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

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

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The Nuts and Bolts of Low-level Laser (Light) Therapy.

Chung H, Dai T, Sharma SK, Huang YY, Carroll JD, Hamblin MR

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

Soon after the discovery of lasers in the 1960s it was realized that laser therapy had the potential to improve wound healing and reduce pain, inflammation and swelling. In recent years the field sometimes known as photobiomodulation has broadened to include light-emitting diodes and other light sources, and the range of wavelengths used now includes many in the red and near infrared. The term “low level laser therapy” or LLLT has become widely recognized and implies the existence of the biphasic dose response or the Arndt-Schulz curve. This review will cover the mechanisms of action of LLLT at a cellular and at a tissular level and will summarize the various light sources and principles of dosimetry that are employed in clinical practice. The range of diseases, injuries, and conditions that can be benefited by LLLT will be summarized with an emphasis on those that have reported randomized controlled clinical trials. Serious life-threatening diseases such as stroke, heart attack, spinal cord injury, and traumatic brain injury may soon be amenable to LLLT therapy.

Ann Biomed Eng 2011 Nov 2

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=22045511

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A randomised clinical trial of the effect of low-level laser therapy for perineal pain and healing after episiotomy: A pilot study.

Santos JD, Oliveira SM, Nobre MR, Aranha AC, Alvarenga MB

Health Sciences Institute, University Paulista, Rua Apeninos, 267, CEP 01533-000, Sao Paulo, Brazil.
OBJECTIVE: to evaluate the effects of low-level laser therapy for perineal pain and healing after episiotomy. DESIGN: a double-blind, randomised, controlled clinical trial comparing perineal pain scores and episiotomy healing in women treated with low-level laser therapy (LLLT) and with the simulation of the treatment. SETTING: the study was conducted in the Birth Centre and rooming-in units of Amparo Maternal, a maternity service located in the city of Sao Paulo, Brazil. PARTICIPANTS: fifty-two postpartum women who had had mediolateral episiotomies during their first normal delivery were randomly divided into two groups of 26: an experimental group and a control group. INTERVENTION: in the experimental group, the women were treated with LLLT. Irradiation was applied at three points directly on the episiotomy after the suture and in three postpartum sessions: up to 2hrs postpartum, between 20 and 24hrs postpartum and between 40 and 48hrs postpartum. The LLLT was performed with diode laser, with a wavelength of 660nm (red light), spot size of 0.04cm(2), energy density of 3.8J/cm(2), radiant power of 15mW and 10s per point, which resulted in an energy of 0.15J per point and a total energy of 0.45J per session. The control group participants also underwent three treatment sessions, but without the emission of radiation (simulation group), to assess the possible effects of placebo treatment. MAIN OUTCOMES: perineal pain scores, rated on a scale from 0 to 10, were evaluated before and immediately after the irradiation in the three sessions. The healing process was assessed using the REEDA scale (Redness, Edema, Echymosis, Discharge Aproximation) before each laser therapy session and 15 and 20 days after the women’s discharge. FINDINGS: comparing the pain scores before and after the LLLT sessions, the experimental group presented a significant within-group reduction in mean pain scores after the second and third sessions (p=0.003 and p<0.001, respectively), and the control group showed a significant reduction after the first treatment simulation (p=0.043). However, the comparison of the perineal pain scores between the experimental and control groups indicated no statistical difference at any of the evaluated time points. There was no significant difference in perineal healing scores between the groups. All postpartum women approved of the low-level laser therapy. CONCLUSIONS: this pilot study showed that LLLT did not accelerate episiotomy healing. Although there was a reduction in perineal pain mean scores in the experimental group, we cannot conclude that the laser relieved perineal pain. This study led to the suggestion of a new research proposal involving another irradiation protocol to evaluate LLLT’s effect on perineal pain relief.
Midwifery 2011 Oct 5

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=21982202

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Dose response effects of 810 nm laser light on mouse primary cortical neurons.

Sharma SK, Kharkwal GB, Sajo M, Huang YY, De Taboada L, McCarthy T, Hamblin MR

Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, Massachusetts; Department of Dermatology, Harvard Medical School, Boston, Massachusetts.

BACKGROUND AND OBJECTIVES: In the past four decades numerous studies have reported the efficacy of low level light (laser) therapy (LLLT) as a treatment for diverse diseases and injuries. Recent studies have shown that LLLT can biomodulate processes in the central nervous system and has been extensively studied as a stroke treatment. However there is still a lack of knowledge on the effects of LLLT at the cellular level in neurons. The present study aimed to study the effect of 810 nm laser on several cellular processes in primary cortical neurons cultured from embryonic mouse brains. STUDY DESIGN/MATERIALS AND METHODS: Neurons were irradiated with fluences of 0.03, 0.3, 3, 10, or 30 J/cm(2) of 810-nm laser delivered over varying times at 25 mW/cm(2) and intracellular levels of reactive oxygen species (ROS), nitric oxide and calcium were measured using fluorescent probes within 5 minutes of the end of irradiation. The changes in mitochondrial function in response to light were studied in terms of adenosine triphosphate (ATP) and mitochondrial membrane potential (MMP). RESULTS: Light induced a significant increase in calcium, ATP and MMP at lower fluences and a decrease at higher fluences. ROS was significantly induced at low fluences, followed by a decrease and a second larger increase at 30 J/cm(2) . Nitric oxide levels showed a similar pattern of a double peak but values were less significant compared to ROS. CONCLUSIONS: The results suggest that LLLT at lower fluences is capable of inducing mediators of cell signaling processes which in turn may be responsible for the beneficial stimulatory effects of the low level laser. At higher fluences beneficial mediators are reduced and high levels of Janus-type mediators such as ROS and NO (beneficial at low concentrations and harmful at high concentrations) may be responsible for the damaging effects of high-fluence light and the overall biphasic dose response. Lasers Surg. Med. (c) 2011 Wiley-Liss, Inc.

