LLLT Literature watch for September 2010

62 new LLLT papers for your review including three RCT‘s: neck pain with radiculopathy, temporomandibular joint pain, muscle fatigue and a review from the BMJ sports medicine journal on frozen shoulder.

Low-level laser therapy for acute neck pain with radiculopathy: a double-blind placebo-controlled randomized study.

Konstantinovic LM, Cutovic MR, Milovanovic AN, Jovic SJ, Dragin AS, Letic MDj, Miler VM

Clinic for Rehabilitation, Medical School, University of Belgrade, Sokobanjska 13, Belgrade, Serbia.

OBJECTIVE: The objective of the study was to investigate clinical effects of low-level laser therapy (LLLT) in patients with acute neck pain with radiculopathy. DESIGN: Double-blind, randomized, placebo-controlled study. SETTING: The study was carried out between January 2005 and September 2007 at the Clinic for Rehabilitation at the Medical School, University of Belgrade, Serbia. PATIENTS AND INTERVENTION: Sixty subjects received a course of 15 treatments over 3 weeks with active or an inactivated laser as a placebo procedure. LLLT was applied to the skin projection at the anatomical site of the spinal segment involved with the following parameters: wavelength 905 nm, frequency 5,000 Hz, power density of 12 mW/cm(2), and dose of 2 J/cm(2), treatment time 120 seconds, at whole doses 12 J/cm(2). OUTCOME MEASURES: The primary outcome measure was pain intensity as measured by a visual analog scale. Secondary outcome measures were neck movement, neck disability index, and quality of life. Measurements were taken before treatment and at the end of the 3-week treatment period. RESULTS: Statistically significant differences between groups were found for intensity of arm pain (P = 0.003, with high effect size d = 0.92) and for neck extension (P = 0.003 with high effect size d = 0.94). CONCLUSION: LLLT gave more effective short-term relief of arm pain and increased range of neck extension in patients with acute neck pain with radiculopathy in comparison to the placebo procedure.

Pain Med 2010 Aug 11(8) 1169-78


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Effects of superpulsed low-level laser therapy on temporomandibular joint pain.

Marini I, Gatto MR, Bonetti GA

Department of Orthodontics and Gnathology, Alma Mater Studiorum University of Bologna, Bologna, Italy.

OBJECTIVES: A randomized double-blind study was conducted to compare the efficacy of superpulsed low-level laser therapy (SLLLT) with nonsteroidal anti-inflammatory drugs in the treatment of pain caused by temporomandibular joint disorders. METHODS: A total of 99 patients with temporomandibular joint disorders, secondary to disc displacement without reduction or osteoarthritis were randomly divided into 3 groups. Thirty-nine patients received SLLLT in 10 sessions over 2 weeks, 30 patients received ibuprofen 800 mg twice a day for 10 days, and 30 patients received sham laser as placebo in 10 sessions over 2 weeks. Pain intensity was measured by visual analog scale at baseline, 2, 5, 10, and 15 days of treatment. Mandibular function was evaluated by monitoring active and passive mouth openings and right and left lateral motions at baseline, 15 days, and 1 month of treatment. Magnetic resonance imaging was performed at baseline and the end of therapy. RESULTS: Mean visual analog scale pain scores in SLLLT group was significantly lower than in nonsteroidal anti-inflammatory drug group and control group (P=0.0001) from fifth day up to the end of the observation period. As for active and passive mouth openings and right and left lateral motions, superiority of SLLLT was evident 1 month after treatment (interaction time treatment, P=0.0001). DISCUSSION: Mandibular function improved in all SLLLT patients proving the effectiveness in the treatment of pain, as demonstrated by a significant improvement in clinical signs and symptoms of temporomandibular joint disc displacement without reduction and osteoarthritis at the end of treatment and stability over a period of 1 month.

Clin J Pain 2010 Sep 26(7) 611-6


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Frozen shoulder: the effectiveness of conservative and surgical interventions–systematic review.

Favejee MM, Huisstede BM, Koes BW

Department of Rehabilitation Medicine, Erasmus University Medical Center, Rotterdam, The Netherlands.

Background A variety of therapeutic interventions is available for restoring motion and diminishing pain in patients with frozen shoulder. An overview article concerning the evidence for the effectiveness of these interventions is lacking. Objective To provide an evidence-based overview regarding the effectiveness of conservative and surgical interventions to treat the frozen shoulder. Methods The Cochrane Library, PubMed, Embase, Cinahl and Pedro were searched for relevant systematic reviews and randomised clinical trials (RCTs). Two reviewers independently selected relevant studies, assessed the methodological quality and extracted data. A best-evidence synthesis was used to summarise the results. Results Five Cochrane reviews and 18 RCTs were included studying the effectiveness of oral medication, injection therapy, physiotherapy, acupuncture, arthrographic distension and suprascapular nerve block (SSNB). Conclusions We found strong evidence for the effectiveness of steroid injections and laser therapy in short-term and moderate evidence for steroid injections in mid-term follow-up. Moderate evidence was found in favour of mobilisation techniques in the short and long term, for the effectiveness of arthrographic distension alone and as an addition to active physiotherapy in the short term, for the effectiveness of oral steroids compared with no treatment or placebo in the short term, and for the effectiveness of SSNB compared with acupuncture, placebo or steroid injections. For other commonly used interventions no or only limited evidence of effectiveness was found. Most of the included studies reported short-term results, whereas symptoms of frozen shoulder may last up to 4 years. High quality RCTs studying long-term results are clearly needed in this field.

Br J Sports Med 2010 Jul 20


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Effect of Light-Emitting Diodes Therapy (LEDT) on Knee Extensor Muscle Fatigue.

Baroni BM, Leal Junior EC, Geremia JM, Diefenthaeler F, Vaz MA

1 Exercise Research Laboratory (LAPEX); Federal University of Rio Grande do Sul (UFRGS) , Porto Alegre RS, Brazil .

Abstract Objective: The purpose of this study was to evaluate the effects of light-emitting diodes therapy (LEDT) on quadriceps muscle fatigue by using torque values from the isokinetic dynamometer as an outcome measure. Background Data: Light therapy is considered an innovative way to prevent muscle fatigue. Although positive results have been obtained in animal models and in clinical experiments, no results are available on the effects of this therapeutic modality on human performance studies with isokinetic dynamometry. Materials and Methods: Seventeen healthy and physically active male volunteers were included in a crossover randomized double-blinded placebo-controlled trial. They performed two sessions of an isokinetic fatigue test (30 maximal concentric knee flexion-extension contractions; range of motion, 90 degrees; angular velocity, 180 degrees per second) after LEDT or placebo treatment. Maximal knee extensor muscle isokinetic voluntary contractions were performed before (PRE-MVC) and after (POST-MVC) the fatigue test. LEDT treatment was performed with a multidiode cluster probe (34 red diodes of 660 nm, 10 mW; 35 infrared diodes of 850 nm, 30 mW) at three points of the quadriceps muscle, with a total irradiating dose of 125.1 J. Results: No differences were observed in the PRE-MVC between LEDT (284.81 +/- 4.52 Nm) and placebo (282.65 +/- 52.64 Nm) treatments. However, for the POST-MVC, higher torques (p = 0.034) were observed for LEDT (237.68 +/- 48.82 Nm) compared with placebo (225.68 +/- 44.14 Nm) treatment. Conclusion: LEDT treatment produced a smaller maximal isometric torque decrease after high-intensity concentric isokinetic exercise, which is consistent with an increase in performance.

Photomed Laser Surg 2010 Jul 13


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Laser phototherapy in the treatment of periodontal disease. A review.

de Paula Eduardo C, de Freitas PM, Esteves-Oliveira M, Aranha AC, Ramalho KM, Simoes A, Bello-Silva MS, Tuner J

Special Laboratory of Lasers in Dentistry (LELO), Department of Restorative Dentistry, School of Dentistry, University of Sao Paulo, 227 Cidade Universitaria, Sao Paulo, SP, Brazil.

Many studies in the literature address the effect of low-power lasers in the management of pathologies related to periodontal tissues. Due to the lack of standardized information and the absence of a consensus, this review presents the current status of laser phototherapy (LPT) in periodontics and discusses its benefits and limits in the treatment of periodontal disease. The literature was searched for reviews and original research articles relating to LPT and periodontal disease. The articles were selected using either electronic search engines or manual tracing of the references cited in key papers. The literature search retrieved references on wound and bone healing, analgesia, hypersensitivity, inflammatory process and antimicrobial photodynamic therapy. Each topic is individually addressed in this review. The current literature suggests that LPT is effective in modulating different periodontal disease aspects in vitro, in animals, and in simple clinical models. Further development of this therapy is now dependent on new clinical trials with more complex study designs.

Lasers Med Sci 2010 Nov 25(6) 781-92


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Importance of pulsing illumination parameters in low-level-light therapy.

Barolet D, Duplay P, Jacomy H, Auclair M

RoseLab Skin Optics Laboratory, Montreal, Quebec, Canada.

The influence of emission parameters in low-level-light therapy on cellular responses is not yet fully understood. This study assessed the impact of various light delivery modes on collagen production in human primary fibroblast cultured in monolayers after three treatments with red light-emitting diode illumination (630 nm, 8 J/cm(2)). Human type I collagen was measured in cell culture supernatants with procollagen type I C-peptide enzyme immunoassay. Results demonstrated that, 72 h post-baseline, specific microsecond pulsing patterns had a more favorable impact on the ability of fibroblasts to produce collagen de novo than comparative conditions of continuous wave, pulsed 50% duty cycle, and millisecond pulsing domains. The cascade of events leading to collagen production by red illumination may be explained by the photodissociation of nitric oxide from cytochrome c oxidase. Short and intermittent light delivery might enhance this cellular event.

J Biomed Opt 2010 Jul-Aug 15(4) 048005


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Effect of Low-Level Laser Irradiation on Unresponsive Oral Lichen Planus: Early Preliminary Results in 13 Patients.

Cafaro A, Albanese G, Arduino PG, Mario C, Massolini G, Mozzati M, Broccoletti R

1 Oral Medicine Unit, Dentistry Section, Department of Biological Sciences and Human Oncology, University of Turin , Turin, Italy .

Abstract Objective: To detail the efficacy of low-level laser therapy (LLLT) for the management of oral lichen planus (OLP) unresponsive to standard therapy. Background: OLP is an inflammatory disease that can be painful, mainly in the atrophic and erosive forms. Numerous drugs have been used with dissimilar results, but most treatments are empiric. However, to date, the most commonly used and useful agents for the treatment of OLP are topical corticosteroids. Materials and Methods: The investigators studied a prospective cohort of 13 patients affected by OLP, who received biostimulation with a pulsed diode laser (GaAs). Patients were exposed to a 904-nm pulsed infrared laser (4 J/cm(2) energy density per minute; spot size, 0.8 cm). Outcome variables, statistically evaluated, were as follows: the size of lesions, visual analogue score of pain, and stability of the obtained result in the follow-up period. Results: We detailed significant reduction in lesion size and in reported pain. No reported complications or therapy side effects were observed in any of the patients treated. Conclusion: This study suggests that LLLT could be a possible treatment for patients with unresponsive OLP. These results, although not conclusive, are a step forward for enhanced management of this quite common condition; however, it would be interesting to the results would be the same with a greater number of patients or in a different clinical setting.

Photomed Laser Surg 2010 Aug 25


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Prophylactic low-level light therapy for the treatment of hypertrophic scars and keloids: a case series.

Barolet D, Boucher A

RoseLab Skin Optics Research Laboratory, Montreal, Quebec, Canada.

BACKGROUND AND OBJECTIVES: Hypertrophic and keloid scars result from alterations in the wound healing process. Treating abnormal scars remains an important challenge. The aim of this case series was to investigate the effectiveness of near infrared (NIR) light emitting diode (LED) treatment as a prophylactic method to alter the wound healing process in order to avoid or attenuate the formation of hypertrophic scars or keloids. STUDY DESIGN/PATIENTS AND METHODS: Three patients (age 27-57) of phototypes I-III with hypertrophic scars or keloids due to acne or surgery participated in this case series. Following scar revision by surgery or CO(2) laser ablation on bilateral areas, one scar was treated daily by the patient at home with non-thermal, non-ablative NIR LED (805 nm at 30 mW/cm(2)) for 30 days. Efficacy assessments, conducted up to a year post-treatment, included the Vancouver Scar scale (VSS), clinical global assessment of digital photographs, and quantitative profilometry analysis using PRIMOS. Safety was documented by adverse effects monitoring. RESULTS: Significant improvements on the NIR-treated versus the control scar were seen in all efficacy measures. No significant treatment-related adverse effects were reported. CONCLUSION: Possible mechanisms involved are inhibition of TGF-beta I expression. Further studies in larger group of patients are needed to evaluate this promising technique.

