Category Archives: Research

Low Level Laser Therapy LLLT / Cold Laser Literature watch for March 2012

40 LLLT papers for you this month including an updated biphasic dose response paper from Mike Hamblin’s team at Harvard (including myself), plus clinical trials on lymphoedema (manual lymphatic drainage vs LLLT), oral mucositis literature review with meta-analysis, onychomycosis, improved treadmill training performance, improved orthodontic tooth movement (with less pain), TMJD, post extraction trismus, and a systematic review of treatments for frozen shoulder citing laser as effective for pain relief, improved range of motion, and overall outcome in adhesive capsulitis. (more…)

Posted in Research | on Low Level Laser Therapy LLLT / Cold Laser Literature watch for March 2012

Low Level Laser Therapy LLLT / Cold Laser Literature watch for Feb 2012

Just 9 papers for you this month including LLLT for orthodontic tooth movement, diabetic periodontitis, ischemic stroke and a laboratory study on chronic mild stress to add to the clinical reports we have seen in recent months.

A plug for the 2012 World Association for Laser Therapy conference in Gold Coast Australia in September. You know you have to go to Australia at some time in your life, well this is that time. Not only does Australia have the most extraordinary wilderness, wildlife and waves of anywhere in the world, it is also the host of this year’s WALT conference. I anticipate that most of the researchers you have read about on this newsletter / blog over recent years will be there . At the WALT 2012 conference in September you can see their latest work and hear their latest thoughts first hand. This land of sun, sea and and so many lasers is probably the most welcoming country i have ever visited, so I suggest you click here to register and click here to book your flights.

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Posted in Research | on Low Level Laser Therapy LLLT / Cold Laser Literature watch for Feb 2012

Low Level Laser Therapy LLLT / Cold Laser Literature watch for Jan 2012

17 papers published this month including LLLT for amblyopia, chronic periodontitis, knee osteoarthritis, cracked nipples in breastfeeding mothers, chronic gingivitis, allergic rhinitis and an editorial written by Prof. Jan Bjordal regarding WALT dosage recommendations. He describes how far we have come and the importance of the WALT dosage recommendations. No abstract is available for editorials so I have prepared one for you along with a short feature on Prof. Jan Bjordal and a summary of his published work.

Low Level Laser Therapy (LLLT) and WALT Dosage Recommendations

No abstract is available for editorials so I have prepared one for you along with a short feature on Prof. Jan Bjordal and a summary of his published work. click here.

Low-Level Laser Therapy Improves Visual Acuity in Adolescent and Adult Patients with Amblyopia.

Ivandic BT, Ivandic T

1 University of Heidelberg , Otto-Meyerhof Center, Heidelberg, Germany .

Abstract Objective: The purpose of this study was to examine the effects of low-level laser therapy (LLLT) on visual acuity in adolescent and adult patients with amblyopia. Background data: Currently, amblyopia can be treated successfully only in children. Methods: In this single-blinded, placebo-controlled study, 178 patients (mean age 46.8 years) with amblyopia caused by ametropia (110 eyes) or strabismus (121 eyes) were included. For LLLT, the area of the macula was irradiated through the conjunctiva from 1 cm distance for 30 sec with laser light (780 nm, 292 Hz, 1:1 duty cycle; average power 7.5 mW; spot area 3 mm(2)). The treatment was repeated on average 3.5 times, resulting in a mean total dose of 0.77 J/cm(2). No occlusion was applied, and no additional medication was administered. Best corrected distant visual acuity was determined using Snellen projection optotypes. In 12 patients (12 eyes), the multifocal visual evoked potential (M-VEP) was recorded. A control group of 20 patients (20 eyes) received mock treatment. Results: Visual acuity improved in approximately 90% of the eyes treated with LLLT (p
Photomed Laser Surg 2012 Jan 11

http://www.ncbi.nlm.NIH.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=22235969

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Effect of Adjunctive Low Level Laser Therapy (LLLT) on Nonsurgical Treatment of Chronic Periodontitis.

Makhlouf M, Dahaba MM, Tuner J, Eissa SA, Harhash TA

1 Laser Institute , Cairo, Egypt .

Abstract Objective: The aim of this split-mouth, double blinded, short-term, controlled clinical trial was to study the effect of low-level laser therapy (LLLT) as an adjunct to scaling and root planing (SRP) for treatment of chronic periodontitis. Background data: LLLT is reported to improve the outcome of traditional SRP, but the evidence is still weak. Materials and methods: Sixteen patients with a probing pocket depth (PPD) of 4-6 mm involving at least three teeth in each quadrant were recruited for the study. Afterwards, SRP quadrants were randomly assigned for 10 sessions of LLLT. Results: Results showed that when compared to sites treated with SRP alone, those treated with SRP+LLLT (10 sessions, 830 nm, 100 mW, 3 J per point, 3 J/cm(2)) exhibited greater reductions in PPD at 5 weeks and 3 months but not at 6 months. Further, SRP+LLLT-treated sites had a statistically significant increase in mean radiographic bone density when comparing 6- and 12-month data and overall from baseline to 12 months. There was a trend to reduce interleukin (IL)-1beta but the difference between control and laser sites was not statistically significant. Conclusions: SRP combined with LLLT improved radiographic bone density and short-term PPD reduction in patients with chronic periodontitis, but did not significantly affect either the gingival crevicular fluid of IL-1beta or the gingival or plaque index.

Photomed Laser Surg 2012 Jan 10

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=22233558

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Analgesic effect of high intensity laser therapy in knee osteoarthritis.

Stiglic-Rogoznica N, Stamenkovic D, Frlan-Vrgoc L, Avancini-Dobrovic V, Vrbanic TS

Center of Physical and Rehabilitation Medicine, Rijeka University Hospital Center, Rijeka, Croatia.

Knee osteoarthritis (KOA), the most common type of osteoarthritis (OA), is associated with pain and inflammation of the joint capsule, impaired muscular stabilization, reduced range of motion and functional disability. High-intensity laser therapy (HILT) involves higher-intensity laser radiation and causes minor and slow light absorption by chromophores. Light stimulation of the deep structures, due to high intensity laser therapy, activates cell metabolism through photochemical effect. The transmissions of pain stimulus are slowed down and result in a quick achievement of pain relief. The aim of our research was to investigate the prompt analgesic effect of HILT on patients with KOA. Knee radiographs were performed on all patients and consequently graded using the Kellgren-Lawrence grading scale (K/L). A group of 96 patients (75 female, 21 male, mean age 59.2) with K/L 2 and 3 were submitted to HILT therapy. Pain intensity was evaluated with visual analogue scale (VAS) before and after the treatment. HILT consisted in one daily application, over a period of ten days, using protocol wavelength, frequency and duration. The results showed statistically significant decrease in VAS after the treatment (p < 0.001). Considering these results, HILT enables prompt analgesic effects in KOA treatment. Therefore HILT is a reliable option in KOA physical therapy.

Coll Antropol 2011 Sep 35 Suppl 2 183-5

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=22220431

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LED Phototherapy Improves Healing of Nipple Trauma: A Pilot Study.

Chaves ME, Araujo AR, Santos SF, Pinotti M, Oliveira LS

1 Department of Mechanical Engineering, Universidade Federal de Minas Gerais , Belo Horionte, Brazil .

Abstract Objective: The purpose of this study was to evaluate the clinical effectiveness of a LED phototherapy prototype apparatus in the healing of nipple trauma in breastfeeding women. Background data: There is no scientific evidence of an effective treatment for nipple trauma. Methods: The experimental group was treated with orientation on nipple care and adequate breastfeeding techniques in addition to active LED phototherapy. The control group was treated with orientation on nipple care and adequate breastfeeding techniques in addition to placebo LED phototherapy. Participants were treated twice a week, for a total of eight sessions. Healing of the nipple lesions was measured by a reduction in their area, and decrease in pain intensity was measured in accordance with an 11-point Pain Intensity Numerical Rating Scale and a standard 7-point patient global impression of change. Results: Statistically significant reductions in measured nipple lesion area (p
Photomed Laser Surg 2012 Jan 27

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=22283620

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Chronic gingivitis: the prevalence of periodontopathogens and therapy efficiency.

Igic M, Kesic L, Lekovic V, Apostolovic M, Mihailovic D, Kostadinovic L, Milasin J

Department of Children and Preventive Dentistry, Dental Clinic, Medical Faculty Nis, University of Nis, Bul dr Zorana Djindjica 52, 18000, Nis, Serbia, igicmarija@gmail.com.

The purpose of this study was to determine the level of gingival inflammation and the prevalence of periodontopathogenic microorganisms in adolescents with chronic gingivitis, as well as to compare the effectiveness of two approaches in gingivitis treatment-basic therapy alone and basic therapy + adjunctive low-level laser therapy (LLLT). After periodontal evaluation, the content of gingival pockets of 140 adolescents with gingivitis was analyzed by multiplex PCR for the presence of P. gingivalis, A. actinomycetemcomitans, T. forsythensis and P. intermedia. Subsequent to bacteria detection, the examinees were divided into two groups with homogenous clinical and microbiological characteristics. Group A was subjected to basic gingivitis therapy, and group B underwent basic therapy along with adjunctive LLLT. A statistically significant difference between the values of plaque-index (PI) and sulcus bleeding index (SBI) before and after therapy was confirmed in both groups (p < 0.001), though more pronounced in group B. Following therapy, the incidence of periodontopathogenic microorganisms decreased considerably. The best result was obtained in P. gingivalis eradication by combined therapy (p = 0.003). The presence of periodontopathogens in adolescents with gingivitis should be regarded as a sign for dentists to foster more effective oral health programs. LLLT appears to be beneficial as adjuvant to basic therapy.

Eur J Clin Microbiol Infect Dis 2012 Jan 6

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=22222990

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Endonasal phototherapy for the treatment of allergic rhinitis/hayfever.

Hili S, Wong B, Fu B, Oyarzabal M

Department of Otorhinolaryngology/Head and Neck Surgery, Medway Maritime Hospital, Windmill Road, Gillingham, Kent, UK. E-mail: bpkfu@yahoo.co.uk.

Clin Otolaryngol 2011 Dec 36(6) 589-91

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=22212547

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Low Level Laser Therapy (LLLT) and World Association for Laser Therapy (WALT) Dosage Recommendations.

Bjordal JM

Department of Evidence-Based Practice, Bergen University College , Bergen, Norway .

Photomed Laser Surg 2012 Jan 10

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=22233559

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Amelioration of Experimental Autoimmune Encephalomyelitis in C57BL/6 Mice by Photobiomodulation Induced by 670 nm Light.

Muili KA, Gopalakrishnan S, Meyer SL, Eells JT, Lyons JA

Department of Health Sciences, College of Health Sciences, University of Wisconsin-Milwaukee, Milwaukee, Wisconsin, United States of America.

BACKGROUND: The approved immunomodulatory agents for the treatment of multiple sclerosis (MS) are only partially effective. It is thought that the combination of immunomodulatory and neuroprotective strategies is necessary to prevent or reverse disease progression. Irradiation with far red/near infrared light, termed photobiomodulation, is a therapeutic approach for inflammatory and neurodegenerative diseases. Data suggests that near-infrared light functions through neuroprotective and anti-inflammatory mechanisms. We sought to investigate the clinical effect of photobiomodulation in the Experimental Autoimmune Encephalomyelitis (EAE) model of multiple sclerosis. METHODOLOGY/PRINCIPAL FINDINGS: The clinical effect of photobiomodulation induced by 670 nm light was investigated in the C57BL/6 mouse model of EAE. Disease was induced with myelin oligodendrocyte glycoprotein (MOG) according to standard laboratory protocol. Mice received 670 nm light or no light treatment (sham) administered as suppression and treatment protocols. 670 nm light reduced disease severity with both protocols compared to sham treated mice. Disease amelioration was associated with down-regulation of proinflammatory cytokines (interferon-gamma, tumor necrosis factor-alpha) and up-regulation of anti-inflammatory cytokines (IL-4, IL-10) in vitro and in vivo. CONCLUSION/SIGNIFICANCE: These studies document the therapeutic potential of photobiomodulation with 670 nm light in the EAE model, in part through modulation of the immune response.

PLoS One 2012 7(1) e30655

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=22292010

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Effects of a Therapeutic Laser and Passive Stretching Program for Treating Tendon Overuse.

Ng GY, Chung PY

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

Abstract Objective: This study investigated the effects of a therapeutic laser, passive stretching, and their combined treatment on the strength of Achilles tendons with overuse pathologies. Background data: Tendinopathy involving overuse is usually treated with exercise and stretching, but there has been no report on the treatment effect of a therapeutic laser combined with passive stretching on managing this condition. Despite the beneficial effect of a therapeutic laser on healing tendons that have had traumatic injury, its effect on degenerative tendons is not known. Methods: Twenty-five mature Sprague-Dawley (SD) rats were used, with 20 subjected to daily bipedal downhill running for 8 weeks, to induce Achilles overuse, and 5 as normal controls. The exercised rats were divided into four groups: 1, laser treatment; 2, passive stretching; 3, combined laser and stretching; and 4, no treatment, running controls. GaAlAs laser with 660 nm wavelength was applied to both Achilles tendons for 50 sec for Groups 1 and 3. Passive stretching of 20 times/10 sec of maximum ankle plantar flexion was applied to Groups 2 and 3. Treatments were applied after each running session for a a total of 56 treatment sessions. On week 9, the tendons were tested for load-relaxation, stiffness, and ultimate strength. Results: Stiffness was different (p=0.01), difference in ultimate strength was marginally insignificant (p=0.07), and load-relaxation difference was not significant among groups. Post-hoc analyses revealed that the mean stiffness of all the four exercise groups was lower than the normal control, whereas the ultimate strength from the laser and combined laser and stretching was not different from that of the normal control group, but was higher than that of the passive stretching and no treatment groups. Conclusions: We conclude that a therapeutic laser and combined laser with passive stretching might slow down the decrease in Achilles tendon strength but would not be able to stop the pathological changes of overuse from developing.

Photomed Laser Surg 2012 Jan 11

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=22235970

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Photobiomodulation enhances nigral dopaminergic cell survival in a chronic MPTP mouse model of Parkinson’s disease.

Peoples C, Spana S, Ashkan K, Benabid AL, Stone J, Baker GE, Mitrofanis J

Discipline of Anatomy & Histology F13, University of Sydney, Australia.