Lasers Surg Med 2011 Sep 43(8) 851-9

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=21956634

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Cytomorphometric and clinical investigation of the gingiva before and after low-level laser therapy of gingivitis in children.

Igic M, Mihailovic D, Kesic L, Milasin J, Apostolovic M, Kostadinovic L, Janjic OT

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

Gingival epithelial cells are the first physical barrier against periodontal pathogenic microorganisms. Bacterial products may penetrate the epithelium and directly disturb its integrity. We investigated the clinical and cytomorphological status of the gingiva in children with gingivitis before and after low-level laser therapy. The study enrolled 130 children divided into three groups: group 1 comprised 50 children with chronic catarrhal gingivitis who received basic treatment, group 2 comprised 50 children with chronic catarrhal gingivitis who received low-level laser treatment in addition to basic treatment, and group 3 comprised 30 children with healthy gingiva as controls. Oral hygiene and the status of the gingiva were assessed using the appropriate indexes before and after treatment. Inflammation of the gingiva was monitored by cytomorphometric evaluation. Cytomorphometric analysis revealed a statistically significant difference (p < 0.001) in the size of the nuclei of the stratified squamous epithelial cells of the gingiva before and after treatment in chronic catarrhal gingivitis. Evaluation using clinical parameters showed that treatment of gingivitis with basic treatment was successful. Cytomorphometric analysis showed that after basic treatment the nuclei of the stratified squamous epithelial cells of the gingiva were reduced in size, although not to the size found in healthy gingiva. However, after adjuvant low-level laser therapy, the size of the nuclei of the stratified squamous epithelial cells in the gingiva matched the size of the nuclei in the cells in healthy gingiva.

Lasers Med Sci 2011 Sep 29

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=21956278

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[Low power laser efficacy in the therapy of inflamed gingive in diabetics with parodontopathy].

Obradovic R, Kesic L, Jovanovic G, Petrovic D, Goran R, Mihailovic D

Medicinski fakultet, Klinika za stomatologiju, Odeljenje za oralnu medicinu i parodontologiju, Nis, Srbija. dr.rada@yahoo.com

BACKGROUND/AIM: There is clear evidence on direct relationship between periodontal disease and diabetes mellitus. Many investigations point out greater prevalence and severity of periodontal disease among diabetic patients. During last decade, low level laser therapy has been used in periodontal therapy. It has biostimulative effect, accelerates wound healing, minimizes pain and swelling, and there is almost no contraindication for its usage. The aim of the paper was to investigate the efficiency of low level laser therapy as adjuvant tool in reduction of gingival inflammation in diabetic patients. METHODS: The study incuded 150 participants divided into three groups: group I (50 participants with diabetes mellitus type 1 and periodontal disease), group II (50 participants with diabetes mellitus type 2 and periodontal disease), group III (nondiabetic participants with periodontal disease). Gingival health evaluation was done using gingival index Loe-Silness. Soft and hard deposits were removed, periodontal pockets cleaned and GaA1As low level laser therapy (5 mW) applied five consecutive days. In each patient, low level laser therapy was not applied on the left side of the jaw in order to compare the effects of the applied therapy. After the first, third and fifth therapy and one month after the last visit gingival index was evaluated. Before the first and after the fifth therapy exfoliative cytology of gingiva was done and nuclei areal was analyzed morphometrically. RESULTS: After all investigated periods, gingival index and nuclei areal were significantly decreased comparing to values before the therapy, at both jaw sides (p < 0.001). After the 1st, 3rd and 5th therapy, the t-test showed a significantly decreased gingival index at the lased side of jaw comparing to non-lased side. CONCLUSION: Low level laser therapy is efficient in gingival inflammation elimination and can be proposed as an adjuvant tool in basic periodontal therapy of diabetic patients.

Vojnosanit Pregl 2011 Aug 68(8) 684-9

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=21991792

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Comparison of Therapeutic Effects between Pulsed and Continuous Wave 810-nm Wavelength Laser Irradiation for Traumatic Brain Injury in Mice.

Ando T, Xuan W, Xu T, Dai T, Sharma SK, Kharkwal GB, Huang YY, Wu Q, Whalen MJ, Sato S, Obara M, Hamblin MR

Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, Massachusetts, United States of America.

BACKGROUND AND OBJECTIVE: Transcranial low-level laser therapy (LLLT) using near-infrared light can efficiently penetrate through the scalp and skull and could allow non-invasive treatment for traumatic brain injury (TBI). In the present study, we compared the therapeutic effect using 810-nm wavelength laser light in continuous and pulsed wave modes in a mouse model of TBI. STUDY DESIGN/MATERIALS AND METHODS: TBI was induced by a controlled cortical-impact device and 4-hours post-TBI 1-group received a sham treatment and 3-groups received a single exposure to transcranial LLLT, either continuous wave or pulsed at 10-Hz or 100-Hz with a 50% duty cycle. An 810-nm Ga-Al-As diode laser delivered a spot with diameter of 1-cm onto the injured head with a power density of 50-mW/cm(2) for 12-minutes giving a fluence of 36-J/cm(2). Neurological severity score (NSS) and body weight were measured up to 4 weeks. Mice were sacrificed at 2, 15 and 28 days post-TBI and the lesion size was histologically analyzed. The quantity of ATP production in the brain tissue was determined immediately after laser irradiation. We examined the role of LLLT on the psychological state of the mice at 1 day and 4 weeks after TBI using tail suspension test and forced swim test. RESULTS: The 810-nm laser pulsed at 10-Hz was the most effective judged by improvement in NSS and body weight although the other laser regimens were also effective. The brain lesion volume of mice treated with 10-Hz pulsed-laser irradiation was significantly lower than control group at 15-days and 4-weeks post-TBI. Moreover, we found an antidepressant effect of LLLT at 4-weeks as shown by forced swim and tail suspension tests. CONCLUSION: The therapeutic effect of LLLT for TBI with an 810-nm laser was more effective at 10-Hz pulse frequency than at CW and 100-Hz. This finding may provide a new insight into biological mechanisms of LLLT.

