. Twelve weeks after surgery, nerve conduction velocity, restoration rate of tibialis anterior wet muscle weight, myelinated nerve number, and calcitonin gene-related peptide (CGRP) protein and mRNA expression of the spinal cord and muscle at the injury site were quantified and statistically analyzed. Results: Compared with the ARSN group, laser therapy significantly increased nerve conduction velocity, restoration rate of tibialis anterior wet muscle weight, myelinated nerve number, and CGRP protein and mRNA expression of the L(4) spinal cord at the injury site. Conclusions: These findings demonstrate that 660-nm GaAlAs LEL therapy upregulates CGRP protein and mRNA expression of the L(4) spinal cord at the injury site and increases the rate of regeneration and target reinnervation after acellular nerve allograft repair of the sciatic nerve gap in rats. Low-energy laser irradiation may be a useful, noninvasive adjunct for promoting nerve regeneration in surgically induced defects repaired with ARSN. Synapse 64:152-160, 2010. (c) 2009 Wiley-Liss, Inc.

Synapse 2009 Oct 22 64(2) 152-160

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=19852068

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Transcranial near infrared laser treatment (NILT) increases cortical adenosine-5′-triphosphate (ATP) content following embolic strokes in rabbits.

Lapchak PA, De Taboada L

University of California San Diego, Department of Neuroscience, 9500 Gilman Drive MTF316, La Jolla, CA 92093-0624, USA.

Transcranial near infrared laser therapy (NILT) improves behavioral outcome following embolic strokes in embolized rabbits and clinical rating scores in acute ischemic stroke (AIS) patients; however, the cellular mechanism(s) involved in NILT neuroprotection have not been elucidated. It has been proposed that mitochondrial energy production may underlie a response to NILT, but this has not been demonstrated using an in vivo embolic stroke model. Thus, we evaluated the effect of NILT on cortical ATP content using the rabbit small clot embolic stroke model (RSCEM), the model originally used to demonstrate NILT efficacy and initiate the NEST-1 clinical trial. Five minutes following embolization, rabbits were exposed to 2 min of NILT using an 808 nm laser source, which was driven to output either continuous wave (CW), or pulsed wave modes (PW). Three hours after embolization, the cerebral cortex was excised and processed for the measurement of ATP content using a standard luciferin-luciferase assay. NILT-treated rabbits were directly compared to sham-treated embolized rabbits and naive control rabbits. Embolization decreased cortical ATP content in ischemic cortex by 45% compared to naive rabbits, a decrease that was attenuated by CW NILT which resulted in a 41% increase in cortical ATP content compared to the sham embolized group (p>0.05). The absolute increase in ATP content was 22.5% compared to naive rabbits. Following PW NILT, which delivered 5 (PW1) and 35 (PW2) times more energy than CW, we measured a 157% (PW1 p=0.0032) and 221% (PW2 p=0.0001) increase in cortical ATP content, respectively, compared to the sham embolized group. That represented a 41% and 77% increase in ATP content compared to naive control rabbits. This is the first demonstration that embolization can decrease ATP content in rabbit cortex and that NILT significantly increases cortical ATP content in embolized rabbits, an effect that is correlated with cortical fluence and the mode of NILT delivery. The data provide new insight into the molecular mechanisms associated with clinical improvement following NILT.

Brain Res 2009 Oct 23

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=19837048

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Acupuncture for schizophrenia: a systematic review and meta-analysis.

Lee MS, Shin BC, Ronan P, Ernst E

Division of Standard Research, Korea Institute of Oriental Medicine, Daejeon 305-811, South Korea. drmslee@gmail.com

BACKGROUND: Acupuncture is one of the most popular types of complementary/alternative medicine. It is sometimes used as a treatment for schizophrenia. AIMS: The objective of this review is to assess systematically the clinical evidence for or against acupuncture as a treatment for schizophrenia. METHODS: We searched 20 databases from their inception to May 2009 without language restrictions. All randomised clinical trials (RCTs) of acupuncture, with or without electrical stimulation or moxibustion for patients with schizophrenia were considered for inclusion. RESULTS: Thirteen RCTs, all originating from China, met the inclusion criteria. One RCT reported significant effects of electroacupuncture (EA) plus drug therapy for improving auditory hallucunations and positive symptom compared with sham EA plus drug therapy. Four RCTs showed significant effects of acupuncture for response rate compared with antipsychotic drugs [n = 360, relative risk (RR): 1.18, 95% confidence interval (CI): 1.03-1.34, p = 0.01; heterogeneity: tau(2) = 0.00, chi(2) = 2.98, p = 0.39, I(2) = 0%]. Seven RCTs showed significant effects of acupuncture plus antipsychotic drug therapy for response rate compared with antipsychotic drug therapy (n = 457, RR: 1.15, 95% CI: 1.04-1.28, p = 0.008, heterogeneity: tau(2) = 0.00, chi(2) = 6.56, p = 0.36, I(2) = 9%). Two RCTs tested laser acupuncture against sham laser acupuncture. One RCT found beneficial effects of laser acupuncture on hallucination and the other RCT showed significant effects of laser acupuncture on response rate, Brief Psychiatric Rating Scale and clinical global index compared with sham laser. The methodological quality was generally poor and there was not a single high quality trial. CONCLUSION: These results provide limited evidence for the effectiveness of acupuncture in treating the symptoms of schizophrenia. However, the total number of RCTs, the total sample size and the methodological quality were too low to draw firm conclusions. As all studies originated from China, international studies are needed to test whether there is any effect.

Int J Clin Pract 2009 Nov 63(11) 1622-33

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=19832819

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Influence of the Use of Laser Phototherapy (lambda660 or 790 nm) on the Survival of Cutaneous Flaps on Diabetic Rats.

Santos NR, Dos Santos JN, Dos Reis JA, Oliveira PC, de Sousa AP, de Carvalho CM, Soares LG, Marques AM, Pinheiro AL

1 School of Dentistry, Federal University of Bahia , Salvador, Bahia, Brazil .

Abstract Objective: The aim of this study was to assess and compare the effects of laser phototherapy (LPT) on cutaneous flaps on diabetic rats. Background: Diabetes mellitus is characterized by high blood glucose levels. Its main complications are delayed wound healing, an impaired blood supply, and a decrease in collagen production. Cutaneous flaps are routinely used in several surgical procedures, and most failures are related to poor blood supply. LPT has been studied using several healing models. Animals and Methods: Twelve Wistar rats were randomized into three groups: group 1 (G1; diabetic animals without treatment), group 2 (G2; diabetic animals irradiated with lambda680 nm), and group 3 (G3; diabetic animals irradiated with lambda790 nm). Diabetes was induced with streptozotocin. A 2- x 8-cm cutaneous flap was raised on the dorsum of each animal, and a plastic sheet was introduced between the flap and the bed to cause poor blood supply. Nonirradiated animals acted as controls. The dose per session was 40 J/cm(2). Laser light was applied transcutaneously and fractioned on 16 contact points at the wound margins (16 x 2.5 J/cm(2)). Animal death occurred on day 8 after surgery. Specimens were taken, processed, cut, stained with eosin (HE) and sirius red, and underwent histological analysis. Results: It is shown that accute inflammation was mostly discrete for G3. Chronic inflammation was more evident for G2. Fibroblast number was higher for G3. Angiogenesis was more evident for G3. Necrosis was more evident for G2. Statistical analysis among all groups showed significant differences (p = 0.04) on the level of acute inflammation between G1 and G3, tissue necrosis between G1 and G2 (p = 0.03), chronic inflammation between (p = 0.04), fibroblastic proliferation between G2 and G3 (p = 0.05), and neovascularization between G2 and G3 (p = 0.04). Conclusion: LPT was effective in increasing angiogenesis as seen on irradiated subjects and was more pronounced when IR laser light was used.