Lasers Surg Med 2010 Aug 42(6) 597-601


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Low-level laser therapy in chronic autoimmune thyroiditis: a pilot study.

Hofling DB, Chavantes MC, Juliano AG, Cerri GG, Romao R, Yoshimura EM, Chammas MC

Radiology Institute (InRad), Hospital das Clinicas, Faculdade de Medicina da Universidade de Sao Paulo, Avenida Dr. Eneas de Carvalho Aguiar, CEP 05403-001 Sao Paulo, Brazil.

BACKGROUND AND OBJECTIVES: Chronic autoimmune thyroiditis (CAT) remains the most common cause of acquired hypothyroidism. There is currently no therapy that is capable of regenerating CAT-damaged thyroid tissue. The objective of this study was to gauge the value of applying low-level laser therapy (LLLT) in CAT patients based on both ultrasound studies (USs) and evaluations of thyroid function and thyroid autoantibodies. STUDY DESIGN/MATERIALS AND METHODS: Fifteen patients who had hypothyroidism caused by CAT and were undergoing levothyroxine (LT4) treatment were selected to participate in the study. Patients received 10 applications of LLLT (830 nm, output power 50 mW) in continuous mode, twice a week, using either the punctual technique (8 patients) or the sweep technique (7 patients), with fluence in the range of 38-108 J/cm(2). USs were performed prior to and 30 days after LLLT. USs included a quantitative analysis of echogenicity through a gray-scale computerized histogram index (EI). Following the second ultrasound (30 days after LLLT), LT4 was discontinued in all patients and, if required, reintroduced. Triiodothyronine, thyroxine (T4), free T4, thyrotropin, thyroid peroxidase (TPOAb) and thyroglobulin (TgAb) antibodies levels were assessed before LLLT and then 1, 2, 3, 6, and 9 months after LT4 withdrawal. RESULTS: We noted all patients’ reduced LT4 dosage needs, including 7 (47%) who did not require any LT4 through the 9-month follow-up. The LT4 dosage used pre-LLLT (96 +/- 22 microg/day) decreased in the 9th month of follow-up (38 +/- 23 microg/day; P < 0.0001). TPOAb levels also decreased (pre-LLLT = 982 +/- 530 U/ml, post-LLLT = 579 +/- 454 U/ml; P = 0.016). TgAb levels were not reduced, though we did observe a post-LLLT increase in the EI (pre-LLLT = 0.99 +/- 0.09, post-LLLT = 1.21 +/- 0.19; P = 0.001). CONCLUSION: The preliminary results indicate that LLLT promotes the improvement of thyroid function, as patients experienced a decreased need for LT4, a reduction in TPOAb levels, and an increase in parenchymal echogenicity.

Lasers Surg Med 2010 Aug 42(6) 589-96


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A Meta-analysis of the Efficacy of Laser Phototherapy on Pain Relief.

Fulop AM, Dhimmer S, Deluca JR, Johanson DD, Lenz RV, Patel KB, Douris, PC, Enwemeka CS

College of Health Sciences, University of Wisconsin-Milwaukee, Milwaukee, WI.

OBJECTIVE: Laser phototherapy has been widely used to relieve pain for more than 30 years, but its efficacy remains controversial. To ascertain the overall effect of phototherapy on pain, we aggregated the literature and subjected the studies to statistical meta-analysis. METHODS: Relevant original studies were gathered from every available source and coded. Articles that met preestablished inclusion criteria were subjected to statistical meta-analysis, using Cohen’s d statistic to determine treatment effect sizes. RESULTS: Fifty-two effect sizes were computed from the 22 articles that met the inclusion criteria. The resulting overall mean effect size was highly significant; d=+0.84 (95% confidence interval=0.44-1.23). The effect size remained significant even when a high outlying d value was conservatively excluded from the analysis; d=+0.66 (95% confidence interval=0.46-0.86). The fail-safe number associated with the overall treatment effect, that is, the number of additional studies in which phototherapy has negative or no effect on pain needed to negate the overall large effect size of +0.84, was 348. DISCUSSION: These findings warrant the conclusion that laser phototherapy effectively relieves pain of various etiologies; making it a valuable addition to contemporary pain management armamentarium.

Clin J Pain 2010 Sep 8


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The brain effects of laser acupuncture in healthy individuals: an FMRI investigation.

Quah-Smith I, Sachdev PS, Wen W, Chen X, Williams MA

School of Psychiatry, Faculty of Medicine, University of New South Wales, Randwick, New South Wales, Australia.

BACKGROUND: As laser acupuncture is being increasingly used to treat mental disorders, we sought to determine whether it has a biologically plausible effect by using functional magnetic resonance imaging (fMRI) to investigate the cerebral activation patterns from laser stimulation of relevant acupoints. METHODOLOGY/PRINCIPAL FINDINGS: Ten healthy subjects were randomly stimulated with a fibreoptic infrared laser on 4 acupoints (LR14, CV14, LR8 and HT7) used for depression following the principles of Traditional Chinese Medicine (TCM), and 1 control non-acupoint (sham point) in a blocked design (alternating verum laser and placebo laser/rest blocks), while the blood oxygenation level-dependent (BOLD) fMRI response was recorded from the whole brain on a 3T scanner. Many of the acupoint laser stimulation conditions resulted in different patterns of neural activity. Regions with significantly increased activation included the limbic cortex (cingulate) and the frontal lobe (middle and superior frontal gyrus). Laser acupuncture tended to be associated with ipsilateral brain activation and contralateral deactivation that therefore cannot be simply attributed to somatosensory stimulation. CONCLUSIONS/SIGNIFICANCE: We found that laser stimulation of acupoints lead to activation of frontal-limbic-striatal brain regions, with the pattern of neural activity somewhat different for each acupuncture point. This is the first study to investigate laser acupuncture on a group of acupoints useful in the management of depression. Differing activity patterns depending on the acupoint site were demonstrated, suggesting that neurological effects vary with the site of stimulation. The mechanisms of activation and deactivation and their effects on depression warrant further investigation.

PLoS One 2010 5(9)


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Lasers in dental traumatology.

Olivi G, Caprioglio C, Genovese MD

Visiting Professor in Restorative Dentistry, University of Genoa Private practice in Rome.

AIM: Dental traumas are frequent in children. They can be complex events and sometimes real emergencies. Since very little attention is devoted to this topic in the international literature and there are no well-coded laser guidelines for these specific clinical events, our aim is to consider and present those situations in which laser-assisted therapy can offer new treatment possibilities. The authors’ aim is to stimulate more extensive scientific research in this area, which might not only increase the use of these technologies, but also improve outcomes and reduce complications connected to dental trauma, particularly in children. Furthermore, laser-assisted therapies drastically reduce the need for analgesics and anti- inflammatory medications compared with conventional procedures. CONCLUSION: Using laser equipment to obtain anaesthesia is another challenge, while the use of low power setting for desensitising tissue and to obtain anaesthesia is also an open field.

Eur J Paediatr Dent 2010 Jun 11(2) 71-6


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Low-level laser irradiation enhances BMP-induced osteoblast differentiation by stimulating the BMP/Smad signaling pathway.

Hirata S, Kitamura C, Fukushiama H, Nakamichi I, Abiko Y, Terashita M, Jimi E

Division of Molecular Signaling and Biochemistry, Department of Biosciences, 2-870-1, Sakaecho-Nishi, Matsudo, Chiba 271-8587, Japan.

Low-level laser irradiation (LLLI) has been shown to induce bone formation and osteoblast differentiation both in vivo and in vitro. However, the molecular mechanism by which LLLI stimulates osteoblast differentiation is still unclear. The aim of the present study was to examine whether Ga-Al-As laser irradiation could enhance BMP2-induced alkaline phosphatase (ALP) activity in C2C12 cells. Laser irradiation at 0.5 W for 20 min enhanced BMP2-induced ALP activity. Laser treatment alone did not affect ALP activity. To exclude the effect of pH or temperature changes during irradiation, we shortened the exposure time to 2 min, with various levels of laser power. At 2.5 W, irradiation stimulated BMP2-induced ALP activity but not cell proliferation, whereas 1 or 5 W laser power did not induce any significant effects. Irradiation stimulated BMP2-induced phosphorylation of Smad1/5/8 and BMP2 expression, but had no effect on the expression of inhibitory Smads 6 and 7, BMP4 or IGF-1. Laser irradiation enhanced Smad-induced Id1 reporter activity as well as expression of BMP-induced transcription factors such as Id1, Osterix and Runx2. Laser irradiation also stimulated BMP-induced expressions of type I collagen, osteonectin and osteocalcin mRNA, markers of osteoblasts. This enhancement of BMP2-induced ALP activity and Smad phosphorylation by laser irradiation was also observed in primary osteoblasts. These results suggest that LLLI accelerates the differentiation of BMP-induced osteoblasts by stimulating the BMP/Smad signaling pathway. (c) 2010 Wiley-Liss, Inc.

J Cell Biochem 2010 Sep 9


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Clinical observations on laser acupuncture in simple obesity therapy.

Hu WL, Chang CH, Hung YC

Department of Chinese Medicine, Chang Gung Memorial Hospital Kaohsiung Medical Center, Chang Gung University College of Medicine, Taiwan.

A previous study has shown that laser acupuncture is a useful healing method for the treatment of visceral postmenopausal obesity in combination with a low-calorie diet. We observe and evaluate the therapeutic effect of laser acupuncture in subjects of simple obesity with a non-restrictive diet protocol. Subjects included 73 women and 22 men with simple obesity and body mass indices > or = 27 kg/m2. Daily energy intake recommendations for obese females and males were 1620.0 and 1894.2 kcal in average, respectively. The gallium aluminum arsenide Handylaser Trion was used to apply 0.25 J of energy to each of the following acupuncture points three times per week for four consecutive weeks: Stomach, Hunger, ST25, ST28, ST40, SP15, and CV9. The subjects’ body weights and body mass indices were recorded before treatment, and four weeks after treatment, and the percent reduction in each parameter was calculated. Statistically significant reductions in body weight and body mass index were detected after four weeks of treatment. The mean reduction and mean percent reduction in body weight were 3.17 kg and 3.80% (p < 0.0001), respectively. The corresponding values for the body mass index were 1.22 kg/m2 and 3.78% (p < 0.0001), respectively. We concluded that laser acupuncture was found to exert a therapeutic effect on simple obesity by reducing both body weight and body mass index. Moreover, subjects showed good compliance with this comfortable and non-restrictive diet protocol.

Am J Chin Med 2010 38(5) 861-7


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Endonasal phototherapy significantly alleviates symptoms of allergic rhinitis, but has a limited impact on the nasal mucosal immune cells.

Brehmer D, Schon MP

Private ENT Clinic Goettingen, Faculty of Medicine, University Witten/Herdecke, Friedrichstr. (3/4), 37073, Gottingen, Germany.

The literature documents the fact that UV irradiation of cutaneous Langerhans cells (LC) in vivo prevents the development of contact allergy and produces long-lasting immunosuppression. However, not much is known about the effect of UV irradiation on the LC of the nasal mucosa and their connection with clinical scores. Local antigen presentation may be necessary for both primary and recall T cell responses to birch pollen in patients with hay fever. Endonasal phototherapy combination of UVB (5%), UVA (25%) and visible light (70%) utilises the immunosuppressive effects of UV irradiation. The aim of this study was to correlate clinical symptom scores with possible changes in the LC of the nasal mucosa induced by UV radiation. The clinical effectiveness of this form of treatment is discussed. Nasal biopsies were obtained from ten birch pollen-sensitive patients with seasonal rhinitis before and after endonasal phototherapy. All patients showed a significant clinical benefit post-treatment as assessed by standardised instruments, including total nasal symptom score, nasal congestion score, nasal itching score, sneezing score, nasal secretion score and impairment-to-health score. However, we found no significant morphological changes, to, or quantitative differences in, the CD1a+, CD4, CD8 or CD31 cells before and 14 days after treatment. Despite the positive clinical effect, the study revealed no effect of UV irradiation on the LC and other analysed cells of the nasal mucosa immune system. Possible reasons for this are discussed.