PLoS One 2011 6(10) e26212

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=22028832

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Effect of laser phototherapy on wound healing following cerebral ischemia by cryogenic injury.

Moreira MS, Velasco IT, Ferreira LS, Ariga SK, Abatepaulo F, Grinberg LT, Marques MM

School of Dentistry, Universidade de Sao Paulo, Sao Paulo 05508-000, Brazil; LIM-51, School of Medicine, Universidade de Sao Paulo, Sao Paulo, Brazil; Postgraduate Program in Biodentistry, Ibirapuera University (UNIB), Sao Paulo, SP, Brazil.

Laser phototherapy emerges as an alternative or auxiliary therapy for acute ischemic stroke, traumatic brain injury, degenerative brain disease, spinal cord injury, and peripheral nerve regeneration, but its effects are still controversial. We have previously found that laser phototherapy immunomodulates the response to focal brain damage. Following direct cortical cryogenic injury the effects of laser phototherapy on inflammation and repair was assessed after cryogenic injury (CI) to the central nervous system (CNS) of rats. The laser phototherapy was carried out with a 780nm AlGaAs diode laser. The irradiation parameters were: power of 40mW, beam area of 0.04cm(2), energy density of 3J/cm(2) (3s) in two points (0.12J per point). Two irradiations were performed at 3h-intervals, in contact mode. Rats (20 non-irradiated – controls and 20 irradiated) were used. The wound healing in the CNS was followed in 6h, 1, 7 and 14days after the last irradiation. The size of the lesions, the neuron cell viability percentages and the amount of positive GFAP labeling were statistically compared by ANOVA complemented by Tukey’s test (p<0.05). The distribution of lymphocytes, leukocytes and macrophages were also analyzed. CI created focal lesions in the cortex represented by necrosis, edema, hemorrhage and inflammatory infiltrate. The most striking findings were: lased lesions showed smaller tissue loss than control lesions in 6h. During the first 24h the amount of viable neurons was significantly higher in the lased group. There was a remarkable increase in the amount of GFAP in the control group by 14days. Moreover, the lesions of irradiated animals had fewer leukocytes and lymphocytes in the first 24h than controls. Considering the experimental conditions of this study it was concluded that laser phototherapy exerts its effect in wound healing following CI by controlling the brain damage, preventing neuron death and severe astrogliosis that could indicate the possibility of a better clinical outcome.

J Photochem Photobiol B 2011 Oct 4

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=22024356

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Effect of 810 nm light on nerve regeneration after autograft repair of severely injured rat median nerve.

Moges H, Wu X, McCoy J, Vasconcelos OM, Bryant H, Grunberg NE, Anders JJ

Department of Anatomy, Physiology and Genetics, Uniformed Services University of the Health Sciences, Bethesda, Maryland 20814.

BACKGROUND AND OBJECTIVE: Destruction of large segments of peripheral nerves results in chronic loss of sensation and paralysis. For this type of severe injury, the defect can be bridged by nerve grafts. However, even with state-of-the-art microsurgical techniques, there is minimal recovery of sensation and motor function. Light therapy (LT) has been shown to improve functional outcome after surgical intervention to repair injured nerves using different techniques. Our objective was to investigate the effect of LT on peripheral nerve regeneration and function after severe median nerve injury and microsurgical autologous nerve graft repair using fibrin glue. STUDY DESIGN/MATERIALS AND METHODS: Adult female Sprague Dawley rats were used for this study. A 6-7 mm segment of the median nerve was excised and sural nerve segments from the same animal were used to bridge the gap using fibrin-based sealant. There were three experimental groups: control, autograft (AG), and autograft + LT (AG + LT). The AG + LT group received LT at the surgery site for 14 consecutive days using an 810 nm wavelength diode laser. Functional recovery was assessed bi-weekly by the grip strength test. Compound muscle action potential (CMAP) measurements were taken pre-injury and at 16 weeks post-surgery. Optical density measurement of S-100 immunoreactivity was done on the transplanted segment of the nerve. RESULTS: The AG + LT group had faster functional recovery of grip strength (P < 0.05), shorter CMAP latency (P < 0.05), and higher S-100 immunoreactivity (P = 0.0213) when compared to the AG group. However, at 15 weeks, grip strength in both the AG and AG + LT groups, while significantly improved, were still below control levels. CONCLUSION: These results suggest that LT can accelerate functional recovery and improve the quality of nerve regeneration after autograft repair of severely injured peripheral nerves. Lasers Surg. Med. 43:901-906, 2011. (c) 2011 Wiley Periodicals, Inc.

Lasers Surg Med 2011 Nov 43(9) 901-6

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=22006732

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Laser photobiostimulation of wound healing: Reciprocity of irradiance and exposure time on energy density for splinted wounds in diabetic mice.