Photomed Laser Surg 2009 Oct 15

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=19831497

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[Types of microcirculation and laser therapy in chronic pancreatitis]

The aim of the study was to evaluate effect of low-intensity laser therapy (LILT) on systemic circulation in patients with chronic pancreatitis (CP) in the phase of exacerbation. 65 patients aged 36-77 years were divided into study (n = 20) and control (n = 45) groups. In addition, 30 healthy subjects were examined. Patients of the study group received drug therapy combined with intravenous blood or skin laser irradiation. Controls were treated with medicinal preparations alone. CP was diagnosed based on characteristic pain syndrome, compromised secretory function of the pancreas, results of laboratory and instrumental analysis. Microcirculation was studied by laser Doppler flowmetry with a LAKK-02 apparatus (Lazma, Russia). CP patients had heterogeneous microcirculation with a significantly increased frequency of its pathologic types (spastic, hyperemic, spastic-congestive). Major characteristics of microcirculation were significantly different from those in healthy subjects. Combination of drug therapy and LILT substantially improved microcirculation regardless of its hemodynamic type.

Klin Med (Mosk) 2009 87(8) 56-61

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=19827533

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[Efficacy of photon therapy in combined postoperative treatment of children with congenital obstructive uropathy and secondary pyelonephritis]

Razin MP, Ignat’ev SV, Illek IaIu, Zaitseva GA, Sukhodoev AV

A total of 110 children aged from 5 to 15 years with different forms of congenital obstructive uropathy and secondary pyelonephritis received standard combined treatment (n = 71) or standard treatment combination with photon therapy 3 months after discharge from hospital. Postoperative combined treatment including photon therapy promoted uneventful course of the postoperative period, normalized immunological indices, achievement of persistent remission.

Urologiia 2009 Jul-Aug (4) 55-8

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=19824386

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Photostimulation of channelrhodopsin-2 expressing ventrolateral medullary neurons increases sympathetic nerve activity and blood pressure in rats.

Abbott SB, Stornetta RL, Socolovsky CS, West GH, Guyenet PG

University of Virginia, Macquarie University;

To explore the specific contribution of the C1 neurons to blood pressure (BP) control, we used an optogenetic approach to activate these cells in vivo. A lentivirus that expresses channelrhodopsin-2 (ChR2) under the control of the catecholaminergic neuron-preferring promoter PRSx8 was introduced into the rostral ventrolateral medulla (RVLM). After 2-3 weeks, ChR2 was largely confined to Phox2b-expressing neurons (89%). The ChR2-expressing neurons were non-GABAergic, non-glycinergic and predominantly catecholaminergic (~54%). Photostimulation of ChR2-transfected RVLM neurons (473 nm, 20Hz, 10 ms, ~9mW) increased BP (15 mmHg) and sympathetic nerve discharge (SND; 64 %). Light pulses at 0.2-0.5Hz evoked a large sympathetic nerve response (16 x baseline) followed by a silent period (1-2 s) during which another stimulus evoked a reduced response. Photostimulation activated most (75%) RVLM baroinhibited neurons sampled with 1/1 action potential entrainment to the light pulses and without accommodation during 20 Hz trains. RVLM neurons unaffected by either CO2 or BP were light-insensitive. Botzinger respiratory neurons were activated but their action potentials were not synchronized to the light pulses. Juxtacellular labeling of recorded neurons revealed that, of these three cell types, only the cardiovascular neurons expressed the transgene. In conclusion, ChR2 expression had no discernable effect on the putative vasomotor neurons at rest and was high enough to allow precise temporal control of their action potentials with light pulses. Photostimulation of RVLM neurons caused a sizable sympathoactivation and rise in blood pressure. These results provide the most direct evidence yet that the C1 neurons have a sympathoexcitatory function.

J Physiol 2009 Oct 12

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=19822543

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Biomodulative Effects of Visible and IR Laser Light on the Healing of Cutaneous Wounds of Nourished and Undernourished Wistar Rats.

Barbosa Pinheiro AL, Silva Meireles GC, Carvalho CM, Ramalho LM, Dos Santos JN

1 Laser Center, School of Dentistry, Federal University of Bahia , Salvador, BA, Brazil .

Abstract Aim: We evaluated histologically the differences in the healing of cutaneous wounds on nourished or undernourished rats following laser phototherapy (LPT) (20 or 40 J/cm(2)). Background: Wound healing occurs due to a competitive mechanism between the synthesis and lysis of collagen. Any factor that increases the lysis or reduces the synthesis of collagen may change the healing process. Nutritional deficiencies have a great effect on wound healing. Methods: Fifty nourished or undernourished Wistar rats had one standardized wound created on the dorsum and were divided into 10 subgroups: Control (standard diet); Control [Northeastern Brazilian basic diet (DBR)]; Standard diet + LPT (lambda635 nm; spatial average energy fluence (SAEF) 20 J/cm(2)); Standard diet + LPT (lambda635 nm; SAEF 40 J/cm(2)); Standard diet + LPT (lambda780 nm; SAEF 20 J/cm(2)); Standard diet + LPT (lambda780 nm; SAEF 40 J/cm(2)); DBR + LPT (lambda635 nm; SAEF 20 J/cm(2)); DBR + LPT (lambda635 nm; SAEF 40 J/cm(2)); DBR + LPT (lambda780 nm; SAEF 20 J/cm(2)); DBR + LPT (lambda780 nm; SAEF 40 J/cm(2)). The first application of the treatment was carried out immediately and repeated daily for seven days. The specimens were routinely processed to wax, cut, stained with H&E and Sirius Red stains, and analyzed using light microscopy. The analyses included re-epithelization, inflammatory infiltrate, and fibroblastic proliferation. Sirius Red stained slides were used to perform descriptive analyses of the collagen fibers. Results: The results showed that LPT with lambda635 wavelength was more effective for the treatment of undernourished subjects, treated with either LPT with lambda730 nm with SAEF of 20 J/cm(2) or lambda780 nm with SAEF of 40 J/cm(2). Conclusion: Nutritional status influenced the progression of the healing process as well as the quality of the healed tissue. In addition, the use of both wavelengths resulted in a positive biomodulatory effect on both nourished and undernourished subjects.