Eur Arch Otorhinolaryngol 2010 Sep 3


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Treating dentin hypersensitivity: therapeutic choices made by dentists of the northwest PRECEDENT network.

Cunha-Cruz J, Wataha JC, Zhou L, Manning W, Trantow M, Bettendorf MM, Heaton LJ, Berg J

Department of Dental Public Health Sciences, School of Dentistry, University of Washington, 1959 NE Pacific St., Box 357475, Seattle, Wash. 98195-7475, USA.

BACKGROUND: Methods used by dental practitioners to diagnose and treat dentin hypersensitivity are not well documented. The authors conducted a survey of dentists in the Northwest Practice-based REsearch Collaborative in Evidence-based DENTistry (PRECEDENT) to ascertain the treatment methods they used. Methods. Via an Internet survey, the authors collected data regarding methods used for diagnosis and treatment of dentin hypersensitivity from 209 Northwest PRECEDENT dentists. RESULTS: The PRECEDENT dentists indicated that they most often used fluoride varnishes and gels, advice regarding toothbrushing and diet, bonding agents, restorative materials and glutaraldehyde/2-hydroxyethyl methacrylate (HEMA) to treat dentin hypersensitivity. They reported that the most successful treatments were fluorides, glutaraldehyde/HEMA, bonding agents, potassium nitrates and restorative treatments; they considered observation, advice regarding toothbrushing and diet and laser therapy to be the least successful. Dentists listed fluorides, calcium phosphates, glutaraldehyde/HEMA and bonding agents as the treatments most desirable for inclusion in a future randomized clinical trial of dental hypersensitivity treatments. CONCLUSIONS: Dentists rely on patients to assess the severity of dentin hypersensitivity. Modalities for the diagnosis and treatment of hypersensitivity are diverse. Methods used to diagnose and treat dentin hypersensitivity in practice are challenging to justify. CLINICAL IMPLICATIONS: Practitioners should be aware of the diversity of methods available for diagnosing and treating dentin hypersensitivity as they manage the care of their patients with this condition.

J Am Dent Assoc 2010 Sep 141(9) 1097-105


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Low-level laser therapy (LLLT; 780 nm) acts differently on mRNA expression of anti- and pro-inflammatory mediators in an experimental model of collagenase-induced tendinitis in rat.

Pires D, Xavier M, Araujo T, Silva JA Jr, Aimbire F, Albertini R

Institute of Research and Development, Av. Shishima Hifumi, 2911, Urbanova, CEP, 12.244-000, Sao Jose dos Campos, SP, Brazil.

Low-level laser therapy (LLLT) has been found to produce anti-inflammatory effects in a variety of disorders. Tendinopathies are directly related to unbalance in expression of pro- and anti-inflammatory cytokines which are responsible by degeneration process of tendinocytes. In the current study, we decided to investigate if LLLT could reduce mRNA expression for TNF-alpha, IL-1beta, IL-6, TGF-beta cytokines, and COX-2 enzyme. Forty-two male Wistar rats were divided randomly in seven groups, and tendinitis was induced with a collagenase intratendinea injection. The mRNA expression was evaluated by real-time PCR in 7th and 14th days after tendinitis. LLLT irradiation with wavelength of 780 nm required for 75 s with a dose of 7.7 J/cm(2) was administered in distinct moments: 12 h and 7 days post tendinitis. At the 12 h after tendinitis, the animals were irradiated once in intercalate days until the 7th or 14th day in and them the animals were killed, respectively. In other series, 7 days after tendinitis, the animals were irradiated once in intercalated days until the 14th day and then the animals were killed. LLLT in both acute and chronic phases decreased IL-6, COX-2, and TGF-beta expression after tendinitis, respectively, when compared to tendinitis groups: IL-6, COX-2, and TGF-beta. The LLLT not altered IL-1beta expression in any time, but reduced the TNF-alpha expression; however, only at chronic phase. We conclude that LLLT administered with this protocol reduces one of features of tendinopathies that is mRNA expression for pro-inflammatory mediators.

Lasers Med Sci 2010 Aug 25


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Development and Evaluation of Fiber Optic Probe-based Helium-Neon Low-level Laser Therapy System for Tissue Regeneration-An In Vivo Experimental Study.

Prabhu V, Rao SB, Rao NB, Aithal KB, Kumar P, Mahato KK

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

Abstract We report the design and development of an optical fiber probe-based Helium-Neon (He-Ne) low-level laser therapy system for tissue regeneration. Full thickness excision wounds on Swiss albino mice of diameter 15 mm were exposed to various laser doses of 1, 2, 3, 4, 6, 8 and 10 J cm(-2) of the system with appropriate controls, and 2 J cm(-2) showing optimum healing was selected. The treatment schedule for applying the selected laser dose was also standardized by irradiating the wounds at different postwounding times (0, 24 and 48 h). The tissue regeneration potential was evaluated by monitoring the progression of wound contraction and mean wound healing time along with the hydroxyproline and glucosamine estimation on wound ground tissues. The wounds exposed to 2 J cm(-2) immediately after wounding showed considerable contraction on days 5, 9, 12, 14, 16 and 19 of postirradiation compared with the controls and other treatment schedules, showing significant (P < 0.001) decrease in the healing time. A significant increase in hydroxyproline and glucosamine levels was observed for the 2 J cm(-2) irradiation group compared with the controls and other treatment groups. In conclusion, the wounds treated with 2 J cm(-2) immediately after the wounding show better healing compared with the controls.

Photochem Photobiol 2010 Jul 30


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Low intensity laser therapy (LILT) in vivo acts on the neutrophils recruitment and chemokines/cytokines levels in a model of acute pulmonary inflammation induced by aerosol of lipopolysaccharide from Escherichia coli in rat.

Mafra de Lima F, Villaverde AB, Salgado MA, Castro-Faria-Neto HC, Munin E, Albertini R, Aimbire F

Institute of Research and Development, Av. Shishima Hifumi, 2911, Urbanova, CEP: 12.244-000, Sao Jose dos Campos, SP, Brazil.

It has been suggested that low intensity laser therapy (LILT) acts on pulmonary inflammation. Thus, we investigate in this work if LILT (650nm, 2.5mW, 31.2mW/cm(2), 1.3J/cm(2), laser spot size of 0.08cm(2) and irradiation time of 42s) can attenuate edema, neutrophil recruitment and inflammatory mediators in acute lung inflammation. Thirty-five male Wistar rats (n=7 per group) were distributed in the following experimental groups: control, laser, LPS, LPS+laser and dexamethasone+LPS. Airway inflammation was measured 4h post-LPS challenge. Pulmonary microvascular leakage was used for measuring pulmonary edema. Bronchoalveolar lavage fluid (BALF) cellularity and myeloperoxidase (MPO) were used for measuring neutrophil recruitment and activation. RT-PCR was performed in lung tissue to assess mRNA expression of tumor necrosis factor-alpha (TNF-alpha), interleukin-1beta (IL-1beta), interleukin (IL-10), cytokine-induced neutrophil chemoattractant-1 (CINC-1), macrophage inflammatory protein-2 (MIP-2) and intercellular adhesion molecule-1 (ICAM-1). Protein levels in both BALF and lung were determined by ELISA. LILT inhibited pulmonary edema and endothelial cytoskeleton damage, as well as neutrophil influx and activation. Similarly, the LILT reduced the TNF-alpha and IL-1beta, in lung and BALF. LILT prevented lung ICAM-1 up-regulation. The rise of CINC-1 and MIP-2 protein levels in both lung and BALF, and the lung mRNA expressions for IL-10, were unaffected. Data suggest that the LILT effect is due to the inhibition of ICAM-1 via the inhibition of TNF-alpha and IL-1beta.

J Photochem Photobiol B 2010 Jul 27


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Photomedicine and LLLT Literature Watch.

Carroll JD

THOR Photomedicine Ltd, 18a East Street, Chesham, HP5 1HQ, UK.

Photomed Laser Surg 2010 Aug 28(4) 575-6


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Influence of Laser Photobiomodulation on Collagen IV During Skeletal Muscle Tissue Remodeling After Injury in Rats.

Baptista J, Martins MD, Pavesi VC, Bussadori SK, Fernandes KP, Junior DD, Ferrari RA

1 Universidade Nove de Julho- UNINOVE , Sao Paulo, Brazil .

Abstract Objective: The aim of the present study was to determine the effect of GaAlAs low-level laser therapy (LLLT) on collagen IV remodeling of the tibialis anterior (TA) muscle in rats after cryolesion. Background: Considerable interest exists in skeletal muscle regeneration in situations such as repair after exercise-induced muscle injury, after muscle transplantation, in muscular dystrophy, exercise-induced muscle injury, and the recovery of strength after atrophy due to disuse. A number of studies have demonstrated the potential of LLLT in facilitating the muscle-healing process; however, no consensus is found in the literature regarding the best laser-irradiation parameters. Methods: Adult male Wistar rats (n = 45) were used and randomly divided into three groups: control (n = 5); nontreated cryolesioned group (n = 20), and LLLT-cryolesioned group (n = 20). The cryolesioned groups were analyzed at 1, 7, 14, and 21 days after the injury procedure. Laser irradiation was performed 3 times per week on the injured region by using the GaAlAs laser (660 nm; beam spot of 0.04 cm(2), output power of 20 mW, power density of 500 mW/cm(2), and energy density of 5 J/cm(2), for 10 sec). The muscles were removed, frozen, cryosectioned, and then stained with hematoxylin-eosin for the visualization of general morphology or used for immunohistochemical analysis of collagen IV. Results: It was demonstrated that LLLT promotes an increase in collagen IV immunolabeling in skeletal muscle in the first 7 days after acute trauma caused by cryoinjury, but does not modify the duration of the tissue-repair process. Even with LLLT, the injured muscle tissue needs approximately 21 days to achieve the same state of organization as that in the noninjured muscle. Conclusion: The collagen IV content is modulated in regenerating skeletal muscle under LLLT, which might be associated with better tissue outcome, although the histologic analysis did not detect tissue improvement in the LLLT group.

Photomed Laser Surg 2010 Aug 11


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Clinic-epidemiological evaluation of ulcers in patients with leprosy sequelae and the effect of low level laser therapy on wound healing: a randomized clinical trial.

Barreto JG, Salgado CG

Dermato-Immunology Laboratory UEPA/UFPA/Marcello Candia, Marituba, Para, Brazil.

BACKGROUND: Mycobacterium leprae is the only pathogenic bacteria able to infect peripheral nerves. Neural impairment results in a set of sensitive, motor and autonomic disturbances, with ulcers originating primarily on the hands and feet. The study objectives were to analyze the clinic-epidemiological characteristics of patients attended at one specialized dressing service from a leprosy-endemic region of the Brazilian Amazon and to evaluate the effect of low level laser therapy (LLLT) on wound healing of these patients. METHODS: Clinic-epidemiological evaluation of patients with leprosy sequelae was performed at the reference unit in sanitary dermatology of the state of Para in Brazil. We conducted anamnesis, identification of the regions affected by the lesions and measurement of ulcer depth and surface area. After that, we performed a randomized clinical trial. Fifty-one patients with ulcers related to leprosy were evaluated, twenty-five of them were randomly assigned to a low level laser therapy group or a control group. Patients were treated 3 times per week for 12 weeks. Outcome measures were ulcer surface area, ulcer depth and the pressure ulcer scale for healing score (PUSH). RESULTS: Ninety-seven ulcers were identified, with a mean (SD) duration of 97.6 (111.7) months, surface area of 7.3 (11.5) cm2, and depth of 6.0 (6.2) mm. Statistical analysis of the data determined that there were no significant differences in the variables analyzed before and after treatment with low level laser therapy. CONCLUSIONS: Ulcers in patients with leprosy remain a major source of economic and social losses, even many years after they have been cured of M. leprae infection. Our results indicate that it is necessary to develop new and more effective therapeutic tools, as low level laser therapy did not demonstrate any additional benefits to ulcer healing with the parameters used in this study. TRIAL REGISTRATION: The trial was registered at ClinicalTrials.gov as NCT00860717.

BMC Infect Dis 2010 10 237


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The effect of the association of near infrared laser therapy, bone morphogenetic proteins, and guided bone regeneration on tibial fractures treated with internal rigid fixation: a Raman spectroscopic study.