Peplow PV, Chung TY, Ryan B, Baxter GD

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

BACKGROUND AND OBJECTIVES: We have used a 660 nm laser diode in genetic diabetic mice to stimulate the healing of wounds covered with a Tegaderm HP dressing that causes a retardation of contraction (splinted wounds). The influence of irradiance (power density) on wound healing has been examined with the same energy dose delivered to the wounds. This energy dose caused maximal stimulation of healing in a previous study. MATERIALS AND METHODS: A circular excisional wound was made on the left flank of diabetic mice using a 5-mm skin punch, and covered with a Tegaderm HP dressing. Four different treatments were tested: Treatment 1, not irradiated (control); treatment 2, 100 mW, 20 seconds; treatment 3, 50 mW, 40 seconds; treatment 4, 25 mW, 80 seconds. Treatments were given daily for 7 days. The irradiances for treatments 2, 3, and 4 were estimated to be 233-313, 116-156, and 58-78 mW/cm(2) , respectively. In total, 53 mice were used. Wounds were harvested on day 14 and healing assessed from hematoxylin-eosin stained sections examined by light microscopy. RESULTS: The wounds were splinted in 42 of the mice, and splinting caused a retardation of healing. The findings showed that wound healing was stimulated to a similar extent by treatments 2, 3, and 4 and occurred mainly by reepithelization and granulation tissue formation. The laser parameters used represent an energy dose of 2.0 J per irradiation and, for an estimated area of irradiation of 32-43 mm(2) , corresponds to an energy density of 4.7-6.3 J/cm(2) . CONCLUSION: Irradiation 660 nm with irradiances estimated to be 233-313, 116-156, and 58-78 mW/cm(2) and an estimated energy density of 4.7-6.3 J/cm(2) each day for 7 days stimulated healing to a similar extent in splinted wounds of diabetic mice. Lasers Surg. Med. (c) 2011 Wiley-Liss, Inc.

Lasers Surg Med 2011 Sep 43(8) 843-50

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=21956633

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[The influence of pulsed infrared laser radiation on the hormone production in the thymus (an experimental study)].

Local irradiation with pulsed (1500 Hz) low-energy infrared laser light of the thymus and thyroid gland region caused well-apparent stimulation of alpha-1-thymosin production in the healthy animals and normalized its level in the stressed ones. Similar stimulation of alpha-1-timosine biosynthesis was observed in an experiment with direct laser irradiation of the cultured HTSC epitheliocytes from the human thymus.

Vopr Kurortol Fizioter Lech Fiz Kult 2011 Jul-Aug (4) 39-42

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=21988030

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Laser Florence 2011. Abstracts of the 25th International Congress Laser Medicine & IALMS Courses, jointly with the Congress of the International Phototherapy Association. November 4-5, 2011. Florence, Italy.

Lasers Med Sci 2011 Nov 26 Suppl 1 S16-43

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=21964622

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Effects of low-level laser irradiation on mesenchymal stem cell proliferation: a microarray analysis.

Wu YH, Wang J, Gong DX, Gu HY, Hu SS, Zhang H

Department of Surgery, Cardiovascular Institute & Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, 167 Beilishi Road, Beijing, 100037, China.

Increased proliferation after low-level laser irradiation (LLLI) has been well demonstrated in many cell types including mesenchymal stem cells (MSCs), but the exact molecular mechanisms involved remain poorly understood. The aim of this study was to investigate the change in mRNA expression in rat MSCs after LLLI and to reveal the associated molecular mechanisms. MSCs were exposed to a diode laser (635 nm) as the irradiated group. Cells undergoing the same procedure without LLLI served as the control group. Proliferation was evaluated using the MTS assay. Differences in the gene expression profiles between irradiated and control MSCs at 4 days after LLLI were analyzed using a cDNA microarray. Gene ontology and pathway analysis were used to find the key regulating genes followed by real-time PCR to validate seven representative genes from the microarray assays. This procedure identified 119 differentially expressed genes. Real-time PCR confirmed that the expression levels of v-akt murine thymoma viral oncogene homolog 1 (Akt1), the cyclin D1 gene (Ccnd1) and the phosphatidylinositol 3-kinase, catalytic alpha polypeptide gene (Pik3ca) were upregulated after LLLI, whereas those of protein tyrosine phosphatase non-receptor type 6 (Ptpn6) and serine/threonine kinase 17b (Stk17b) were downregulated. cDNA microarray analysis revealed that after LLLI the expression levels of various genes involved in cell proliferation, apoptosis and the cell cycle were affected. Five genes, including Akt1, Ptpn6, Stk17b, Ccnd1 and Pik3ca, were confirmed and the PI3K/Akt/mTOR/eIF4E pathway was identified as possibly playing an important role in mediating the effects of LLLI on the proliferation of MSCs.

Lasers Med Sci 2011 Sep 29

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=21956279

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Violet laser acupuncture-part 3: pilot study of potential effects on temperature distribution.

Litscher G, Wang L, Huang T, Zhang W

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

Infrared thermography for temperature distribution monitoring was performed in ten healthy volunteers (M/F, 5/5; mean age+/-SD, 24.9+/-3.3 years) before, during, and after stimulation by noninvasive violet (405nm) laser needle at the Dazhui (GV14) acupoint. Significant (p<0.001) increases of temperature at a region of interest around the acupoint were observed. Furthermore, temperature also increased significantly (p<0.05) at a so-called “far field” area Zhiyang (GV9). In two persons, however, needle acupuncture and placebo (deactivated laser) did not have the same temperature effects. Violet laser induces changes in skin surface temperature distributions.

