March 2009 LLLT Literature Watch

This bimonthly literature watch is another record breaker with 46 papers reviewed including nerve regeneration, lymphoedema, wound healing, inflammation, musculoskeletal pain, dental and some mechanism papers.

Abstracts from 7th international congress of the world association for laser therapy october 19-22, 2008.

Photomed Laser Surg 2009 Feb 27(1) 155-209

Phototherapy in peripheral nerve regeneration: From basic science to clinical study.

Rochkind S

Division of Peripheral Nerve Reconstruction, Department of Neurosurgery, Tel Aviv Sourasky Medical Center, Tel Aviv University, Tel Aviv, Israel.

Object This review summarizes the continuous study of low-power laser radiation treatment of a severely injured peripheral nerve. Laser phototherapy was applied as a supportive factor for accelerating and enhancing axonal growth and regeneration after injury or a reconstructive peripheral nerve procedure. In nerve cell cultures, laser phototherapy was used to stimulate activation of nerve cells. Methods Low-power laser radiation was used for treatment of peripheral nerve injury using a rat sciatic nerve model after crush injury, neurorrhaphy, or neurotube reconstruction. Nerve cell growth and axonal sprouting were investigated using laser phototherapy on embryonic rat brain cultures. The outcome in animal studies facilitated a clinical double-blind, placebo-controlled, randomized study that measured the effectiveness of 780-nm laser phototherapy on patients suffering from incomplete peripheral nerve injuries for 6 months to several years. Results Animal studies showed that laser phototherapy has an immediate protective effect, maintains functional activity of the injured nerve, decreases scar tissue formation at the injury site, decreases degeneration in corresponding motor neurons of the spinal cord, and significantly increases axonal growth and myelinization. In cell cultures, laser irradiation accelerates migration, nerve cell growth, and fiber sprouting. A pilot clinical double-blind, placebocontrolled, randomized study showed that in patients with incomplete long-term peripheral nerve injury, 780-nm laser radiation can progressively improve peripheral nerve function, which leads to significant functional recovery. Conclusions Using 780-nm laser phototherapy accelerates and enhances axonal growth and regeneration after injury or a reconstructive peripheral nerve procedure. Laser activation of nerve cells, their growth, and axonal sprouting can be considered as potential treatment of neuronal injury. Animal and clinical studies show the promoting action of phototherapy on peripheral nerve regeneration, making it possible to suggest that the time for broader clinical trials has arrived.

Neurosurg Focus 2009 26(2) E8

The Effect of Low-Level Laser Therapy on Trismus and Facial Swelling Following Surgical Extraction of a Lower Third Molar.

Aras MH, Gungormus M

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

Abstract Objective: The purpose of this study was to evaluate the effect of low-level laser therapy (LLLT) on postoperative trismus and edema after the removal of mandibular third molars. Materials and Methods: Thirty-two patients who were to undergo surgical removal of lower third molars were studied. Patients were randomly allocated to two groups, LLLT and placebo. Patients in the LLLT group received 12 J (4 J/cm(2)) low-level laser irradiation to the operative side intraorally 1 cm from the target tissue, and to the masseter muscle extraorally immediately after surgery. In the placebo group the handpiece was inserted into the operative side intraorally and was applied to the masseter muscle extraorally each for 1 min, but laser power was not activated. Inter-incisal opening and facial swelling were evaluated on postoperative days 2 and 7. Student’s t-test used to analyze the data. Results: It was determined that the trismus and the swelling in LLLT group were significantly less than in the placebo group on postoperative days 2 and 7. Conclusion: Within the limitations of this study it can be concluded that LLLT can be beneficial for the reduction of postoperative trismus and swelling after third molar surgery.

Photomed Laser Surg 2009 Jan 16

Phototherapy Improves Healing of Chronic Venous Ulcers.

Caetano KS, Frade MA, Minatel DG, Santana LA, Enwemeka CS

Department of Bioengineering, Faculty of Medicine, University of Sao Paulo, Ribeirao Preto, Brazil.

Abstract Objective: We tested the hypothesis that LED phototherapy with combined 660-nm and 890-nm light will promote healing of venous ulcers that failed to respond to other forms of treatment. Background Data: A variety of dressings, growth factors, and adjunct therapies are used to treat venous ulcers, but none seems to yield satisfactory results. Materials and Methods: We used a randomized placebo-controlled double-blind study to compare a total of 20 patients divided with 32 chronic ulcers into three groups. In group 1 the ulcers were cleaned, dressed with 1% silver sulfadiazine (SDZ) cream, and treated with placebo phototherapy (<.03 J/cm(-3)) using a Dynatron Solaris 705((R)) phototherapy research device. In group 2 the ulcers were treated similarly but received real phototherapy (3 J/cm(-2)) instead of placebo. In group 3 (controls), the ulcers were simply cleaned and dressed with SDZ without phototherapy. The ulcers were evaluated with digital photography and computer image analysis over 90 d or until full healing was attained. Results: Ulcers treated with phototherapy healed significantly faster than controls when compared at day 30 (p < 0.01), day 60 (p < 0.05), and day 90 (p < 0.001), and similarly healed faster than the placebo-treated ulcers at days 30 and 90 (p < 0.01), but not at day 60. The beneficial effect of phototherapy was more pronounced when the confounding effect of small-sized ulcers was removed from the analysis. Medium- and large-sized ulcers healed significantly faster with treatment (>/=40% rate of healing per month) than placebo or control ulcers (p < 0.05). Conclusion: Phototherapy promotes healing of chronic venous ulcers, particularly large recalcitrant ulcers that do not respond to conventional treatment.

Photomed Laser Surg 2009 Jan 16

Clinical Evaluation of Nd:YAG and 685-nm Diode Laser Therapy for Desensitization of Teeth with Gingival Recession.

Dilsiz A, Canakci V, Ozdemir A, Kaya Y

1 Department of Periodontology, Faculty of Dentistry, Ataturk University , Erzurum, Turkey .

Abstract Objectives: The aim of this study was to evaluate the effectiveness of two types of lasers, the Nd:YAG laser and the 685-nm diode laser, as dentin desensitizers as well as both the immediate and late therapeutic effects on teeth with gingival recession. Materials and Methods: The study was conducted on 56 teeth in 14 patients with Miller’s class 1 and 2 gingival recession with clinically elicitable dentin hypersensitivity (DH). The patients were divided into two groups: a Nd:YAG-laser-treated group and a 685-nm diode laser-treated group. DH was assessed by means of an air stimulus, and a visual analog scale (VAS) was used to measure DH. The selected teeth in the two groups received laser therapy for three sessions. Teeth subjected to Nd:YAG-laser treatment were irradiated at 1 W and 10 Hz for 60 sec at 1064 nm, and those receiving 685-nm diode laser treatment were irradiated at 25 mW and 9 Hz for 100 sec. Results: Significant reductions in DH occurred at all time points measured during the three treatment sessions in both treatment groups. Comparing the means of the responses in the three treatment sessions for the two groups revealed that the Nd:YAG laser group had a higher degree of desensitization compared to the other group (p < 0.01). The immediate and late therapeutic effects of the Nd:YAG laser were more evident than those of the 685-nm diode laser. Conclusions: Both of these lasers can be used to reduce DH without adverse effects. Desensitization of teeth with gingival recession with the Nd:YAG laser was more effective than with the diode laser. The Nd:YAG laser appears to be a promising new tool for successfully reducing DH.

Photomed Laser Surg 2009 Mar 12

Effectiveness and Safety of Transcranial Laser Therapy for Acute Ischemic Stroke.