Photomed Laser Surg 2009 Oct 12

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=19821705

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Pain Threshold Improvement for Chronic Hyperacusis Patients in a Prospective Clinical Study.

Zazzio M

Audio Laser-Kliniken , Flygeln, Hovmantorp, Sweden .

Abstract Objective: The aim of this study was to investigate if laser therapy in combination with pulsed electromagnetic field therapy/repetitive transcranial magnetic stimulation (rTMS) and the control of reactive oxygen specimens (ROS) would lead to positive treatment results for hyperacusis patients. Background Data: Eight of the ten patients treated for tinnitus, who were also suffering from chronic hyperacusis, claimed their hyperacusis improved. Based upon that, a prospective, unblinded, uncontrolled clinical trial was planned and conducted. ROS and hyperacusis pain thresholds were measured. Materials and Methods: The patients were treated twice a week with a combination of therapeutic laser, rTMS, and the control and adjustment of ROS. A magnetic field of no more than 100 muT was oriented behind the outer ear, in the area of the mastoid bone. ROS were measured and controlled by administering different antioxidants. At every treatment session, 177-504 J of laser light of two different wavelengths was administered toward the inner ear via meatus acusticus. Results: The improvements were significantly better in the verum group than in a placebo group, where 40% of the patients were expected to have a positive treatment effect. The patients in the long-term follow-up group received significantly greater improvements than the patients in the short-term follow-up group. Conclusion: The treatment is effective in treating chronic hyperacusis.

Photomed Laser Surg 2009 Oct 12

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=19821704

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Evaluation of Low-Level Laser Therapy with a He-Ne Laser on the Healing of an Osteochondral Defect using a Biomechanical Test.

Javadieh F, Bayat M, Torkaman G

1 Medical Faculty, Shahid Beheshti University , M.C., Tehran, Iran .

Abstract Objective: The aim of the present study was to examine the influence of low-level laser therapy (LLLT) on the healing of an osteochondral defect in rabbits. Background data: Full-thickness defects of articular cartilage in the knee have a negligible capacity to heal spontaneously. Biostimulatory effects of LLLT on chondrocytes and articular cartilage were reported. Materials and Methods: An osteochondral defect with a 5-mm diameter was surgically induced in the right femoral patellar groove of forty-two adult male rabbits. They were divided into control and experimental groups. The experimental group received He-Ne laser treatment (632.8 nm, 10 mW, circular laser beam, with a surface area of 0.0314 cm(2)) of 148.4 J/cm(2) three times a week. The control group received placebo LLLT with the equipment switched off. Each group was divided into four subgroups: A, B, C, and D. The subgroups were sacrificed at 2, 4, 8, and 16 wk after surgery, respectively. The femur was removed and the defect was examined biomechanically by the in-situ indentation method. The instantaneous stiffness, maximum force, equilibrium load, and energy absorption were calculated. Results: The results of the experimental group were higher than those of the control group. Only one significant difference was observed between the control and experimental groups: the second part of the energy absorption of the experimental group (56.11 +/- 11.5) was significantly higher than that of the control group (18.9 +/- 4) (p = 0.015) 4 wk after surgery. Conclusion: LLLT with a He-Ne laser of an osteochondral defect in rabbits could not significantly accelerate the healing of the osteochondral defect from a biomechanical standpoint when compared with a control group.

Photomed Laser Surg 2009 Oct 12

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=19821703

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Effects of Low-Level Laser Therapy on Pain and Scar Formation after Inguinal Herniation Surgery: A Randomized Controlled Single-Blind Study.

de Paiva Carvalho RL, Alcantara PS, Kamamoto F, Cressoni MD, Casarotto RA

1 Postgraduate Program in Rehabilitation Sciences , University of Sao Paulo, Sao Paulo, Brazil .

Abstract Objective: The aim of this study was to investigate the efficacy of an infrared GaAlAs laser operating with a wavelength of 830 nm in the postsurgical scarring process after inguinal-hernia surgery. Background: Low-level laser therapy (LLLT) has been shown to be beneficial in the tissue-repair process, as previously demonstrated in tissue culture and animal experiments. However, there is lack of studies on the effects of LLLT on postsurgical scarring of incisions in humans using an infrared 830-nm GaAlAs laser. Method: Twenty-eight patients who underwent surgery for inguinal hernias were randomly divided into an experimental group (G1) and a control group (G2). G1 received LLLT, with the first application performed 24 h after surgery and then on days 3, 5, and 7. The incisions were irradiated with an 830-nm diode laser operating with a continuous power output of 40 mW, a spot-size aperture of 0.08 cm(2) for 26 s, energy per point of 1.04 J, and an energy density of 13 J/cm(2). Ten points per scar were irradiated. Six months after surgery, both groups were reevaluated using the Vancouver Scar Scale (VSS), the Visual Analog Scale, and measurement of the scar thickness. Results: G1 showed significantly better results in the VSS totals (2.14 +/- 1.51) compared with G2 (4.85 +/- 1.87); in the thickness measurements (0.11 cm) compared with G2 (0.19 cm); and in the malleability (0.14) compared with G2 (1.07). The pain score was also around 50% higher in G2. Conclusion: Infra-red LLLT (830 nm) applied after inguinal-hernia surgery was effective in preventing the formation of keloids. In addition, LLLT resulted in better scar appearance and quality 6 mo postsurgery.

Photomed Laser Surg 2009 Oct 12

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=19821701

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Green Tea and Red Light-A Powerful Duo in Skin Rejuvenation.

Sommer AP, Zhu D

Institute of Micro and Nanomaterials, University of Ulm , Ulm, Germany .

Abstract Objective: Juvenile skin has been the subject of intense research efforts since ancient times. This article reports on synergistic complementarities in the biological actions of green tea and red light, which inspired the design of a green tea-assisted facial rejuvenation program. Background Data: The approach is based on previous laboratory experiments providing insight into a mechanism by which visible light interacts with cells and their microenvironment. Methods: After 2 months of extreme oxidative stress, green tea-filled cotton pads were placed once per day for 20 minutes onto the skin before treatment with an array of light-emitting diodes (central wavelength 670 nm, dermal dose 4 J/cm(2)). Results: Rejuvenated skin, reduced wrinkle levels, and juvenile complexion, previously realized in 10 months of light treatment alone, were realized in 1 month. Conclusion: The accelerated skin rejuvenation based on the interplay of the physicochemical and biological effects of light with the reactive oxygen species scavenging capacity of green tea extends the action spectrum of phototherapy. The duo opens the gate to a multitude of possible biomedical light applications and cosmetic formulas, including reversal of topical deterioration related to excess reactive oxygen species, such as graying of hair.