Lopes CB, Pacheco MT, Silveira L Jr, Cangussu MC, Pinheiro AL

Laser Center, IP&D, FCS, UNIVAP, Urbanova, S J Campos, SP, Brazil.

Fractures have different etiology and treatment and may be associated or not to bone losses. Laser light has been shown to improve bone healing. We aimed to assess, through Raman spectroscopy, the level of CHA (approximately 958 cm(-1)) on complete fractures animals treated with IRF treated or not with Low Level Laser Therapy-LLLT and associated or not to BMPs and GBR. Complete tibial fractures were created on 15 animals that were divided into five groups. LLLT (Laser Unit, Kondortech, Sao Carlos, SP, Brazil, lambda790 nm, 4 J/cm(2)/point, 40 mW, phi approximately 0.5 cm(2), 16 J/cm(2) session) started immediately after surgery and repeated at 48 h interval (2 weeks). Animal death occurred after 30 days. Raman spectroscopy was performed at the surface of the fracture. Our results showed significant differences between the groups IRF + BL /IRF_NBL (p = 0.05); between all experimental groups and untreated bone; bone/IRF + BL; IRF + BL + Bio + GBR; IRF + BL + LLLT; IRF + BL + Bio + GBR + LLLT; IRF_NBL (p < 0.001, all); IRF_NBL/IRF + BL + LLLT (p = 0.03); IRF_NBL/IRF + BL + Bio + GBR + LLLT (p = 0.02); IRF + BL/IRF + BL + LLLT (p = 0.04); IRF + BL/IRF + BL + Bio + GBR + LLLT (p = 0.002); IRF + BL + Bio + GBR/IRF + BL + Bio + GBR + LLLT (p = 0.05). It is concluded that the use of NIR LLLT associated to BMPs and GBR was effective in improving bone healing on fractured bones due to increased levels of CHA.

J Biomed Mater Res A 2010 Sep 15 94(4) 1257-63


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Types of hair loss and treatment options, including the novel low-level light therapy and its proposed mechanism.

Ghanaat M

Department of Dermatology, SUNY Downstate Medical Center, Brooklyn, NY, USA.

Androgenetic alopecia (AGA) is the most common form of hair loss in men, and female pattern hair loss (FPHL) is the most common form of hair loss in women. Traditional methods of treating hair loss have included minoxidil, finasteride, and surgical transplantation. Currently there is a myriad of new and experimental treatments. In addition, low-level light therapy (LLLT) has recently been approved by the United States Food and Drug Administration (FDA) for the treatment of hair loss. There are several theories and minimal clinical evidence of the safety and efficacy of LLLT, although most experts agree that it is safe. More in vitro studies are necessary to elucidate the mechanism and effectiveness at the cellular level, and more controlled studies are necessary to assess the role of this new treatment in the general population.

South Med J 2010 Sep 103(9) 917-21


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Adjunctive periodontal therapy: a review of current techniques.

Bader HI

Harvard School of Dental Medicine, USA.

This paper has reviewed the different types of adjunctive therapeutic approaches used in the control of periodontitis. While there are many avenues of current clinical use and research, it is generally agreed that all of the modalities reviewed are adjunctive to basic mechanical control of the root surface environment in the form of SRP.

Dent Today 2010 Jul 29(7) 94-6, 98; quiz 98, 103


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Interventions for treating oral mucositis for patients with cancer receiving treatment.

Clarkson JE, Worthington HV, Furness S, McCabe M, Khalid T, Meyer S

Dental Health Services Research Unit, University of Dundee, The Mackenzie Building, Kirsty Semple Way, Dundee, UK, DD2 4BF.

BACKGROUND: Treatment of cancer is increasingly effective but associated with short and long term side effects. Oral side effects, including oral mucositis (mouth ulceration), remain a major source of illness despite the use of a variety of agents to treat them. OBJECTIVES: To assess the effectiveness of interventions for treating oral mucositis or its associated pain in patients with cancer receiving chemotherapy or radiotherapy or both. SEARCH STRATEGY: Electronic searches of Cochrane Oral Health Group and PaPaS Trials Registers (to 1 June 2010), CENTRAL via The Cochrane Library (to Issue 2, 2010), MEDLINE via OVID (1950 to 1 June 2010), EMBASE via OVID (1980 to 1 June 2010), CINAHL via EBSCO (1980 to 1 June 2010), CANCERLIT via PubMed (1950 to 1 June 2010), OpenSIGLE (1980 to 1 June 2010) and LILACS via the Virtual Health Library (1980 to 1 June 2010) were undertaken. Reference lists from relevant articles were searched and the authors of eligible trials were contacted to identify trials and obtain additional information. SELECTION CRITERIA: All randomised controlled trials comparing agents prescribed to treat oral mucositis in people receiving chemotherapy or radiotherapy or both. Outcomes were oral mucositis, time to heal mucositis, oral pain, duration of pain control, dysphagia, systemic infection, amount of analgesia, length of hospitalisation, cost and quality of life. DATA COLLECTION AND ANALYSIS: Data were independently extracted, in duplicate, by two review authors. Authors were contacted for details of randomisation, blindness and withdrawals. Risk of bias assessment was carried out on six domains. The Cochrane Collaboration statistical guidelines were followed and risk ratio (RR) values calculated using fixed-effect models (less than 3 trials in each meta-analysis). MAIN RESULTS: Thirty-two trials involving 1505 patients satisfied the inclusion criteria. Three comparisons for mucositis treatment including two or more trials were: benzydamine HCl versus placebo, sucralfate versus placebo and low level laser versus sham procedure. Only the low level laser showed a reduction in severe mucositis when compared with the sham procedure, RR 5.28 (95% confidence interval (CI) 2.30 to 12.13).Only 3 comparisons included more than one trial for pain control: patient controlled analgesia (PCA) compared to the continuous infusion method, therapist versus control, cognitive behaviour therapy versus control. There was no evidence of a difference in mean pain score between PCA and continuous infusion, however, less opiate was used per hour for PCA, mean difference 0.65 mg/hour (95% CI 0.09 to 1.20), and the duration of pain was less 1.9 days (95% CI 0.3 to 3.5). AUTHORS’ CONCLUSIONS: There is weak and unreliable evidence that low level laser treatment reduces the severity of the mucositis. Less opiate is used for PCA versus continuous infusion. Further, well designed, placebo or no treatment controlled trials assessing the effectiveness of interventions investigated in this review and new interventions for treating mucositis are needed.

Cochrane Database Syst Rev 2010 8 CD001973


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High fluence low-power laser irradiation induces apoptosis via inactivation of Akt/GSK3beta signaling pathway.

Huang L, Wu S, Xing D

MOE Key Laboratory of Laser Life Science & Institute of Laser Life Science, College of Biophotonics, South China Normal University, Guangzhou 510631, China.

High fluence low-power laser irradiation (HF-LPLI) is a newly discovered stimulus through generating reactive oxygen species (ROS) to trigger cell apoptosis. Activation of glycogen synthase kinase 3beta (GSK3beta) is proved to be involved in intrinsic apoptotic pathways under various stimuli. However, whether the proapoptotic factor GSK3beta participates in HF-LPLI-induced apoptosis has not been elucidated. Therefore, in the present study, we investigated the involvement of GSK3beta in apoptosis under HF-LPLI treatment (120 J/cm(2), 633 nm). We found that GSK3beta activation could promote HF-LPLI-induced apoptosis, which could be prevented by Lithium Chloride (a selective inhibitor of GSK3beta) exposure or by GSK3beta-KD (a dominant-negative GSK3beta) overexpression. We also found that the activation of GSK3beta by HF-LPLI was due to the inactivation of protein kinase B (Akt), a widely reported and important upstream negative regulator of GSK3beta, indicating the existence and inactivation of Akt/GSK3beta signaling pathway. Moreover, the inactivation of Akt/GSK3beta pathway depended on the fluence of HF-LPLI treatment. Furthermore, vitamin c, a ROS scavenger, completely prevented the inactivation of Akt/GSK3beta pathway, indicating ROS generation was crucial for the inactivation. In addition, GSK3beta promoted Bax activation by down-regulating Mcl-1 upon HF-LPLI treatment. Taken together, we have identified a new and important proapoptotic signaling pathway that is consisted of Akt/GSK3beta inactivation for HF-LPLI stimulation. Our research will extend the knowledge into the biological mechanisms induced by LPLI. J. Cell. Physiol. (c) 2010 Wiley-Liss, Inc.

J Cell Physiol 2010 Aug 3


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Influence of naloxone and methysergide on the analgesic effects of low-level laser in an experimental pain model.

Peres e Serra A, Ashmawi HA

Faculdade de Medicina da Universidade de Sao Paulo (FMUSP), SP.

BACKGROUND AND OBJECTIVES: Although the mechanism of action of laser phototherapy (LPT) is not known, it is a promising analgesic method. The aim of this study was to evaluate whether the action of LPT depends on the activation of peripheral opioid or serotonergic receptors. METHOD: Inflammatory pain was induced through the injection of carrageenin in the left posterior paw of male Wistar rats. The InGaAIP visible laser diode (660 nm) with fluency of 2.5 J*cm(-2) was used. Von Frey filaments were used to analyze mechanical hyperalgesia. Animals were separated into five groups: Carrageenin; Laser (LPT); Non-coherent light; LPT + Naloxone; and LPT + Methysergide. RESULTS: Low-Level Laser phototherapy proved to be an effective analgesic method, while non-coherent light did not show a similar effect. The use of naloxone blocked the analgesic effect of LPT, while methysergide did not affect LPT-induced analgesia. CONCLUSIONS: According to the parameter used in this study, LPT produced analgesia. Analgesia induced by laser phototherapy is mediated by peripheral opioid receptors. Laser phototherapy does not seem to interact with peripheral serotonergic receptors.

Rev Bras Anestesiol 2010 May-Jun 60(3) 302-10


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[Buccal manifestations in patients submitted to chemotherapy]

Hespanhol FL, Tinoco EM, Teixeira HG, Falabella ME, Assis NM

Faculdade de Odontologia, Suprema – Faculdade de Ciencias Medicas e da Saude de Juiz de Fora, Salvaterra, Juiz de Fora MG, Brazil.

Several changes in the oral cavity due to chemotherapy can be observed and can lead to important systemic complications, increasing the time of the patient in hospital and the costs of the treatment as well as affect the quality of life of the patients. The aim of this study was to assess the oral manifestation in patients treated with chemotherapy according to sex, age and tumor type. Data was collected in an oncology hospital in Juiz de Fora, Minas Gerais State, from patients’ records that were submitted to oncologic treatment. It was possible to verify that mucositis, associated or not to other type of lesions, was the most common lesion in both sex of all ages (15.5%). Xerostomia and other lesions, such as Candida infection and aphthous lesions, were also present. It is possible to improve the quality of life of the patient during and after anti-neoplastic therapies through a protocol of odontological assistance that includes changes of the oral environment previous to chemotherapy such as profilaxis, caries removal, treatment of periodontal and periapical lesions, oral hygiene instructions, diet orientation and laser therapy. It is very important the insertion of the dentist in the oncologic medical team for the early diagnosis of the oral manifestation and follow-up during treatment time.

Cien Saude Colet 2010 Jun 15 Suppl 1 1085-94


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Multiple roles of cytochrome c oxidase in mammalian cells under action of red and IR-A radiation.

Karu TI

Laboratory of Laser Biology and Medicine, Institute of Laser and Information Technologies, Russian Academy of Sciences, Troitsk, Moscow Region, Russian Federation.

This article reviews the current knowledge in photobiology and photomedicine about the influence of monochromatic, quasimonochromatic, and bread-band radiation of red-to-near infrared (IR-A) part on solar spectrum upon mammalian cells and human skin. The role of cytochrome c oxidase as the photoacceptor and photosignal transducer is underlined and its photosensitivity at certain circumstances is discussed. The role of ATP as a critical signaling molecule is discussed.

IUBMB Life 2010 Aug 62(8) 607-10


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Low-level laser therapy in the management of neck pain.

Peres MF, Lucchetti G

Instituto Israelita de Ensino e Pesquisa, Albert Einstein Hospital, Sao Paulo, Brazil.

Curr Pain Headache Rep 2010 Oct 14(5) 325-7


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Comparative analysis of analgesic efficacy of selected physiotherapy methods in low back pain patients.