Zivin JA, Albers GW, Bornstein N, Chippendale T, Dahlof B, Devlin T, Fisher M, Hacke W, Holt W, Ilic S, Kasner S, Lew R, Nash M, Perez J, Rymer M, Schellinger P, Schneider D, Schwab S, Veltkamp R, Walker M, Streeter J

From the Department of Neurosciences, University of California San Diego, La Jolla, Calif; Stanford Stroke Center, Stanford University Medical Center, Palo Alto, Calif; Tel Aviv Medical Center, Tel Aviv, Israel; Scripps Hospital, Encinitas, Calif; Sahlgrenska University Hospital, Gothenburg, Sweden; Erlanger Health System, Chattanooga, Tenn; University of Massachusetts Medical School, Worcester, Mass; Department of Neurology, Universitat Heidelberg, Heidelberg, Germany; Fawcett Memorial Hospital, Port Charlotte, Fla; Triage Wireless, Inc, San Diego, Calif; the Department of Neurology, University of Pennsylvania School of Medicine, Philadelphia, Pa; Boston University, Boston, Mass; DeKalb Neurology Associates, Decatur, Ga; Hospital Nacional Dos de Mayo, Lima, Peru; St. Luke’s Health System, Kansas City, Mo; Universitatsklinikum Erlangen, Erlangen, Germany; the Department of Neurology, Universitat Leipzig, Leipzig, Germany; Universitatsklinikum Erlangen, Erlangen, Germany; Department of Neurology, Universitat Heidelberg, Heidelberg, Germany; Stanford Center for Biomedical Informatics Research, Stanford School of Medicine, Palo Alto, Calif; and PhotoThera, Inc, Carlsbad, Calif.

BACKGROUND AND PURPOSE: We hypothesized that transcranial laser therapy (TLT) can use near-infrared laser technology to treat acute ischemic stroke. The NeuroThera Effectiveness and Safety Trial-2 (NEST-2) tested the safety and efficacy of TLT in acute ischemic stroke. METHODS: This double-blind, randomized study compared TLT treatment to sham control. Patients receiving tissue plasminogen activator and patients with evidence of hemorrhagic infarct were excluded. The primary efficacy end point was a favorable 90-day score of 0 to 2 assessed by the modified Rankin Scale. Other 90-day end points included the overall shift in modified Rankin Scale and assessments of change in the National Institutes of Health Stroke Scale score. RESULTS: We randomized 660 patients: 331 received TLT and 327 received sham; 120 (36.3%) in the TLT group achieved favorable outcome versus 101 (30.9%), in the sham group (P=0.094), odds ratio 1.38 (95% CI, 0.95 to 2.00). Comparable results were seen for the other outcome measures. Although no prespecified test achieved significance, a post hoc analysis of patients with a baseline National Institutes of Health Stroke Scale score of <16 showed a favorable outcome at 90 days on the primary end point (P<0.044). Mortality rates and serious adverse events did not differ between groups with 17.5% and 17.4% mortality, 37.8% and 41.8% serious adverse events for TLT and sham, respectively. CONCLUSIONS: TLT within 24 hours from stroke onset demonstrated safety but did not meet formal statistical significance for efficacy. However, all predefined analyses showed a favorable trend, consistent with the previous clinical trial (NEST-1). Both studies indicate that mortality and adverse event rates were not adversely affected by TLT. A definitive trial with refined baseline National Institutes of Health Stroke Scale exclusion criteria is planned.

Stroke 2009 Feb 20

Evaluation of mitochondrial respiratory chain activity in muscle healing by low-level laser therapy.

Silveira PC, Silva LA, Fraga DB, Freitas TP, Streck EL, Pinho R

Laboratorio de Fisiologia e Bioquimica do Exercicio, Programa de Pos-graduacao em Ciencias da Saude, Universidade do Extremo Sul Catarinense, 88806-000 Criciuma, SC, Brazil.

BACKGROUND: Recent studies demonstrate that low-level laser therapy (LLLT) modulates many biochemical processes, especially the decrease of muscle injures, the increase in mitochondrial respiration and ATP synthesis for accelerating the healing process. OBJECTIVE: In this work, we evaluated mitochondrial respiratory chain complexes I, II, III and IV and succinate dehydrogenase activities after traumatic muscular injury. METHODS: Male Wistar rats were randomly divided into three groups (n=6): sham (uninjured muscle), muscle injury without treatment, muscle injury with LLLT (AsGa) 5J/cm(2). Gastrocnemius injury was induced by a single blunt-impact trauma. LLLT was used 2, 12, 24, 48, 72, 96, and 120 hours after muscle-trauma. RESULTS: Our results showed that the activities of complex II and succinate dehydrogenase after 5days of muscular lesion were significantly increased when compared to the control group. Moreover, our results showed that LLLT significantly increased the activities of complexes I, II, III, IV and succinate dehydrogenase, when compared to the group of injured muscle without treatment. CONCLUSION: These results suggest that the treatment with low-level laser may induce an increase in ATP synthesis, and that this may accelerate the muscle healing process.

J Photochem Photobiol B 2009 Jan 21

Effects of low-level light therapy on hepatic antioxidant defense in acute and chronic diabetic rats.

Lim J, Ali ZM, Sanders RA, Snyder AC, Eells JT, Henshel DS, Watkins JB 3rd

School of Public and Environmental Affairs, Indiana University, Bloomington, IN 47405, USA.

Diabetes causes oxidative stress in the liver and other tissues prone to complications. Photobiomodulation by near infrared light (670 nm) has been shown to accelerate diabetic wound healing, improve recovery from oxidative injury in the kidney, and attenuate degeneration in retina and optic nerve. The present study tested the hypothesis that 670 nm photobiomodulation, a low-level light therapy, would attenuate oxidative stress and enhance the antioxidant protection system in the liver of a model of type I diabetes. Male Wistar rats were made diabetic with streptozotocin (50 mg/kg, ip) then exposed to 670 nm light (9 J/cm(2)) once per day for 18 days (acute) or 14 weeks (chronic). Livers were harvested, flash frozen, and then assayed for markers of oxidative stress. Light treatment was ineffective as an antioxidant therapy in chronic diabetes, but light treatment for 18 days in acutely diabetic rats resulted in the normalization of hepatic glutathione reductase and superoxide dismutase activities and a significant increase in glutathione peroxidase and glutathione-S transferase activities. The results of this study suggest that 670 nm photobiomodulation may reduce, at least in part, acute hepatic oxidative stress by enhancing the antioxidant defense system in the diabetic rat model.

J Biochem Mol Toxicol 2009 Jan 23(1) 1-8

Influence of laser (660 nm) on functional recovery of the sciatic nerve in rats following crushing lesion.

Belchior AC, Dos Reis FA, Nicolau RA, Silva IS, Perreira DM, de Carvalho PD

University for State and Pantanal Region Development (UNIDERP), Campo Grande, Mato Grosso do Sul, Brazil.

With the aim of accelerating the regenerative processes, the objective was to study the influence of gallium-aluminum-arsenide (GaAlAs) laser (660 nm) on functional and histomorphological recovery of the sciatic nerve in rats. The sciatic nerves of 12 Wistar rats were crushed divided into two groups: control and laser therapy. For the latter, GaAlAs laser was utilized (660 nm, 4 J/cm(2), 26.3 mW and 0.63 cm(2) beam), at three equidistant points on the lesion, for 20 days. Comparison of the sciatic functional index (SFI) showed that there was a significant difference only between the pre-lesion value of the laser therapy group and that after the 21st day in the control group. It was concluded that the parameters and methods utilized demonstrated positive results regarding the SFI over the time period evaluated.

Lasers Med Sci 2009 Feb 6

Inflammatory and Oxidative Stress Markers in Experimental Crystalopathy: Their Modification by Photostimulation.

Rubio CR, Simes JC, Moya M, Soriano F, Palma JA, Campana V

Catedra de Fisica Biomedica, Facultad de Ciencias Medicas, Universidad Nacional de Cordoba, Vicente Bustos y Rene Favaloro, Capital, Cordoba, Argentina.