Photomed Laser Surg 2009 Oct 9

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=19817517

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Effect of 830 nm Laser Phototherapy on Osteoblasts Grown In Vitro on Biosilicate((R)) Scaffolds.

Renno AC, McDonnell PA, Crovace MC, Zanotto ED, Laakso L

1 Department of Bioscience, Federal University of Sao Paulo , Santos, SP, Brazil .

Abstract Objective: The purpose of this study was (i) to develop a method for successfully seeding osteoblasts onto a glass-ceramic scaffold designed for use in clinical settings, and (ii) to determine whether the application of laser phototherapy at 830 nm would result in osteoblast proliferation on the glass-ceramic scaffold. Background: The use of bioscaffolds is considered a promising strategy for a number of clinical applications where tissue healing is sub-optimal. As in vitro osteoblast growth is a slow process, laser phototherapy could be used to stimulate osteoblast proliferation on bioscaffolds. Methods: A methodology was developed to seed an osteoblastic (MC3T3) cell line onto a novel glass-ceramic scaffold. Seeded scaffolds were irradiated with a single exposure of 830 nm laser at 10 J/cm(2) (at diode). Non-irradiated seeded scaffolds acted as negative controls. Cell proliferation was assessed seven days after irradiation. Results: Osteoblastic MC3T3 cells were successfully grown on discs composed of a glass-ceramic composite. Laser irradiation produced a 13% decrease in MC3T3 cell proliferation on glass-ceramic discs (mean +/- SD = 0.192 +/- 0.002) compared with control (non-irradiated) discs (mean +/-SD = 0.22 +/- 0.002). Conclusions: Despite successful seeding of bioscaffolds with osteoblasts, laser phototherapy resulted in a reduction in cell growth compared to non-irradiated controls. Future research combining laser phototherapy and glass-ceramic scaffolds should take into account possible interactions of the laser with matrix compounds.

Photomed Laser Surg 2009 Oct 9

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=19814702

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Laser Phototherapy as Topical Prophylaxis Against Radiation-Induced Xerostomia.

Simoes A, de Campos L, de Souza DN, de Matos JA, Freitas PM, Nicolau J

1 Department of Dental Materials, Division of Oral Biology, Faculdade de Odontologia, Universidade de Sao Paulo , Sao Paulo, SP, Brazil .

Abstract The common consequences of radiotherapy (RT) to the head and neck are oral mucositis, xerostomia, and severe pain. The aim of this study was to verify how laser phototherapy (LPT) used for oral mucositis could influence xerostomia symptoms and hyposalivation of patients undergiong RT. Patients were divided into two groups: 12 individuals receiving three laser irradiations per week (G1) and 10 patients receiving one laser irradiation per week (G2). A diode laser (660 nm, 6 J/cm(2), 0.24 J, 40 mW) was used until completely healing of the lesions or the end of the RT. At the first and last laser sessions, whole resting and stimulated saliva were collected, and questionnaires were administered. According to Wilcoxon and Student statistical test, xerostomia for G1 was lower than for G2 (p < 0.05), and salivary flow rate was no different before and after RT, except for stimulated collection of G2, which was lower (p < 0.05). Our results suggest that LPT can be beneficial as an auxiliary therapy for hypofunction of salivary glands.

Photomed Laser Surg 2009 Oct 9

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=19814701

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Methodological quality of systematic reviews analyzing the use of laser therapy in restorative dentistry.

Salmos J, Gerbi ME, Braz R, Andrade ES, Vasconcelos BC, Bessa-Nogueira RV

Center for Laser Therapy, Dental School, University of Pernambuco, Av. General Newton Cavalcanti, 1650, 54753-020, Camaragibe, Pernambuco, Brazil, janainasalmos@hotmail.com.

The purpose of this study was to identify systematic reviews (SRs) that compared laser with other dental restorative procedures and to evaluate their methodological quality. A search strategy was developed and implemented for MEDLINE, the Cochrane Library, LILACS, and the Brazilian Dentistry Bibliography (1966-2007). Inclusion criteria were: the article had to be an SR (+/- meta-analysis); primary focus was the use of laser in restorative dentistry; published in English, Spanish, Portuguese, Italian, German. Two investigators independently selected and evaluated the SRs. The overview quality assessment questionnaire (OQAQ) was used to evaluate methodological quality, and the results were averaged. There were 145 references identified, of which seven were SRs that met the inclusion criteria (kappa = 0.81). Of the SRs, 71.4% appraised lasers in dental caries diagnosis. The mean overall OQAQ score was 4.4 [95% confidence interval (CI) 2.4-6.5]. Of the SRs, 57.1% had major flaws, scoring

Lasers Med Sci 2009 Oct 8

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=19813047

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[Retinopathy of prematurity. Prevention, screening and treatment guidelines.]

Castro Conde JR, Echaniz Urcelay I, Botet Mussons F, Pallas Alonso CR, Narbona E, Sanchez Luna M

Hospital Universitario de Canarias, Universidad de La Laguna, Tenerife.

ROP screening is carried out at all the Spanish hospitals, but there is little agreement on the criteria used for its screening and other aspects related to its practice. Our aim is to report on recommendations for prevention, screening, treatment and follow-up of the retinopathy of prematurity in Spain. Prevention strategies and recommendations for screening, exploration and treatment of ROP, as well as of the organisation of the services to carry out it are reviewed. The most recent bibliography on the basis of the scientific evidence is considered, taking as reference, the guidelines published by the American Academy of Pediatrics (AAP) in 2006 and the recommendations updated in 2007 in the United Kingdom. The recommended prevention strategies are based on the best neonatal practice. The standards, as far as the screening is concerned, are established by birth weight (

An Pediatr (Barc) 2009 Oct 5

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=19811960

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The Effect of Laser Irradiation on Proliferation of Human Breast Carcinoma, Melanoma, and Immortalized Mammary Epithelial Cells.

Powell K, Low P, McDonnell PA, Laakso EL, Ralph SJ

1 School of Medical Science, Griffith University , Gold Coast, Queensland, Australia .

Abstract Objective: This study compared the effects of different doses (J/cm(2)) of laser phototherapy at wavelengths of either 780, 830, or 904 nm on human breast carcinoma, melanoma, and immortalized human mammary epithelial cell lines in vitro. In addition, we examined whether laser irradiation would malignantly transform the murine fibroblast NIH3T3 cell line. Background: Laser phototherapy is used in the clinical treatment of breast cancer-related lymphoedema, despite limited safety information. This study contributes to systematically developing guidelines for the safe use of laser in breast cancer-related lymphoedema. Methods: Human breast adenocarcinoma (MCF-7), human breast ductal carcinoma with melanomic genotypic traits (MDA-MB-435S), and immortalized human mammary epithelial (SVCT and Bre80hTERT) cell lines were irradiated with a single exposure of laser. MCF-7 cells were further irradiated with two and three exposures of each laser wavelength. Cell proliferation was assessed 24 h after irradiation. Results: Although certain doses of laser increased MCF-7 cell proliferation, multiple exposures had either no effect or showed negative dose response relationships. No sign of malignant transformation of cells by laser phototherapy was detected under the conditions applied here. Conclusion: Before a definitive conclusion can be made regarding the safety of laser for breast cancer-related lymphoedema, further in vivo research is required.