We have shown previously that photobiomodulation or near-infrared light (NIr) treatment protects dopaminergic cells of the substantia nigra pars compacta (SNc) in an acute MPTP (1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine) model of Parkinson’s disease (PD). In this study, we tested the protective and rescue action of NIr treatment in a chronic MPTP model, developed to resemble more closely the slow progressive degeneration in PD patients. We examined three regions of dopaminergic cells, the SNc, periaqueductal grey matter (PaG) and zona incerta-hypothalamus (ZI-Hyp). BALB/c mice had MPTP or saline injections over five weeks, followed by a three-week survival. NIr treatment was applied either at the same time as (simultaneous series) or after (post-treatment series) the MPTP insult. There were four groups within each series; Saline, Saline-NIr, MPTP and MPTP-NIr. Brains were processed for tyrosine hydroxylase (TH) immunochemistry and cell number was analysed using the optical fractionator method. In the SNc, there was a significant reduction ( approximately 45%) in TH(+) cell number in the MPTP groups compared to the saline controls of both series. In the MPTP-NIr groups of both series, TH(+) cell number was significantly higher ( approximately 25%) than in the MPTP groups, but lower than in the saline controls ( approximately 20%). By contrast in the PaG and ZI-Hyp, there were no significant differences in TH(+) cell number between the MPTP an MPTP-NIr groups of either series. In summary, exposure to NIr either at the same time or well after chronic MPTP insult saved many SNc dopaminergic cells from degeneration.

Parkinsonism Relat Disord 2012 Jan 27

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=22285756

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Low-level laser therapy for closed-head traumatic brain injury in mice: effect of different wavelengths.

Wu Q, Xuan W, Ando T, Xu T, Huang L, Huang YY, Dai T, Dhital S, Sharma SK, Whalen MJ, Hamblin MR

Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, Massachusetts; Department of Dermatology, Harvard Medical School, Boston, Massachusetts; Department of Burns and Plastic Surgery, Jinan Central Hospital Affiliated to Shandong University, Jinan, China.

BACKGROUND AND OBJECTIVES: Traumatic brain injury (TBI) affects millions worldwide and is without effective treatment. One area that is attracting growing interest is the use of transcranial low-level laser therapy (LLLT) to treat TBI. The fact that near-infrared light can penetrate into the brain would allow non-invasive treatment to be carried out with a low likelihood of treatment-related adverse events. LLLT may treat TBI by increasing respiration in the mitochondria, causing activation of transcription factors, reducing inflammatory mediators and oxidative stress, and inhibiting apoptosis. STUDY DESIGN/MATERIALS AND METHODS: We tested LLLT in a mouse model of closed-head TBI produced by a controlled weight drop onto the skull. Mice received a single treatment with continuous-wave 665, 730, 810, or 980 nm lasers (36 J/cm(2) delivered at 150 mW/cm(2) ) 4-hour post-TBI and were followed up by neurological performance testing for 4 weeks. RESULTS: Mice with moderate-to-severe TBI treated with 665 and 810 nm laser (but not with 730 or 980 nm) had a significant improvement in Neurological Severity Score that increased over the course of the follow-up compared to sham-treated controls. Morphometry of brain sections showed a reduction in small deficits in 665 and 810 nm laser treated mouse brains at 28 days. CONCLUSIONS: The effectiveness of 810 nm agrees with previous publications, and together with the effectiveness of 660 nm and non-effectiveness of 730 and 980 nm can be explained by the absorption spectrum of cytochrome oxidase, the candidate mitochondrial chromophore in transcranial LLLT. Lasers Surg. Med. (c) 2012 Wiley Periodicals, Inc.

Lasers Surg Med 2012 Jan 24

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=22275301

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Low-Level Laser Irradiation Affects the Release of Basic Fibroblast Growth Factor (bFGF), Insulin-Like Growth Factor-I (IGF-I), and Receptor of IGF-I (IGFBP3) from Osteoblasts.

Saygun I, Nizam N, Ural AU, Serdar MA, Avcu F, Tozum TF

1 Department of Periodontology, Gulhane Military Medical Academy , Ankara, Turkey .

Abstract Objective: It was the aim of the present study to evaluate whether the laser irradiation of osteoblasts could enhance the release of growth factors including basic fibroblast growth factor (bFGF), insulin-like growth factor-I (IGF-I), and receptor of IGF-I (IGFBP3). Background data: Low-level laser therapy (LLLT) has been shown to have biostimulatory effects on various cell types by enhancing production of some cytokines and growth factors. Materials and methods: Human mesenchymal stem cells (MSCs) were seeded in osteogenic medium and differentiated into osteoblasts. Three groups were formed: in the first group (single dose group), osteoblasts were irradiated with laser (685 nm, 25 mW, 14.3 mW/cm(2), 140 sec, 2 J/cm(2)) for one time; and in the second group, energy at the same dose was applied for 2 consecutive days (double dose group). The third group was not irradiated with laser and served as the control group. Proliferation, viability, bFGF, IGF-I, and IGFBP3 levels were compared between groups. Results: Both of the irradiated groups revealed higher proliferation, viability, bFGF, IGF-I, and IGFBP3 expressions than did the nonirradiated control group. There was increase in bFGF and IGF-I expressions and decrease in IGFBP3 in the double dose group compared to single dose group. Conclusions: The results of the present study indicate that LLLT increases the proliferation of osteoblast cells and stimulates the release of bFGF, IGF-I, and IGFBP3 from these cells. The biostimulatory effect of LLLT may be related to the enhanced production of the growth factors.

Photomed Laser Surg 2012 Jan 11

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=22235971

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Effect of low-level laser irradiation on osteoblast proliferation and bone formation.

Grassi FR, Ciccolella F, D’Apolito G, Papa F, Iuso A, Salzo AE, Trentadue R, Nardi GM, Scivetti M, De Matteo M, Silvestris F, Ballini A, Inchingolo F, Dipalma M, Scacco S, Tete S

Department of Clinical Methodology and Medical Surgery Technology, University of Bari, Bari, Italy.

Applications of laser therapy in biostimulation and healing injured tissues are widely described in medical literature. The present study focuses on the effects of laser irradiation on the growth rate and differentiation of human osteoblast-like cells seeded on titanium or zirconia surfaces. Cells were laser irradiated with low therapeutical doses at different intervals and the effects of irradiation were evaluated at each time-point. After 3 hours lasered cells showed an enhanced mitogen activity compared to non-lasered control cells and a higher alkaline phosphatase activity, marker of bone formation. At the same time, the mRNA of RUNX2 and OSTERIX, two genes involved in osteoblast differentiation, showed a clear decrease in lasered cells. This reached the lowest value 6 to 12 hours after irradiation, after which the transcripts started to increase, indicating that the laser treatment did promote the osteogenic potential of growth-induced cells. These results indicate that Low Level Laser Treatment (LLLT) stimulates osteogenic cell proliferation.

J Biol Regul Homeost Agents 2011 Oct-Dec 25(4) 603-14

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=22217992

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Current acute stroke trials and their potential impact on the therapeutic time window.

Schellinger PD, Kohrmann M

Department of Neurology and Neurogeriatry, JW Klinikum Minden, Germany. peter.schellinger@klinikum-minden.de.

Several trials in acute stroke are underway or have been completed recently. Among the latter, ECASS 3 was a milestone regarding the extension of the rigid 3-h time window out to 4.5 h for intravenous thrombolysis with recombinant tissue plasminogen activator. Several other approaches are being tested for thrombolytic therapy, among them modern imaging-based patient selection of patients and interventional approaches. Other pharmaceutical strategies include neuroprotection, and restoration, biophysical approaches, such as near infrared laser therapy, hemodynamic augmentation, and sphenopalatine ganglion stimulation. This perspective will cover the recently completed and currently recruiting acute stroke trials with respect to their potential role in expanding the therapeutic time window for acute ischemic stroke.

Expert Rev Neurother 2012 Feb 12(2) 169-77

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=22288672

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Effectiveness of low-level laser therapy in temporomandibular disorders: a systematic review and meta-analysis.

Petrucci A, Sgolastra F, Gatto R, Mattei A, Monaco A

Aim: To assess the scientific evidence on the efficacy of low-level laser therapy (LLLT) in the treatment of temporomandibular disorders (TMD). Methods: The databases of PubMed, Science Direct, Cochrane Clinical Trials Register, and PEDro were manually and electronically searched up to February 2010. Two independent reviewers screened, extracted, and assessed the quality of the publications. A meta-analysis- was performed to quantify the pooled effect of LLLT on pain and function in patients with chronic TMD. Results: The literature search identified 323 papers without overlap between selected databases, but after the two-phase study selection, only six randomized clinical trials (RCT) were included in the systematic review. The primary outcome of interest was the change in pain from baseline to endpoint. The pooled effect of LLLT on pain, measured through a visual analog scale with a mean difference of 7.77 mm (95% confidence interval [CI]: -2.49 to 18.02), was not statistically significant from placebo. Change from baseline to endpoint of secondary outcomes was 4.04 mm (95% CI 3.06 to 5.02) for mandibular maximum vertical opening; 1.64 mm (95% CI 0.10 to 3.17) for right lateral excursion and 1.90 mm (95% CI: -4.08 to 7.88) for left lateral excursion. Conclusion: Currently, there is no evidence to support the effectiveness of LLLT in the treatment of TMD. J Orofac Pain 2011;25:298-307.

J Orofac Pain 2011 Fall 25(4) 298-307

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=22247925

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Root surface treatment using diode laser in delayed tooth replantation: radiographic and histomorphometric analyses in rats.

Carvalho ED, Costa FT, Campos MS, Anbinder AL, Neves AC, Habitante SM, Lage-Marques JL, Raldi DP

Department of Dentistry, University of Taubate, Taubate, Sao Paulo Department of Bioscience and Oral Diagnosis, School of Dentistry of Sao Jose dos Campos, UNESP-Universidade Estadual Paulista, Sao Jose dos Campos, Sao Paulo, Brazil.

Abstract – Background aim: The aim of this study was to evaluate, by radiographic and histomorphometric analyses, the effects of high-power diode laser irradiation on the root surfaces of delayed replanted rat teeth. Material and methods: Maxillary right incisors were extracted from 60 Wistar rats and kept dry for 60 min. Subsequently, the root canals were prepared and filled with calcium hydroxide paste. According to the root surface treatment before the replantation, the teeth were assigned to four groups (n = 15): G1 (negative control) – no root surface treatment; G2 (positive control) – treated with 2% sodium fluoride solution; G3 – irradiated with a high-power diode laser (810 nm, continuous mode, 1.0 W, 30 s); and G4 – irradiated with a diode laser using the same parameters as those used for G3 but in pulsed mode. The rats were euthanized after 15, 30, and 60 days of replantation. The specimens were digitally radiographed and processed for histomorphometric analysis to determine the average root resorption areas and to evaluate the histological events. Results: The percentage of root resorption was in the following order: G1 > G2 > G4 > G3. Both histomorphometric and radiographic analyses showed significantly lower means (P < 0.05) of the occurrence of root resorption in the irradiated groups (G3 and G4) when compared to the control groups (G1 and G2). Replacement resorption and ankylosis were observed in histological sections only after 30 and 60 days; however, such events were not observed in G3. Conclusion: Root surface treatments with high-powered diode laser irradiation prior to delayed replantation reduced the occurrence of external root resorption compared to no treatment or sodium fluoride treatment at up to 60 days.

Dent Traumatol 2012 Jan 12

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=22236150

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Acne treatments come out a wash.

Consum Rep 2012 Jan 77(1) 9

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=22232826

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Low Level Laser Therapy LLLT / Cold Laser Literature watch for Dec 2011

22 new papers for your review: RCT on OA knee; systematic review of treatment modalities for neurosensory deficit after lower third molar surgery found LLLT to provide significant improvement; review of transcranial LLLT for neurodegenerative diseases, laser biomodulation of normal and neoplastic cells (another comprehensive study by Farouk Al-Watban with very interesting results); Laser vs LED study on skin flap viability, angiogenesis and mast cells (spoiler alert, LED wins); treatment of dermatitis in 10 koi carp with 980nm laser!; and yet another case of LLLT for burning mouth syndrome.

As it happens, a customer wrote just a minute ago to say that his patient had rapid resolution of burning mouth that lasted 18 hours after the first LED treatment.

Efficacy of low level laser therapy associated with exercises in knee osteoarthritis: a randomized double-blind study.

Alfredo PP, Bjordal JM, Dreyer SH, Meneses SR, Zaguetti G, Ovanessian V, Fukuda TY, Junior WS, Martins RA, Casarotto RA, Marques AP

Department of Speech Therapy, Physical Therapy and Occupational Therapy, School of Medicine, Sao Paulo University, Sao Paulo, Brazil.

Objectives: To estimate the effects of low level laser therapy in combination with a programme of exercises on pain, functionality, range of motion, muscular strength and quality of life in patients with osteoarthritis of the knee.Design: A randomized double-blind placebo-controlled trial with sequential allocation of patients to different treatment groups.Setting: Special Rehabilitation Services.Subjects: Forty participants with knee osteoarthritis, 2-4 osteoarthritis degree, aged between 50 and 75 years and both genders.Intervention: Participants were randomized into one of two groups: the laser group (low level laser therapy dose of 3 J and exercises) or placebo group (placebo laser and exercises).Main measures: Pain was assessed using a visual analogue scale (VAS), functionality using the Lequesne questionnaire, range of motion with a universal goniometer, muscular strength using a dynamometer, and activity using the Western Ontario and McMaster Universities Osteoarthritis (WOMAC) questionnaire at three time points: (T1) baseline, (T2) after the end of laser therapy (three weeks) and (T3) the end of the exercises (11 weeks).Results: When comparing groups, significant differences in the activity were also found (P = 0.03). No other significant differences (P > 0.05) were observed in other variables. In intragroup analysis, participants in the laser group had significant improvement, relative to baseline, on pain (P = 0.001), range of motion (P = 0.01), functionality (P = 0.001) and activity (P < 0.001). No significant improvement was seen in the placebo group.Conclusion: Our findings suggest that low level laser therapy when associated with exercises is effective in yielding pain relief, function and activity on patients with osteoarthritis of the knees.

Clin Rehabil 2011 Dec 14

http://www.ncbi.nlm.NIH.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=22169831

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Treatment Modalities of Neurosensory Deficit After Lower Third Molar Surgery: A Systematic Review.

Leung YY, Fung PP, Cheung LK

Clinical Assistant Professor, Discipline of Oral and Maxillofacial Surgery, Faculty of Dentistry, University of Hong Kong, Hong Kong, China.