Abstract Crystalopathies are inflammatory pathologies caused by cellular reactions to the deposition of crystals in the joints. The anti-inflammatory effect of the helium-neon (He-Ne) laser and that of the nonsteroidal anti-inflammatory drugs (NSAIDs) diclofenac, meloxicam, celecoxib, and rofecoxib was studied in acute and chronic arthritis produced by hydroxyapatite and calcium pyrophosphate in rats. The presence of the markers fibrinogen, L-citrulline, nitric oxide, and nitrotyrosine was determined. Crystals were injected into the posterior limb joints of the rats. A dose of 8 J/cm(2) of energy from an He-Ne laser was applied for 3 d in some groups and for 5 d in other groups. The levels of some of the biomarkers were determined by spectrophotometry, and that of nitrotyrosine was determined by ELISA. For statistical analysis, Fisher’s exact test was used, and p < 0.05 was considered significant. In arthritic rats, the fibrinogen, L-citrulline, nitric oxide, and nitrotyrosine levels increased in comparison to controls and to the laser-treated arthritic groups (p < 0.001), (p < 0.001), (p < 0.02), and (p < 0.01), respectively. When comparing fibrinogen from arthritic rats with disease induced by hydroxyapatite with undiseased and arthritic rats treated with NSAIDs, the He-Ne laser decreased levels to values similar to those seen in controls (p < 0.01). Inflammatory and oxidative stress markers in experimental crystalopathy are positively modified by photobiostimulation.

Photomed Laser Surg 2009 Jan 15

The Effectiveness of Conservative Treatments of Carpal Tunnel Syndrome: Splinting, Ultrasound, and Low-Level Laser Therapies.

Dincer U, Cakar E, Kiralp MZ, Kilac H, Dursun H

Department of Physical Medicine and Rehabilitation, Gulhane Military Medical Academy, Haydarpasa Training Hospital, Istanbul, Turkey.

Abstract Objective: The objective of this study was to investigate the effectiveness of splinting, ultrasound (US), and low-level laser (LLL) in the management of carpal tunnel syndrome (CTS). Background Data: CTS is the entrapment mononeuropathy most frequently seen in clinical practice, caused by compression of the median nerve at the wrist. Although several treatment modalities are routinely in use, there is no consensus about the best way to manage CTS. Materials and Methods: In our study, patients were randomly allocated to three groups that received the following treatment protocols: splinting only, splinting plus US, and splinting plus LLL therapy. Patients were assessed with the Boston Questionnaire, patient satisfaction inquiry, visual analogue scale for pain, and electroneuromyography. Results and Conclusion: The study was completed with a total of 100 hands of 50 women patients with bilateral CTS at 3 mo after treatment. At the end of the follow-up period, each of the groups had improvements to varying degrees. It appeared that the combinations of US or LLL therapy with splinting were more effective than splinting alone in treating CTS. However, LLL therapy plus splinting was more advantageous than US therapy plus splinting, especially for the outcomes of lessening of symptom severity, pain alleviation, and increased patient satisfaction.

Photomed Laser Surg 2009 Jan 26

Blue 470-nm Light Kills Methicillin-Resistant Staphylococcus aureus (MRSA) in Vitro.

Enwemeka CS, Williams D, Enwemeka SK, Hollosi S, Yens D

School of Health Professions, Behavioral, and Life Sciences, New York Institute of Technology, Old Westbury, New York.

Abstract Background Data: In a previous study, we showed that 405-nm light photo-destroys methicillin-resistant Staphylococcus aureus (MRSA). The 390-420 nm spectral width of the 405-nm superluminous diode (SLD) source may raise safety concerns in clinical practice, because of the trace of ultraviolet (UV) light within the spectrum. Objective: Here we report the effect of a different wavelength of blue light, one that has no trace of UV, on two strains of MRSA-the US-300 strain of CA-MRSA and the IS-853 strain of HA-MRSA-in vitro. Materials and Methods: We cultured and plated each strain, and then irradiated each plate with 0, 1, 3, 5, 7, 9, 11, 13, 15, 17, 19, 25, 30, 35, 40, 45, 50, 55, or 60 J/cm(2) of energy a single time, using a 470-nm SLD phototherapy device. The irradiated specimens were then incubated at 35 degrees C for 24 h. Subsequently, digital images were made and quantified to obtain colony counts and the aggregate area occupied by bacteria. Results: Photo-irradiation produced a statistically significant dose-dependent reduction in both the number and the aggregate area of colonies formed by each strain (p < 0.001). The higher the dose the more bacteria were killed, but the effect was not linear, and was more impressive at lower doses than at higher doses. Nearly 30% of both strains was killed with as little as 3 J/cm(2) of energy. As much as 90.4% of the US-300 and the IS-853 colonies, respectively, were killed with an energy density of 55 J/cm(2). This same dose eradicated 91.7% and 94.8% of the aggregate area of the US-300 and the IS-853 strains, respectively. Conclusion: At practical dose ranges, 470-nm blue light kills HA-MRSA and CA-MRSA in vitro, suggesting that a similar bactericidal effect may be attained in human cases of cutaneous and subcutaneous MRSA infections.

Photomed Laser Surg 2009 Jan 28

Light and Life: A Personal Overview of Development in the Fields of Photosurgery and Phototherapy.

Ohshiro T

Ohshiro Clinic and Japan Medical Laser Laboratory, Shinjuku. Tokyo, Japan.

Photomed Laser Surg 2009 Jan 30

Efficacy of pneumatic compression and low-level laser therapy in the treatment of postmastectomy lymphoedema: a randomized controlled trial.

Kozanoglu E, Basaran S, Paydas S, Sarpel T

Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Cukurova University, Adana, Turkey.

Objective: To compare the long-term efficacy of pneumatic compression and low-level laser therapies in the management of postmastectomy lymphoedema.Design: Randomized controlled trial.Setting: Department of Physical Medicine and Rehabilitation of Cukurova University, Turkey.Subjects: Forty-seven patients with postmastectomy lymphoedema were enrolled in the study.Interventions: Patients were randomly allocated to pneumatic compression (group I, n=24) and low-level laser (group II, n=23) groups. Group I received 2 hours of compression therapy and group II received 20 minutes of laser therapy for four weeks. All patients were advised to perform daily limb exercises.Main measures: Demographic features, difference between sum of the circumferences of affected and unaffected limbs (triangle upC), pain with visual analogue scale and grip strength were recorded.Results: Mean age of the patients was 48.3 (10.4) years. triangle upC decreased significantly at one, three and six months within both groups, and the decrease was still significant at month 12 only in group II (P = 0.004). Improvement of group II was greater than that of group I post treatment (P = 0.04) and at month 12 after 12 months (P = 0.02). Pain was significantly reduced in group I only at posttreatment evaluation, whereas in group II it was significant post treatment and at follow-up visits. No significant difference was detected in pain scores between the two groups. Grip strength was improved in both groups, but the differences between groups were not significant.Conclusions: Patients in both groups improved after the interventions. Group II had better long-term results than group I. Low-level laser might be a useful modality in the treatment of postmastectomy lymphoedema.

Clin Rehabil 2009 Feb 23(2) 117-24

Light-emitting diodes (LEDs) in dermatology.

Barolet D

RoseLab Skin Optics Research Laboratory, 3333 Graham Blvd., Montreal, Quebec, Canada.

Light-emitting diode photobiomodulation is the newest category of nonthermal light therapies to find its way to the dermatologic armamentarium. In this article, we briefly review the literature on the development of this technology, its evolution within esthetic and medical dermatology, and provide practical and technical considerations for use in various conditions. This article also focuses on the specific cell-signaling pathways involved and how the mechanisms at play can be put to use to treat a variety of cutaneous problems as a stand-alone application and/or complementary treatment modality or as one of the best photodynamic therapy light source.

Semin Cutan Med Surg 2008 Dec 27(4) 227-38

A study to determine the efficacy of a novel handheld light-emitting diode device in the treatment of photoaged skin.