Photomed Laser Surg 2009 Oct 7

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=19811082

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KTP/532 YAG laser treatment for allergic rhinitis.

Yaniv E, Hadar T, Shvero J, Tamir R, Nageris B

Nose and Sinus Institute, Department of Otorhinolaryngology, Rabin Medical Center, Beilinson Campus, Petah Tiqwa and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel. docyaniv@yahoo.com

BACKGROUND: The purpose of this study was to investigate the efficacy of the KTP/532 YAG laser to reduce nasal congestion and discharge in patients with allergic rhinitis. METHODS: Forty-eight patients with symptoms of allergic rhinitis were treated with the KTP/532 laser. All had positive skin tests for common allergens. Treatments were provided on an ambulatory basis in one to three sessions under local anesthesia with lidocaine nose spray. Outcome was determined by daily symptom reports and regular endoscopy examination and interviews for 12 months. RESULTS: Treatment was very well tolerated. There were no major side effects. At examination after 1 year, nasal obstruction was improved in 69% and nasal discharge in 40% of cases. CONCLUSION: The KTP/532 YAG laser is effective for the treatment of nasal obstruction and discharge. Comparison with other techniques showed it to be the most effective in reducing nasal discharge. It can be done as an office procedure and does not damage the nasal mucous membrane. The KTP/532 YAG laser is effective as an additional treatment for patients refractory to medication.

Am J Rhinol Allergy 2009 Sep-Oct 23(5) 527-30

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=19807988

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The effects of 660 nm and 780 nm laser irradiation on viability of random skin flap in rats.

Cury V, Bossini PS, Fangel R, Crusca Jde S, Renno AC, Parizotto NA

Department of Physiotherapy, Federal University of Sao Carlos, Sao Carlos, SP, Brazil.

BACKGROUND AND OBJECTIVE: Some studies have shown that laser phototherapy is able to increase skin flap viability by decreasing the necrotic area and increasing neoangiogenesis. However, the mechanism by which laser acts on cells is not fully understood. The present study investigated the effects of two different laser wavelengths at 30 and 40 J/cm(2) on the viability of skin flap in rats. MATERIAL AND METHODS: Sixty male animals were used in this study. They were distributed into the following groups (n = 12 each group): control group, group irradiated with 660 nm at 30 J/cm(2); group irradiated with 780 nm, at 30 J/cm(2), group irradiated with 660 nm at 40 J/cm(2); and group irradiated with 780 nm at 40 J/cm(2). The skin flap was performed on the back of all animals studied, with a plastic sheet interposed between the flap and the donor site. Laser irradiation was done immediately after the surgery and on days 1, 2, 3, and 4 post-surgery. The percentage of the necrotic area of the flap was calculated at day 7 post-surgery. RESULTS: Control group showed a necrotic area of 62.83%. Interestingly, no statistically significant differences were found among the treated groups and the control group. CONCLUSION: This present study showed that 660 nm and 780 nm lasers at doses of 30 and 40 J/cm(2) were not effective for decreasing the necrotic area of the skin flaps in rats.

Photomed Laser Surg 2009 Oct 27(5) 721-4

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=19803711

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Effect of phototherapy with low intensity laser on local and systemic immunomodulation following focal brain damage in rat.

Moreira MS, Velasco IT, Ferreira LS, Ariga SK, Barbeiro DF, Meneguzzo DT, Abatepaulo F, Marques MM

LIM-51, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil.

Brain injury is responsible for significant morbidity and mortality in trauma patients, but controversy still exists over therapeutic management for these patients. The objective of this study was to analyze the effect of phototherapy with low intensity lasers on local and systemic immunomodulation following cryogenic brain injury. Laser phototherapy was applied (or not-controls) immediately after cryogenic brain injury performed in 51 adult male Wistar rats. The animals were irradiated twice (3 h interval), with continuous diode laser (gallium-aluminum-arsenide (GaAlAs), 780 nm, or indium-gallium-aluminum-phosphide (InGaAlP), 660 nm) in two points and contact mode, 40 mW, spot size 0.042 cm(2), 3 J/cm(2) and 5 J/cm(2) (3 s and 5 s, respectively). The experimental groups were: Control (non-irradiated), RL3 (visible red laser/ 3 J/cm(2)), RL5 (visible red laser/5 J/cm(2)), IRL3 (infrared laser/3 J/cm(2)), IRL5 (infrared laser/5 J/cm(2)). The production of interleukin-1IL-1beta (IL-1beta), interleukin6 (IL-6), interleukin-10 (IL-10), and tumor necrosis factor-alpha (TNF-alpha) was analyzed by enzyme immunoassay technique (ELISA) test in brain and blood samples. The IL-1beta concentration in brain of the control group was significantly reduced in 24 h (p<0.01). This reduction was also observed in the RL5 and IRL3 groups. The TNF-alpha and IL-6 concentrations increased significantly (p<0.01 and p<0.05, respectively) in the blood of all groups, except by the IRL3 group. The IL-6 levels in RL3 group were significantly smaller than in control group in both experimental times. IL-10 concentration was maintained stable in all groups in brain and blood. Under the conditions of this study, it is possible to conclude that the laser phototherapy can affect TNF-alpha, IL-1beta and IL-6 levels in the brain and in circulation in the first 24 h following cryogenic brain injury.

J Photochem Photobiol B 2009 Dec 2 97(3) 145-51

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=19800810

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Effects of 780-nm Low-level Laser Therapy with a Pulsed Gallium Aluminum Arsenide Laser on the Healing of a Surgically Induced Open Skin Wound of Rat.

Bayat M, Azari A, Golmohammadi MG

Physical Therapy Research Group, Academic Center for Education, Culture, and Research, Iran Medical Science Branch University , Vanak, Tehran, Iran .

Abstract Objective: The aim of the present investigation is to evaluate the effects of a 780-nm low-level laser on open skin wound healing. Background Data: Optimal parameters of low-level laser therapy (LLLT) for wound healing are discussed. Methods: One full-thickness skin wound was surgically induced in the dorsum skin of 30 rats. The rats were divided into two groups. Rats in the experimental group were daily treated with a gallium aluminum arsenide (GaAlAs) laser (2 J/cm(2), lambda = 780 nm, pulse frequency of 2336 Hz). Rats in the sham-exposed group received LLLT with switched off equipment. After 4, 7, and 15 days, wounds were checked by histological and biomechanical methods. Data were analyzed by the Mann-Whitney U-test. Results: Fibroblasts, endothelium of blood vessels, blood vessel sections, and maximum stress were significantly increased, whereas macrophages were significantly decreased, compared with those of the sham-exposed group. Conclusion: Pulsed LLLT with a 780-nm GaAlAs laser significantly accelerates the process of healing of surgically induced, full-thickness skin wounds in rat.