PURPOSE: To conduct a systematic review to answer the clinical question, “What are the available treatment modalities and their outcomes of neurosensory deficit after lower third molar surgery?” MATERIALS AND METHODS: A systematic search, including a computer search of several databases with specific keywords, a reference search, and a manual search of 3 key maxillofacial journals were performed. Relevant articles were then evaluated and those that fulfilled the 6 predetermined criteria were chosen to enter the final review. The various treatment modalities and their outcomes of neurosensory deficit after lower third molar surgery, in the selected studies in the final review, were analyzed. RESULTS: Ten articles entered the final review. Six treatment modalities of lingual nerve or inferior alveolar nerve deficit after lower third molar surgery were identified. External neurolysis, direct suturing, autogenous vein graft, and a Gore-Tex tube as a conduit were the 4 surgical treatments. Significant improvement after surgical treatment ranged from 25% to 66.7%. Acupuncture and low-level laser therapy were 2 available nonsurgical treatment modalities that were found to have produced significant improvement in sensation after treatment in more than 50% of subjects. There was insufficient information to determine the best timing of treatment of nerve injury after third molar surgery. CONCLUSIONS: Four surgical treatments and 2 nonsurgical treatments were identified in the management of neurosensory disturbance after lower third molar surgery. Most treatments showed an improvement in sensation but the outcomes were variable. Complete recovery was uncommon in all kinds of available treatments.

J Oral Maxillofac Surg 2011 Dec 16

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=22177820

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Transcranial near-infrared laser therapy applied to promote clinical recovery in acute and chronic neurodegenerative diseases.

Lapchak PA

Cedars-Sinai Medical Center, Department of Neurology, 110 North George Burns Road, D-2091, Los Angeles, CA 90048, USA. paul.lapchak@cshs.org.

One of the most promising methods to treat neurodegeneration is noninvasive transcranial near-infrared laser therapy (NILT), which appears to promote acute neuroprotection by stimulating mitochondrial function, thereby increasing cellular energy production. NILT may also promote chronic neuronal function restoration via trophic factor-mediated plasticity changes or possibly neurogenesis. Clearly, NILT is a treatment that confers neuroprotection or neurorestoration using pleiotropic mechanisms. The most advanced application of NILT is for acute ischemic stroke based upon extensive preclinical and clinical studies. In laboratory settings, NILT is also being developed to treat traumatic brain injury, Alzheimer’s disease and Parkinson’s disease. There is some intriguing data in the literature that suggests that NILT may be a method to promote clinical improvement in neurodegenerative diseases where there is a common mechanistic component, mitochondrial dysfunction and energy impairment. This article will analyze and review data supporting the continued development of NILT to treat neurodegenerative diseases.

Expert Rev Med Devices 2012 Jan 9(1) 71-83

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=22145842

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Laser biomodulation of normal and neoplastic cells.

Al-Watban FA, Andres BL

World Academy for Laser Applications (WALA), PO Box 59803, Riyadh, 11535, Kingdom of Saudi Arabia, watban@hotmail.com.

This study was designed to determine the laser dose for the stimulation, zero-bioactivation, and inhibition of normal and neoplastic cells in vitro. The medical use of laser biomodulation has been occurring for decades in the area of tissue healing and inflammatory conditions. The potential to modulate the regeneration and differentiation of early cellular precursors by laser photons is a valuable endeavor searching for novel and efficient methods. A 35-mW HeNe (632.8-nm) laser and power density of 1.25 mW/cm(2) was used to irradiate tissue culture dishes seeded with 400 cells/dish of normal cells (CHO, CCL-226, 3 T3, and HSF) and neoplastic cells (EMT-6 and RIF-1). All cell lines were cultured using DMEM supplemented with 10% and 5% FBS, 2 mM glutamine and 100 U pen-strep antibiotic. Irradiation times of 16, 32, 48, 64, 80, 96, 112, 128, 144, and 160 s for three consecutive days to deliver cumulative doses of 60, 120, 180, 240, 300, 360, 420, 480, 540, and 600 mJ/cm(2) were done, respectively. Cell cultures were stained and colony-forming efficiency was determined. Data analysis was done using Student’s t test, alpha = 0.05. A trend of stimulation, zero-bioactivation, and inhibition in all cell lines was observed except for CCL-226 which gave a pattern of inhibition, zero-bioactivation, and inhibition. The optimum biostimulatory dose was at 180 mJ/cm(2) and bioinhibitory doses were from 420-600 mJ/cm(2) cumulative doses. This study established the dose-dependency of cell growth to laser treatments, that the extent of cellular proliferation is influenced by the type of cells involved, and the risk when laser irradiation is performed on patients with undiagnosed neoplasms and during pregnancy. On the other hand, the ability of laser irradiation to regulate embryonic fibroblasts and human skin fibroblast in vitro suggests possible laser biomodulatory effects on embryonic and adult stem cells directed for tissue regeneration. Studies on the effects of light treatments exploring different laser parameters for the clonal expansion and differentiation of stem cells are recommended.

Lasers Med Sci 2011 Dec 29

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Effect of low-level laser therapy in the treatment of burning mouth syndrome: a case series.

Santos Lde F, Carvalho Ade A, Leao JC, Cruz Perez DE, Castro JF

1 Department of Clinical and Preventive Dentistry, Oral Medicine Unit, Federal University of Pernambuco , Recife/PE, Brazil .

Abstract Objective: The aim of this study was evaluate the effect of low-level laser therapy (LLLT) in the treatment of burning mouth syndrome (BMS) patients. Background data: BMS is a clinical condition characterized by a burning sensation in a morphologically normal oral mucosa, without association with systemic disorders. Methods: Ten patients with oral burning sensation were included in the study. After careful evaluation of medical history and oral examination, the diagnosis of BMS was established. All patients were submitted to one weekly session of LLLT for 10 weeks. A continuous wavelength of 660 nm, power 40 mW, 20 J/cm(2), 0.8 J/point, with each point irradiated for 10 sec. In all sessions the burning intensity was evaluated with a 10-cm visual analogue scale (VAS), with 0 indicating no symptoms and 10 indicating the worst burning possible. The burning intensity evaluation by VAS was performed immediately before (VAS baseline) and immediately after each LLLT session. The nonparametric Wilcoxon test was used for statistical analysis, considering significance of 5%. Results: All patients reported improvement in all sessions, with reduction in VAS scores by up to 58% in the tenth session. When only the VAS baseline of the first session was compared with the other sessions, there was a statistically significant reduction in VAS scores in the fourth (p=0.03), fifth (p=0.03), sixth (p=0.009), seventh (p=0.003), eighth, ninth, and tenth (all p=0.002) sessions. Conclusions: LLLT may be an alternative treatment for the relief of oral burning in patients with BMS.

Photomed Laser Surg 2011 Dec 29(12) 793-6

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=22150094

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LED (660 nm) and laser (670 nm) use on skin flap viability: angiogenesis and mast cells on transition line.

Nishioka MA, Pinfildi CE, Sheliga TR, Arias VE, Gomes HC, Ferreira LM

Post Graduation Plastic Surgery, Federal University of Sao Paulo, R. Napoleao de Barros, 715, 4 masculine andar, CEP 04024-900, Sao Paulo, SP, Brazil.

Skin flap procedures are commonly used in plastic surgery. Failures can follow, leading to the necrosis of the flap. Therefore, many studies use LLLT to improve flap viability. Currently, the LED has been introduced as an alternative to LLLT. The objective of this study was to evaluate the effect of LLLT and LED on the viability of random skin flaps in rats. Forty-eight rats were divided into four groups, and a random skin flap (10 x 4 cm) was performed in all animals. Group 1 was the sham group; group 2 was submitted to LLLT 660 nm, 0.14 J; group 3 with LED 630 nm, 2.49 J, and group 4 with LLLT 660 nm, with 2.49 J. Irradiation was applied after surgery and repeated on the four subsequent days. On the 7th postoperative day, the percentage of flap necrosis was calculated and skin samples were collected from the viable area and from the transition line of the flap to evaluate blood vessels and mast cells. The percentage of necrosis was significantly lower in groups 3 and 4 compared to groups 1 and 2. Concerning blood vessels and mast cell numbers, only the animals in group 3 showed significant increase compared to group 1 in the skin sample of the transition line. LED and LLLT with the same total energies were effective in increasing viability of random skin flaps. LED was more effective in increasing the number of mast cells and blood vessels in the transition line of random skin flaps.

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=22207449

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[Pilot study on the use of diode laser therapy for treatment of dermatitis in koi carp (Cyprinus carpio)].

Pees M, Schmidt V, Pees K

PD Dr. Michael Pees, Klinik fur Vogel und Reptilien der Universitat Leipzig, An den Tierkliniken 17, 04103 Leipzig, E-Mail: pees@vogelklinik.uni-leipzig.de.

Objective: Therapy of dermatitis in koi using a diode laser technique. Material and methods: A diode laser with a wavelength of 980nm and an energy density of 9J/cm2 was used to treat defined skin alterations in ten koi carp. The clinical situation after repeated laser application was recorded. In addition, the diode laser was used for surgical removal of proliferative skin alterations caused by Dermocystidium sp. in two koi ponds. Results: An improvement of the clinical situation following laser therapy was seen in nine of the ten koi carp. Complete healing of the wound area occurred in four carp. A pronounced healing process was observed in four patients and a low healing tendency in one fish. Healing of the skin lesions following removal of the alterations caused by Dermocystidium sp. was unproblematic in one pond, whereas in the other collection a repeated treatment was necessary due to relapse of the alterations. Conclusions and clinical relevance: Diode laser therapy for treatment of dermatitis in koi is a promising technique. An expedited wound healing process was seen in wound areas that were present for long periods and resistant to previous therapy attempts, including antibiotics. Wound healing was undisturbed following surgical use of the laser technique for the removal of skin proliferations. Therefore, the diode laser technique can be recommended for the treatment of dermatitis in koi, especially in cases of unsuccessful treatment using anti-infective drugs, and for the treatment of Dermocystidium infections.

Tierarztl Prax Ausg K Kleintiere Heimtiere 2011 39(2) 89-96

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=22143586

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Therapeutic effect of near infrared (NIR) light on Parkinson’s disease models.

Quirk BJ, Desmet KD, Henry M, Buchmann E, Wong-Riley M, Eells JT, Whelan HT

Department of Neurology, Medical College of Wisconsin, 8701 W. Watertown Plank Rd, Milwaukee, WI, 53226, USA.

Parkinson’s disease (PD) is a neurodegenerative disorder that affects large numbers of people, particularly those of a more advanced age. Mitochondrial dysfunction plays a central role in PD, especially in the electron transport chain. This mitochondrial role allows the use of inhibitors of complex I and IV in PD models, and enhancers of complex IV activity, such as NIR light, to be used as possible therapy. PD models fall into two main categories; cell cultures and animal models. In cell cultures, primary neurons, mutant neuroblastoma cells, and cell cybrids have been studied in conjunction with NIR light. Primary neurons show protection or recovery of function and morphology by NIR light after toxic insult. Neuroblastoma cells, with a gene for mutant alpha-synuclein, show similar results. Cell cybrids, containing mtDNA from PD patients, show restoration of mitochondrial transport and complex I and IV assembly. Animal models include toxin-insulted mice, and alpha-synuclein transgenic mice. Functional recovery of the animals, chemical and histological evidence, and delayed disease progression show the potential of NIR light in treating Parkinson’s disease.

Front Biosci (Elite Ed) 2012 4 818-23

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=22201916

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[Combined treatment of the patients presenting with bacterial vesiculitis].

Karpukhin IV, Kiiatkin VA, Bobkov AD, Kazantsev SN

Ultrasound treatment in combination with laser irradiation of the blood and antibacterial therapy is known to exert strong anti-inflammatory, antibacterial, and analgesic effects, stimulate metabolism of sex hormones, and improve spermatogenesis in the patients presenting with chronic bacterial vesiculitis (CBV). This treatment is indicated to the patients with CBV at the stage of latent inflammation, to those recovering after acute vesiculities, and to the patients with chronic prostatovesiculitis at the stage of latent inflammation. This therapeutic modality is contraindicated in the cases of acute vesiculitis, acute prostatitis, acute bleeding hemorrhoids, rectal fissures and tumours, and general contraindications for physiotherapy. The above treatment resulted in the substantial or moderate improvement of clinical condition in 42 (82.4%) of the patients in group 1 and in 5 (50.0%) ones in group 2. During the 6 month follow-up period, remission of CBV was documented in 10 (83.3%) of the patients in group 1 and in 1 (33.3%) patient in group 2.

Vopr Kurortol Fizioter Lech Fiz Kult 2011 Sep-Oct (5) 36-8

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=22165145

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[The development of method of intravenous laser irradiation of blood with green laser in patients with hyperlipidemia].

The impact of intravenous laser irradiation of blood with green laser in patients with hyperlipidemia was investigated. The blood of patients was chosen as sample for analysis. The patients were divided in two groups: patients with atherosclerosis of various localization and patients with atherosclerosis associated with diabetes mellitus. The effectiveness of laser impact was evaluated according the blood biochemical indicators. The levels of crude cholesterol, triglycerides, low and very low density lipoproteins, apoproteins A and B, highly sensitive C-reactive protein, atherogenity indicator, glucose content, uric acid content were determined befor and after 1, 3 and 6 months after impact. The study results indicate the occurrence of hypolipedemic and hypoglycemic effects.

Klin Lab Diagn 2011 Aug (8) 15-7

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=22164411

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Spectroscopic and histological evaluation of wound healing progression following Low Level Laser Therapy (LLLT).

Prabhu V, Rao SB, Chandra S, Kumar P, Rao L, Guddattu V, Satyamoorthy K, Mahato KK

Biophysics Unit, Manipal Life Sciences Centre, Manipal University, Manipal 576104, Karnataka, India.

The present study focuses on the evaluation of the effect of He-Ne laser on tissue regeneration by monitoring collagen synthesis in wound granulation tissues in Swiss albino mice using analysis of laser induced fluorescence (LIF) and light microscopy techniques. The spectral analyses of the wound granulation tissues have indicated a dose dependent increase in collagen levels during the post-wounding days. The histological examinations on the other hand have also shown a significant increase in collagen deposition along with the reduced edema, leukocytes, increased granulation tissue, and fibroblast number in the optimal laser dose treated group compared to the non-illuminated controls. ((c) 2011 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim).

J Biophotonics 2011 Dec 15

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=22174176

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GaAs 904-nm laser irradiation improves myofiber mass recovery during regeneration of skeletal muscle previously damaged by crotoxin.

Silva LH, Silva MT, Gutierrez RM, Conte TC, Toledo CA, Aoki MS, Liebano RE, Miyabara EH

Department of Anatomy, Biomedical Sciences Institute, University of Sao Paulo, Lineu Prestes Av., 2415, 05508-000, Sao Paulo, SP, Brazil.