J Acupunct Meridian Stud 2011 Sep 4(3) 164-7

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=21981866

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Violet laser acupuncture-part 4: acute effects on human arterial stiffness and wave reflection.

Litscher G, Wang L, Gaischek I, Gao XY

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

We investigated the effects of violet laser acupuncture on arterial stiffness and other important parameters of the functional state of the heart such as augmentation index (AIx). This investigation ties together the medical perspectives of Eastern and Western medical practitioners; the Western medical perspective of the functional states of the human heart including systolic and diastolic blood pressures, and the Eastern medical perspective regarding taking patients’ pulses for diagnosis and using acupuncture for subsequent treatments. Pulse wave velocity (PWV) is a direct marker of arterial stiffness; AIx indicates wave reflection. Both parameters can be measured by cuff applied to the brachial artery. The first results from a pilot study of 10 healthy volunteers (M/F, 3/7; mean age+/-SD, 27.8+/-6.8 years) regarding violet laser acupuncture (405nm; 110mW; 500mum; 10min) showed a marked but not statistically significant decrease in aortic PWV and an increase in brachial AIx during and after laser acupuncture at the acupoint Baihui. Further studies including control measurements are necessary.

J Acupunct Meridian Stud 2011 Sep 4(3) 168-74

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=21981867

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Laser therapy for dentine hypersensitivity.

Cunha-Cruz J

Dental Public Health Sciences, University of Washington, Seattle, Washington, USA.

Data sourcesMedline, Embase, the Cochrane Central database as well as the Cochrane Oral Health Group’s Trials Register and the National Research Register. In addition relevant journals were hand searched from 2000 to 2010 (Lasers in Medical Sciences, Lasers in Surgery and Medicine, Photomedicine and Laser Surgery, Photodiagnosis and Photodynamic Therapy, Journal of Oral Rehabilitation, Journal of Periodontology, Journal of Clinical Periodontology, Journal of Endodontics, Clinical Oral Investigations, Journal of Dental Research, Journal of Oral Laser Applications, Journal of Periodontal Research and Periodontology 2000) together with the reference lists of relevant trials.Study selectionRandomised controlled trials (RCT) that included patients with two or more hypersensitive teeth confirmed by evaporative stimulus or tactile hypersensitivity assessment, comparing laser therapy versus other topical desensitising agents, such as fluoride varnish, dentine bonding agents etc, that were published in English.Data extraction and synthesisStudies were assessed for quality by two reviewers independently and data were extracted using a standardised form. Because of heterogeneity of the studies meta-analysis was not performed, so a qualitative synthesis is presented.ResultsEight trials (234 participants) met the inclusion criteria. Half of the included studies compared GaALAS laser with topical desensitising agents, but the findings were conflicting. The remaining studies involved Nd:YAG laser, Er:YAG laser and CO2 laser, and all showed that the three types of lasers were superior to topical desensitising agents, but the superiority was slight.ConclusionsThe review suggests that laser therapy has a slight clinical advantage over topical medicaments in the treatment of dentine hypersensitivity. However more large sample-sized, long-term, high-quality randomised controlled clinical trials are needed before definitive conclusions can be made.

Evid Based Dent 2011 12(3) 74-5

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=21979766

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670 nm Laser Light and EGCG Complementarily Reduce Amyloid-beta Aggregates in Human Neuroblastoma Cells: Basis for Treatment of Alzheimer’s Disease?

Sommer AP, Bieschke J, Friedrich RP, Zhu D, Wanker EE, Fecht HJ, Mereles D, Hunstein W

1 Institute of Micro and Nanomaterials, Nanobionic Laboratory, University of Ulm , Ulm, Germany .

Abstract Objective: The aim of the present study is to present the results of in vitro experiments with possible relevance in the treatment of Alzheimer’s disease (AD). Background Data: Despite intensive research efforts, there is no treatment for AD. One root cause of AD is the extra- and intracellular deposition of amyloid-beta (Abeta) fibrils in the brain. Recently, it was shown that extracellular Abeta can enter brain cells, resulting in neurotoxicity. Methods: After internalization of Abeta(42) into human neuroblastoma (SH-EP) cells, they were irradiated with moderately intense 670-nm laser light (1000 Wm(-2)) and/or treated with epigallocatechin gallate (EGCG). Results: In irradiated cells, Abeta(42) aggregate amounts were significantly lower than in nonirradiated cells. Likewise, in EGCG-treated cells, Abeta(42) aggregate amounts were significantly lower than in non-EGCG-treated cells. Except for the cells simultaneously laden with Abeta(42) and EGCG, there was a significant increase in cell numbers in response to laser irradiation. EGCG alone had no effect on cell proliferation. Laser irradiation significantly increased ATP levels in Abeta(42)-free cells, when compared to nonirradiated cells. Laser-induced clearance of Abeta(42) aggregates occurred at the expense of cellular ATP. Conclusions: Irradiation with moderate levels of 670-nm light and EGCG supplementation complementarily reduces Abeta aggregates in SH-EP cells. Transcranial penetration of moderate levels of red to near-infrared (NIR) light has already been amply exploited in the treatment of patients with acute stroke; the blood-brain barrier (BBB) penetration of EGCG has been demonstrated in animals. We hope that our approach will inspire a practical therapy for AD.

Photomed Laser Surg 2011 Oct 26

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=22029866

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Effects of LED phototherapy on bone defects grafted with MTA, bone morphogenetic proteins and guided bone regeneration: a Raman spectroscopic study.