Sadick NS

Department of Dermatology, Weill Medical College of Cornell University, New York, NY 10021, USA.

The use of visible or near-infrared spectral light alone for the purpose of skin rejuvenation has been previously reported in the literature. These devices use large arrays of diodes to deliver light to the skin. In this study, a novel method of light-emitting diode (LED) photo rejuvenation incorporating a combination of these wavelengths delivered from a small handheld unit is proposed. Twenty-two subjects with facial rhytides received eight light therapy treatments over a course of 4 weeks, using the Omnilux handheld LED system. Assessment of global skin grading was evaluated at weeks 6, 9, and 12 by a dermatologist. Additional outcome measures included assessments of clinical photography and patient satisfaction scores. Seventy-four percent of the subjects reported a visible improvement in fine lines and wrinkles at 8 weeks posttreatment. Combination red and near-infrared LED therapy delivered from a small portable handheld unit represents an effective and acceptable method of photo rejuvenation. Further studies to optimize the parameters of treatment are required.

J Cosmet Dermatol 2008 Dec 7(4) 263-7

Molecular mechanisms of cell proliferation induced by low power laser irradiation.

Gao X, Xing D

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

ABSTRACT: Low power laser irradiation (LPLI) promotes proliferation of multiple cells, which (especially red and near infrared light) is mainly through the activation of mitochondrial respiratory chain and the initiation of cellular signaling. Recently, the signaling proteins involved in LPLI-induced proliferation merit special attention, some of which are regulated by mitochondrial signaling. Hepatocyte growth factor receptor (c-Met), a member of tyrosine protein kinase receptors (TPKR), is phosphorylated during LPLI-induced proliferation, but tumor necrosis factor alpha (TNF-alpha) receptor has not been affected. Activated TPKR could activate its downstream signaling elements, like Ras/Raf/MEK/ERK, PI3K/Akt/eIF4E, PI3K/Akt/eNOS and PLC-gamma/PKC pathways. Other two pathways, DeltaPsim/ATP/cAMP/JNK/AP-1 and ROS/Src, are also involved in LPLI-induced proliferation. LPLI-induced cell cycle progression can be regulated by the activation or elevated expressions of cell cycle-specific proteins. Furthermore, LPLI induces the synthesis or release of many molecules, like growth factors, interleukins, inflammatory cytokines and others, which are related to promotive effects of LPLI.

J Biomed Sci 2009 Jan 16(1) 4

Treatment of neck pain: noninvasive interventions: results of the Bone and Joint Decade 2000-2010 Task Force on Neck Pain and Its Associated Disorders.

Hurwitz EL, Carragee EJ, van der Velde G, Carroll LJ, Nordin M, Guzman J, Peloso PM, Holm LW, Cote P, Hogg-Johnson S, Cassidy JD, Haldeman S

Department of Public Health Sciences, John A. Burns School of Medicine, University of Hawaii at Manoa, Honolulu, HI, USA.

STUDY DESIGN: Best evidence synthesis. OBJECTIVE: To identify, critically appraise, and synthesize literature from 1980 through 2006 on noninvasive interventions for neck pain and its associated disorders. SUMMARY OF BACKGROUND DATA: No comprehensive systematic literature reviews have been published on interventions for neck pain and its associated disorders in the past decade. METHODS: We systematically searched Medline and screened for relevance literature published from 1980 through 2006 on the use, effectiveness, and safety of noninvasive interventions for neck pain and associated disorders. Consensus decisions were made about the scientific merit of each article; those judged to have adequate internal validity were included in our best evidence synthesis. RESULTS: Of the 359 invasive and noninvasive intervention articles deemed relevant, 170 (47%) were accepted as scientifically admissible, and 139 of these related to noninvasive interventions (including health care utilization, costs, and safety). For whiplash-associated disorders, there is evidence that educational videos, mobilization, and exercises appear more beneficial than usual care or physical modalities. For other neck pain, the evidence suggests that manual and supervised exercise interventions, low-level laser therapy, and perhaps acupuncture are more effective than no treatment, sham, or alternative interventions; however, none of the active treatments was clearly superior to any other in either the short- or long-term. For both whiplash-associated disorders and other neck pain without radicular symptoms, interventions that focused on regaining function as soon as possible are relatively more effective than interventions that do not have such a focus. CONCLUSION: Our best evidence synthesis suggests that therapies involving manual therapy and exercise are more effective than alternative strategies for patients with neck pain; this was also true of therapies which include educational interventions addressing self-efficacy. Future efforts should focus on the study of noninvasive interventions for patients with radicular symptoms and on the design and evaluation of neck pain prevention strategies.

J Manipulative Physiol Ther 2009 Feb 32(2 Suppl) S141-75

Ultrastructural analysis of the low level laser therapy effects on the lesioned anterior tibial muscle in the Gerbil.

Iyomasa DM, Garavelo I, Iyomasa MM, Watanabe IS, Issa JP

Department of Physiotherapy, Faculty of Sciences and Technology, Sao Paulo State University, Presidente Prudente, SP, Brazil.

Low level laser therapy (LLLT) is known for its positive results but studies on the biological and biomodulator characteristics of the effects produced in the skeletal muscle are still lacking. In this study the effects of two laser dosages, 5 or 10J/cm(2), on the lesioned tibial muscle were compared. Gerbils previously lesioned by 100g load impact were divided into three groups: GI (n=5) controls, lesion non-irradiated; GII (n=5), lesion irradiated with 5J/cm(2) and GIII (n=5), lesion irradiated with 10J/cm(2), and treated for 7 consecutive days with a laser He-Ne (lambda=633nm). After intracardiac perfusion, the muscles were dissected and reduced to small fragments, post-fixed in 1% osmium tetroxide, dehydrated in increasing alcohol concentrations, treated with propylene oxide and embedded in Spurr resin at 60 degrees C. Ultrafine cuts examined on a transmission electron microscope (Jeol 1010) revealed in the control GI group a large number of altered muscle fibers with degenerating mitochondria, intercellular substance containing degenerating cell fragments and budding blood capillaries with underdeveloped endothelial cells. However, groups GII and GIII showed muscle fibers with few altered myofibrils, regularly contoured mitochondria, ample intermembrane spaces and dilated mitochondrial crests. The clean intercellular substance showed numerous collagen fibers and capillaries with multiple abluminal processes, intraluminal protrusions and several pinocytic vesicles in endothelial cells. It was concluded that laser dosages of 5 or 10J/cm(2) delivered by laser He-Ne (lambda=633nm) during 7 consecutive days increase mitochondrial activity in muscular fibers, activate fibroblasts and macrophages and stimulate angiogenesis, thus suggesting effectivity of laser therapy under these experimental conditions.

Micron 2009 Feb 13

Immunohistochemical Assessment of Myofibroblasts and Lymphoid Cells During Wound Healing in Rats Subjected to Laser Photobiomodulation at 660 nm.

Ribeiro MA, Albuquerque RL, Ramalho LM, Pinheiro AL, Bonjardim LR, Da Cunha SS

Propedeutics and Integrated Clinics, Federal University of Bahia, School of Dentistry, Salvador, Bahia, Brazil.

Abstract Objective: The goal of this study was to assess the biomodulatory effect of low-level laser therapy (LLLT) on myofibroblasts and T and B cells during wound healing. Background Data: Phtotobiomodulation using LLLT has been extensively applied to improve wound healing. Materials and Methods: Standardized artificial surgical wounds were made on the backs of 24 male rats. Half of them underwent LLLT (20 J/cm(2)) at 660 nm delivered for 7 d. At 8 and 14 d post-surgery the healing wounds were removed and immunohistochemical analysis of myofibroblasts, T cells, and B cells was carried out. The mean of each cell subset was calculated and compared to one another using two-way analysis of variance (ANOVA) and Tukey’s test. Results: The average number of myofibroblasts was statistically significantly higher in the irradiated group than in the non-irradiated group on the eighth (p = 0.001) but not the 14th (p = 0.555) day. B and T cells were significantly more conspicuous in the irradiated group on both the eighth (p = 0.004 and 0.02, respectively) and 14th days (p = 0.04 and 0.03, respectively). Conclusions: Our results suggest that LLLT facilitates myofibroblastic differentiation during the early stages of the cicatricial repair process. Furthermore, LLLT also appears to modulate the inflammatory response by downregulating lymphocytic proliferation during the wound healing process.