This work investigated the effect of gallium arsenide (GaAs) irradiation (power: 5 mW; intensity: 77.14 mW/cm(2), spot: 0.07 cm(2)) on regenerating skeletal muscles damaged by crotoxin (CTX). Male C57Bl6 mice were divided into six groups (n = 5 each): control, treated only with laser at doses of 1.5 J or 3 J, CTX-injured and, CTX-injured and treated with laser at doses of 1.5 J or 3 J. The injured groups received a CTX injection into the tibialis anterior (TA) muscle. After 3 days, TA muscles were submitted to GaAs irradiation at doses of 1.5 or 3 J (once a day, during 5 days) and were killed on the eighth day. Muscle histological sections were stained with hematoxylin and eosin (H&E) in order to determine the myofiber cross-sectional area (CSA), the previously injured muscle area (PIMA) and the area density of connective tissue. The gene expression of MyoD and myogenin was detected by real-time PCR. GaAs laser at a dose of 3 J, but not 1.5 J, significantly increased the CSA of regenerating myofibers and reduced the PIMA and the area density of intramuscular connective tissue of CTX-injured muscles. MyoD gene expression increased in the injured group treated with GaAs laser at a dose of 1.5 J. The CTX-injured, 3-J GaAs laser-treated, and the CTX-injured and treated with 3-J laser groups showed an increase in myogenin gene expression when compared to the control group. Our results suggest that GaAs laser treatment at a dose of 3 J improves skeletal muscle regeneration by accelerating the recovery of myofiber mass.

Lasers Med Sci 2011 Dec 6

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=22143119

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Effect of low-level laser therapy on cochlear hair cell recovery after gentamicin-induced ototoxicity.

Rhee CK, He P, Jung JY, Ahn JC, Chung PS, Suh MW

Department of Otolaryngology-Head & Neck Surgery, Dankook University College of Medicine, Cheonan, Korea.

Cochlear hair cells are the sensory receptors of the auditory system. It is well established that antibiotic drugs such as gentamicin can damage hair cells and cause hearing loss. Rescuing hair cells after ototoxic injury is an important issue in hearing recovery. Although many studies have indicated a positive effect of low-level laser therapy (LLLT) on neural cell survival, there has been no study on the effects of LLLT on cochlear hair cells. Therefore, the aim of this study was to elucidate the effects of LLLT on hair cell survival following gentamicin exposure in organotypic cultures of the cochlea of rats. The cochlea cultures were then divided into a control group (n = 8), a laser-only group (n = 8), a gentamicin-only group (n = 8) and a gentamicin plus laser group (n = 7). The control cultures were allowed to grow continuously for 11 days. The laser-only cultures were irradiated with a laser with a wavelength of 810 nm at 8 mW/cm(2) for 60 min per day (0.48 J/cm(2)) for 6 days. The gentamicin groups were exposed to 1 mM gentamicin for 48 h and allowed to recover (gentamicin-only group) or allowed to recover with daily irradiation (gentamicin plus laser group). The hair cells in all groups were stained with FM1-43 and counted every 3 days. The number of hair cells was significantly larger in the gentamicin plus laser group than in the gentamicin-only group. The number of hair cells was larger in the laser-only group than in the control group, but the difference did not reach statistical significance. These results suggest that LLLT may promote hair cell survival following gentamicin damage in the cochlea. This is the first study in the literature that has demonstrated the beneficial effect of LLLT on the recovery of cochlear hair cells.

Lasers Med Sci 2011 Dec 4

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=22138884

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In Vitro effect of low-level laser therapy on typical oral microbial biofilms.

Basso FG, Oliveira CF, Fontana A, Kurachi C, Bagnato VS, Spolidorio DM, Hebling J, Costa CA

Piracicaba Dental School, University of Campinas, Piracicaba, SP, Brazil.

The aim of this study was to evaluate the effect of specific parameters of low-level laser therapy (LLLT) on biofilms formed by Streptococcus mutans, Candida albicans or an association of both species. Single and dual-species biofilms – SSB and DSB – were exposed to laser doses of 5, 10 or 20 J/cm2 from a near infrared InGaAsP diode laser prototype (LASERTable; 780 +/- 3 nm, 0.04 W). After irradiation, the analysis of biobilm viability (MTT assay), biofilm growth (cfu/mL) and cell morphology (SEM) showed that LLLT reduced cell viability as well as the growth of biofilms. The response of S. mutans (SSB) to irradiation was similar for all laser doses and the biofilm growth was dose dependent. However, when associated with C. albicans (DSB), S. mutans was resistant to LLLT. For C. albicans, the association with S. mutans (DSB) caused a significant decrease in biofilm growth in a dose-dependent fashion. The morphology of the microorganisms in the SSB was not altered by LLLT, while the association of microbial species (DSB) promoted a reduction in the formation of C. albicans hyphae. LLLT had an inhibitory effect on the microorganisms, and this capacity can be altered according to the interactions between different microbial species.

Braz Dent J 2011 22(6) 502-10

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=22189647

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Laser irradiation effect on Staphylococcus aureus and Pseudomonas aeruginosa biofilms isolated from venous leg ulcer.

Baffoni M, Bessa LJ, Grande R, Di Giulio M, Mongelli M, Ciarelli A, Cellini L

M Baffoni, BS, Department of Biomedical Sciences, University ‘G. d’Annunzio’, Chieti-Pescara, Chieti, Italy LJ Bessa, BS, Department of Biomedical Sciences, University ‘G. d’Annunzio’, Chieti-Pescara, Chieti, Italy R Grande, PhD, Department of Drug Sciences, University ‘G. d’Annunzio’, Chieti-Pescara, Chieti, Italy M Di Giulio, PhD, Department of Drug Sciences, University ‘G. d’Annunzio’, Chieti-Pescara, Chieti, Italy L Cellini, PhD, Department of Drug Sciences, University ‘G. d’Annunzio’, Chieti-Pescara, Chieti, Italy M Mongelli, MD, Division of Vascular Surgery, “Santo Spirito” Hospital of Pescara, Italy A Ciarelli, MD, Division of Vascular Surgery, “Santo Spirito” Hospital of Pescara, Italy.

Chronic wounds, including diabetic foot ulcers, pressure ulcers and venous leg ulcers, represent a significant cause of morbidity in developed countries, predominantly in older patients. The aetiology of these wounds is probably multifactorial, but the role of bacteria in their pathogenesis is still unclear. Moreover, the presence of bacterial biofilms has been considered an important factor responsible for wounds chronicity. We aimed to investigate the laser action as a possible biofilm eradicating strategy, in order to attempt an additional treatment to antibiotic therapy to improve wound healing. In this work, the effect of near-infrared (NIR) laser was evaluated on mono and polymicrobial biofilms produced by two pathogenic bacterial strains, Staphylococcus aureus PECHA10 and Pseudomonas aeruginosa PECHA9, both isolated from a chronic venous leg ulcer. Laser effect was assessed by biomass measurement, colony forming unit count and cell viability assay. It was shown that the laser treatment has not affected the biofilms biomass neither the cell viability, although a small disruptive action was observed in the structure of all biofilms tested. A reduction on cell growth was observed in S. aureus and in polymicrobial biofilms. This work represents an initial in vitro approach to study the influence of NIR laser treatment on bacterial biofilms in order to explain its potentially advantageous effects in the healing process of chronic infected wounds.

Int Wound J 2011 Dec 19

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=22182280

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Does LED phototherapy influence the repair of bone defects grafted with MTA, bone morphogenetic proteins, and guided bone regeneration? A description of the repair process on rodents.

Pinheiro AL, Soares LG, Barbosa AF, Ramalho LM, Dos Santos JN

Center of Biophotonics, School of Dentistry, Federal University of Bahia, Av. Araujo Pinho, 62, Canela, Salvador, BA, CEP 40110-150, Brazil, albp@ufba.br.

This work carried out a histological analysis on bone defects grafted (MTA) treated or not with LED, BMPs, and membrane (GBR). Benefits of their isolated or combined usage on bone repair were reported, but not their association. Ninety rats were divided into ten groups and each subdivided into three. Defects on G II and I were filled with the blood clot. G II was further LED irradiated. G III and IV were filled with MTA; G IV was further LED irradiated. In G V and VI, the defects were filled with MTA and covered with a membrane (GBR). G VI was further LED irradiated. In G VII and VIII, BMPs were added to the MTA and group VIII was further LED irradiated. In G IX and X, the MTA + BMP graft was covered with a membrane (GBR). G X was further LED irradiated. LED was applied over the defect at 48-h intervals and repeated for 15 days. Specimens were processed, cut, and stained with H&E and Sirius red and underwent histological analysis. The use of LED light alone dramatically reduced inflammation. However, its use on MTA associated with BMP and/or GBR increased the severity of the inflammatory reaction. Regarding bone reabsorption, the poorest result was seen when the LED light was associated with the MTA + BMP graft. In the groups Clot and MTA + GBR, no bone reabsorption was detectable. Increased collagen deposition was observed when the LED light was associated with the use of the MTA associated with BMP and/or GBR. Increased new bone formation was observed when the LED light was used alone or associated with the use of MTA + GBR, MTA + BMP, on association of MTA + BMP + GBR and when BMP was added to the MTA. Our results indicate that the use of LED light alone or in association with MTA, MTA + BMP, MTA + GBR, and MTA + BMP + GBR caused less inflammation, and an increase of both collagen deposition and bone deposition as seen on both histological and morphometric analysis.

Lasers Med Sci 2011 Dec 15

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Low level laser therapy (830nm) improves bone repair in osteoporotic rats: Similar outcomes at two different dosages.

Bossini PS, Renno AC, Ribeiro DA, Fangel R, Ribeiro AC, Lahoz MD, Parizotto NA

Department of Physiotherapy, Federal University of Sao Carlos (UFSCar), Rodovia Washington Luis (SP-310), Km 235, Sao Carlos, SP, Brazil.

BACKGROUND AND OBJECTIVE: The goal of this study was to investigate the effects of low level laser therapy (LLLT) in osteoporotic rats by means of subjective histopathological analysis, deposition of collagen at the site of fracture, biomechanical properties and immunohistochemistry for COX-2, Cbfa-1 and VEGF. MATERIAL AND METHODS: A total of 30 female Wistar rats (12weeks-old, +/-250g) were submitted to ovariectomy (OVX). Eight weeks after the OVX, a tibial bone defect was created in all animals and they were randomly divided into 3 groups (n=10): control bone defect group (CG): bone defects without any treatment; laser 60J/cm(2) group (L60): animals irradiated with LLLT, at 60J/cm(2) and laser 120J/cm(2) group (L120): animals irradiated with LLLT, at 120J/cm(2). RESULTS: In the laser treated groups, at both fluences, a higher amount of newly formed bone was evidenced as well as granulation tissue compared to control. Picrosirius analysis demonstrated that irradiated animals presented a higher deposition of collagen fibers and a better organization of these fibers when compared to other groups, mainly at 120J/cm(2). COX-2, Cbfa-1 or VEGF immunoreactivity was detected in a similar manner either 60J/cm(2) or 120J/cm(2) fluences. However, no differences were shown in the biomechanical analysis. CONCLUSION: Taken together, our results support the notion that LLLT improves bone repair in the tibia of osteoporotic rats as a result of stimulation of the newly formed bone, fibrovascularization and angiogenesis.

Exp Gerontol 2011 Nov 21

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=22138375

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Using Affordable LED Arrays for Photo-Stimulation of Neurons.

Valley M, Wagner S, Gallarda BW, Lledo PM

Laboratory for Perception and Memory, Institut Pasteur and Centre National de la Recherche Scientifique (CNRS).

Standard slice electrophysiology has allowed researchers to probe individual components of neural circuitry by recording electrical responses of single cells in response to electrical or pharmacological manipulations(1,2). With the invention of methods to optically control genetically targeted neurons (optogenetics), researchers now have an unprecedented level of control over specific groups of neurons in the standard slice preparation. In particular, photosensitive channelrhodopsin-2 (ChR2) allows researchers to activate neurons with light(3,4). By combining careful calibration of LED-based photostimulation of ChR2 with standard slice electrophysiology, we are able to probe with greater detail the role of adult-born interneurons in the olfactory bulb, the first central relay of the olfactory system. Using viral expression of ChR2-YFP specifically in adult-born neurons, we can selectively control young adult-born neurons in a milieu of older and mature neurons. Our optical control uses a simple and inexpensive LED system, and we show how this system can be calibrated to understand how much light is needed to evoke spiking activity in single neurons. Hence, brief flashes of blue light can remotely control the firing pattern of ChR2-transduced newborn cells.

J Vis Exp 2011 (57)

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=22127025

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Effect of low-level laser therapy on proliferation, differentiation, and adhesion of steroid-treated osteoblasts.

Nogueira GT, Mesquita-Ferrari RA, Souza NH, Artilheiro PP, Albertini R, Bussadori SK, Fernandes KP

Master’s student, Department of Rehabilitation Sciences, Universidade Nove de Julho, Sao Paulo, SP, Brazil.

There has recently been constant effort to evaluate therapies that may have a positive effect on bone regeneration. However, there are few studies in the literature on the effects of low-level laser therapy (LLLT) involving tissues treated with anabolic steroids. The present study evaluated the effects of LLLT (AsGaAl 780 nm, 3 J/cm(2), 10 mW, beam spot of 0.04 cm(2), total energy 0.12 J) on the proliferation, adhesion, and differentiation of osteoblasts cultured in the presence of nandrolone decanoate (ND). The MTT method was employed to evaluate cell proliferation and adhesion. Cell differentiation was evaluated by measuring alkaline phosphatase activity. There was a significant decrease in cell proliferation in the irradiated group treated with 50 muM ND when compared to the control group, after 48 h. After 72 h, cell proliferation was significantly greater in the control group than in the irradiated groups treated with the steroid at concentrations of 10, 25, and 50 muM. With regard to cell differentiation, alkaline phosphatase activity was significantly higher in the irradiated group treated with 50 muM ND than in the control group, irradiated non-treated group, and irradiated group treated with 25 muM ND. After 60 min of plating, the irradiated non-treated group and irradiated groups treated with the steroid at concentrations of 5, 10, and 25 muM exhibited a significant increase in cell adhesion compared to the control group. LLLT in combination with a high concentration of steroid inhibited cell proliferation, possibly by inducing cell differentiation, while irradiation combined with lower concentrations of the steroid induced an increase in cell adhesion.

Lasers Med Sci 2011 Dec 22

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=22190155

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Effects of low level laser therapy on proliferation and neurotrophic factor gene expression of human schwann cells in vitro.

Yazdani SO, Golestaneh AF, Shafiee A, Hafizi M, Omrani HA, Soleimani M

Neuroscience Research Center, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran; Stem Cell Biology Department, Stem Cell Technology Research Center, Tehran, Iran; Functional Neurosurgery Research Center, Department of Neurosurgery, Shohada Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Previous studies have been proposed that proliferation and release of certain growth factors by different types of cells can be modulated by low level laser therapy. We aimed to demonstrate the effect of laser irradiation on human schwann cell proliferation and neurotrophic factor gene expression in vitro. Human schwann cells (SCs) were harvested from sural nerve that was obtained from organ donor followed by treatment with an 810nm, 50mW diode laser (two different energies: 1J/cm(2) and 4J/cm(2)) in three consecutive days. SC proliferation was measured, after first irradiation on days 1, 4 and 7 by the MTT assay. Real time PCR analysis was utilized on days 5 and 20 to evaluate the expression of key genes involved in nerve regeneration consist of NGF, BDNF and GDNF. Evaluation of cellular proliferation following one day after laser treatment revealed significant decrease in cell proliferation compared to control group. However on day 7, significant increase in proliferation was found in both the irradiated groups in comparison with the control group. No significant difference was found between the laser treated groups. Treatment of SCs with laser resulted in significant increase in NGF gene expression on day 20. Difference between two treated groups and control group was not significant for BDNF and GDNF gene expression. Our results demonstrate that low level laser therapy stimulate human schwann cell proliferation and NGF gene expression in vitro.