Pinheiro AL, Soares LG, Cangussu MC, Santos NR, Barbosa AF, Junior LS

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

We studied peaks of calcium hydroxyapatite (CHA) and protein and lipid CH groups in defects grafted with mineral trioxide aggregate (MTA) treated or not with LED irradiation, bone morphogenetic proteins and guided bone regeneration. A total of 90 rats were divided into ten groups each of which was subdivided into three subgroups (evaluated at 15, 21 and 30 days after surgery). Defects were irradiated with LED light (wavelength 850 +/- 10 nm) at 48-h intervals for 15 days. Raman readings were taken at the surface of the defects. There were no statistically significant differences in the CHA peaks among the nonirradiated defects at any of the experimental time-points. On the other hand, there were significant differences between the defects filled with blood clot and the irradiated defects at all time-points (p < 0.001, p = 0.02, p < 0.001). There were significant differences between the mean peak CHA in nonirradiated defects at all the experimental time-points (p < 0.01). The mean peak of the defects filled with blood clot was significantly different from that of the defects filled with MTA (p < 0.001). There were significant differences between the defects filled with blood clot and the irradiated defects (p < 0.001). The results of this study using Raman spectral analysis indicate that infrared LED light irradiation improves the deposition of CHA in healing bone grafted or not with MTA.

Lasers Med Sci 2011 Oct 21

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=22016039

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The effect of noncoherent red light irradiation on proliferation and osteogenic differentiation of bone marrow mesenchymal stem cells.

Peng F, Wu H, Zheng Y, Xu X, Yu J

Department of Orthopedics, Renmin Hospital of Wuhan University, Wuhan, 430060, China.

Mesenchymal stem cells (MSCs) are promising for use in regenerative medicine. Low-level light irradiation (LLLI) has been shown to modulate various processes in different biological systems. The aim of our study was to investigate the effect of red light emitted from a light-emitting diode (LED) on bone marrow MSCs with or without osteogenic supplements. MSCs both with and without osteogenic supplements were divided into four groups, and each group was irradiated at doses of 0, 1, 2 and 4 J/cm(2). Cellular proliferation was evaluated using WST-8 and 5-ethynyl-2′-deoxyuridine (EdU) fluorescence staining. The alkaline phosphatase activity, mineralization, and expression of osteoblast master genes (Col1alpha1, Alpl, Bglap and Runx2) were monitored as indicators of MSC differentiation towards osteoblasts. In groups without osteogenic supplements, red light at all doses significantly stimulated cellular proliferation, whereas the osteogenic phenotype of the MSCs was not enhanced. In groups with osteogenic supplements, red light increased alkaline phosphatase activity and mineralized nodule formation, and stimulated the expression of Bglap and Runx2, but decreased cellular proliferation. In conclusion, nonconherent red light can promote proliferation but cannot induce osteogenic differentiation of MSCs in normal media, while it enhances osteogenic differentiation and decreases proliferation of MSCs in media with osteogenic supplements.

Lasers Med Sci 2011 Oct 21

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=22016038

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Low-level laser therapy improves repair following complete resection of the sciatic nerve in rats.

Medalha CC, Di Gangi GC, Barbosa CB, Fernandes M, Aguiar O, Faloppa F, Leite VM, Renno AC

Department of Bioscience, Federal University of Sao Paulo (UNIFESP), Avenida Ana Costa 95, CEP 04021-001, Santos, SP, Brazil, cmedalha@unifesp.br.

The aim of this study is to analyze the effects of low-level laser therapy (LLLT) on the regeneration of the sciatic nerve in rats following a complete nerve resection. Male Wistar rats were divided into a control injury group, injury groups irradiated with a 660-nm laser at 10 or 50 J/cm(2), and injury groups irradiated with an 808-nm laser at 10 or 50 J/cm(2). Treatment began 24 h following nerve resection and continued for 15 days. Using the sciatic functional index (SFI), we show that the injured animals treated with 660 nm at 10 and 50 J/cm(2) had better SFI values compared with the control injury and the 808-nm groups. Animals irradiated with the 808-nm laser at 50 J/cm(2) show higher values for fiber density than do control animals. In addition, axon and fiber diameters were larger in animals irradiated with 660 nm at 50 J/cm(2) compared to the control group. These findings indicate that 660-nm LLLT is able to provide functional gait recovery and leads to increases in fiber diameter following sciatic nerve resection.

Lasers Med Sci 2011 Oct 19

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=22009383

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Low-level diode laser therapy reduces lipopolysaccharide (LPS)-induced bone cell inflammation.

Huang TH, Lu YC, Kao CT

Graduate School of Dentistry, Chung Shan Medical University Hospital, Chung Shan Medical University, 110, section 1, Chien Kuo N Road, Taichung City, 40201, Taiwan.

In this study, the aim is to investigate the cytologic effects of inflammatory bone cells after in vitro low-level laser therapy (LLLT). A human osteosarcoma cell line (MG63) was cultured, infected with lipopolysaccharide (LPS) and exposed to low-level laser treatment at 5 or 10 J/cm(2) using a 920 nm diode laser. MG63 cell attachment was observed under a microscope, and cell viability was quantified by mitochondrial colorimetric assay (MTT). LPS-treated MG63 cells were irradiated with LLLT, and the inflammatory markers iNOS, TNF-alpha and IL-1, were analyzed by reverse transcription polymerase chain reaction (RT-PCR) and Western blot. The data were collected and analyzed by one-way analysis of variance (ANOVA); p < 0.05 indicated a statistically significant difference. Low-level laser treatment on MG63 cells increased their ability to attach and survive. After irradiation, the expression levels of iNOS, TNF-alpha and IL-1 in LPS-infected MG63 cells decreased over time (p < 0.05). Conclusions: low-level diode laser treatment increased the MG63 cell proliferative ability and decreased the expression of inflammatory mediators in MG63 cells.