Photomed Laser Surg 2009 Oct 1

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=19795994

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Effect of Low-Level Laser Irradiation on Bisphosphonate-Induced Osteonecrosis of the Jaws: Preliminary Results of a Prospective Study.

Scoletta M, Arduino PG, Reggio L, Dalmasso P, Mozzati M

1 Oral Surgery Unit, Dentistry Section, Department of Clinical Physiopathology, University of Turin , Turin, Italy .

Abstract Objective: The aim of this study was to detail the clinical efficacy of low-level laser therapy (LLLT) for the management of bisphosphonate-induced osteonecrosis of the jaws (ONJ-BP). Background: ONJ-BP is the correct term, recently emerged, to describe a significant complication in a subset of patients receiving drugs such as zoledronic acid, pamidronate, and alendronate. No definitive standard of care has been set for ONJ-BP and no definitively agreed guidelines have been provided. There is currently no consensus on the correct approach to the issue. Materials and Methods: The investigators studied a prospective cohort of 20 patients affected by ONJ-BP, who received biostimulation with a pulsed diode laser (GaAs). Patients were exposed to a 904-nm infrared laser (50 kHz, 28.4 J/cm(2) energy density, 40% duty cycle, spot size 0.8 cm). Outcome variables were the size of lesions, edema, visual analogue score of pain, presence of pus, fistulas, and halitosis. Preoperative results were compared with the postoperative outcome and statistically evaluated. Results: Four weeks after LLLT, a statistically significant difference was observed for reported pain (p = 0.0001), clinical size (p = 0.0034), edema (p = 0.0005), and presence of pus and fistulas (p = 0.0078 and p = 0.03, respectively). Conclusion: This study suggests that LLLT would appear to be a promising modality of treatment for patients with ONJ-BP, providing that clinical efficacy is safe and well tolerated, especially by those patients who require conservative treatment. Of course, this needs to be addressed further in larger and randomly controlled studies in different clinical settings.

Photomed Laser Surg 2009 Oct 1

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=19795990

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Visible light induces no formation in sperm and endothelial cells.

Ankri R, Friedman H, Savion N, Kotev-Emeth S, Breitbart H, Lubart R

Department of Physics, Bar Ilan University, Ramat Gan 52900, Israel.

BACKGROUND: Visible light-based stimulation using low-intensity lasers, LEDs, and broadband visible light devices has been recently introduced for therapy of human tissues in the absence of exogenous photosensitizers. Nitric oxide (NO) formation might be a potential mechanism for photobiomodulation because it is synthesized in cells by nitric oxide synthase (NOS), which contains both flavin and heme groups that absorb visible light. NO synthesis may also result from increased reactive oxygen species (ROS), which are found in various cell cultures following visible light illumination. NO is mainly known for inducing blood vessel dilation by endothelial cells, and in sperm cells NO is considered as an important agent in acrosome reaction and capacitation process, which are essential for successful fertilization. PURPOSE: To study NO formation in endothelial and sperm cells following visible light irradiation. MATERIALS AND METHODS: Sperm and endothelial cells were illuminated with broadband visible light, 400-800 nm, 130 mW/cm(2), for 5 minutes. During illumination, the endothelial cells were incubated in PBS free of Ca(+2) and Mg(+2), and the sperm cells were incubated in NKM buffer, to induce “stress conditions.” NO production was quantified by using the Griess reagent which reacts with nitrite in the medium to yield an Azo compound which has an absorption band at 540 nm. RESULTS: Visible light illumination increased NO concentration both in sperm and endothelial cells. Blue light was more effective than red. Light-induced NO occurred only when endothelial cells were incubated in PBS free of Ca(+2) and Mg(+2), and in sperm cells, only when incubated in NKM. CONCLUSION: Light induces NO formation in endothelial and sperm cells. In endothelial cells, NO formation may explain previous results demonstrating enhanced wound healing and pain relief following illumination. In illuminated sperm cells, NO formation may account for the enhanced fertilization rate. Lasers Surg. Med. (c) 2009 Wiley-Liss, Inc.

Lasers Surg Med 2009 Sep 29

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=19790248

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Anti-Inflammatory Effect of Low-Level Laser and Light-Emitting Diode in Zymosan-Induced Arthritis.

de Morais NC, Barbosa AM, Vale ML, Villaverde AB, de Lima CJ, Cogo JC, Zamuner SR

1 Laboratory of Inflammation, Institute of Research and Development, University of Vale do Paraiba , Sao Jose dos Campos, Brazil .

Abstract Objective: The aim of this work was to investigate the effect of low-level laser therapy (LLLT) and light-emitting diode (LED) on formation of edema, increase in vascular permeability, and articular joint hyperalgesia in zymosan-induced arthritis. Background Data: It has been suggested that low-level laser and LED irradiation can modulate inflammatory processes. Material and Methods: Arthritis was induced in male Wistar rats (250-280 g) by intra-articular injection of zymosan (1 mg in 50 muL of a sterile saline solution) into one rear knee joint. Animals were irradiated immediately, 1 h, and 2 h after zymosan administration with a semiconductor laser (685 nm and 830 nm) and an LED at 628 nm, with the same dose (2.5 J/cm(2)) for laser and LED. In the positive control group, animals were injected with the anti-inflammatory drug dexamethasone 1 h prior to the zymosan administration. Edema was measured by the wet/dry weight difference of the articular tissue, the increase in vascular permeability was assessed by the extravasation of Evans blue dye, and joint hyperalgesia was measured using the rat knee-joint articular incapacitation test. Results: Irradiation with 685 nm and 830 nm laser wavelengths significantly inhibited edema formation, vascular permeability, and hyperalgesia. Laser irradiation, averaged over the two wavelengths, reduced the vascular permeability by 24%, edema formation by 23%, and articular incapacitation by 59%. Treatment with LED (628 nm), with the same fluence as the laser, had no effect in zymosan-induced arthritis. Conclusion: LLLT reduces inflammatory signs more effectively than LED irradiation with similar irradiation times (100 sec), average outputs (20 mW), and energy doses (2 J) in an animal model of zymosan-induced arthritis. The anti-inflammatory effects of LLLT appear to be a class effect, which is not wavelength specific in the red and infrared parts of the optical spectrum.

Photomed Laser Surg 2009 Sep 25

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=19780633

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[Comparison of non-invasive and invasive techniques in the treatment of patients with myofascial pain syndrome.]