J Photochem Photobiol B 2011 Nov 23

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=22178388

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Knowledge of the physical properties and interaction of laser with biological tissue in dentistry.

Cavalcanti TM, Almeida-Barros RQ, Catao MH, Feitosa AP, Lins RD

Universidade Estadual da Paraiba, Campina Grande, PB, Brasil.

The trend in dentistry is to incorporate less invasive methods to minimize pain and discomfort during and after dental intervention. Therefore, it is believed that laser therapy is an excellent treatment option, since it has beneficial effects for the irradiated tissues, such as activation of microcirculation, production of new capillaries, inflammatory and analgesic effects, in addition to stimulation of growth and cell regeneration. The comprehension of the interaction between lasers and tissue is based mainly on understanding the reactions that can be induced in those tissues by laser. This work intends to show how important it is to know the physical properties of laser as well as its interactions with biological tissues, since its effects and mechanisms of action are complex and are the object of various studies to better understand its forms of application and indications.

An Bras Dermatol 2011 Oct 86(5) 955-960

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=22147036

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Effect of low-level laser therapy on the initial stages of tissue repair: basic principles.

Piva JA, Abreu EM, Silva VD, Nicolau RA

Universidade Paulista, Sao Jose dos Campos, SP, Brasil.

O objetivo do estudo foi realizar uma revisao de literatura a respeito da terapia com laser de baixa potencia e sua relacao com as fases iniciais de reparo. Foram analisados 22 artigos, observou-se a utilizacao de diferentes doses e comprimentos de ondas (632,8 a 904 nm). Nos estudos in vitro foram utilizadas doses entre 2,2 e 16 J/cm(2). A dose de 5 J/cm(2) tem sido apontada como responsavel por mudancas significativas in vitro, porem a dose de 16 J/cm(2) promove efeito inibitorio sobre o crescimento celular em culturas. Em estudos in vivo, envolvendo animais foram utilizadas doses entre 0,04 a 21 J/cm(2). Para estudos em humanos foram utilizadas doses entre 1,8 a 16 J/cm(2). Conclui-se que a terapia com laser de baixa potencia exerce efeitos antiinflamatorios importantes nos processos iniciais da cicatrizacao: reducao de mediadores quimicos, de citocinas, do edema, diminuicao da migracao de celulas inflamatorias e incremento de fatores de crescimento contribuindo diretamente para o processo de reabilitacao tecidual. Porem, a falta de padronizacao dificulta a escolha de parametros ideais.

An Bras Dermatol 2011 Oct 86(5) 947-954

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=22147035

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Posted in Research | on Low Level Laser Therapy LLLT / Cold Laser Literature watch for Dec 2011

Low Level Laser Therapy LLLT / Cold Laser Literature watch for Nov 2011

21 new LLLT papers for your review this month including:

– How to report LLLT beam & dose parameters
– Bisphosphonate osteonecrosis of the jaw (BRONJ)
– Rotator cuff tendinitis
– The effect of LED on a patient in a persistent vegetative state
– Two papers on herpes simplex
– A study on acneiform rash due to EGFRI
– LLLT for “coronally advanced flap adjunct” (a gingival surgical
procedure)
– Lymphedema Praecox

How to Report Low-Level Laser Therapy (LLLT)/Photomedicine Dose and Beam Parameters in Clinical and Laboratory Studies.

Jenkins PA, Carroll JD

1 SpectraMedics Pty Ltd , Oakbank, SA, Australia ; SpectraVET Inc., Irradia LLC, and Irradia Education Inc., Lawndale, North Carolina; and Immunophotonics Inc., Columbia, Missouri. 2 THOR Photomedicine Ltd, Chesham, United Kingdom

Background: Dose and beam parameters are critical for successful laser, LED, and other light therapy treatments, however, in our experience, researchers frequently make critical errors and omissions when submitting papers for publication. Journals frequently publish studies with missing data, mathematical errors, and no reported verification of beam parameters. This makes reproducibility impossible, and further confounds an already complex subject. Objective: This article is intended to be a reference document for non-physicist researchers conducting low-level laser therapy (LLLT) laboratory studies and clinical trials to help them design and report the beam and dose aspects of their trials. Recommendations: It provides a checklist to help LLLT researchers understand and report all the necessary parameters for a repeatable scientific study. It includes the eight most important beam parameters to report, which are: wavelength, power, irradiation time, beam area at the skin or culture surface (this is not necessarily the same as the aperture size), pulse parameters, anatomical location, number of treatments, and interval between treatments. The three commonly used dose parameters are time, energy, and energy density. In addition, more thorough reporting would include coherence, application technique (contact, projection, scanning, pressure), beam profile, and spectral width, as these may also be considered important. Beam power often decreases as the device warms up and as the device ages; therefore, this should be checked routinely during an experiment/trial. Measurements of beam area and beam power require special instruments and trained technicians to operate them. Power measurements should be taken before, after, and at frequent intervals during research trials. Conclusion: Reviewers should insist that the minimum eight most important beam parameters are included and authors should take care to measure and record these accurately before during and after an experiment or clinical trial.

Photomed Laser Surg 2011 Nov 22

http://www.ncbi.nlm.NIH.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=22107486

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Early Surgical Laser-Assisted Management of Bisphosphonate-Related Osteonecrosis of the Jaws (BRONJ): A Retrospective Analysis of 101 Treated Sites with Long-Term Follow-Up.

Vescovi P, Manfredi M, Merigo E, Guidotti R, Meleti M, Pedrazzi G, Fornaini C, Bonanini M, Ferri T, Nammour S

1 Oral Medicine, Pathology and Laser-Assisted Surgery Unit, University of Parma , Parma, Italy .

Abstract Background data: The management of bisphosphonate-related osteonecrosis of the jaws (BRONJ) is still controversial. Objective: The purpose of this study was to compare surgical and nonsurgical approaches to the treatment of BRONJ and the possible usefulness of Nd:YAG and Er:YAG lasers. Methods: One hundred and twenty-eight patients (33 males, 95 females; 52 with diagnosis of multiple myeloma, 53 with diagnosis of bone metastasis, and 23 with diagnosis of osteoporosis) affected by BRONJ were evaluated at the Unit of Oral Pathology and Medicine and Laser-Assisted Surgery of the University of Parma, Italy, between January 2004 and July 2009. Overall number of BRONJ sites was 151, and number of treated sites was 101. In order to assess the efficacy of different treatments, sites were subclassified as follows: Group 1 (G1): 12 sites treated with medical therapy; Group 2 (G2): 27 sites treated with medical therapy associated with low level laser therapy (LLLT); Group 3 (G3): 17 sites treated with a combination of medical and surgical therapy; Group 4 (G4): 45 sites treated with a combination of medical therapy, surgical (including laser-assisted) therapy, and LLLT. Outcome of treatment was assessed using the staging system proposed by Ruggiero et al. Transition from a higher stage to a lower one for at least 6 months was considered as clinical improvement and suggestive of a successful treatment. Results: Clinical improvement was achieved in 3 out of 12 (25%) BRONJ sites in G1. Sites if G2 with an improvement were 18 out of 27 (66%). Nine out 17 BRONJ sites (53%) in G3 had a transition to a lower stage after treatment. For sites in G4, a clinical improvement was recorded in 40 out of 45 cases (89%). Conclusions: In our experience, the percentage of success obtained with a combined approach based on medical therapy, surgical (including laser-assisted) therapy, and LLLT (G4) is significantly higher than the percentage of improvement obtained in G1, G2, and G3.

Photomed Laser Surg 2011 Nov 4

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=22054203

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The Effect of 670-nm Low Laser Therapy on Herpes Simplex Type 1.

Munoz Sanchez PJ, Capote Femenias JL, Diaz Tejeda A, Tuner J

1 Leonardo Fernandez Sanchez Dental Clinic , Cienfuegos, Cuba .

Abstract Objective: The purpose of this work was to study the effect of low-level laser therapy (LLLT) on the healing and relapse intervals in patients with recurrent labial herpes simplex infections. Background data: Several pharmaceuticals are available to reduce symptoms and improbe healing of labial herpes, but only LLLT has been reported to significantly influence the length of the recurrence period. Material and methods: In an initial study, 232 patients with herpes simplex type 1 virus symptoms were consecutively selected for either LLLT or conventional therapy, including acyclovir cream or tablets. One of the dentists was responsible for the diagnosis, a second dentist for the treatment, and and a third for the evaluation, to allow for a semi-blinded procedure. Patients in the laser group received 670-nm laser irradiation, 40 mW, 1.6 J, 2.04 J/cm(2), 51 mW/cm(2) per blister in the prodromal stage and 4.8 J in the crust and secondarily infected stages, plus 1.2 J at the C2-C3 vertebrae. Patients were monitored daily during the first week to control healing, and monthly for 1 year to check on recurrence. In a consecutive study, 322 patients receiving LLLT were followed during 5 years to observe the period of ocurrences. Results: An obvious effect of LLLT was found for both initial healing and for the length of the recurrence periods. Conclusions: LLLTof herpes simples virus 1 (HSV-1) appears to be an effective treatment modality without any observed side effects.

Photomed Laser Surg 2011 Nov 2

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=22047597

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Effects of low-level laser therapy in combination with physiotherapy in the management of rotator cuff tendinitis.

Eslamian F, Shakouri SK, Ghojazadeh M, Nobari OE, Eftekharsadat B

Physical Medicine and Rehabilitation Research Center, Imam Reza hospital, Tabriz University of Medical Sciences, Golgasht Ave, Tabriz, Iran, eslamiyanf@tbzmed.ac.ir.

Rotator cuff tendinitis is one of the main causes of shoulder pain. The objective of this study was to evaluate the possible additive effects of low-power laser treatment in combination with conventional physiotherapy endeavors in these patients. A total of 50 patients who were referred to the Physical Medicine and Rehabilitation Clinic with shoulder pain and rotator cuff disorders were selected. Pain severity measured with visual analogue scale (VAS), abduction, and external rotation range of motion in shoulder joint was measured by goniometry, and evaluation of daily functional abilities of patients was measured by shoulder disability questionnaire. Twenty-five of the above patients were randomly assigned into the control group and received only routine physiotherapy. The other 25 patients were assigned into the experimental group and received conventional therapy plus low-level laser therapy (4 J/cm(2) at each point over a maximum of ten painful points of shoulder region for total 5 min duration). The above measurements were assessed at the end of the third week of therapy in each group and the results were analyzed statistically. In both groups, statistically significant improvement was detected in all outcome measures compared to baseline (p < 0.05). Comparison between two different groups revealed better results for control of pain (reduction in VAS average) and shoulder disability problems in the experimental group versus the control (3.1 +/- 2.2 vs. 5 +/- 2.6, p = 0.029 and 4.4 +/- 3.1 vs. 8.5 +/- 5.1, p = 0.031, respectively ) after intervention. Positive objective signs also had better results in the experimental group, but the mean range of active abduction (144.92 +/- 31.6 vs. 132.80 +/- 31.3) and external rotation (78.0 +/- 19.5 vs. 76.3 +/- 19.1) had no significant difference between the two groups (p = 0.20 and 0.77, respectively). As one of physical modalities, gallium-arsenide low-power laser combined with conventional physiotherapy has superiority over routine physiotherapy from the view of decreasing pain and improving the patient’s function, but no additional advantages were detected in increasing shoulder joint range of motion in comparison to other physical agents.

Lasers Med Sci 2011 Nov 4

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=22052627

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Focal Increase in Cerebral Blood Flow After Treatment with Near-Infrared Light to the Forehead in a Patient in a Persistent Vegetative State.

Nawashiro H, Wada K, Nakai K, Sato S

1 Department of Neurosurgery, National Defense Medical College , Tokorozawa, Saitama, Japan .

Abstract Objective: This study aimed to quantify the cerebral blood flow (CBF) after bilateral, transcranial near-infrared light-emitting diode (LED) irradiation to the forehead in a patient in a persistent vegetative state following severe head injury. Background data: Positive behavioral improvement has been observed following transcranial near-infrared light therapy in humans with chronic traumatic brain injury and acute stroke. Methods: Single-photon emission computed tomography with N-isopropyl-[123I]p-iodoamphetamine (IMP-SPECT) was performed following a series of LED treatments. Results: IMP-SPECT showed unilateral, left anterior frontal lobe focal increase of 20%, compared to the pre-treatment value for regional CBF (rCBF) for this area, following 146 LED treatments over 73 days from an array of 23×850 nm LEDs, 13 mW each, held 5 mm from the skin, 30 min per session, the power density 11.4 mW/cm(2); the energy density 20.5 J/cm(2) at the skin. The patient showed some improvement in his neurological condition by moving his left arm/hand to reach the tracheostomy tube, post-LED therapy. Conclusions: Transcranial LED might increase rCBF with some improvement of neurological condition in severely head-injured patients. Further study is warranted.

Photomed Laser Surg 2011 Nov 2

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=22047598

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Coronally advanced flap adjunct with low intensity laser therapy: a randomized controlled clinical pilot study.

Ozturan S, Durukan SA, Ozcelik O, Seydaoglu G, Cenk Haytac M

Department of Periodontology, Faculty of Dentistry, Cukurova University, Adana, Turkey.

AIM: Coronally advanced flap (CAF) technique and its modifications have been proposed in the literature. Low intensity laser therapy (LILT) is shown to increase wound healing. The aim of this split-mouth randomized controlled pilot study was to assess the effects of LILT with respect to root coverage after CAF procedure for the treatment of multiple-recession type defects (MRTD). MATERIAL AND METHODS: Ten patients with symmetrical 74 Miller I and II gingival recessions were included in this study (37 in test, 37 in control group). A diode laser (588 nm) was applied to test sites before and immediately after surgery, and for 5 min. daily 7 days post-operatively. Comparisons of the surgical sites were made with clinical measurements. RESULTS: Statistically significant differences were observed between test and control sites in the gingival recession depth (GRD), gingival recession width (GRW) and width of the keratinized tissue (WKT) and clinical attachment level (CAL) measurements after 1 year (p = 0.014, p = 0.015, p = 0.009 and p = 0.018 respectively). The test group presented greater complete root coverage (n = 7, 70%) compared with the control group (n = 3, 30%) after treatment. CONCLUSION: Within the limitations of this study, the results indicated that LILT may improve the predictability of CAF in multiple recessions.