Lasers Med Sci 2011 Oct 16

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=22002329

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Complications in comparing lasers and LED. Comment on Esper MA, Nicolau RA, Arisawa EA (2011) The effect of two phototherapy protocols on pain control in orthodontic procedure – a preliminary clinical study. Lasers Med Sci 26:657-663.

Tuner J, Jenkins P

Private dental clinic, Spjutvagen 11, 772 32, Grangesberg, Sweden, jan.tuner@swipnet.se.

Lasers Med Sci 2011 Oct 14

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=21997801

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[The comparative assessment of the wound-healing effects of the treatment with the use of Bioptron, Minitag, Orion+ apparatuses and hollow cathode lamps (experimental study)].

The objective of the present experimental study was the comparative assessment of the wound-healing effects of radiation emitted from Bioptron, Minitag, Orion+ apparatuses and hollow cathode lamps (HCL). The emitters of any type were shown to be equally efficacious in that they accelerated wound epithelization by 30% on the average compared with control. Based on the difference between spectral and power characteristics of different sources of radiation and dynamics of their wound-healing efficacy (including that of two types of HCL), the authors arrived at the conclusion that the further development of the proposed approach to wound healing is a promising line of research in the field of spectral phototherapy.

Vopr Kurortol Fizioter Lech Fiz Kult 2011 Jul-Aug (4) 42-5

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=21988031

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[The use of ozone and low-intensive laser irradiation in complex treatment of complicated duodenal ulcer].

The study is based on the examination of 12 patients with perforative duodenal ulcer and 24 patients operated on recurrent bleeding duodenal ulcer. Some component of the immune system, such as T- and B-lymphocytes rates, immunoglobulin rate and macrophagal activity, were decreased prior the beginning of the complex treatment. Normalisation of humoral and cell immunity was registered on 10-12 days after the beginning of the ozone and low-intensive laser irradiation.

Khirurgiia (Mosk) 2011 (7) 53-5

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=21983535

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Effect of incoherent LED radiation on third-degree burning wounds in rats.

Fiorio F, Silveira L, Munin E, De Lima CJ, Fernandes KP, Mesquita-Ferrari RA, de Carvalho PT, Lopes-Martins R, Aimbire F, Albertini R

Abstract The main physiological characteristics in a burn process are the increase of the capillary permeability and the occurrence of edema and exudation. Light-emitting diode (LED) has been proposed as treatment of burning. This study investigated the effects of LED on the repair process of rat skin submitted to a third-degree burning. The lesions were produced on the dorsal surface of male Wistar rats. Animals were divided into 4 groups (n=6) as follows: L1 and L2 groups as LED-treated burned rats, and received LED therapy along 7 and 15 days with 48 h intervals, respectively; C1 and C2 groups as control, non-treated burned rats. A red LED (640 nm – 30 mW) operating with a fluence of 4 J/cm(2) was used. The wound area was measured daily after irradiation. Animals were euthanized at the 8(th) and 16th days after burning, and the wound fragment was submitted to histology. The inflammatory cells as well as the damaged area at the 8th day after burns were significantly lower for the LED-treated group when compared to control. Furthermore, the LED phototherapy effect on cellular migration was even more pronounced at the 16th day. Our results indicated that the treatment with a LED system was clearly effective in reducing the number of inflammatory cells and improving the healing process in an experimental model of third-degree burnings.

J Cosmet Laser Ther 2011 Oct 7

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=21981305

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The Plasma Membrane is Involved in the Visible Light-Tissue Interaction.

Lavi R, Ankri R, Sinyakov M, Eichler M, Friedmann H, Shainberg A, Breitbart H, Lubart R

1 Department of Chemistry, Bar-Ilan University , Ramat-Gan, Israel .

Abstract Objective: The aim of the present study was to determine whether the plasma membrane is also involved in the light-tissue interaction because of the nicotinamide adenine dinucleotide phosphate (NADPH) oxidase electron chain, which can serve as a photosensitizer. Background data: It has been suggested that the mechanism of photobiostimulation involves light-induced low levels of reactive oxygen species (ROS) that serve as signal transduction messengers. Production of ROS following visible-light irradiation was verified by the electron paramagnetic resonance (EPR) spin-trapping technique, and the mitochondrial cytochromes were suggested as the main cellular target for visible-light absorption. Methods: Isolated sperm membranes were illuminated with visible light and the increase in oxygen radical production was measured using the EPR spin-trapping technique coupled with the probe 5,5-dimethyl-1-pyrroline-N-oxide (DMPO). A broadband visible light source (400-800 nm) at 40-130 mW/cm(2) with appropriate filters provided the illumination. In order to determine whether the light-induced ROS production is a result of a photo-accelerated electron transfer in the enzyme-catalyzed reaction with oxygen in the plasma membrane, or resulted from a photochemical reaction of the chromophores alone with oxygen, denatured membranes were irradiated as well. Results: Visible-light-induced oxyradicals were detected in isolated sperm membranes. Blue light was found to be more effective than red. Illuminated denatured membranes produced the same amount of ROS as non-denatured membranes. Conclusions: Visible-light illumination, especially in the blue region, increases ROS levels in isolated plasma membranes. The mechanism of ROS formation is probably a photochemical reaction of the membranal chromophhores, for example, cytochromes or flavins with oxygen, and not an enzyme-catalyzed photochemical reaction.

Photomed Laser Surg 2011 Oct 3

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=21967485

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Enhancement of cutaneous immune response to bacterial infection after low-level light therapy with 1072nm infrared light: A preliminary study.