Photomed Laser Surg 2009 Feb 27(1) 49-55

Low-level laser therapy in subacromial impingement syndrome.

Bal A, Eksioglu E, Gurcay E, Gulec B, Karaahmet O, Cakci A

Ministry of Health, Ankara Diskapi Yildirim Beyazit Education and Research Hospital, Department of Physical Therapy and Rehabilitation, Ankara, Turkey.

Abstract Background Data and Objective: Although previous studies have evaluated the effect of different kinds of physical therapy in subacromial impingement syndrome (SIS), there have been few investigations assessing the effectiveness of low-level laser therapy (LLLT) in shoulder disorders. The goal of this prospective randomized study was to assess whether gallium-arsenide (Ga-As) laser therapy improves the outcome of a comprehensive home exercise program in patients with SIS. Materials and Methods: Forty-four newly-diagnosed SIS patients were enrolled in this study. Group 1 patients (n = 22) received Ga-As laser therapy combined with a 12-wk comprehensive home exercise program, and group 2 patients (n = 22) received the same 12-wk comprehensive home exercise program alone. Night pain, shoulder pain and disability index (SPADI), and University of California-Los Angeles end-result (UCLA) scores were used as outcome measures. Results: Both groups showed a significant reduction in night pain and SPADI scores at the second and 12th weeks with respect to baseline values, with the exception of the SPADI total score at the second week in group 1. UCLA results improved significantly in both groups at the 12th in comparison to the second week. There were no significant differences between groups in mean actual changes in night pain and SPADI scores at the second week from baseline. When values at the 12th week were compared to baseline, mean actual changes in night pain differed significantly between the groups, with a larger change in group 1, but there was no difference between groups in mean actual change in SPADI scores. Second- and 12th-week UCLA scores did not differ between the two groups. Conclusion: Our study was unable to demonstrate any distinct advantage of low-level laser therapy over exercise alone. Comprehensive home exercise programs should be the primary therapeutic option in the rehabilitation process in SIS.

Photomed Laser Surg 2009 Feb 27(1) 31-6

Neodymium-doped yttrium-aluminium-garnet laser irradiation abolishes the increase in interleukin-6 levels caused by peptidoglycan through the p38 mitogen-activated protein kinase pathway in human pulp cells.

Shiba H, Tsuda H, Kajiya M, Fujita T, Takeda K, Hino T, Kawaguchi H, Kurihara H

Department of Periodontal Medicine, Hiroshima University Graduate School of Biomedical Sciences, Hiroshima, Japan.

The anti-inflammatory effects of low-power laser irradiation have previously been reported. However, how the laser irradiation regulates the expression of inflammatory cytokines remains unknown. In the present study, to elucidate the mechanism behind the anti-inflammatory effect, we examined the effects of low-power neodymium-doped yttrium-aluminium-garnet (Nd:YAG) laser irradiation on interleukin (IL)-6 expression in human pulp (HP) cells stimulated by peptidoglycan (PGN) and focused on intracellular signaling pathways. Low-power Nd:YAG laser irradiation obviated the PGN-induced increase in IL-6 levels in HP cells. A p38 mitogen-activated protein kinase inhibitor, SB203580, also inhibited the increase in IL-6 messenger RNA levels. PGN stimulated the activity of phosphorylated p38 in HP cells. Low-power laser irradiation inhibited the activity. Thus, suppression of the phosphorylated p38 activity by low-power laser irradiation in HP cells culminates in inhibition of the increase in IL-6 induced by PGN, suggesting that low-power laser irradiation regulates intracellular signaling molecule activities to exert its anti-inflammatory effect.

J Endod 2009 Mar 35(3) 373-6

Comparative analysis of coherent light action (laser) versus non-coherent light (light-emitting diode) for tissue repair in diabetic rats.

Dall Agnol MA, Nicolau RA, de Lima CJ, Munin E

Instituto de Pesquisa e Desenvolvimento (IP&D), Universidade do Vale do Paraiba (UNIVAP), Sao Jose dos Campos, Sao Paulo, Brazil,

The already known benefits produced by the interaction of coherent light (laser) with biologic tissues determine its use as an adjuvant in the treatment of several complications associated with diabetes. Non-coherent light, such as that emitted by light emitting diodes (LEDs), becomes a promising alternative, because of its low cost and easy handling in these applications. Thirty-six rats were given surgical dorsum lesions. The lesions for the control group did not receive any supporting therapy. The other groups were irradiated only once, 30 min after the establishment of the lesion, with LED (640 nm with 40 nm full bandwidth at half maximum) or laser (660 nm). The histomorphological and histomorphometrical parameters were quantified. The coherent and non-coherent lights produced similar effects during a period of 168 h after the lesions had been made. For the group composed of diabetic animals, 72 h after creation of the lesion, it was observed that the therapy with LEDs had been more efficient than that with the laser in the reduction of the wounds’ diameters.

Lasers Med Sci 2009 Feb 24

Cyclooxygenase-2 and vascular endothelial growth factor expression in 5-fluorouracil-induced oral mucositis in hamsters: evaluation of two low-intensity laser protocols.

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

Department of Experimental Surgery, Federal University of Sao Paulo, Rua Botucatu 740, Sao Paulo, Brazil, CEP 04023-062,

GOAL OF WORK: The aim of this study was to investigate the mechanisms whereby low-intensity laser therapy may affect the severity of oral mucositis. 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 a 35 mW laser, 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. This tissue was used for immunohistochemistry for cyclooxygenase-2 (COX-2), vascular endothelial growth factor (VEGF), and factor VIII (marker of microvessel density) and the resulting staining was quantified. MAIN RESULTS: Peak severity of mucositis was reduced in the 35 mW laser group as compared to the 100 mW laser and control groups. This reduced peak clinical severity of mucositis in the 35 mW laser group was accompanied by a significantly lower level of COX-2 staining. The 100 mW laser did not have an effect on the severity of clinical mucositis, but was associated with a decrease in VEGF levels at the later time-points, as compared to the other groups. There was no clear relationship of VEGF levels or microvessel density to clinical mucositis severity. CONCLUSION: The tissue response to laser therapy appears to vary by dose. Low-intensity laser therapy appears to reduce the severity of mucositis, at least in part, by reducing COX-2 levels and associated inhibition of the inflammatory response.

Support Care Cancer 2009 Feb 22

Mitochondrial Responses of Normal and Injured Human Skin Fibroblasts Following Low Level Laser Irradiation-An In Vitro Study.

Zungu IL, Hawkins Evans D, Abrahamse H

Laser Research Group, Faculty of Health Sciences, University of Johannesburg, Johannesburg, South Africa.