J Clin Periodontol 2011 Nov 38(11) 1055-62

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=22092477

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Acneiform rash due to epidermal growth factor receptor inhibitors: high-level laser therapy as an innovative approach.

Gobbo M, Ottaviani G, Mustacchi G, Di Lenarda R, Biasotto M

Division of Oral Pathology, Dental Science Department, University of Trieste, Ospedale Maggiore, Piazza dell’Ospitale 2, 34100, Trieste, Italy.

Acneiform rash associated with epidermal growth factor receptor inhibitors frequently presents facial manifestations. The treatment modality for such lesions still needs to be elucidated. The aim of this original report was to evaluate the effectiveness of high-level laser therapy in reducing the severity of facial acneiform rash induced by cetuximab, an epidermal growth factor receptor inhibitors. Four patients with metastatic colorectal cancer and two patients with head and neck cancer showing cetuximab-induced facial rash were treated by high-level laser therapy in two 8-min-long consecutive sessions/day over a 4-day treatment. Patients wore protective glasses to prevent eye damage related to laser light. Subsequently, patients were seen once a week for up to 21 days and after 180 days. During each day of treatment and each follow-up recall, patients were asked to complete a questionnaire about the onset and progression of their acneiform rash (for a total of eight sessions). Cetuximab-related toxicity and general discomfort visual analogue scales were also recorded in each of these eight sessions in the treated and control areas in each patient. After the fourth session of high-level laser therapy, the patients showed a noteworthy decrease in both cetuximab-related toxicity and visual analogue scales, up to a complete regression of the lesions at the end of the follow-up in all treated areas. The high-level laser therapy was effective in the healing of acneiform rash associated with epidermal growth factor receptor inhibitors with no side effects.

Lasers Med Sci 2011 Nov 26

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=22120470

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Treatment of Lymphedema Praecox through Low Level Laser Therapy (LLLT).

Mahram M, Rajabi M

Associate Professor of Pediatrics Department, Qazvin University of Medical Sciences, Qazvin, Iran.

A 15-year-old girl with right lower extremity lymphedema praecox was treated through Low Level Laser Therapy (LLLT), by means of a GaAs and GaAlAs diodes laser-therapy device. Treatment sessions were totally 24, each cycle containing 12 every other day 15-minute sessions, and one month free between the cycles. The treatment was achieved to decrease the edema and no significant increase in circumference of involved leg was found following three months after the course of treatment. Although LLLT can be considered a beneficial treatment for Lymphedema Praecox, any definite statement around its effectiveness needs more studies on more cases.

J Res Med Sci 2011 Jun 16(6) 848-51

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=22091317

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Prevention of recurrent herpes labialis outbreaks through low-intensity laser therapy: a clinical protocol with 3-year follow-up.

de Paula Eduardo C, Bezinelli LM, de Paula Eduardo F, Marques da Graca Lopes R, Ramalho KM, Stella Bello-Silva M, Esteves-Oliveira M

Special Laboratory of Lasers in Dentistry – LELO, Department of Restorative Dentistry, Faculdade de Odontologia da Universidade de Sao Paulo, Sao Paulo, Brazil, cpeduard@usp.br.

Lasers Med Sci 2011 Nov 16

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=22086666

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Comparison of the long – term effectiveness of physiotherapy programs with low – level laser therapy and pulsed magnetic field in patients with carpal tunnel syndrome.

Dakowicz A, Kuryliszyn-Moskal A, Kosztyla-Hojna B, Moskal D, Latosiewicz R

Department of Rehabilitation, Medical University of Bialystok, Bialystok, Poland.

Purpose: The aim of the study was to compare the long term effects of low – level laser therapy (LLLT) and pulsed magnetic field (PMF) in the rehabilitation of patients with carpal tunnel syndrome (CTS).Methods: The study included 38 patients with idiopathic CTS, confirmed by electroneurographic (ENG) examination. All patients were randomly assigned to 2 groups: group L (18 patients) treated with LLLT and group M (20 patients) with PMF therapy. Clinical assessment, including day and night pain, the presence of paresthesia, functional tests (Phalen, Tinel, armband tests) and pain severity according to the Visual Analogue Scale (VAS) was conducted before treatment, after the first series of 10 sessions, after a two-week break, after the second series of 10 sessions and six months after the last series.Results: After LLLT a significant reduction of day and night pain was observed at each stage of treatment and 6 months after the last series (p
Photochem Photobiol 2011 Nov 4

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=22053933

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Near infrared Transcranial Laser Therapy applied at Various Modes to Mice Following Traumatic Brain Injury Significantly Reduces Long-Term Neurological Deficits.

Oron U

Ramat Aviv, Tel-Aviv, Israel, 69978; oronu@post.tau.ac.il.

Near-infrared transcranial laser therapy (TLT) has been found to modulate various biological processes including traumatic brain injury (TBI). Following TBI in mice, in this study we assessed the possibility of various near-infrared TLT modes (pulsed vs. continuous) producing a beneficial effect on the long-term neurobehavioral outcome and brain lesions of these mice. TBI was induced by a weight-drop device, and neurobehavioral function was assessed from one hour and up to 56 days post-trauma using a neurological severity score (NSS). The extent of recovery is expressed as dNSS, the difference between the initial score, and that at any other, later, time point. An 808nm Ga-Al-As diode laser was employed transcranially 4, 6 or 8 hrs post-trauma to illuminate the entire cortex of the brain. Mice were divided into several groups of 6-8 mice: one control group that received a sham treatment and experimental groups that received either TLT continuous wave (CW) or pulsed wave (PW) mode transcranially. MRI was taken prior to sacrifice 56 days post-CHI. From 5 to 28 days post-TBI, the NSS of the laser-treated mice were significantly lower (p
J Neurotrauma 2011 Oct 31

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=22040267

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Laser immunotherapy with gold nanorods causes selective killing of tumour cells.

Rejiya CS, Kumar J, Raji V, Vibin M, Abraham A

Department of Biochemistry, University of Kerala, Kariavattom Campus, Thiruvananthapuram 695 581, Kerala, India.

Therapeutic approaches that exploit nanoparticles to deliver drugs selectively to cancer cells are currently considered one of the most promising avenues in the area of cancer therapeutics. Recently, gold nanorods (AuNRs) have shown promising biological applications due to their unique electronic and optical properties. In this paper, we have demonstrated the anti-cancer potential of gold nanorods with low power laser light. Gold nanorods (AuNRs), surface modified with poly (styrene sulfonate) PSS and functionalized with epidermal growth factor receptor antibody conjugated with gold nanorods (anti-EGFR-AuNRs) were successfully synthesised and characterized by UV-Visible-NIR spectrophotometry and High Resolution Transmission Electron Microscopy (HR-TEM). Inductively Coupled Plasmon Atomic Emission Spectrometry (ICP-AES) and Immunofluorescence studies confirmed the efficient uptake of these functionalized gold nanorods by human squamous carcinoma cells, A431. The in vitro photothermal therapy was conducted in four groups – control, laser alone, unconjugated AuNRs with laser and anti-EGFR conjugated AuNRs with laser. Phase contrast images have revealed cell morphology changes and cell death after the laser irradiation. In order to determine whether the cell death occur due to apoptosis or necrosis, we have evaluated the biochemical parameters such as lactate dehydrogenase release, reactive oxygen species level, mitochondrial membrane potential and caspase-3 activity. Flow cytometry analysis have shown the cell cycle changes after laser irradiation with antibody conjugated gold nanorods. Thus the results of our experiments confirmed that immunolabeled gold nanorods can selectively destruct the cancer cells and induce its apoptosis through ROS mediated mitochondrial pathway under low power laser exposure.

Pharmacol Res 2011 Nov 17

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=22115972

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Laser photostimulation (660 nm) of wound healing in diabetic mice is not brought about by ameliorating diabetes.

Peplow PV, Chung TY, Baxter GD

Department of Anatomy and Structural Biology, University of Otago, Dunedin, New Zealand. phil.peplow@stonebow.otago.ac.nz.

BACKGROUND AND OBJECTIVES: We have used a 660-nm laser diode in genetic diabetic mice to stimulate the healing of wounds covered with a Tegaderm HP dressing that causes a retardation of contraction (splinted wounds). It is possible that the stimulation of healing could be due to possible diabetes-modifying properties of laser light. This has been examined by using the 660 nm laser to irradiate non-wounded diabetic mice with the same dose and at same location as for wounded diabetic mice. MATERIALS AND METHODS: Twenty-two diabetic mice were used and divided into two equal groups. Body weight and water intake of mice were measured daily for 7 days prior to the start of treatment (Day 0). The left flank of mice in the experimental group was irradiated with 660 nm laser, 100 mW, 20 seconds/day, 7 days; for mice in the control group, the left flank was sham-treated with the laser power supply not switched on. Body weight and water intake of mice were measured to Day 14. On Day 14, the mice were fasted for 4 hours, anaesthetized with sodium pentobarbitone (i.p.) and blood collected by cardiac puncture into heparinized tubes. The plasma was assayed for glucose and glycated hemoglobin A1c. RESULTS: There were no significant differences in body weight and water intake over 22 days between mice in the experimental group and control group. On day 14, the mean blood plasma glucose level was not significantly different between the two groups; glycated hemoglobin A1c was not detected in the samples. CONCLUSION: Irradiation of the left flank in diabetic mice with 660 nm laser system does not have a significant hypoglycemic effect, and the laser-stimulated healing of wounds in diabetic mice is due to cellular and biochemical changes in the immediate wound environment. Lasers Surg. Med. (c) 2011 Wiley Periodicals, Inc.

Lasers Surg Med 2011 Nov 22

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=22109569

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Effects of the combination of low-level laser irradiation and recombinant human bone morphogenetic protein-2 in bone repair.

Rosa AP, de Sousa LG, Regalo SC, Issa JP, Barbosa AP, Pitol DL, de Oliveira RH, de Vasconcelos PB, Dias FJ, Chimello DT, Siessere S

Department of Morphology, Stomatology and Physiology, School of Dentistry at Ribeirao Preto, University of Sao Paulo, Avenida do Cafe, s/n – Bairro – Monte Alegre, 14040-904, Ribeirao Preto, Sao Paulo, Brazil.

Low-level laser irradiation (LLLI) and recombinant human bone morphogenetic protein type 2 (rhBMP-2) have been used to stimulate bone formation. LLLI stimulates proliferation of osteoblast precursor cells and cell differentiation and rhBMP-2 recruits osteoprogenitor cells to the bone healing area. This in vivo study evaluated the effects of LLLI and rhBMP-2 on the bone healing process in rats. Critical bone defects were created in the parietal bone in 42 animals, and the animals were divided into six treatment groups: (1) laser, (2) 7 mug of rhBMP-2, (3) laser and 7 mug of rhBMP-2, (4) 7 mug of rhBMP-2/monoolein gel, (5) laser and 7 mug rhBMP-2/monoolein gel, and (6) critical bone defect controls. A gallium-aluminum-arsenide diode laser was used (wavelength 780 nm, output power 60 mW, beam area 0.04 cm(2), irradiation time 80 s, energy density 120 J/cm(2), irradiance 1.5 W/cm(2)). After 15 days, the calvarial tissues were removed for histomorphometric analysis. Group 3 defects showed higher amounts of newly formed bone (37.89%) than the defects of all the other groups (P < 0.05). The amounts of new bone in defects of groups 1 and 4 were not significantly different from each other (24.00% and 24.75%, respectively), but were significantly different from the amounts in the other groups (P < 0.05). The amounts of new bone in the defects of groups 2 and 5 were not significantly different from each other (31.42% and 31.96%, respectively), but were significantly different from the amounts in the other groups (P < 0.05). Group 6 defects had 14.10% new bone formation, and this was significantly different from the amounts in the other groups (P < 0.05). It can be concluded that LLLI administered during surgery effectively accelerated healing of critical bone defects filled with pure rhBMP-2, achieving a better result than LLLI alone or the use of rhBMP-2 alone.

Lasers Med Sci 2011 Nov 18

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=22095190

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Development of a minimally invasive laser needle system: effects on cortical bone of osteoporotic mice.

Kang H, Ko CY, Ryu Y, Seo DH, Kim HS, Jung B

Department of Biomedical Engineering, Yonsei University, 234 Maeji-ri, Heungup-myun, Wonju-si, Gangwon-do, 220-710, Korea.

Many studies have shown the positive effects of low-level laser therapy in the treatment of bone disease. However, laser radiation is scattered in the skin surface which reduces the initial photon density for tissue penetration and consequently the therapeutic efficacy. We developed a minimally invasive laser needle system (MILNS) to avoid laser scattering in tissue and investigated its stimulatory effects in the cortical bone of osteoporotic mice. The MILNS was designed to stimulate cortical bone directly by employing fine hollow needles to guide 100 mum optical fibers. The study animals comprised 12 mice which were subjected to sciatic denervation of the right hind limb and were randomly divided into two groups, a sham group and a laser group which were treated using the MILNS for 2 weeks without and with laser irradiation, respectively. In vivo micro-CT images were taken to analyze the structural parameters and bone mineral density. After 2 weeks of treatment with the MILNS, the relative changes in mean polar moment inertia, cross-section thickness, and periosteal perimeter were significantly higher in the laser group than in the sham group. Moreover, the distribution of bone mineral density index was higher in the laser group. The MILNS was developed as a minimally invasive treatment modality for bone disease and resulted in positive therapeutic efficacy in the cortical bone of osteoporotic mice.

Lasers Med Sci 2011 Nov 9

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=22083368

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Light therapy by blue LED improves wound healing in an excision model in rats.

Adamskaya N, Dungel P, Mittermayr R, Hartinger J, Feichtinger G, Wassermann K, Redl H, van Griensven M

Ludwig Boltzmann Institute for Experimental and Clinical Traumatology, AUVA Research Center, Austrian Cluster for Tissue Regeneration, Donaueschingenstrasse 13, A-1200 Vienna, Austria.