Gul K, Onal SA

Department of Anesthesiology and Reanimation, Bingol State Hospital, Bingol, Turkey. kursadgul@yahoo.com

OBJECTIVES: We compared in this study the efficiency of non-invasive techniques including transcutaneous electrical nerve stimulation (TENS) and laser treatments with invasive techniques including lidocaine and botulinum toxin-A injection in patients with myofascial pain syndrome (MPS). METHODS: One hundred patients who admitted to Firat University Hospital Pain Department and who were diagnosed as MPS were included in the study. Patients were randomized into four groups of 25 patients each. Sixty sessions of TENS and 20 sessions of laser treatments were performed in the first and second groups, respectively. Lidocaine and botulinum toxin-A were injected in the third and fourth groups, respectively. 2 ml (20 mg) 1% lidocaine was injected in each patient twice a week for one month in Group III. 25 U (0.5 ml) of botulinum toxin-A was injected in each patient only once in Group IV. Pain was evaluated with visual analogue scale (VAS), palpable muscle spasm scoring (PMSS) and anesthesiometer at baseline, 15, 30 and 45 days. RESULTS: There were no statistically significant differences between the groups with respect to age, sex and education level. Pain control was statistically better in Group IV compared with the other groups with respect to VAS, PMSS and anesthesiometer scores. CONCLUSION: Botulinum toxin-A injection provided better pain control when compared to trigger point injection with lidocaine and non-invasive techniques including TENS and laser treatments.

Agri 2009 Jul 21(3) 104-12

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=19780001

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Effect of Low-Level Laser Therapy with Output Power of 30 mW and 60 mW in the Viability of a Random Skin Flap.

Costa MS, Pinfildi CE, Gomes HC, Liebano RE, Arias VE, Silveira TS, Ferreira LM

1 Division of Plastic Surgery, Federal University of Sao Paulo , Sao Paulo, SP, Brazil .

Abstract Objective: To assess the effects of low-level laser therapy (LLLT) with output power of 30 and 60 mW in the viability of a random skin flap in rats. Background Data: Output power values in LLLT are not well defined. Materials and Methods: Controlled, single-blind experimental study. Thirty-six animals were randomly distributed into three groups: sham group (SG), 30-mW output power (30G), and 60-mW output power (60G). In both treated groups, a fluency of 3 J/cm(2) was used. Two minutes after elevation of a random-pattern cranially based dorsal flap (4 x 10 cm), laser irradiation was applied and repeated on the first, second, third, and fourth postoperative days. Percentages of flap necrosis were calculated on the seventh postoperative day. Also, four fragments of each flap were collected to allow determination of the percentages of vascular density according to the bidimensional method of the morphometric analysis of blood vessels. Statistical analysis included the Wilcoxon test and Kruskal-Wallis variance analysis. A significance level of 5% was elected (p < 0.05). Results: Laser-treated animals presented significantly less necrosis than the sham group (SG, 53%; 30G, 24%; p < 0.05) (60G, 25%; p < 0.05). Also, laser-treated animals presented significantly more vascular density than the sham group (SG, 37%; 30G, 57%; p < 0.05) (60G, 59%; p < 0.05). Conclusion: LLLT (660 nm) with 30-mW and 60-mW output power was efficient in the increase of skin flap viability, but there was no difference between them.

Photomed Laser Surg 2009 Sep 21

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=19764895

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Low-Level Laser Irradiation (InGaAlP-660 nm) Increases Fibroblast Cell Proliferation and Reduces Cell Death in a Dose-Dependent Manner.

Frigo L, Favero GM, Campos Lima HJ, Maria DA, Bjordal JM, Joensen J, Iversen VV, Marcos RL, Parizzoto NA, Lopes-Martins RA

1 Biological Sciences and Health Center, Cruzeiro do Sul University , Sao Paulo, Brazil .

Abstract Background and Objective: Impaired cell metabolism and increased cell death in fibroblast cells are physiological features of chronic tendinopathy. Although several studies have shown that low-level laser therapy (LLLT) at certain parameters has a biostimulatory effect on fibroblast cells, it remains uncertain if LLLT effects depend on the physiological state. Study Design/Material and Methods: High-metabolic immortal cell culture and primary human keloid fibroblast cell culture were used in this study. Trypan blue exclusion and the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) test were used to determine cell viability and proliferation. Propidium iodide stain was used for cell-cycle analysis by flow cytometry. Laser irradiation was performed daily on three consecutive days with a GaAlAs 660-nm laser (mean output: 50 mW, spot size 2 mm(2), power density =2.5 W/cm(2)) and a typical LLLT dose and a high LLLT dose (irradiation times: 60 or 420 s; fluences:150 or 1050 J/cm(2); energy delivered: 3 or 21 J). Results: Primary fibroblast cell culture from human keloids irradiated with 3 J showed significant proliferation by the trypan blue exclusion test (p < 0.05), whereas the 3T3 cell culture showed no difference using this method. Propidium iodide staining flow cytometry data showed a significant decrease in the percentage of cells being in proliferative phases of the cell cycle (S/g(2)/M) when irradiated with 21 J in both cell types (hypodiploid cells increased). Conclusions: Our data support the hypothesis that the physiological state of the cells affects the LLLT results, and that high-metabolic rate and short- cell-cycle 3T3 cells are not responsive to LLLT. In conclusion, LLLT with a dose of 3 J reduced cell death significantly, but did not stimulate cell cycle. A LLLT dose of 21 J had negative effects on the cells, as it increased cell death and inhibited cell proliferation.

Photomed Laser Surg 2009 Sep 21

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=19764894

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[Effect of electroacupuncture on epileptic EEG and intracellular Ca2+ content in the hippocampus in epilepsy rats]

Yang F, Xu GL, Yang YQ, Shen DK, Feng PZ, Wang P, Liu XG

Shanghai Institute of Acu-moxibustion and Meridians, Shanghai 200030, China. saildoctor@126.com

OBJECTIVE: To study the underlying mechanism of electroacupuncture (EA) in relieving epilepsy in pentylenetetrazole (PTZ)-induced epilepsy rats. METHODS: Twenty SD rats were randomly divided into normal control, model, EA, Nimodipine groups, with 5 cases in each. Epilepsy model was established by intraperitoneal injection of PTZ (32.0 mg/kg), once daily for 28 days. EA (100 Hz, 0.6 mA) was applied to “Baihui” (GV 20) and “Dazhui” (GV 14), once daily for 7 days. For Nimodipine group, the rats were given with nimodipine (0.25 mg/kg, i.p.), once daily for 7 days. Electroencephalogram (EEG) was recorded and the fluorescence intensity of Ca2+ of the hippocampus tissue sections was detected by laser scanning confocal microscope (LSCM) after incubation in artificial cerebrospinal fluid containing Flou-3/AM (10 micromol/L) and pluronic F-127 (5 microl). RESULTS: Compared with model group, the latencies of epileptic EEG seizure prolonged obviously (P < 0.05), and epileptic EEG seizure frequencies decreased significantly (P < 0.05) in EA and Nimodipine groups. The fluorescence intensity of intracellular Ca2+ in hippocampus tissue in model group was obviously higher than that in control group (P < 0.01). In comparison to model group, Ca2+ levels in EA and Nimodipine groups lowered considerably (P < 0.05, P < 0.01). No significant differences were found between EA and Nimodipine groups in the aforementioned 3 indexes (P > 0.05). CONCLUSION: EA has an obvious anti-epileptic effect, which may be closely related to its effect in downregulating the increased hippocampal Ca2+ level in PTZ-kindled epilepsy rats.