Charlusz M, Gasztych J, Irzmanski R, Kujawa J

Department of Internal Diseases and Cardiological Rehabilitation, Physiotherapy Ward, Medical Military Faculty, Medical University, Lodz.

BACKGROUND: Low back pain syndromes are one of the most frequent causes of movement limitation in populations of highly industrialized countries. They are listed as the main cause of inability to work among people of working age. Chronic pain and the associated limitation of movement underlie the quest for effective therapies. The use of ultrasound, LLLT, vacuum therapy with Ultra Reiz current in physical therapy of these patients prompts research over their effectiveness in the therapy of patients with low-back pain. The aim of the work was to evaluate the analgesic efficacy of LLLT, ultrasound, and vacuum therapy with Ultra Reiz current in patients with low back pain. MATERIAL AND METHODS: The study involved 94 people divided into three groups (A,B,C). Group A (n=35) received a series of 10 low energy laser therapy sessions (wave length 808 nm, surface density of radiation 510 mW/cm(2), continuous wave form, scanning mode, a dose of 12 J/cm(2) on a surface of 100 cm(2) [10x10cm]). Patients in Group B (n=27) had ultrasound sessions with a wave intensity of 1 W/cm(2) for 3 minutes. Patients in Group C (n=32) underwent vacuum therapy (8 kPa) combined with Ultra Reiz current. Subjective pain assessment was carried out using a modified Latinen questionnaire and a visual analogue scale of pain intensity. Lumbosacral spine mobility was evaluated with the Schober test and the finger-to- floor test. RESULTS: In Group A, following low energy laser therapy, a statistically significant decrease in pain intensity was observed, together with decreased analgesic consumption compared to the other groups. In Group C, following vacuum therapy combined with Ultra Reiz currents, a significant decrease in the frequency of pain was observed together with increased physical activity compared to both Groups A and B, assessed according to a modified Laitinen pain indicator questionnaire. The biggest improvement in global spine mobility and lumbosacral flexion was observed in Group C (vacuum therapy plus Ultra Reiz current) compared to the other groups. However, the most significant improvement in lower spine extension was noted in Group B (ultrasound). CONCLUSIONS: 1. The study showed slightly higher analgesic efficacy of laser biostimulation in comparison to vacuum therapy combined with Ultra Reiz current in patients with low back pain. 2. A more prominent increase in lumbosacral spine mobility was observed after vacuum therapy combined with Ultra Reiz current and ultrasound therapy.

Ortop Traumatol Rehabil 2010 May-Jun 12(3) 225-36


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Low-level laser therapy supported teeth extractions of two patients receiving IV zolendronate.

Kan B, Altay MA, Tasar F, Akova M

Faculty of Dentistry, Department of Oral and Maxillofacial Surgery, Hacettepe University, Ankara, Turkey.

BRONJ (bisphosphonate-related osteonecrosis of jaws) is a frequently encountered disease, particularly in the maxillofacial region, and a consequence of bisphosphonate use. Treatment of BRONJ remains controversial, as efficiency of medical and surgical approaches as well as a combination of these methods with supportive treatments have not been clearly demonstrated in the literature. In recent years, laser usage alone or in combination with the main therapy methods, has become popular for the treatment of bisphosphonate-related osteo-necrosis of jaws. In this article, we present the successful management of two dental patients who had high potentials for BRONJ development as a result of chemo and radiotherapy combined with IV zoledronic acid application. Multiple consecutive teeth extractions followed with primary wound closure and LLLT applications were performed under high doses of antibiotics prophylaxis. Satisfactory wound healing in both the surrounding soft and hard tissues was achieved. LLLT application combined with atraumatic surgical interventions under antibiotics prophylaxis is a preferable approach in patients with a risk of BRONJ development. Adjunctive effect of LLLT in addition to careful infection control on preventing BRONJ was reported and concluded.

Lasers Med Sci 2010 Jul 29


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Testing Photobiomodulatory Effects of Laser Irradiation on Wound Healing: Development of an Improved Model for Dressing Wounds in Mice.

Chung TY, Peplow PV, Baxter GD

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

Abstract Objective: To develop a suitable method for dressing skin wounds in BKS.Cg-m(+)/(+)Lepr(db) mice for subsequent use in laser irradiation of wounds. The healing of nonirradiated wounds (controls) was examined histologically to provide essential reference data. Background data: Dressing excisional skin wounds in mice has many advantages. However, previous studies using dressings such as Tegaderm W or OpSite, with or without adhesives, have shown that this is not easily achieved. Materials and Methods: In a pilot study, a full-thickness wound was made on the left flank in six diabetic and six nondiabetic mice, and five different methods were tried for dressing the wounds with Tegaderm HP to develop an optimized procedure. The optimized procedure was used in subsequent studies, with a total of 23 diabetic and 13 nondiabetic mice being controls for laser-irradiated mice. Measurements of healing outcomes from histologic sections of controls were statistically analyzed. Results: The optimized procedure used Tegaderm HP with Cavilon and Fixomull Stretch strips for the first dressing, and with Mastisol for subsequent dressings. Wound closure by contraction was retarded in a large proportion of diabetic mice (approximately 80%) and a small proportion of nondiabetic mice. These wounds, described as “splinted,” healed mainly by epithelial regeneration and granulation tissue formation. Conclusion: A simple, easy-to-perform procedure was developed for dressing wounds in diabetic and nondiabetic mice. It was found to cause splinting with wound healing mimicking that in human patients. This model is suitable for examining the effects of different therapies on wound healing, including lasers.

Photomed Laser Surg 2010 Jul 28


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Laser photobiomodulation of proliferation of cells in culture: a review of human and animal studies.

Peplow PV, Chung TY, Baxter GD

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

AIM: The aim of this article was to review experimental studies of laser irradiation of human and animal cells in culture to assess the photobiomodulatory effects of such irradiation. BACKGROUND: Previous studies have shown that various types of cells respond differently to laser irradiation, depending on irradiation parameters. Cellular outcomes measured or examined include cell numbers, cell viability, and ultrastructural features. A review of these studies may provide a further insight into the clinical effects brought about by laser light on cells and tissues, including laser effects in wound healing and repair of nerves and skeletal muscle after injury. METHODS: A systematic review was completed of original research articles investigating the effects of laser therapy on human and animal cells in culture (January 2002 to September 2009). Relevant articles were primarily sourced from PubMed and Medline by using EndNote X1, and from secondary searches. Search terms were “cell proliferation,” “laser therapy,” “laser irradiation,” “laser phototherapy,” and “phototherapy.” RESULTS: In total, 46 relevant articles were included in the review, comprising work completed on a variety of cell types. Although results consistently demonstrated the potential of laser irradiation to affect cellular proliferation in a wavelength- and dosage-dependent manner, the relevance of other key irradiation parameters, such as irradiance, to such effects remained unclear. CONCLUSIONS: Findings from studies of cells in culture clearly demonstrate the ability of laser irradiation to modulate (typically stimulate) cellular proliferation. The relevance of some irradiation parameters remains occult and represents an important area for further research.

Photomed Laser Surg 2010 Aug 28 Suppl 1 S3-40


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The interaction of light with nanoscopic layers of water may be essential to the future of photobiomodulation.

Santana-Blank L, Rodriguez-Santana E

Photomed Laser Surg 2010 Aug 28 Suppl 1 S173-4


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Assessment of the effect of the use of laser light or dantrolene on facial muscle under occlusal wear: a Raman spectroscopic study in a rodent model.

Lisboa MV, Lopes CB, Rocha R, Ramos TA, de Abreu ID, Cangussu MC, Pinheiro AL, dos Santos JN

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

OBJECTIVE: The aim of the present study was to use Raman spectroscopy to measure levels of CaPi in muscles under occlusal wear and treated with laser phototherapy (LPT) or muscle-relaxant therapy or both on rodents. BACKGROUND: The etiology of temporomandibular disorders is multifactorial. Malocclusion may influence the masticatory muscles, causing fatigue. A major type of fatigue is the metabolic, caused by the increased accumulation of metabolites such as inorganic phosphate. Raman spectroscopy allows nondestructive analysis of the biochemical composition of tissues. METHODS: The 30 male Wistar rats were randomly divided into three groups: occlusal wear (G-1), occlusal wear + LPT (G-2), and occlusal wear + muscle relaxant (G-3). Ten untreated animals were used for baseline data. Under intraperitoneal general anesthesia, animals of groups 1, 2, and 3 had unilateral amputation of molar cusps to simulate an occlusal-wear situation. The masseter muscle of G-2 received LPT (lambda830 nm, 4 J/cm(2), 40 mW, phi approximately 2 mm) after the procedure and repeated every other day for 14-30 days. Animals of G-3 were treated with a daily injection of dantrolene (2.5 mg/kg in 0.5 ml of H(2)O) beginning 24 h after cusp removal. Animals were killed with an overdose of general anesthetics at days 14 and 30 after cusps removal, and the ipsilateral masseter muscle was excised and divided into two parts. One part was routinely processed and underwent histologic analysis; the other was kept in liquid nitrogen for Raman spectroscopy. The mean value of the intensity of the peak 958 per centimeter was determined. RESULTS: No morphologic changes were seen. Raman analysis showed significantly less Raman intensity in the laser group at 30 days (p < 0.01). CONCLUSION: Occlusal wear did not caused morphologic alterations in the masseter muscle but resulted in changes of the levels of CaP(i) that were less compromising when the laser light was used.

Photomed Laser Surg 2010 Aug 28 Suppl 1 S135-41


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The Anti-inflammatory Effect of Low-Level Laser Therapy on Experimentally Induced Inflammation of Rabbit Temporomandibular Joint Retrodiscal Tissues.

Kucuk BB, Oral K, Selcuk NA, Toklu T, Civi OG

Aims: To investigate the effect of low-level laser therapy (LLLT) on experimentally induced inflammation in retrodiscal tissues of the rabbit temporo?mandibular joint (TMJ) using scintigraphic imaging. Methods: Eleven male New Zealand rabbits were included in this study. Six randomly selected rabbits were imaged to provide normal joint images (normal group) before the initiation of the experiment. A 5% formalin solution was locally injected into both right and left TMJs of all rabbits. Subsequently, Ga-Al-As laser (wavelength: 815 nm; energy density: 12 J/cm2; output power: 250 mW) was applied for 48 seconds. The treatment was performed six times for 2 weeks to the left TMJ of all rabbits. The right TMJs of the rabbits were used as the control (nontreated) TMJ group, while left TMJs were used as the treated TMJ group. Static images of TMJ were taken at 24 hours, 7 days, and 14 days after the beginning of the treatment. The images of all TMJs were taken in the posteroanterior direction with the rabbit under sedation and its mouth open. The Mann-Whitney U test was used to compare group differences, and intragroup differences were determined by the Friedman test and Wilcoxon sign test. Results: Significant differences were found between normal and both the control and treated TMJ groups. A reduction of inflammation in both treated and control TMJ groups was obtained, but there was no statistically significant difference between the groups. Conclusion: Under the conditions used in this study, quantitative scintigraphic measurements of TMJ inflammation of the treated TMJ group decreased but did not differ significantly from those of the control TMJ group. J Orofac Pain 2010;24:293-297.

J Orofac Pain 2010 Summer 24(3) 293-7


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Evaluation of inflammatory biomarkers associated with oxidative stress and histological assessment of low-level laser therapy in experimental myopathy.

Servetto N, Cremonezzi D, Simes JC, Moya M, Soriano F, Palma JA, Campana VR

Catedra de Fisica Biomedica, Facultad de Ciencias Medicas, Universidad Nacional de Cordoba, Santa Rosa 1085, (5000) Cordoba, Argentina.