Celine Lee SY, Seong IW, Kim JS, Cheon KA, Gu SH, Kim HH, Park KH

Department of Microbiology, Korea University Medical School, 126-1, 5-Ga, Anam-Dong, Seongbuk-Gu, Seoul 136-705, South Korea; Hayan-nara Dermatology Group, 142-3, Sankok-dong, Bupyeong-ku, Incheon, South Korea.

We investigated the photobiomodulation effects of 1072nm infrared light on the natural immune response involved in anti-bacterial and wound healing processes. Thirty mice infected with MRSA on the skin were divided into two groups. The experimental group was treated with 1072nm infrared light (irradiance: 20mW/cm(2), fluence: 12J/cm(2) for 10min) at 2, 4, 8, 12, 24h, 3 and 5days after inoculation and the control group with sham light. Serial changes of the mRNA levels of TLR2, IL-1beta, TNF-alpha, IL-6, iNOS, MCP-1, TGF-beta, bFGF and VEGF were studied by real time RT-PCR and those of the expression level of VEGF, bFGF, TGF-beta and NF-kappaB by immunohistochemistry. The mRNA levels of the cytokines involved in the early phase of anti-bacterial immune response (IL-1beta, TNF-alpha, IL-6, MCP-1) increased significantly in the 1072nm group, peaking between 12 and 24h post-inoculation. These levels normalized after 3-5days. Immunohistochemistry revealed a notably stronger expression of VEGF in the 1072nm group from 8-h post-inoculation to 5-day post-inoculation. We concluded that 1072nm infrared light had a photobiomodulation effect which resulted in an enhanced biological immune response to the bacterial infection by MRSA and also increased the expression of VEGF to a significant level.

J Photochem Photobiol B 2011 Sep 6

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=21955546

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Low-level laser irradiation, cyclooxygenase-2 (COX-2) expression and necrosis of random skin flaps in rats.

Esteves Junior I, Masson IB, Oshima CT, Paiotti AP, Liebano RE, Plapler H

Department of Surgery, Division of Operative Technique and Experimental Surgery, Federal University of Sao Paulo – UNIFESP, Sao Paulo, SP, Brazil.

Skin flaps are still a matter of concern among surgeons, as failures can occur leading to flap necrosis. However, low-level laser irradiation has been reported as an effective tool to improve the viability of ischemic flaps, yet its mechanisms of action remain unclear. We investigated the effect of low-level laser irradiation on the viability of random skin flaps in rats and determined COX-2 expression in the flap pedicle. The study animals comprised 24 EPM-1 Wistar rats which were randomly allocated into three equal groups. A cranially based dorsal random skin flap measuring 10 x 4 cm was created in all the animals. In one group, laser irradiation was simulated (sham group), and in the other two groups the animals were irradiated at 12 points with 0.29 J at 20 mW (energy density 10.36 J/cm(2), irradiance 0.71 W/cm(2)), or with 7.3 J at 100 mW (energy density 260.7 J/cm(2), irradiance 3.57 W/cm(2)). These procedures were applied to the cranial half of the flap immediately after surgery and were repeated on days 2 and 5 after surgery. The percentage necrotic area was determined on day 7 after surgery by the paper template method. The immunohistochemical expression of COX-2 in the samples was given scores from 0 to 3. The necrotic area was smaller in group irradiated at 7.3 J compared to sham-treated group and to the group irradiated at 0.29 J (P < 0.05); there was no difference between the sham-treated group and group irradiated at 0.29 J. COX-2 expression was lower in the group irradiated at 7.3 J than in the sham-treated group and the group irradiated at 0.29 J (P < 0.001). Low-level laser therapy was effective in decreasing random skin flap necrosis in rats using a laser energy of 7.30 J per point. Laser irradiation also decreased the expression of COX-2 in the flap pedicle.Lasers Med Sci 2011 Oct 21

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=22016040

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Manual labor metacarpophalangeal arthropathy in a truck driver: a case report.

Emary PCOBJECTIVE: The purpose of this study is to present an unusual and rarely described case of occupational hand arthropathy involving the metacarpophalangeal (MCP) joints. CLINICAL FEATURES: A 62-year-old male truck driver (of 35 years) presented to a chiropractic clinic with pain and stiffness along the third metacarpal and MCP joint of the left hand. Examination revealed severe pain and limited flexion at the third MCP joint. Bilateral radiographs demonstrated severe osteoarthritis (OA) of this joint in the left (nondominant) hand and mild-to-moderate (asymptomatic) OA in the same joint on the right. Results of laboratory blood tests were unremarkable for metabolic, inflammatory, or infectious joint disease. INTERVENTION AND OUTCOME: The patient was diagnosed with bilateral, third MCP joint OA associated with manual labor. He was treated unsuccessfully with a short course of low-level laser therapy, MCP joint mobilization, and hand-stretching exercises. After 3(1/2) years, the patient continues to work despite ongoing and worsening symptoms. Three serial left hand radiographs are presented, highlighting the progressive nature of this arthropathy. CONCLUSION: The differential diagnosis in patients presenting with manual labor MCP joint OA should include hemochromatosis and calcium pyrophosphate dihydrate crystal deposition disease. Because of the increased risk of serious systemic disease, it is imperative that these latter 2 disorders are ruled out before the former is diagnosed.

J Chiropr Med 2010 Dec 9(4) 193-9

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=22027112

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About James Carroll

Founder and CEO at THOR Photomedicine Ltd. About THOR
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1 Response to Low Level Laser Therapy LLLT / Cold Laser Literature watch for Oct 2011

  1. Shawnsa Christy says:

    thank you

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