Abstract Laser irradiation has proved to be very efficient in speeding and improving the quality of healing in pathological conditions of diverse etiologies. However, the mechanisms by which the beneficial effects are attained are not clear. Mitochondria are the primary phototargets during irradiation. The study aimed to establish if laser irradiation had an effect on hypoxic and acidotic cells. The study also aimed to use existing information regarding the possible mechanism of action (established in wounded cells) and apply these principles to acidic and hypoxic irradiated cells to determine whether laser has a stimulatory or inhibitory effect. Cell cultures were modified to simulate conditions of hypoxia (hypoxic gas mixture 95% N(2) and 5% O(2)) and acidosis (pH 6.7) whereas the central scratch model was used to simulate a wound. Cells were irradiated with a helium-neon (632.8 nm, 3 mW cm(-2)) laser using 5 or 16 J cm(-2) on days 1 and 4. Mitochondrial responses were measured 1 or 24 h after laser irradiation by assessing changes in mitochondrial membrane potential (MMP), cyclic AMP, intracellular Ca(2+) and adenosine triphosphate (ATP) cell viability. Hypoxia and acidosis significantly reduced MMP when compared with normal nonirradiated control cells. Wounded, hypoxic and acidotic cells irradiated with 5 J cm(-2) showed an increase in mitochondrial responses when compared with nonirradiated cells while 16 J cm(-2) showed a significant decrease. The study confirmed that laser irradiation with 5 J cm(-2) stimulated an increase in intracellular Ca(2+) which resulted in an increase in MMP, ATP and cAMP, which ultimately results in photobiomodulation to restore homeostasis of injured cells.

Photochem Photobiol 2009 Feb 11

Phenothiazine Chloride and Soft Laser Light Have a Biostimulatory Effect on Human Osteoblastic Cells.

Stein E, Koehn J, Sutter W, Schmidl C, Lezaic V, Wendtlandt G, Watzinger F, Turhani D

Department of Cranio-Maxillofacial and Oral Surgery, Medical University of Vienna, Vienna, Austria.

Abstract Objective: Low-level laser therapy (LLLT) is a well accepted tool to accelerate wound healing and to reduce inflammation after oral implant insertion. Since there are no in vitro data on a combination of LLLT with prior photosensitization, it was the aim of this study to investigate if photosensitization with phenothiazine chloride results in an alteration of the biostimulatory effect of low-level laser irradiation. Background Data: LLLT and antimicrobial photodynamic therapy are well established for the treatment of peri-implantitis. In vitro studies have shown a biostimulatory effect of LLLT on various cell types, including osteogenic cells. Materials and Methods: SaOS-2 cells were treated with the photosensitizer phenothiazine chloride before irradiation with matched laser light. At 24-h intervals the viability and differentiation were analyzed in treated and untreated cells. Results: While the biostimulatory effect of the LLLT could be observed for the lower irradiation dose, the pretreatment with phenothiazine chloride did not significantly affect the growth and differentiation of the SaOS-2 cells. Conclusion: It can thus be concluded that combined treatment with phenothiazine chloride and LLLT does not result in a synergistic enhancement of the biostimulatory effect of LLLT, but there was also no evidence for antagonizing effects on growth and differentiation of human osteoblasts.

Photomed Laser Surg 2009 Jan 26

Effect of Low-Level Infrared Laser Therapy on Large Surgical Osteochondral Defect in Rabbit: A Histological Study.

Bayat M, Kamali F, Dadpay M

Cellular and Molecular Biology Research Center, and Anatomy Department, Medical Faculty, Shahid Beheshti University (M.C.), Tehran, Iran.

Abstract Objective: The present study investigates whether low-level laser therapy (LLLT) can accelerate healing of large osteochondral defects in rabbits. Background Data: LLLT has been used in the treatment of musculoskeletal disorders and fractures. Materials and Methods: Seventy rabbits were divided into control and experimental groups. Under sterile conditions and after general anesthesia, the rabbits received one full-thickness defect 5 mm wide by 10 mm deep in the distal portion of the patellar groove of the right femur. The rabbits in the experimental group were exposed to a pulsed 890-nm infrared laser (1500 Hz, 4.8 J/cm(2) energy density, spot size 1 cm) twice weekly. The rabbits were killed at 2 wk, 1 mo, 2 mo, and 4 mo post-surgery. The defects were evaluated macroscopically and histologically for the filling of the defect, integration of repair tissue, matrix staining, and cellular morphology. The Student’s t-test was performed to determine the differences between the control and experimental groups. Statistical significance was set at p < 0.05. Results: Results in the experimental group were better than those in the control group; however, there were no significant differences between the two study groups. Conclusion: LLLT did not accelerate healing of large osteochondral defects in rabbits.

Photomed Laser Surg 2009 Jan 26

Laser Therapy Converts Diabetic Wound Healing to Normal Healing.

Al-Watban FA

Laser Medicine Research Section, Biological and Medical Research Department, King Faisal Specialist Hospital and Research Centre, Riyadh, Kingdom of Saudi Arabia.

Abstract Objective: We have determined optimal laser dosimetric parameters in comparison with polychromatic light-emitting diodes (LEDs) that can speed up healing in four animal models: non-diabetic oval full-thickness wounds, diabetic oval full-thickness wounds, non-diabetic burns, and diabetic burns in Sprague-Dawley rats. Materials and Methods: This series of studies used 532-, 633-, 810-, 980-, and 10,600-nm lasers (visible to far infrared) and polychromatic LED clusters (510-872 nm, visible to infrared) as photon sources. Sprague-Dawley rats (n = 893) were used; however, animals that died before and during the experiments from anesthesia accidents and for any other reason were excluded from statistical analysis. Results: The improvements seen (>10% improvement of impairment) show that phototherapy with the 633-nm laser is quite promising for alleviating diabetic wound and burn healing, and exhibited the best results with 38.5% and 53.4% improvements, respectively. Conclusion: In this induced-diabetes model, wound and burn healing were improved by 40.3% and 45%, respectively, in 633-nm laser dosimetry experiments, and diabetic wound and burn healing was accelerated by phototherapy. This indicates that the healing rate was normalized in the phototherapy-treated diabetic rats. In view of these interesting findings, 633-nm laser therapy given three times per week at 4.71 J/cm(2) per dose for diabetic burns, and three times per week at 2.35 J/cm(2) per dose for diabetic wound healing are recommended as actual doses for human clinical trials, especially after major surgery in those with impaired healing, such as diabetics and the elderly.

Photomed Laser Surg 2009 Feb 4

Effect of Laser Phototherapy on the Release of TNF-alpha and MMP-1 by Endodontic Sealer-Stimulated Macrophages.

Sousa LR, Cavalcanti BN, Marques MM

Departamento de Dentistica, Faculdade de Odontologia, Universidade de Sao Paulo, Sao Paulo, Brazil.

Abstract Objective: Our aim was to analyze the effect of laser phototherapy on the secretory activity of macrophages activated by interferon-gamma (IFN-gamma) and lipopolysaccharide (LPS), and stimulated by substances leached from an epoxy resin-based sealer (AH-Plus) and a calcium hydroxide-based sealer (Sealapex). Background Data: Laser phototherapy can modulate the inflammatory process, improving wound healing. This type of therapy could be useful for modulating postoperative symptoms seen after endodontic treatment. Materials and Methods: Cytotoxicity was indirectly assessed by measuring mitochondrial activity. Macrophages were stimulated by the leached substances or not (controls), and the groups were then irradiated or not. The secretion of pro-inflammatory cytokines (TNF-alpha and MMP-1) was analyzed using ELISA. Two irradiations at 6-h intervals were done with an As-Ga-Al diode laser (780 nm, 70 mW, spot size 4.0 mm(2), 3 J/cm(2), for 1.5 sec) in contact mode. Results: The sealers were non-cytotoxic to macrophages. The production of TNF-alpha was significantly decreased by laser phototherapy, regardless of experimental group. The level of secretion of MMP-1 was similar in all groups. Conclusion: Based on the conditions of this study we concluded that in activated macrophages, laser phototherapy impairs the secretion of the pro-inflammatory cytokine TNF-alpha, but has no influence on MMP-1 secretion.

Photomed Laser Surg 2009 Jan 30

Effects of Red Light Emitting Diode on Apoptosis of HeLa Cells and Suppression of Implanted HeLa Cells Growth in Mice.

Zhang L, Xiong Z, Li Z, Yao B, Zhang D

Institute of Hematology & Blood Disease Hospital, Chinese Academy of Medical Sciences & Peking Union of Medical College, State Key Lab of Experimental Hematology.