The objective of the present work was to study the effect of helium-neon (He-Ne) and gallium-arsenide (Ga-As) laser upon inflammatory biomarkers associated with oxidative stress: fibrinogen, nitric oxide (NO), L-citrulline, and superoxide dismutase (SOD). These were evaluated through histological assessment, in rats with experimental myopathy. MATERIALS AND METHODS: The groups studied were: (A) control, (B) injured, (C) injured and treated with He-Ne laser, (D) injured and treated with Ga-As laser, (E) irradiated with He-Ne; and (F) irradiated with Ga-As laser. Myopathy was induced by injecting 0.05 mg/rat/day of adrenaline in the left posterior limb muscle at the same point on 5 consecutive days, in groups B, C, and D. Low-level laser therapy (LLLT) was applied with 9.5 J/cm(2) daily for 7 consecutive days with each laser. The determination of the biomarkers was made by spectrophotometry. The muscles (5/8, single blinded) were stained with Gomori Trichrome and examined by optic microscopy. The quantitative variables were statistically analyzed by the Fisher’s test and categorical data by the Axionvision 4.8 program. Pearson’s chi-squared test was applied, setting significant difference at P < 0.05 for all cases. RESULTS: In group B, the biomarkers were significantly increased compared to the other groups (P < 0.001), except for NO which in group B decreased significantly (P < 0.001). In group B, there was a higher inflammatory infiltration level (80.67%) in relation to destroyed fibers. CONCLUSIONS: LLLT caused significant changes in inflammatory biomarkers and oxidative stress: decreased levels of fibrinogen, L-citrulline and SOD as opposed to the increase of NO in rats with experimental myopathies and significant muscle recovery.

Lasers Surg Med 2010 Aug 42(6) 577-83


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Targeted increase in cerebral blood flow by transcranial near-infrared laser irradiation.

Uozumi Y, Nawashiro H, Sato S, Kawauchi S, Shima K, Kikuchi M

Department of Neurosurgery, National Defense Medical College, 3-2 Namiki, Tokorozawa, Saitama 359-8513, Japan.

BACKGROUND AND OBJECTIVE: Brain function is highly dependent on cerebral blood flow (CBF). The precise mechanisms by which blood flow is controlled by NIR laser irradiation on the central nervous system (CNS) have not been elucidated. In this study, we examined the effect of 808 nm laser diode irradiation on CBF in mice. STUDY DESIGN/MATERIALS AND METHODS: We examined the effect of NIR irradiation on CBF at three different power densities (0.8, 1.6 and 3.2 W/cm(2)) and directly measured nitric oxide (NO) in brain tissue during NIR laser irradiation using an amperometric NO-selective electrode. We also examined the contribution of NO and a neurotransmitter, glutamate, to the regulation of CBF by using a nitric oxide synthase (NOS) inhibitor, N(g)-nitro-L-arginine methyl ester hydrochloride (L-NAME), and an N-methyl-D-aspartate (NMDA) receptor blocker, MK-801, respectively. We examined the change in brain tissue temperature during NIR laser irradiation. We also investigated the protection effect of NIR laser irradiation on transient cerebral ischemia using transient bilateral common carotid artery occlusion (BCCAO) in mice. RESULTS: We showed that NIR laser irradiation (1.6 W/cm(2) for 15-45 minutes) increased local CBF by 30% compared to that in control mice. NIR laser irradiation also induced a significant increase in cerebral NO concentration. In mice that received L-NAME, NIR laser irradiation did not induce any increase in CBF. Mice administered MK-801 showed an immediate increase but did not show a delayed additional increase in local CBF. The increase in brain tissue temperature induced by laser irradiation was estimated to be as low as 0.8 degrees C at 1.6 W/cm(2), indicating that the heating effect is not a main mechanism of the CBF increase in this condition. Pretreatment with NIR laser irradiation improved residual CBF and reduced the numbers of apoptotic cells in the hippocampus. CONCLUSION: Our data suggest that NIR laser irradiation is a promising experimental and therapeutic tool in the field of cerebral circulation research.

Lasers Surg Med 2010 Aug 42(6) 566-76


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Collagen changes and realignment induced by low-level laser therapy and low-intensity ultrasound in the calcaneal tendon.

Wood VT, Pinfildi CE, Neves MA, Parizoto NA, Hochman B, Ferreira LM

Division of Plastic Surgery, Universidade Federal de Sao Paulo (UNIFESP), CEP 04023-002 Sao Paulo, SP, Brazil.

BACKGROUND AND OBJECTIVE: The treatment of calcaneal tendon injuries requires long-term rehabilitation. Ultrasound (US) and low-level laser therapy (LLLT) are the most used and studied physical agents in the treatment of tendon injuries; however, only a few studies examined the effects of the combination of US and LLLT. Therefore, the purpose of this study was to investigate which treatment (the exclusive or combined use of US and LLLT) most effectively contribute to tendon healing. STUDY DESIGN/MATERIALS AND METHODS: This was a controlled laboratory study with 50 rats whose Achilles tendon was injured by direct trauma. The rats were randomly divided into five groups and treated for 5 consecutive days, as follows: group 1 (control) received no treatment; group 2 was treated with US alone; group 3 was treated with LLLT alone; group 4 was treated first with US followed by LLLT; and group 5 was treated first with LLLT followed by US. On the sixth post-injury day, the tendons were removed and examined by polarized light microscopy. The organization of collagen fibers was assessed by birefringence measurements. Picrosirius-stained sections were examined for the presence of types I and III collagen. RESULTS: There was a significantly higher organization of collagen fibers in group 2 (US) than in the control group (P = 0.03). The amount of type I collagen found in groups 2 (US), 3 (LLLT), and 5 (LLLT + US) was significantly higher than that in the control group (P

Lasers Surg Med 2010 Aug 42(6) 559-65


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Anti-inflammatory effects of low-level light emitting diode therapy on Achilles tendinitis in rats.

Xavier M, David DR, de Souza RA, Arrieiro AN, Miranda H, Santana ET, Silva JA Jr, Salgado MA, Aimbire F, Albertini R

Institute of Research and Development, IP&D, Vale do Paraiba University, UNIVAP, Av. Shishima Hifumi, 2911, 12244-000 Sao Jose dos Campos, Sao Paulo, Brazil.

BACKGROUND AND OBJECTIVES: The present study investigated the effects of low-level light emitting diode (LED) therapy (880 +/- 10 nm) on inflammatory process in a experimental model of Achilles tendinitis induced by collagenase. STUDY DESIGN/MATERIALS AND METHODS: Fifty-six male Wistar were separated into seven groups (n = 8), three groups in the experimental period of 7 days and four groups in the experimental period of 14 days, the control group (CONT), tendinitis group (TEND), LED therapy group (LEDT) for both experimental periods, and LED therapy group 7th to 14th day (LEDT delay) for 14 days experimental period. The LED parameters was 22 mW CW of optical output power, distributed in an irradiation area of 0.5 cm(2), with an irradiation time of 170 seconds, the applied energy density was 7.5 J/cm(2) in contact. The therapy was initiated 12 hours after the tendinitis induction, with a 48-hour interval between the irradiations. The histological analysis and inflammatory mediators were quantified. RESULTS: Our results showed that LED decreases the inflammatory cells influx and mRNA expression to IL-1 beta, IL-6, tumor necrosis factor-alpha (TNF-alpha) in both phase, and cyclooxygenase-2 (COX-2) just in initial phase (P < 0.05). CONCLUSION: Our results suggest that the anti-inflammatory therapy with low-power LED (880 nm) enhanced the tissue response in all groups. We can conclude that the LED was able to reduce signs of inflammation in collagenase-induced tendinitis in rats by reducing the number of inflammatory cells and decrease mRNA expression of cytokines.

Lasers Surg Med 2010 Aug 42(6) 553-8


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Effects of low-level laser therapy on collagen expression and neutrophil infiltrate in 5-fluorouracil-induced oral mucositis in hamsters.

Lopes NN, Plapler H, Lalla RV, Chavantes MC, Yoshimura EM, da Silva MA, Alves MT

Department of Experimental Surgery, Federal University of Sao Paulo, Sao Paulo CEP 04023-062, Brazil.

BACKGROUND AND OBJECTIVES: Several studies have suggested that low-level laser therapy (LLLT) can ameliorate oral mucositis; however, the mechanisms involved are not well understood. The aim of this study was to investigate the mechanisms of action of LLLT on chemotherapy-induced oral mucositis, as related to effects on collagen expression and inflammation. MATERIALS AND METHODS: A hamster cheek pouch model of oral mucositis was used with all animals receiving intraperitoneal 5-fluorouracil, followed by surface irritation. Animals were randomly allocated into three groups, and treated with an InGaAIP diode laser at a wavelength of 660 nm and output power of 35 or 100 mW laser, or no laser. Clinical severity of mucositis was assessed at four time-points by a blinded examiner. Buccal pouch tissue was harvested from a subgroup of animals in each group at four time-points. Collagen was qualitatively and quantitatively evaluated after picrosirius staining. The density of the neutrophil infiltrate was also scored. RESULTS: Peak clinical severity of mucositis was reduced in the 35 mW laser group as compared to the 100 mW and control groups. The reduced peak clinical severity of mucositis in the 35 mW laser group was accompanied by a decrease in the number of neutrophils and an increase in the proportion of mature collagen as compared to the other two groups. The total quantity of collagen was significantly higher in the control (no laser) group at the day 11 time-point, as compared to the 35 mW laser group, consistent with a more prolonged inflammatory response in the control group. CONCLUSION: This study supports two mechanisms of action for LLLT in reducing mucositis severity. The increase in collagen organization in response to the 35 mW laser indicates that LLLT promotes wound healing. In addition, LLLT also appears to have an anti-inflammatory effect, as evidenced by the reduction in neutrophil infiltrate.

Lasers Surg Med 2010 Aug 42(6) 546-52


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Varying ratios of wavelengths in dual wavelength LED photomodulation alters gene expression profiles in human skin fibroblasts.

McDaniel DH, Weiss RA, Geronemus RG, Mazur C, Wilson S, Weiss MA

Laser Skin & Vein Center of Virginia, Institute of Anti-Aging Research; Virginia Beach, Virginia 23462, USA.

BACKGROUND AND OBJECTIVE: LED photomodulation has been shown to profoundly influence cellular behavior. A variety of parameters with LED photomodulation can alter cellular response in vitro. The effects of one visible and one infrared wavelength were evaluated to determine the optimal ratio to produce a net increase in dermal collagen by altering the ratio of total energy output of each wavelength. The ratio between the two wavelengths (590 and 870 nm) was shifted in 25% increments. STUDY DESIGN/MATERIALS AND METHODS: Human skin fibroblasts in culture were exposed to a 590/870 nm LED array with total combined energy density fixed at 4.0 mW/cm.. The ratio of 590/870 nm tested parameters were: 100/0%, 75/25%, 50/50%, 25/75%, and 0/100%. These ratios were delivered using pulsed duty cycle of exposure (250 milliseconds “on” time/100 milliseconds “off” time/100 pulses) for a total energy fluence of 0.1 J/cm.. Gene expression was examined using commercially available extra cellular matrix and adhesion molecule RT PCR Arrays (SA Biosciences, Frederick, MD) at 24 hours post-exposure. RESULTS: Different expression profiles were noticed for each of the ratios studied. Overall, there was an average (in an 80 gene array) of 6% expression difference in up or downregulation between the arrays. The greatest increase in collagen I and decrease in collagenase (MMP-1) was observed with 75/25% ratio of 590/870 nm. The addition of increasing proportions of IR wavelengths causes alteration in gene expression profile. The ratios of the wavelengths caused variation in magnitude of expression. CONCLUSIONS: Cell metabolism and gene expression can be altered by simultaneous exposure to multiple wavelengths of low energy light. Varying the ratios of specific wavelength intensity in both visible and near infrared light therapy can strongly influence resulting fibroblast gene expression patterns.

Lasers Surg Med 2010 Aug 42(6) 540-5


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Low pulse energy Nd:YAG laser irradiation exerts a biostimulative effect on different cells of the oral microenvironment: “an in vitro study”.