BACKGROUND: Low level light therapy (LLLT) is an attractive alternative to enhance wound healing. So far most studies are performed with red or infrared irradiation. However, we recently showed that blue light (470 nm) can significantly influence biological systems, improving perfusion by release of nitric oxide from nitrosyl complexes with haemoglobin in a skin flap model in rats. Here, we compared the effects of blue and red low level light by light-emitting diodes (LEDs) on in vivo wound healing in an excision wound model in rats. METHODS: Circular excision wounds were surgically created on the dorsum of each rat. Excisions on either the left or right side were illuminated post-OP and on five consecutive days for 10 min by LED at 470 nm or 630 nm with an intensity of 50 mW/cm(2),while protecting the contralateral side from exposure. In the control group, neither side was illuminated. On day 7 post-OP, we analysed planimetric and histological parameters, as well as expression of keratin-1, keratin-10 and keratin-17 on mRNA level. RESULTS: Illumination substantially influenced wound healing. Blue light significantly decreased wound size on day 7, which correlated with enhanced epithelialisation. Light also affected mRNA expression. Both wavelengths decreased keratin-1 mRNA on day 7 post-OP, while keratin-10 mRNA level was elevated in both light treated group compared to control. Keratin-17 mRNA was also elevated in the red light group, but was unchanged in the blue light group. CONCLUSION: In contrast to previous studies, we showed that also blue light significantly influences wound healing. Furthermore, our data suggest that light therapy can play an important role in normotrophic wound healing by affecting keratin expression. Illumination would provide an easily applicable, safe and cost-effective treatment of surface wounds.

Injury 2011 Sep 42(9) 917-21

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=22081819

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The Relevance of Accurate Comprehensive Treatment Parameters in Photobiomodulation.

Enwemeka CS

Office of the Dean, College of Health Sciences, University of Wisconsin , Milwaukee, Wisconsin.

Photomed Laser Surg 2011 Nov 9

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=22070214

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Posted in Research | on Low Level Laser Therapy LLLT / Cold Laser Literature watch for Nov 2011

Low Level Laser Therapy LLLT / Cold Laser Literature watch for Oct 2011

28 new LLLT papers for your review this month, including three from the Hamblin stable at Harvard. First on this list (and one I co-authored) is an invited paper called the “The Nuts and Bolts of Low-level Laser (Light) Therapy“. It’s everything you need to know about the latest thinking on the mechanism of action, beam parameters, dose and where the research is going. Next from the Hamblin lab is a dose response study on cortical neurones and, guess what, once again: less is more. 810nm light (25 mW/cm2) on mouse primary cortical neurons induced a significant increase in calcium, ATP and MMP at lower fluences but decreased them at higher fluences. A beautiful biphasic dose response curve shows that increasing the dose beyond  a certain point (3J/cm2 in this case) showed a decline from the peak effect at 10 and 30J/cm2. The third paper in today’s Hamblin trio compares pulsed and continuous wave 810-nm laser for traumatic brain injury in mice with significant benefits of 10Hz over 100Hz or CW. Whilst on the subject of dose, an RCT on perineal pain and healing after episiotomy showed that LLLT  did not accelerate episiotomy healing, there was a small reduction in pain; however the laser was 15 mW and used for only 10 s per point, so this is not a surprise.

If you don’t know how much is enough, or how much is too much you better get trained. Details of worldwide training courses here.

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Low Level Laser Therapy LLLT / Cold Laser Literature watch for Sept 2011

15 new research papers for you this month including LLLT treatments for: osteonecrosis of the jaw in cancer patients, laser vs ultrasound for shoulder myofascial pain syndrome, radiation-induced mucositis in head and neck cancer patients, persistent idiopathic facial pain and a negative study for subacromial impingement syndrome. This negative result is hardly a surprise as the laser was only 6mW. It is a shame the authors did not come on our training course before embarking on this study. There are ten more papers to review including Alzheimer’s disease, TMJ, respiratory diseases in children and a a MUST READ editorial on the effect of LLLT on suppression of activity of peripheral nerve endings by Dr Roberta Chow MD PhD.

Association of laser phototherapy with PRP improves healing of bisphosphonate-related osteonecrosis of the jaws in cancer patients: A preliminary study.

Martins MA, Martins MD, Lascala CA, Curi MM, Migliorati CA, Tenis CA, Marques MM

School of Dentistry, Universidade de Sao Paulo, Sao Paulo, SP, Brazil; Department of Oral Pathology, School of Dentistry, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil.

The aim of this study was to compare retrospectively the effect of three different treatments on the healing outcome of bisphosphonate-related osteonecrosis of the jaws (BRONJ) in cancer patients. Twenty-two cancer patients were treated for BRONJ with one of the following protocols: clinical (pharmacological therapy), surgical (pharmacological plus surgical therapy), or PRP plus LPT (pharmacological plus surgical plus platelet rich plasma (PRP) plus laser phototherapy (LPT). The laser treatment was applied with a continuous diode laser (InGaAlP, 660nm) using punctual and contact mode, 40mW, spot size 0.042 cm(2), 6J/cm(2) (6s) and total energy of 0.24J per point. The irradiations were performed on the exposed bone and surrounding soft tissue. The analysis of demographic data and risk factors was performed by gathering the following information: age, gender, primary tumor, bisphosphonate (BP) used, duration of BP intake, history of chemotherapy, use of steroids, and medical history of diabetes. The association between the current state of BRONJ (with or without bone exposure) and other qualitative variables was determined using the chi-square or Fisher’s exact test. In all tests, the significance level adopted was 5%. Most BRONJ lesions occurred in the mandible (77%) after tooth extraction (55%) and in women (72%). A significantly higher percentage of patients reached the current state of BRONJ without bone exposure (86%) in the PPR plus LPT group than in the pharmacological (0%) and surgical (40%) groups after 1-month follow-up assessment. These results suggest that the association of pharmacological therapy and surgical therapy with PRP plus LPT significantly improves BRONJ healing in oncologic patients. Although prospective studies with larger sample sizes are still needed, this preliminary study may be used to inform a better-designed future study.

Oral Oncol 2011 Sep 20

http://www.ncbi.nlm.NIH.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=21940198

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Comparison of the effects of low energy laser and ultrasound in treatment of shoulder myofascial pain syndrome: a randomized single-blinded clinical trial.

Rayegani S, Bahrami M, Samadi B, Sedighipour L, Mokhtarirad M, Eliaspoor D

Physical Medicine and Rehabilitation Department, Shohada Medical Center, Shaheed Beheshti Medical University of Medical Sciences, Tehran, Ira- bahrami7mh@gmail.com.

BACKGROUND: Myofascial pain syndrome (MPS) is one of the most prevalent musculoskeletal diseases. MPS impaired quality of life in the patients. There is a lot of controversy about different treatment options which include medical treatments, physical therapy, injections, ultrasound and laser. The effects of laser in MPS are challenging. AIM: To assess the effects of laser and ultrasound in treatment of MPS. DESIGN: Randomized single blinded clinical trial SETTING: Outpatient physical therapy clinic at university hospital POPULATION: Sixty three subjects (females: 46, males: 17), (age range: 17-55 year old) who had a diagnosis of definite MPS were entered in the study. METHODS: We measured the pain intensity at rest, during activity and at night using Visual Analogue Scale (VAS) questionnaire. The patients also filled the Neck Disability Index (NDI) form and the pain threshold provoked by pressure was determined using algometric assessment. Then, the patients were categorized randomly in groups A, B and C (receiving laser therapy, ultrasound and sham laser therapy, respectively). Six weeks after the initial visit, they were visited again and filled the forms again. RESULTS: Ultrasound was effective in VAS improvement during activity (46%), at rest (39%) and at night (35%). It also improved NDI scores (34%) and algometric assessment (37%). Laser was effective in VAS improving during activity (54%), at night (51%) and at rest (51%) and also improved NDI scores (73%). It was also found effective in algometric assessment improvement (105%). Laser resulted in more NDI score and algometric assessment improvements comparing to ultrasound (p<0.05). CONCLUSION: This study introduces laser as one of the preferred treatments of myofascial pain syndrome in shoulder.

Eur J Phys Rehabil Med 2011 Sep 47(3) 381-9

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=21946400

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Evaluation of low-level laser therapy in the prevention and treatment of radiation-induced mucositis: A double-blind randomized study in head and neck cancer patients.

Carvalho PA, Jaguar GC, Pellizzon AC, Prado JD, Lopes RN, Alves FA

Stomatology Department – Hospital A.C. Camargo, Sao Paulo, Brazil.

The purpose of this prospective study was to determine the effect of the low-level laser in the prevention and treatment of mucositis in head and neck cancer patients. A total of 70 patients with malignant neoplasms in the oral cavity or oropharynx were evaluated. The patients were randomized into two low-level laser therapy groups: Group 1 (660nm/15mW/3.8J/cm(2)/spot size 4mm(2)) or Group 2 (660nm/5mW/1.3J/cm(2)/spot size 4mm(2)) starting on the first day of radiotherapy. Oral mucositis was assessed daily and weekly using the NCI and WHO scales. Oral pain was scored daily with a visual analogue scale before laser application. The patients in Group 1 had a mean time of 13.5days (range 6-26days) to present mucositis grade II, while the patients in Group 2 had a mean time of 9.8days (range 4-14days) (both WHO and NCI p=0.005). In addition, Group 2 also presented a higher mucositis grade than Group 1 with significant differences found in weeks 2 (p=0.019), 3 (p=0.005) and 4 (p=0.003) for WHO scale and weeks 2 (p=0.009) and 4 (p=0.013) for NCI scale. The patients in Group 1 reported lower pain levels (p=0.004). Low-level laser therapy during radiotherapy was found to be effective in controlling the intensity of mucositis and pain.

Oral Oncol 2011 Sep 10

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=21911312

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Treatment of Persistent Idiopathic Facial Pain (PIFP) with a Low-Level Energy Diode Laser.

Yang HW, Huang YF

1 Oral Medicine Center, Chung Shan Medical University Hospital , Taichung City, Taiwan .

Abstract Objective: The purpose of this study was to test the therapeutic efficacy of low- level energy diode laser on persistent idiopathic facial pain (PIFP). Background data: PIFP has presented a diagnosis and management challenge to clinicians. Many patients were misdiagnosed, which resulted in unnecessary dental procedures. Low-level energy diode laser therapy has been applied to different chronic and acute pain disorders, including neck, back, and myofacial pain; degenerative osteoarthritis; and headache, and it may be an effective alternative treatment for PIFP. Methods: A total of 16 patients, who were diagnosed with PIFP, were treated with an 800-nm wavelength diode laser. A straight handpiece having an end size of 0.8 cm in diameter, or an angled handpiece with an end size of 0.5 cm in diameter was used. When laser was applied, the handpiece directly contacted the involved symptomatic region with an energy density of 105 J/cm(2). Overall pain and discomfort was analyzed with a 10-cm visual analogue scale (VAS) before and after treatment. Results: All patients received diode laser therapy between 1 and10 times. The average pain score was 7.4 before the treatment (ranging from 2.9 to 9.8), and 4.1 after the treatment. An average pain reduction of 43.87% (ranging from 9.3% to 91.8%) was achieved. The pain remained unchanged at a lower level for up to 12 months. Conclusions: Low-level energy diode laser may be an effective treatment for PIFP.

Photomed Laser Surg 2011 Sep 9

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=21905852

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Are ultrasound, laser and exercise superior to each other in the treatment of subacromial impingement syndrome? A randomized clinical trial.

Calis H, Berberoglu N, Calis M

Kayseri Education and Research Hospital, Physical Therapy and Rehabilitation Clinic, Kayseri, Turkey – mcalis@erciyes.edu.tr.

BACKGROUND: Subacromial impingement syndrome (SIS) is the most common reason for shoulder pain. Ultrasound and laser are the physical therapy modalities, in conservative treatment of SIS. AIM: The aim of this study was to define and compare the efficacy of ultrasound, laser and exercise in the treatment of SIS. DESIGN: This was a randomized controlled trial with-pre and post-treatment evaluations SETTING: Out-patients referred to physical medicine and rehabilitation unit. POPULATION: This study was performed on 52 patients with SIS. The patients were randomly allocated into three groups METHODS: The patients were treated five days a week for three weeks with hotpack+ultrasound+exercise (the first group); hotpack+laser+exercise (the second group), or hotpack+exercise (the third group). The pre and post treatment ranges of motion were measured in the patients. The visual analogue scale (VAS) was used to evaluate the severity of pain. Constant scoring was used to evaluate the shoulder functions and the results were compared after the treatment. RESULTS: When the post-treatment results of the groups were compared with the pretreatment results, there was a statistically significant improvement in each of the three groups, in the pain, the range of motion and the functional improvement at the shoulder (P<0.05). However, the inter-group comparison did not reveal any statistically significant difference in the parameters indicating improvement (P>0.05). CONCLUSION: The results of this study demonstrated that ultrasound and laser treatments were not superior to each other in the treatment of SIS. CLINICAL REHABILITATION IMPACT:. Exercise treatment forms the base for the conservative treatment.

Eur J Phys Rehabil Med 2011 Sep 47(3) 375-80

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=21946399

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[Efficacy evaluation of low-level laser therapy on temporomandibular disorder].

Wang X, Yang Z, Zhang W, Yi X, Liang C, Li X

State Key Laboratory of Oral Diseases, Sichuan University, Chengdu 610041, China.

OBJECTIVE: To evaluate effectiveness of low-level laser therapy (LLLT) on temporomandibular joint (TMJ) pain. METHODS: The patients with TMJ pain were randomly assigned laser group (n=21) or control group(n=21), once a day for 6 consecutive days of treatment. TMJ pain and function were measured at baseline, just after treatment course, 1 month and 2 months after the treatment. RESULTS: The changes of visual analogue scale (VAS) were appearing over time in both groups but presented statistically significant differences between groups (P<0.001). VAS of laser group decreased faster than that of control group. The same tendency occurred for painless maximum vertical opening (MVO), left lateral excursion (LLE) and right lateral excursion (RLE), which increased faster in laser group. There were no statistically significant differences between groups and evaluation times for protrusion excursion (PE), but an interaction between group and evaluation times existed and should be explored further. CONCLUSION: LLLT is an appropriate treatment for TMJ pain.

Hua Xi Kou Qiang Yi Xue Za Zhi 2011 Aug 29(4) 393-5, 399

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=21932661

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[Polarized light acts as epigenetic factor in inhibition of inflammation; a genome wide expression analysis in recurrent respiratory diseases of children].

Falus A, Fenyo M, Eder K, Madarasi A

Semmelweis Egyetem, Altalanos Orvostudomanyi Kar Genetikai, Sejt- es Immunbiologiai Intezet Budapest. faland@dgci.sote.hu

Whole-body polarized light therapy has been primarily investigated in various clinical observations and in a few in vitro model systems. AIMS: In the present study, clinical and molecular effects of whole-body polarized light treatment on children suffering from recurrent respiratory infection were studied. METHODS: Incidence and duration of respiratory symptoms as well as the length of appropriate antibiotic therapy have been measured. Simultaneously, genome-wide gene expression pattern was examined by whole genome cDNA microarray in peripheral lymphocytes of children. RESULTS: Twenty of twenty five children showed a marked clinical improvement, while in five of twenty five had poor or no changes. Gene expression pattern of the peripheral lymphocytes of the patients was compared in favorable and poor responders. Lymphocytes of the children with a documented improved clinical response to polarized light therapy showed a decrease in the expression of chemokine genes, such as CXCL1, CXCL2, IL-8 and in that of the tumor necrosis alpha (TNFalpha) gene. On the contrary, a rapid elevation was found in the expression of gene encoding for CYP4F2, a leukotriene-B(4)-metabolizing enzyme. In children with poor clinical response to polarized light therapy, no similar changes were detected in the gene expression pattern of the lymphocytes. CONCLUSIONS: Improved clinical symptoms and modified gene expression profile of lymphocytes reveals anti-inflammatory effect upon whole body polarized light irradiation.