Low intensity irradiation of cells by laser was an effective method of biostimulation. Here, we have extended these actions to evaluate the apoptosis effects in red light emitting diode (RLED) exposure. Through morphological observation, flow cytometric analysis, intracellular calcium measurement and RT-PCR, we found that HeLa cells in 24 h RLED irradiation in in-vitro experiments would significantly affects the induction of cellular apoptosis, and morphological changes such as the loose arrangement of cells, the noticeable development of apoptotic bodies,and the accompaniment of arrested S phase and activated caspases-3,-6,-8. Moreover, intracellular calcium concentrations markedly increased 40.3 +/- 1.3% and 43.1 +/- 0.8% respectively, relative to an extracellular solution containing the Ca(2+) and Ca(2+) free unexposed group. In in-vivo tests, RLED irradiation decreased the growth of tumors on day 50 and attenuated the elevation of vascular endothelial growth factor (VEGF) expression in HeLa cell implanted BALB/c mice. Taken together, our results suggest that RLED could induce HeLa cell apoptosis and convey potential antitumor properties.

J Radiat Res (Tokyo) 2009 Jan 22

The effects of polarized light therapy in pressure ulcer healing.

Durovic A, Maric D, Brdareski Z, Jevtic M, Durdevic S

Military Medical Academy, Clinic for Phyisical Medicine and Rehabilitation, Belgrade, Serbia.

BACKGROUND/AIM: Neglecting polarized light as an adjuvant therapy for pressure ulcers and methodology distinctions in the trials engaging polarized light are the reasons for many dilemmas and contradictions. The aim of this study was to establish the effects of polarized light therapy in pressure ulcer healing. METHODS: This prospective randomized single-blind study involved 40 patients with stage I-III of pressure ulcer. The patients in the experimental group (E) were subjected, besides polarized light therapy, to standard wound cleaning and dressing. Standard wound cleaning and dressing were the only treatment used in the control group (C). A polarized light source was a Bioptron lamp. Polarized light therapy was applied for six min daily, five times a week, four weeks. The Pressure Ulcer Scale for Healing (PUSH) was used in the assessment of outcome. Statistic analysis included Mann Whitney Test, Fisher Exact Test, Wilcoxon Signed Rank test. RESULTS: There were significant differences between the groups at the end of the treatment regarding the surface of pressure ulcer (E: 10.80 +/- 19.18; C: 22,97 +/- 25,47; p = 0.0005), rank of pressure ulcer (E: 5.90 +/- 2.48; C: 8.6 +/- 1.05; p = 0.0005) and total PUSH score (E: 7.35 +/- 3.17; C: 11.85 +/- 2.35; p = 0,0003). The patients in the experimental group had significantly better values of the parameters monitored than the patients in the control group. CONCLUSION: After a four-week polarized light therapy 20 patients with stage I-III ulcer had significant improvement in pressure ulcer healing, so it could be useful to apply polarized light in the treatment of pressure ulcers.

Vojnosanit Pregl 2008 Dec 65(12) 906-12

[Polioxidonium in comprehensive therapy of recurrent herpetic stomatitis in children with allergic diseases]

In the study with participation of 96 children of 1-7 years age with recurrent herpetic stomatitis and allergic diseases therapeutic efficacy of Polioxidonium was investigated. Polioxidonium was used in combination with traditional methods and with He-Ne-laser irradiation. Local oral cavity immunity, indexes of cellular immunity (in the reaction of lymphocytes blast-transformation with phytohemagglutinin), indexes of humoral immunity (IgG and IgE) were studied, complement C(3)-component was determined. Polioxidonium in combination with traditional methods and with laser therapy for recurrent herpetic stomatitis treatment in children with allergic diseases influenced favourably upon clinical course of allergic diseases, let achieve stable remission, increased efficacy of their treatment, promoted immunological status and shorten the terms of medical rehabilitation.

Stomatologiia (Mosk) 2008 87(6) 52-5

Microcirculatory responses to acupuncture stimulation and phototherapy.

Komori M, Takada K, Tomizawa Y, Nishiyama K, Kondo I, Kawamata M, Ozaki M

Department of Anesthesiology, Medical Center East, Tokyo Women’s Medical University, 2-1-10, Nishiogu, Arakawa-ku, Tokyo 116-8567, Japan.

BACKGROUND: Acupuncture stimulation and phototherapy have been reported to have analgesic effects and improve the microcirculation. However, few studies have directly examined changes in peripheral blood vessels, either quantitatively or objectively. We assessed the responses of arteriolar blood flow to acupuncture stimulation and phototherapy under direct vision to examine the effects of these treatments. METHODS: We used 40 rabbits with a rabbit ear chamber attached to the auricle. The rabbit ear chamber was fixed to the auricle under a dissecting microscope. Arterioles were selected and observed with the use of a microscope video camera. Pentobarbital was injected IV. The trachea was intubated and spontaneous respiration was maintained. Rabbits were randomly assigned to receive acupuncture stimulation (acupuncture group, n = 10), near-infrared lamp irradiation (lamp group, n = 10), near-infrared low-powered laser irradiation (laser group, n = 10), or no irradiation (control group, n = 10). In the acupuncture group, an acupuncture needle was placed in the auricle for 20 min. The lamp group repeatedly received 1 s of near infrared irradiation (1540 mW) followed by 4 s of treatment cessation. The laser group continuously received 60 mW of laser irradiation. In the lamp and laser groups, the auricle (same site as that of the acupuncture needles in the acupuncture group) was irradiated for 10 min with a contact probe. Arteriolar diameter and blood flow velocity were measured at baseline and for 60 min after acupuncture or irradiation treatment. Blood flow rate was calculated by multiplying the blood flow velocity by the cross-sectional area of the vessels. RESULTS: Arteriolar diameter significantly increased to 131% +/- 14% in the acupuncture group (P < 0.005), 129% +/- 19% in the lamp group (P < 0.005), and 128% +/- 11% in the laser group (P < 0.005) when compared with the pretreatment value (100%). Maximum values were reached 20 min after the end of the acupuncture stimulation, and 10 min after the end of lamp and laser irradiation. The three groups showed significant increases in arteriolar diameter when compared with the control group (P < 0.005). Blood flow velocity and blood flow rate showed similar trends to arteriolar diameter. Treatment effect persisted for 40-50 min after the end of stimulation and irradiation. CONCLUSIONS: Acupuncture stimulation and phototherapy were directly confirmed to increase the diameter and blood flow velocity of the peripheral arterioles. Acupuncture stimulation and phototherapy, associated with minimal systemic and local side effects, can enhance the microcirculation and may be a useful supportive treatment for diseases caused by poor peripheral blood flow.

Anesth Analg 2009 Feb 108(2) 635-40

Lymphedema: a primer on the identification and management of a chronic condition in oncologic treatment.

Lawenda BD, Mondry TE, Johnstone PA

Radiation Oncology, Naval Medical Center, San Diego, CA, 92134, USA.

The primary goals of oncologic therapy are the compassionate care of cancer patients, eradication of disease, and palliation of symptoms. Advances in various targeted therapies such as highly conformal and image-guided radiotherapy techniques, sentinel lymph node dissection, and molecularly targeted agents hold the promise of allowing those goals to be reached with fewer treatment-related complications. Unfortunately, certain side effects remain problematic due to the inability to completely avoid injuring normal tissues. Lymphedema, a chronic condition that occurs as a result of the body’s inability to drain lymph fluid from the tissues, is a common treatment-related side effect experienced by cancer patients. In this review, many of the important aspects of lymphedema with which clinicians who treat cancer patients should be familiar are outlined, including the anatomy, pathophysiology, diagnosis, and management of this condition. The authors also identify some of the resources available both to cancer patients with lymphedema and to the clinicians who treat them. It is hoped that this review will convey the importance of the early identification and management of this incurable disorder because this is essential to minimizing its complications.