Chellini F, Sassoli C, Nosi D, Deledda C, Tonelli P, Zecchi-Orlandini S, Formigli L, Giannelli M

Department of Anatomy, Histology and Forensic Medicine, University of Florence, Florence, Italy. f _

BACKGROUND AND OBJECTIVES: Dental lasers represent a promising therapeutic tool in the treatment of periodontal and peri-implant diseases. However, their clinical application remains still limited. Here, we investigated the potential biostimulatory effect of low pulse energy neodymium:yttrium-aluminum-garnet (Nd:YAG) laser irradiation on different cells representative of the oral microenvironment and elucidated the underlying molecular mechanisms. MATERIALS AND METHODS: Saos-2 osteoblasts, H-end endothelial cells, and NIH/3T3 fibroblasts pre-treated or not with photosensitizing dye methylene blue (MB), were irradiated with low pulse energy (20 mJ) and high repetition rate (50-70 Hz) Nd:YAG laser, and evaluated for cell viability and proliferation as well as for the expression of specific differentiation markers by confocal immunofluorescence and real-time RT-PCR. Changes in intracellular Ca(2+) levels after laser exposure were also evaluated in living osteoblasts. RESULTS: Nd:YAG laser irradiation did not affect cell viability in all the tested cell types, even when combined with pre-treatment with MB, and efficiently stimulated cell growth in the non-sensitized osteoblasts. Moreover, a significant induction in the expression of osteopontin, ALP, and Runx2 in osteoblasts, type I collagen in fibroblasts, and vinculin in endothelial cells could be observed in the irradiated cells. Pre-treatment with MB negatively affected cell differentiation in the unstimulated and laser-stimulated cells. Notably, laser irradiation also caused an increase in the intracellular Ca(2+) in osteoblasts through the activation of TRPC1 ion channels. Moreover, the pharmacologic or genetic inhibition of these channels strongly attenuated laser-induced osteopontin expression, suggesting a role for the laser-mediated Ca(2+) influx in regulating osteoblast differentiation. CONCLUSION: Low pulse energy and high repetition rate Nd:YAG laser irradiation may exert a biostimulative effect on different cells representative of the oral microenvironment, particularly osteoblasts. Pre-treatment with MB prior to irradiation hampers this effect and limits the potential clinical application of photosensitizing dyes in dental practice.

Lasers Surg Med 2010 Aug 42(6) 527-39


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Low-intensity laser irradiation stimulates mineralization via increased BMPs in MC3T3-E1 cells.

Fujimoto K, Kiyosaki T, Mitsui N, Mayahara K, Omasa S, Suzuki N, Shimizu N

Department of Orthodontics, Nihon University School of Dentistry, 1-8-13, Kanda Surugadai, Chiyoda-ku, Tokyo 101-8310, Japan.

BACKGROUND: Previously, we reported that low-intensity laser irradiation accelerated bone formation, and that this mechanism deeply involved insulin-like growth factor I expression. However, as bone formation is supported by many local factors, the mechanism involved in laser irradiation remains incompletely understood. Therefore, the purpose of this study was to determine the effects of laser irradiation on the osteogenic response in vitro. METHODS: Mouse osteoblast-like cells, MC3T3-E1, were cultured and were irradiated for 5-20 minutes (0.96-3.82 J/cm(2)) at the subconfluent stage using a low-intensity Ga-Al-As diode laser apparatus. After laser irradiation, expression of bone morphogenetic proteins (BMPs), transcription factors (Runx2, Osterix, Dlx5, Msx2), and phosphorylation of Smad1 were determined, and calcium content of cell cultures was also determined. RESULTS: Irradiation at 1.91 J/cm(2) significantly increased the expression of BMPs and Runx2, Osterix, Dlx5, Msx2, and the phosphorylation of Smad1. Noggin, a BMP receptor blocker, inhibited the laser-induced Runx2 expression and phosphorylation of Smad1. Moreover, laser irradiation significantly increased the calcium content of cell cultures, and noggin inhibited this increase. CONCLUSION: These results suggest that low-intensity laser irradiation stimulates in vitro mineralization via increased expression of BMPs and transcription factors associated with osteoblast differentiation.

Lasers Surg Med 2010 Aug 42(6) 519-26


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Mitochondrial signaling for histamine releases in laser-irradiated RBL-2H3 mast cells.

Wu ZH, Zhou Y, Chen JY, Zhou LW

Surface Physics Laboratory (National key laboratory), Department of Physics, Fudan University, Shanghai 200433, China.

BACKGROUND: The low power laser irradiation (LPLI) can promote the wound healing, but the mechanism is still not fully understood. We have found in our previous work that the LPLI induces mast cells to release the histamine and thus suggested that the increased histamine release is probably one of the causes for promoting the wound healing since mast cells have been found to play positive roles in the process of wound healing. This study aims to explore the mechanism of histamine release in RBL-2H3 mast cells under laser irradiations. MATERIALS AND METHODS: The wavelength effect of laser irradiations, the permeability function of mitochondrial membrane, the Bcl-2 effect, the cytosolic alkalinization and the increment of intracellular Ca(2+) ([Ca(2+)](i)), on histamine release in RBL-2H3 cells were studied, respectively, with the corresponding fluorescence probes. RESULTS: The action bands of laser irradiations were consistent with the absorption bands of cytochrome c oxidase, suggesting that cytochrome c oxidase is the photoacceptor. After laser irradiation, (1) the cytochrome c releases from mitochondrial to cytosol reflecting an increased permeability of mitochondrial membrane, (2) the cytosolic alkalinization appears, (3) [Ca(2+)](i) increases, and (4) finally the enhancement of histamine release occurs. When Bcl-2 was used to inhibit the permeability of mitochondrial membrane these cellular signaling from (1) to (4) were all suppressed obviously. CONCLUSION: As a photoacceptor, cytochrome c oxidase absorbs incident photons and initiates the mitochondrial signaling. When the signals are transferred from the mitochondrial to the cytosol, the cytosolic alkalinization appears leading to the opening of a Ca(2+) channel on the membrane, the transient receptor potential vanilloid (TRPV), and an increment of [Ca(2+)](i). The increased [Ca(2+)](i) consequently mediates an enhanced histamine release. Such a responding chain is a suggested mechanism to understand the histamine release in RBL-2H3 cells under laser irradiations.

Lasers Surg Med 2010 Aug 42(6) 503-9


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Effect of Ga-Al-As laser irradiation on COX-2 and cPLA2-alpha expression in compressed human periodontal ligament cells.

Mayahara K, Yamaguchi A, Sakaguchi M, Igarashi Y, Shimizu N

Department of Orthodontics, Nihon University School of Dentistry, 1-8-13 Kanda, Surugadai, Chiyoda-Ku, Tokyo 101-8310, Japan.

BACKGROUND AND OBJECTIVE: Prostaglandin E(2) (PGE(2)), which has bone-resorptive activity, is produced by human periodontal ligament (PDL) cells in response to mechanical stress. We previously reported that low level laser (LLL) irradiation inhibited PGE(2) production in PDL cells in response to mechanical stress; however, the mechanism underlying this inhibitory effect was unclear. Thus, we sought to determine the mechanism underlying the inhibitory effect of LLL on PGE(2) production in compressed PDL cells. STUDY DESIGN/MATERIALS AND METHODS: A compressive force of 2.0 g/cm(2) was applied for 24 hours to human PDL cells obtained from premolars extracted for orthodontic treatment. LLL irradiation (Ga-Al-As laser, 830 nm, 3.82 J/cm(2)) was applied 6 hours before, 1 hour before, and immediately after the application of compressive force. The mRNA expression of COX-2 and cPLA(2)-alpha was then examined by real-time PCR. RESULTS: LLL irradiation significantly inhibited COX-2 and cPLA(2)-alpha mRNA expression, which was increased in response to the application of a compressive force. Moreover, LLL irradiation immediately after compression had the strongest inhibitory effect on the expression of these genes. CONCLUSIONS: The inhibition of PGE(2) production by LLL irradiation in compressed PDL cells may be due to the inhibition of COX-2 and cPLA(2)-alpha expression and is most pronounced immediately after the application of a compressive force.

Lasers Surg Med 2010 Aug 42(6) 489-93


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Effect of laser therapy on DNA damage.

Fonseca AS, Moreira TO, Paixao DL, Farias FM, Guimaraes OR, de Paoli S, Geller M, de Paoli F

Departamento de Ciencias Fisiologicas, Instituto Biomedico, Universidade Federal do Estado do Rio de Janeiro, Rua Frei Caneca, 94, Rio de Janeiro 20211040, Brazil.

BACKGROUND AND OBJECTIVE: Whereas the biostimulative effect on tissues using low intensity laser therapy for treating many diseases has been described, the photobiological basis and adverse effects are not well understood. The aim of this study, using experimental models, is to observe the combined effect of physical damage (laser) and a chemical agent (hydrogen peroxide) on Escherichia coli cultures and bacterial plasmids. MATERIALS AND METHODS: Survival of E. coli AB1157 (wild type) and BW9091 (xth(-)) cultures were used as an experimental model to assess the effect of agents on DNA, also agarose gel electrophoretic profile of bacterial plasmids for studying single and double strand breaks in DNA exposed to laser irradiation and in DNA pre-exposed to laser and subsequently incubated with hydrogen peroxide. RESULTS: Data indicate low intensity laser: (i) did not alter the survival of E. coli cultures, (ii) pre-exposure had a protective effect against lethal action of hydrogen peroxide on E. coli cultures, and (iii) did not alter the electrophoretic profile and action of hydrogen peroxide on plasmids. This suggests that low intensity therapeutic red laser doses at different emission modes induces sub-lethal effects on E. coli wild type and exonuclease III mutant cultures inducing protective mechanisms against lethal action of hydrogen peroxide. Laser action on bacterial plasmids is related to lesions other than single or double DNA strands breaks. CONCLUSIONS: This study shows a protective effect or DNA repair mechanism induction by pre-exposure to low intensity red laser on the lethal action of oxidant agents and, therefore, laser therapy protocol should consider fluencies, wavelength and tissue conditions before beginning treatment.

Lasers Surg Med 2010 Aug 42(6) 481-8


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Effect of pulsing in low-level light therapy.

Hashmi JT, Huang YY, Sharma SK, Kurup DB, De Taboada L, Carroll JD, Hamblin MR

Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, Massachusetts, USA.

BACKGROUND AND OBJECTIVE: Low level light (or laser) therapy (LLLT) is a rapidly growing modality used in physical therapy, chiropractic, sports medicine and increasingly in mainstream medicine. LLLT is used to increase wound healing and tissue regeneration, to relieve pain and inflammation, to prevent tissue death, to mitigate degeneration in many neurological indications. While some agreement has emerged on the best wavelengths of light and a range of acceptable dosages to be used (irradiance and fluence), there is no agreement on whether continuous wave or pulsed light is best and on what factors govern the pulse parameters to be chosen. STUDY DESIGN/MATERIALS AND METHODS: The published peer-reviewed literature was reviewed between 1970 and 2010. RESULTS: The basic molecular and cellular mechanisms of LLLT are discussed. The type of pulsed light sources available and the parameters that govern their pulse structure are outlined. Studies that have compared continuous wave and pulsed light in both animals and patients are reviewed. Frequencies used in other pulsed modalities used in physical therapy and biomedicine are compared to those used in LLLT. CONCLUSION: There is some evidence that pulsed light does have effects that are different from those of continuous wave light. However further work is needed to define these effects for different disease conditions and pulse structures.

Lasers Surg Med 2010 Aug 42(6) 450-66


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Introduction to experimental and clinical studies using low-level laser (light) therapy (LLLT).

Hamblin MR

Lasers Surg Med 2010 Aug 42(6) 447-9


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Lasertherapy efficacy in temporomandibular disorders: control study.

Santos Tde S, Piva MR, Ribeiro MH, Antunes AA, Melo AR, Silva ED

Brazilian College of Maxillofacial Surgery, Brazil.

Temporomandibular dysfunction is characterized by the presence of painful joint/muscular symptoms muscle in the face. The main justification for the use of lasers in laser therapy dysfunction is its analgesic effect, which was observed in most studies in the literature. AIM: We evaluated the effectiveness of laser therapy in the treatment of temporomandibular disorders. METHODS: 50 volunteers with temporomandibular disorders were divided into two groups (control and experimental) had amplitudes of movements of mouth opening, right and left laterality recorded before and after laser application. Was also recorded, the score the individual gave to pain by visual analog scale and, through physical examination, the pain points. We used the AsGaAl laser with a 40mW power, with 80J/cm(2) for 16 seconds at four selected points for just one session with reassessment after a week. Study design: Clinical. RESULTS: It was noted that laser therapy increased the mean amplitude of mandibular movements (p = 0.0317) and decreased significantly (43.6%) the pain intensity measured by the visual analog scale. CONCLUSIONS: The laser decreases the painful symptoms of the patient after application through its analgesic and/or a placebo effect.

Braz J Otorhinolaryngol 2010 Jun 76(3) 294-9


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[Surgical and radiotherapy in treatment of postauricular keloids–case report]

Gveric T, Grah J, Huljev D, Zdilar B, Barisic J, Trajbar D, Ahmetasevic SG, Ivkosic A

Sveti Duh General Hospital, Zagreb, Croatia.