Zhen Ci Yan Jiu 2009 Jun 34(3) 163-6

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=19761108

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Biophoton Detection and Low-Intensity Light Therapy: A Potential Clinical Partnership.

Tafur J, Van Wijk EP, Wijk RV, Mills PJ

1 Department of Psychiatry, Behavioral Medicine Laboratory, University of California at San Diego , San Diego, CA.

Abstract Low-intensity light therapy (LILT) is showing promise in the treatment of a wide variety of medical conditions. Concurrently, our knowledge of LILT mechanisms continues to expand. We are now aware of LILT’s potential to induce cellular effects through, for example, accelerated ATP production and the mitigation of oxidative stress. In clinical use, however, it is often difficult to predict patient response to LILT. It appears that cellular reduction/oxidation (redox) state may play a central role in determining sensitivity to LILT and may help explain variability in patient responsiveness. In LILT, conditions associated with elevated reactive oxygen species (ROS) production, e.g. diabetic hyperglycemia, demonstrate increased sensitivity to LILT. Consequently, assessment of tissue redox conditions in vivo may prove helpful in identifying responsive tissues. A noninvasive redox measure may be useful in advancing investigation in LILT and may one day be helpful in better identifying responsive patients. The detection of biophotons, the production of which is associated with cellular redox state and the generation of ROS, represents just such an opportunity. In this review, we will present the case for pursuing further investigation into the potential clinical partnership between biophoton detection and LILT.

Photomed Laser Surg 2009 Sep 15

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=19754267

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The Effect of Low-Level Laser Therapy on Healing of Skin Incisions Made Using a Diode Laser in Diabetic Rats.

Akyol U, Gungormus M

Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Ataturk University , Erzurum, Turkey .

Abstract Background and Objective: To investigate the effect of low-level laser therapy (LLLT) on healing of skin incisions made using a diode laser in diabetic rats. Material and Methods: Eighteen diabetic Wistar rats were used for this study. One incision was performed on the left side of the dorsum using a diode laser, and the other two incisions were made with a scalpel and diode laser on the right side of each rat. The wound on the left side of each rat received laser stimulation (10 J/cm(2)). The rats were assigned to three experimental groups. Group 1, scalpel (n = 18); Group 2, diode (n = 18); Group 3, diode + biostimulation (n = 18). Results: Reepithelialization was fastest in Group 2 than Group 1 at day 10. The difference between Groups 1 and 3 was also statistically significant in reepithelialization at day 10. There was a significant difference between Groups 1 and 2 and between Groups 2 and 3 in inflammation at day 10. There was no difference between any of the groups in inflammation and reepithelialization at day 20. Conclusions: Scalpel incisions heal more slowly than diode and diode + biostimulation incisions in diabetic rats. We can suggest that diode + biostimulation may produce the least amount of tissue injury, with the fastest resolution of inflammatory response in diabetic rats. Diode laser incision (4 W) with 10-J/cm(2) LLLT seems to have a beneficial effect on skin incisions in diabetic rats.

Photomed Laser Surg 2009 Sep 15

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=19754259

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Effects of Laser Photobiomodulation on Cutaneous Wounds Treated with Mitomycin C: A Histomorphometric and Histological Study in a Rodent Model.

Santos NR, Dos Santos JN, Sobrinho JB, Ramalho LM, Carvalho CM, Soares LG, Pinheiro AL

1 Laser Center, School of Dentistry, Federal University of Bahia (UFBA) , Salvador, Brazil .

Abstract Aim: The aim of the present study was to assess histologically the effect of Laser Photobiomodulation (LPBM) on skin wounds treated with Mitomycin C (MMC). Background Data: Wound healing occurs because of a competitive mechanism between the synthesis and lyses of collagen. Therefore, any factor that increases the lyses or reduces the synthesis of collagen may result in changes in the healing process. MMC is an antineoplastic drug that inhibits fibroblast proliferation, collagen synthesis, and neoangiogenesis. LPBM has been shown to stimulate wound healing, increasing the production of collagen, fibroblastic proliferation, and angiogenesis. Materials and Methods: Forty-eight Wistar rats were randomly distributed into 4 main groups (n = 12): G1 – control (G1a – 7 d and G1b – 14 d); G2 – MMC (G2a – 7 d and G2b – 14 d); G3 – MMC + lambda660 nm laser (G3a – 7 d and G3b – 14 d); and G4 – MMC + lambda790 nm laser (G4a – 7 d and G4b – 14 d). Under general anesthesia, one excisional wound was created on the dorsum of each animal. Two ml of MMC solution was applied to the wound 4 h after surgery for 5 min. LPBM was performed on groups G3 (lambda690 nm; 20 J/cm(2); 30 mW; Phi = 2 mm) and G4 (lambda790 nm; 20 J/cm(2); 40 mW; Phi = 2 mm), starting immediately after the application of the MMC and repeated every other day during the experimental period. Laser light was applied transcutaneously at 4 equidistant points on the wound margin (4 x 5 J/cm(2), 20 J/cm(2)/session). The specimens were routinely cut and processed to wax. The slides were stained with HE and Sirius red. Computerized hystomorphometry was performed. Results: LPBM resulted in reduced inflammation and an increase in both fibroblast proliferation and collagen deposition. Conclusion: The use of LPBM improves wound healing in subjects treated with MMC.

Photomed Laser Surg 2009 Sep 11

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=19747035

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About James Carroll

Founder and CEO at THOR Photomedicine Ltd. View biography (PDF)
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2 Responses to 62 new papers in the November 2009 LLLT literature watch

  1. Thank you for your round-up, good work.
    You make particular note of work carried out on Age Related Macular Degeneration. But nowhere can I find any other reference or paper.
    Can you please direct me.
    On another note , I am currently working with two very senior consultants within the NHS with LLLT on stroke victims. Once more I cannot find any other sources for this.Again can you please direct me.
    Kindest Regards and may we all go from strength to strength in 2010 with LLLT

  2. I mentioned the research regarding AMD in my other post about the last 10 years of LLLT, not this Oct / Nov 09 literature watch. It was in the May 08 literature watch but easier to see the abstract here. http://www.ncbi.nlm.nih.gov/pubmed?term=18588438

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