CA Cancer J Clin 2009 Jan-Feb 59(1) 8-24

Effect of low-intensity laser irradiation and wideband red light on experimentally ischemized myocardium.

Malinovskaya SL, Monich VA, Artifeksova AA

State Medical Academy, Nizhniy Novgorod, Russia.

The effect of helium-neon laser irradiation and wideband red light on electrical activity of open rat heart was examined after experimentally produced ischemia. The red light applied with the help of optical fibers modified parameters of cardiac electrical activity and intensity of lipid peroxidation in the myocardium. The effects of laser and red light irradiation differed significantly.

Bull Exp Biol Med 2008 May 145(5) 573-5

Regulation of cellular immunity by Photo(chemo)therapy.

Grundmann SA, Beissert S

Department of Dermatology, University of Muenster, Muenster, Germany.

Phototherapy and photochemotherapy are important treatment regimens for inflammatory as well as malignant diseases in dermatology. Both treatment modalities have been developed already three decades ago and therefore profound knowledge exists on the use, efficacy, and long-term side effects. Since the development of new mmunosuppressive medications, biologics, and changes in medical reimbursement policies, phototherapy is currently less frequently used compared to previous years to treat psoriasis or atopic dermatitis. However, cost-effectiveness analysis demonstrated that phototherapy can significantly induce therapeutic beneficial effects on a large number of inflammatory and malignant skin disorders at a low cost of treatment rate. Since many chronic skin disorders require rotational treatment regimens to decrease the development of (long-term) adverse events, phototherapy will play an important role in dermatology in future years. In the following the molecular as well as cellular mechanisms of phototherapy are described and discussed in light of the fact that photobiology is a very active field in biomedical research.

Front Biosci 2009 14 4326-36

Complementary and alternative medicine for allergic rhinitis.

Man LX

Department of Otolaryngology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA.

PURPOSE OF REVIEW: Otolaryngologists and other physicians who diagnose and treat allergic rhinitis encounter patients who use complementary medicine and alternative remedies. This article reviews the recent literature regarding complementary and alternative therapies for the treatment of allergic rhinitis. RECENT FINDINGS: There are a myriad of modalities for treating allergic rhinitis. Few are studied with rigorous randomized, double-blind, placebo-controlled trials for clinical efficacy. Often, the biological mechanisms and adverse effects are even less well understood. A few therapies, including spirulina, butterbur, and phototherapy hold some promise. Thus far, complementary and alternative therapies have not been integrated into the general treatment armamentarium of allergic rhinitis. SUMMARY: Several studies report beneficial effects of certain alternative treatments for allergic rhinitis. Additional insight into the mechanisms of action, short-term and long-term effects, and adverse events is needed.

Curr Opin Otolaryngol Head Neck Surg 2009 Mar 2

Photostimulation of astrocytes with femtosecond laser pulses.

Zhao Y, Zhang Y, Liu X, Lv X, Zhou W, Luo Q, Zeng S

Britton Chance Center for Biomedical Photonics, Wuhan National Laboratory for Optoelectronics, Department of Biomedical Engineering, Huazhong University of Science & Technology, Wuhan, China.

The involvement of astrocytes in brain functions rather than support has been identified and widely concerned. However the lack of an effective stimulation of astrocytes hampers our understanding of their essential roles. Here, we employed 800-nm near infrared (NIR) femtosecond laser to induce Ca2+ wave in astrocytes. It was demonstrated that photostimulation of astrocytes with femtosecond laser pulses is efficient with the advantages of non-contact, non-disruptiveness, reproducibility, and high spatiotemporal precision. Photostimulation of astrocytes would facilitate investigations on information processing in neuronal circuits by providing effective way to excite astrocytes.

Opt Express 2009 Feb 2 17(3) 1291-8

[Effectiveness of photo- and mesophotophoresis in the combined treatment of patients with chronic generalized parodontitis]

Prikuls VF, Gerasimenko MIu

Vopr Kurortol Fizioter Lech Fiz Kult 2008 Nov-Dec (6) 42-3

[Photophoresis and mesophotophoresis of angioprotectant group preparations for comprehensive treatment of patients with chronic generalized parodontitis]

Examination of 118 patients with chronic generalized parodontitis of medium and heavy severity was performed and treatment was elaborated with the use of laser therapy and angioprotectants’ photophoresis and mesophotophoresis. Use of the mentioned physical and physical-pharmacological methods in comprehensive cure let to shorten the course of treatment and increase remission duration.

Stomatologiia (Mosk) 2008 87(6) 27-30

Future considerations in cutaneous photomedicine.

Winstanley DA, Uebelhoer NS

Department of Dermatology, Naval Medical Center San Diego, 34520 Bob Wilson Drive, San Diego, CA 92134, USA.

Laser and light technology and their use in dermatology are rapidly advancing. Radiofrequency devices have recently integrated lasers to augment the beneficial effects of both while minimizing potential complications of each. Laser-assisted liposuction is becoming more commonplace, and new investigations into the noninvasive selective destruction of fat with lasers have been undertaken. A better understanding of photobiology has generated renewed interest in the effects of low-level laser therapy on skin and wound healing. Lasers also are being used in novel ways for the purposes of in vivo diagnosis, producing some incredible imaging that may prove useful in the early diagnosis and evaluation of cutaneous disease. Finally, more recent work in the field of photochemical tissue bonding may be bringing us closer to sutureless and scarless surgery. Although not an exhaustive review, this article explores some recent advances in laser and light technologies for dermatologic applications and diagnosis.

Semin Cutan Med Surg 2008 Dec 27(4) 301-8

[Effect of low-intensity laser radiation on the function of vascular endothelium in patients with chronic viral hepatitis]

The aim of the study was to measure plasma levels of stable metabolites of nitric oxide, nitrates, and nitrites (NOx) in patients with chronic viral hepatitis and evaluate the possibility of their correction by low-power laser irradiation. NO metabolites (total nitrites and nitrates) were measured colorimetrically from the development of colour in the reaction of nitrite with sulfanilamide diazotization in Griess reagent. Colour intensity was determined with Victor2 enzyme immunoanalyzer, Perkin Elmaer (Finland). The patients were divided into three groups. In group 1 (control, n = 30) they received combined medicamentous therapy, in group 2 (n = 45) medicamentous therapy and a course of intravenous laser therapy, in goup 3 (n = 45) medicamentous therapy and skin laserotherapy. The results indicate that medicamentous treatment of patients with chronic hepatitis does not bring any beneficial changes in plasma NOx whose levels are significantly improved in case of simultaneous laser therapy. It is concluded that different laserotherapeutic modalities have beneficial effect on NO-producing function of endothelium and thereby improve its functional state. Compensation of NO deficit by laser therapy ensures overall protection of the organism against free radicals and decreases severity of oxidative stress.

Klin Med (Mosk) 2009 87(1) 49-52

Light therapy as a treatment for sexual dysfunctions.

Bossini L, Fagiolini A, Valdagno M, Roggi M, Tallis V, Trovarelli S, Ponchietti R, Castrogiovanni P

Psychother Psychosom 2009 78(2) 127-8

Response to Letter to the Editor: Effect of Low-Level Laser Therapy on Mast Cells in Second-Degree Burns in Rats.

Bayat M

School of Medicine, Shaheed Beheshti University of M.C., PO Box: 19395-4719, Evin, Tehran, Iran.

Photomed Laser Surg 2009 Jan 30

[Effectiveness of laser puncture in elderly patients with bronchial asthma]

Nikitin AV, Esaulenko IE, Shatalova OL

Vopr Kurortol Fizioter Lech Fiz Kult 2008 Nov-Dec (6) 38-9

Buyers’ guide to dental lasers. Lasers entering into the mainstream of dentistry.

Freedman G

Dent Today 2008 Dec 27(12) 92, 94, 96 passim

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