Treatment of keloid remains a great challenge for clinicians, in spite of numerous therapeutic regimens reported in the literature to date. Earlobe or postauricular regions are predominant locations for postoperative keloids due to the treatment of lop ears. There are several treatments that include intralesional steroid injections, surgical excision, cryotherapy, laser therapy, radiotherapy and pharmacotherapy. A case is presented with fourth recurrence of keloids after surgical treatment of lop ears with final satisfactory outcome after combined therapy that included surgical excision, skin flap transposition and radiotherapy. It is concluded that interdisciplinary approach that includes a combination of surgery and radiotherapy results in a satisfactory outcome of keloid treatment.

Acta Med Croatica 2010 Mar 64(1) 55-8


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Low-level laser therapy stimulates mineralization via increased Runx2 expression and ERK phosphorylation in osteoblasts.

Kiyosaki T, Mitsui N, Suzuki N, Shimizu N

Department of Orthodontics, Nihon University School of Dentistry, Chiyoda-ku, Tokyo, Japan.

OBJECTIVE: This study examined the effects of low-level laser therapy (LLLT) on osteoblasts via insulin-like growth factor I (IGF-I) signal transduction. BACKGROUND: Because orthodontic treatment is usually accompanied by bone formation, if bone formation can be promoted, the treatment and retention periods will be shorter. Recently, we reported the stimulatory effects of LLLT on bone formation. It was dependent on increased IGF-I, which plays an essential role in the anabolic regulation of bone metabolism. However, the signal transduction of IGF-I stimulated by LLLT was not elucidated. MATERIALS AND METHODS: Mouse osteoblastic MC3T3-E1 cells were cultured with or without LLLT (0.96-3.82 J/cm(2)), and the expression of IGF-I and Runt-related transcription factor 2 (Runx2) and the phosphorylation of extracellular-signal-regulated kinase (ERK) were determined by using real-time PCR and Western blot analysis. RESULTS: LLLT at 1.91 J/cm(2) significantly increased the expression of IGF-I and Runx2 and of ERK phosphorylation. Cyclolignan picropodophyllin (PPP; an IGF-I receptor inhibitor) partly inhibited the LLLT-induced expression of these factors. Moreover, when conditioned medium from the LLLT (1.91 J/cm(2)) cells was added to the MC3T3-E1 culture, the calcium content in the mineralized nodules increased significantly. PPP or noggin [a bone morphogenetic protein (BMP) antagonist] partly inhibited the LLLT-induced change in calcium content, and the addition of both PPP and noggin inhibited most of the LLLT-induced change in calcium content. CONCLUSION: These results suggest that LLLT stimulates in vitro mineralization through increased IGF-I and BMP production, through Runx2 expression and ERK phosphorylation in osteoblasts.

Photomed Laser Surg 2010 Aug 28 Suppl 1 S167-72


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Theoretic, experimental, clinical bases of the water oscillator hypothesis in near-infrared photobiomodulation.

Santana-Blank L, Rodriguez-Santana E, Santana-Rodriguez K

Fundalas, Foundation Interdisciplinary for Research and Development, Caracas, Venezuela.

The objective of this review is to propose and document a role for the water oscillator in near-infrared (NIR) photobiomodulation. Greater understanding of the role of the water oscillator may add to a more-coherent description of central effects of NIR light on redox centers and key transmembrane enzymes such as cytochrome c oxidase (CcO). In addition, water provides a complementary pathway for absorption and transportation of NIR energy in photobiomodulation. Because of its unexpected potential, we propose terming it the “water oscillator paradox.” Photobiologic mechanisms involved in the treatment of complex diseases are discussed in light of the present state of the art.

Photomed Laser Surg 2010 Aug 28 Suppl 1 S41-52


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Laser and light-based therapies for acne vulgaris: a current guide based on available data.

Kim GK, Del Rosso JQ

Mohave Skin & Cancer Clinics, Las Vegas, NV, USA.

There are some patients that, despite their continued use of optimized topical and systemic medication and skin care regimens, exhibit at least partial persistence of acne vulgaris (AV) lesions that is bothersome and treatment-resistant to pharmacologic approaches. Additionally, professional, public and governmental concern regarding “antibiotic resistance” has led to interest in therapeutic alternatives other than antibiotics. These challenges drive research into non-pharmacologic approaches to AV treatment, including laser and light-based approaches.

J Drugs Dermatol 2010 Jun 9(6) 614-21


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A portable laser photostimulation and imaging microscope.

Nikolenko V, Peterka DS, Yuste R

Department of Biological Sciences, Howard Hughes Medical Institute, Columbia University, New York, NY 10027, USA.

We describe a compact microscope that uses a spatial light modulator (SLM) to control the excitation laser light. The flexibility of SLMs, which can mimic virtually any optical transfer function, enables the experimenter to create, in software, arbitrary spatio-temporal light patterns, including focusing and beam scanning, simply by calculating the appropriate phase mask. Our prototype, a scan-less device with no moving parts, can be used for laser imaging or photostimulation, supplanting the need for an elaborate optical setup. As a proof of principle, we generate complex excitation patterns on fluorescent samples and also perform functional imaging of neuronal activity in living brain slices.

J Neural Eng 2010 Aug 7(4) 045001


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A systematic review on the effectiveness of physical and rehabilitation interventions for chronic non-specific low back pain.

van Middelkoop M, Rubinstein SM, Kuijpers T, Verhagen AP, Ostelo R, Koes BW, van Tulder MW

Department of General Practice, Erasmus MC, University Medical Center, PO Box 2040, 3000 CA, Rotterdam, The Netherlands.

Low back pain (LBP) is a common and disabling disorder in western society. The management of LBP comprises a range of different intervention strategies including surgery, drug therapy, and non-medical interventions. The objective of the present study is to determine the effectiveness of physical and rehabilitation interventions (i.e. exercise therapy, back school, transcutaneous electrical nerve stimulation (TENS), low level laser therapy, education, massage, behavioural treatment, traction, multidisciplinary treatment, lumbar supports, and heat/cold therapy) for chronic LBP. The primary search was conducted in MEDLINE, EMBASE, CINAHL, CENTRAL, and PEDro up to 22 December 2008. Existing Cochrane reviews for the individual interventions were screened for studies fulfilling the inclusion criteria. The search strategy outlined by the Cochrane Back Review Groups (CBRG) was followed. The following were included for selection criteria: (1) randomized controlled trials, (2) adult (>/=18 years) population with chronic (>/=12 weeks) non-specific LBP, and (3) evaluation of at least one of the main clinically relevant outcome measures (pain, functional status, perceived recovery, or return to work). Two reviewers independently selected studies and extracted data on study characteristics, risk of bias, and outcomes at short, intermediate, and long-term follow-up. The GRADE approach was used to determine the quality of evidence. In total 83 randomized controlled trials met the inclusion criteria: exercise therapy (n = 37), back school (n = 5), TENS (n = 6), low level laser therapy (n = 3), behavioural treatment (n = 21), patient education (n = 1), traction (n = 1), and multidisciplinary treatment (n = 6). Compared to usual care, exercise therapy improved post-treatment pain intensity and disability, and long-term function. Behavioural treatment was found to be effective in reducing pain intensity at short-term follow-up compared to no treatment/waiting list controls. Finally, multidisciplinary treatment was found to reduce pain intensity and disability at short-term follow-up compared to no treatment/waiting list controls. Overall, the level of evidence was low. Evidence from randomized controlled trials demonstrates that there is low quality evidence for the effectiveness of exercise therapy compared to usual care, there is low evidence for the effectiveness of behavioural therapy compared to no treatment and there is moderate evidence for the effectiveness of a multidisciplinary treatment compared to no treatment and other active treatments at reducing pain at short-term in the treatment of chronic low back pain. Based on the heterogeneity of the populations, interventions, and comparison groups, we conclude that there are insufficient data to draw firm conclusion on the clinical effect of back schools, low-level laser therapy, patient education, massage, traction, superficial heat/cold, and lumbar supports for chronic LBP.

Eur Spine J 2010 Jul 18


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Modernization of traditional acupuncture using multimodal computer-based high-tech methods-recent results of blue laser and teleacupuncture from the Medical University of Graz.

Litscher G

Research Unit of Biomedical Engineering in Anesthesia and Intensive Care Medicine and TCM Research Center, Medical University of Graz, Austria.

Basic and clinical research in traditional Chinese and Korean acupuncture has been performed at the Research Unit of Biomedical Engineering in Anesthesia and Intensive Care Medicine and the Traditional Chinese Medicine Research Center at the Medical University of Graz since 1997. This publication focuses on the latest innovative aspects that underline the further enhancement and development of acupuncture. In this context, novel biomedical and neuroscientific methods are of paramount importance for the fast and efficient modernization of the ancient Asian healing method. Traditional and future oriented acupuncture stimulation methods can be divided into manual needle, laser needle (blue, red and infrared laser light) and electrical punctual stimulation at the body, hand and ear. Special emphasis in this research article is given to totally new technical and methodological investigations, e.g. the first data published worldwide in medicine obtained with new blue laser acupuncture equipment. In this regard, critical summary and recent results from peripheral and central measurements during acupuncture stimulation using high-tech bioengineering assessment are given. In addition, we describe the first teleacupuncture performed between Asia and Europe.

J Acupunct Meridian Stud 2009 Sep 2(3) 202-9


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Low-level laser therapy for the treatment of epidermolysis bullosa: a case report.

Minicucci EM, Barraviera SR, Miot H, Almeida-Lopes L

Department of Dermatology and Radiotherapy, Botucatu School of Medicine of Sao Paulo State University – UNESP, Botucatu – SP, Brazil.

Epidermolysis bullosa (EB) is a rare group of diseases characterized by skin fragility. There is no specific treatment, short of protection from trauma, currently available for these patients. Low-level laser therapy (LLLT) was effective as an analgesic and in accelerating cutaneous wound healing after six sessions of therapy in a child with dystrophic EB with cutaneous scarring and blisters on the limbs and trunk.

J Cosmet Laser Ther 2010 Aug 12(4) 203-5


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Phenotype characterization of pericytes during tissue repair following low-level laser therapy.

Medrado A, Costa T, Prado T, Reis S, Andrade Z

Laboratory of Experimental Pathology, Oswaldo Cruz Foundation, Salvador, Brazil.

BACKGROUND/PURPOSE: The action of low-level laser therapy (LLLT) on pericytes during wound healing is not well established. The objective of this study was to identify the effect of laser treatment on pericytes during tissue repair. METHODS: Punch biopsies were performed on 40 Wistar rats. Twenty animals had their wounds treated with a dose of 4 J/cm(2) using a 670 nm diode laser (9 mW output, 0.031 W/cm(2)) every other day, while the controls received sham irradiation. Animals were sacrificed 3, 7, 10 and 14 days after punch biopsy. Immunohistochemistry staining with anti-desmin, anti-smooth muscle alpha-actin and anti-NG2 antibodies was used to characterize and count pericytes around blood vessels and myofibroblasts dispersed in the extracellular matrix (ECM). The morphology of pericytes was confirmed by transmission electronic microscopy. RESULTS: The laser group exhibited significantly more smooth muscle alpha-actin-positive staining cells at day 7 and more desmin-positive staining cells at day 10 around blood vessels. Laser treatment was also associated with higher numbers of NG2-positive staining cells, especially on days 3 and 7 post-biopsy (P<0.05). Ultrastructural findings confirmed the presence of pericytes sharing the basal membrane with endothelial cells. CONCLUSION: LLLT stimulated the proliferation and migration of pericytes to the ECM and their phenotypic modulation to myofibroblasts.

Photodermatol Photoimmunol Photomed 2010 Aug 26(4) 192-7


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Electrotherapy: yesterday, today and tomorrow.

Tiktinsky R, Chen L, Narayan P

National Hemophilia Center, Sheba Medical Center, Tel Hashomer Hospital, Ramat Gan, Israel.

The use of electrotherapy has been part of physical therapy treatment for the past few decades. There have been numerous modalities used such as TENS, interferential, diathermy, magnetic therapy, ultrasound, laser and surface electromyography to name a few. There has been an upsurge in the past decade of new and innovative modalities. There needs to be extensive research on each of these electrotherapy devices to determine the proper use of each device.

Haemophilia 2010 Jul 16 Suppl 5 126-31


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About James Carroll

Founder and CEO at THOR Photomedicine Ltd. About THOR
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