Orv Hetil 2011 Sep 11 152(37) 1492-9

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=21893480

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Inhibition of Abeta(25-35)-induced cell apoptosis by Low-power-laser-irradiation (LPLI) through promoting Akt-dependent YAP cytoplasmic translocation.

Zhang H, Wu S, Xing D

Deposition of amyloid-beta-peptide (Abeta) in the brain is considered a pathological hallmark of Alzheimer’s disease (AD). Our previous studies show that Yes-associated protein (YAP) is involved in the regulation of apoptosis induced by Abeta(25-35) through YAP nuclear translocation and its pro-apoptotic function is mediated by its interaction with p73. In the present study, we first found that Low-power laser irradiation (LPLI) promoted YAP cytoplasmic translocation and inhibited Abeta(25-35)-induced YAP nuclear translocation. Moreover, the cytoplasmic translocation was in an Akt-dependent manner. Activated Akt by LPLI phosphorylated YAP on ser127 (S127) and resulted in decreasing the interaction between YAP and p73, and in suppressing the proapoptotic gene bax expression following Abeta(25-35) treatment. Inhibition of Akt expression by siRNA significantly abolished the effect of LPLI. More importantly, LPLI could inhibit Abeta(25-35)-induced cell apoptosis through activation of Akt/YAP/p73 signaling pathway. Therefore, our findings first suggest that YAP may be a therapeutic target and these results directly point to a potential therapeutic strategy for the treatment of AD through Akt/YAP/p73 signaling pathway with LPLI.

Cell Signal 2011 Sep 14

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=21945154

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Infrared (810 nm) low-level laser therapy in rat Achilles tendinitis: A consistent alternative to drugs.

Marcos RL, Junior EC, de Moura Messias F, de Carvalho MH, Pallotta RC, Frigo L, Dos Santos RA, Ramos L, Teixeira S, Bjordal JM, Lopes-Martins RA

Laboratory of Pharmacology and Experimental Therapeutics, Department of Pharmacology, Institute of Biomedical Sciences, University of Sao Paulo – Sao Paulo, Brazil. Post Graduate Program in Rehabilitation Sciences, Nove de Julho University (UNINOVE) – Sao Paulo – SP, Brazil. Laboratory of Hypertension, Department of Pharmacology, Institute of Biomedical Sciences, University of Sao Paulo – Sao Paulo – SP, Brazil. Biological Sciences and Health Center, Cruzeiro do Sul University – Sao Paulo – SP, Brazil. Section of Evidence Based Practice, Bergen University College – Bergen, Norway.

Non-steroidal anti-inflammatory drugs (NSAID) are widely used and can reduce musculoskeletal pain in spite of the cost of adverse reactions like gastrointestinal ulcers or cardiovascular events. The current study investigates if a safer treatment such as low-level laser therapy (LLLT) could reduce tendinitis inflammation, and whether a possible pathway could be through inhibition of either of the two cyclooxygenase isoforms in inflammation. Wistar rats (6 animals/group) were injected with saline (control) or collagenase in their Achilles tendons. Then we treated them with three different doses of infrared LLLT (810nm; 100mW; 10s, 30s and 60s; 5W/cm(2) ; 1J, 3J, 6J) at the sites of the injections, or intramuscular diclofenac, a non-selective COX inhibitor/NSAID. We found that LLLT-dose of 3J significantly reduced inflammation through less COX-2-derived gene expression and PGE(2) production, and less edema formation compared to non-irradiated controls. Diclofenac controls exhibited significantly lower PGE(2) cytokine levels at 6h than collagenase control, but cyclooxygenase isoform 1-derived gene expression and cytokine PGE(2) levels were not affected by treatments. As LLLT seems to act on inflammation through a selective inhibition of the COX-2 isoform in collagenase-induced tendinitis, LLLT may have potential to become a new and safer non-drug alternative to coxibs.

Photochem Photobiol 2011 Sep 12

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=21910734

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Phototherapy and the peripheral nervous system.

Chow R

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

Effects of laser irradiation on the peripheral nervous system (PNS) underlie the potential for phototherapy to be acknowledged as a mainstream therapy for the future. Pain and inflammation are among the most important manifesta- tions of PNS function and the spectrum of diseases with these symptoms and signs, from osteoarthritis to diabetic neurop- athy, which can be modified by phototherapy, is vast. Both pain and inflammation are mediated by unmyelin- ated peripheral nerve terminals of small diameter Ad and C fibers, the nociceptors, which lie a few microns below the surface of the skin in the epidermis.1,2 The superficial nature of these fibers means that these important somatosensory nerves are within the penetration depths of all laser and LED wavelengths. These afferent nerve endings connect the out- side world via second order neurons to the midbrain, sub- cortical, and cortical centers of the brain. By transducing noxious heat, cold, and other stimuli to sensory information that is processed into sensation and emotions, the skin is directly connected to the brain. Deeper nerve fascicles and trunks in the dermis and below are also within the pene- tration depths of infrared laser wavelengths as are the nervi vasorum, the nerves supplying blood vessels. Neural in- flammation, which is the phenomenon of inflammation arising from the release of bioactive substances, such as bradykinin, from activated peripheral sensory nerve end- ings, is an important but often unrecognized component of any acute or chronic pain condition.3 This too, in addition to pain, can be inhibited by suppression of activity of peripheral nerve endings. The absorption of photons by this complex neural network of the somatosensory nervous system is one of the mechanisms underlying modulation of pain and inflammation, and is one of the most important applications of phototherapy.

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Photomed Laser Surg 2011 Sep 29(9) 591-2

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[Role of endogenous porphyrins in the effects of low-intensity laser radiation of the red region on free radical processes in the blood of rats under experimental endotoxic shock].

The role of endogenous porphyrins in the effects of laser radiation of the red region (632.8 nm) on free radical processes in the blood of rats under endotoxic shock induced by the administration of lipopolysaccharide B (25 mg/kg) has been studied. The measurements of the functional activity of polymorphonuclear leukocytes (the method of luminol-dependent chemiluminescence), the superoxide dismutase activity of blood plasma (using nitro blue tetrazolium), and the degree of lipid oxidation of erythrocyte membranes (the method of fluorescence of cis-parinaric acid) have been carried out. It has been found that low-intensity laser radiation strongly affects all processes examined irrespective of the administration of lipopolysaccharide B. The effect of radiation was most pronounced in animals injected with the polysaccharide, the changes being dependent on the concentration of endogenous porphyrins in samples.

Biofizika 2011 Jul-Aug 56(4) 705-13

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Antiinflammatory effect of low-level laser therapy on Staphylococcus epidermidis endophthalmitis in rabbits.

Ma WJ, Li XR, Li YX, Xue ZX, Yin HJ, Ma H

Tianjin Medical University Eye Centre, Tianjin, 300070, China.

A rabbit model of endophthalmitis was established to evaluate the antiinflammatory effect of low-level laser therapy (LLLT) as an adjunct to treatment for Staphylococcus epidermidis endophthalmitis. Rabbits were randomly divided into three groups to receive intravitreal injections into their left eye: group A received 0.5 mg vancomycin (100 mul), group B received 0.5 mg vancomycin + 0.2 mg dexamethasone (100 mul), and group C received 0.5 mg vancomycin (100 mul) and continuous wave semiconductor laser irradiation (10 mW, lambda = 632 nm) focused on the pupil. Slit lamp examination and B-mode ultrasonography were conducted to evaluate the symptoms of endophthalmitis. Polymorphonuclear cells and tumour necrosis factor alpha (TNF-alpha) in aqueous fluid were measured at 0 h, and 1, 2, 3, 7 and 15 days. A histology test was conducted at 15 days. B-mode ultrasonography and histology revealed that groups B and C had less inflammation than group A at 15 days. Groups B and C had fewer polymorphonuclear cells and lower levels of TNF-alpha in aqueous fluid than group A at 2, 3 and 7 days (P < 0.05). There was no significant difference between groups B and C (P > 0.05). There was no significant difference between groups A, B and C at 15 days (P > 0.05). As an adjunct to vancomycin therapy to treat S. epidermidis endophthalmitis, LLLT has an antiinflammatory effect similar to that of dexamethasone.

Lasers Med Sci 2011 Sep 27

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Effects of low-level laser irradiation in ultrastructural morphology, and immunoexpression of VEGF and VEGFR-2 of rat masseter muscle.

Dias FJ, Issa JP, Barbosa AP, de Vasconcelos PB, Watanabe IS, Mizusakiiyomasa M

Department of Morphology, Stomatology and Physiology, Faculty of Dentistry of Ribeirao Preto, University of Sao Paulo, Avenida do Cafe, s/n, Monte Alegre, 14040-904 Ribeirao Preto, SP, Brazil.

The present study evaluates by ultrastructural and immunohistochemical methods, the possible changes on muscular tissue affected by LLLI during a treatment, for example, in cases of temporomandibular joint disorders. Sixty male Wistar rats divided into 6 groups (n=10) received ten laser irradiations, with different energy densities (groups I-0; II-0.5; III-1.0; IV-2.5; V-5.0; and VI-20J/cm(2)). Muscles were removed and processed for transmission electron microscopic and immunohistochemical (VEGF and VEGFR-2) analyses. Captured photomicrographs of immunohistochemistry and transmission electron microscopy were evaluated. It was observed in the irradiated muscles, mitochondria of different shapes and sizes, with increased plasticity evidenced by organelles in fusion, division and the presence of elongated structures with characteristics of mitochondria, proximity with the dilated sarcoplasmatic reticulum, suggesting organelles with large amounts of energy, and the presence of cytoplasmic protrusions in the capillaries with high dosages. All studied groups showed immunostainings for both markers (VEGF and VEGFR-2), but in general those who received higher doses also showed the markings more pronounced, suggesting dose-dependent biomodulation. It was concluded that the LLLI was able to modify the ultrastructural characteristics and immunohistochemical pattern of VEGF and VEGFR-2 in the masseter muscle of rats.

Micron 2011 Aug 30

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The 800-nm diode laser irradiation induces skin collagen synthesis by stimulating TGF-beta/Smad signaling pathway.

Dang Y, Liu B, Liu L, Ye X, Bi X, Zhang Y, Gu J

School of Life Science, East China Normal University, Shanghai, 200062, China, dangyongyan@gmail.com.

The 800-nm diode laser is used clinically for hair removal and leg vein clearance. However, the effects of the laser on skin collagen synthesis have not been established. This study aims to research whether the 800-nm laser can be used for non-ablative rejuvenation and its possible mechanism by using an animal model. Eight 2-month-old rats were irradiated with the 800-nm diode laser at 20, 40, and 60 J/cm(2), respectively. Skin samples were taken for histological study and dermal thickness measurement at day 30 after laser irradiation. The expression of procollagen type I, III, IV, transforming growth factor-beta (TGF-beta), Smad2, 3, 4, and phosphorylated-Smad2, 3 in the rat skin was analyzed 24 h after completing all laser treatments by using RT-PCR and Western blot. Immunohistochemistry was performed to evaluate the content of type I collagen in the skin at day 30 after laser irradiation. The 800-nm diode laser treatments markedly improved the histological structure and increased dermal thickness compared to the non-irradiated controls. Laser irradiation at 40 J/cm(2) significantly up-regulated the expression of procollagen type I and IV, TGF-beta and Smad2, 3, 4. The p-Smad2 and p-Smad3 levels were also enhanced in the laser-irradiated skin. The 800-nm laser is effective in improving skin structure and inducing skin new collagen expression. New collagen synthesis induced by the 800-nm laser was mediated by TGF-beta/Smad signaling pathway. Thus, it seemed that the 800-nm laser could be used for non-ablative rejuvenation in the future.

Lasers Med Sci 2011 Sep 4

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Histopathological evaluation of the effect of intranasal phototherapy on nasal mucosa in rabbits.

Apuhan T, Terzi EH, Kukner A, Gok U

Department of Otorhinolaryngology and Head and Neck Surgery, Izzet Baysal Medicine Faculty of Abant Izzet Baysal University, Bolu, Turkey.

Allergic rhinitis is a high-incidence allergic inflammation of the nasal airways that impacts quality of life. Of the numerous therapies used to treat allergic rhinitis, intranasal phototherapy has emerged as a promising new treatment modality for inflammatory airway disease. Phototherapy is widely used for the treatment of immune-mediated skin diseases because its profound immunosuppressive effect inhibits hypersensitivity reactions in the skin. Intranasal phototherapy using a combination of Ultraviolet-A (UVA) and Ultraviolet-B (UVB) plus Visible light (VIS) has been shown to suppress the clinical symptoms of allergic rhinitis, but limited data regarding its adverse effects on the nasal mucosa currently exists. In this study, we demonstrate that UV displays no harmful effects on the nasal mucosa cells of rabbits following 2weeks of intranasal phototherapy.

J Photochem Photobiol B 2011 Oct 5 105(1) 94-7

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[Treatment and prevention of cancer treatment related oral mucositis].

Ruiz-Esquide G, Nervi B, Vargas A, Maiz A

Departamento de Nutricion, Diabetes y Metabolismo, Facultad de Medicina, Pontificia Universidad Catolica de ChileSantiago, Chile.

One ofthe most common and troublesome complications ofmodern intensive anticancer treatments is oral mucositis. The purpose ofthis review is to summarize current evidente and clinical guidelines regarding its prevention and therapy. The use of keratinocyte growth factor-1, supplementary glutamine and other recently developed treatment modalities are discussed. The injury ofthe oral mucosa caused by antineoplastic agents promotes the local expression of multiple pro-inflammatory and pro-apoptotic molecules and eventually leads to the development of ulcers. Such lesions predispose patients to several infectious and nutritional complications. Also, they lead to modification of treatment schedules, potentially affecting overall prognosis. Local cryotherapy with ice chips and phototherapy with low energy laser may be useful as preventive measures. Mouthwashes with allopurinol and phototherapy with low energy laser can be used as treatment. In radiotherapy, special radiation administration techniques should be used to minimize mucosal injury. Pain control should always be optimized, with the use ofpatient controlled analgesia and topical use of morphine. Supplemental glutamine should not be used outside of research protocols. Lastly, thorough attention should bepaid to general care and hygiene measures.

Rev Med Chil 2011 Mar 139(3) 373-81

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