THOR Photobiomodulation Therapy Products & Training

21 new LLLT papers for your review this month including:

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

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

Jenkins PA, Carroll JD

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

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

Photomed Laser Surg 2011 Nov 22

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

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

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

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

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

Photomed Laser Surg 2011 Nov 4

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

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

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

1 Leonardo Fernandez Sanchez Dental Clinic , Cienfuegos, Cuba .

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

Photomed Laser Surg 2011 Nov 2

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

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

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

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

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

Lasers Med Sci 2011 Nov 4

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

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

Nawashiro H, Wada K, Nakai K, Sato S

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

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

Photomed Laser Surg 2011 Nov 2

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

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

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

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

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

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

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

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

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

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

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

Lasers Med Sci 2011 Nov 26

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

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

Mahram M, Rajabi M

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

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

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

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

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

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

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

Lasers Med Sci 2011 Nov 16

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

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

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

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

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

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

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

Oron U

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

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

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

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

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

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

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

Pharmacol Res 2011 Nov 17

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

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

Peplow PV, Chung TY, Baxter GD

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

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

Lasers Surg Med 2011 Nov 22

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

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

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

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

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

Lasers Med Sci 2011 Nov 18

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

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

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

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

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

Lasers Med Sci 2011 Nov 9

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

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

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

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

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

Injury 2011 Sep 42(9) 917-21

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

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The Relevance of Accurate Comprehensive Treatment Parameters in Photobiomodulation.

Enwemeka CS

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

Photomed Laser Surg 2011 Nov 9

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

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

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

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

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

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

Oral Oncol 2011 Sep 20

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

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

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

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

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

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

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

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

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

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

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

Oral Oncol 2011 Sep 10

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

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

Yang HW, Huang YF

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

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

Photomed Laser Surg 2011 Sep 9

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

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

Calis H, Berberoglu N, Calis M

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

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

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

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

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

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

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

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

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

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

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

Falus A, Fenyo M, Eder K, Madarasi A

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

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

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

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

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

Zhang H, Wu S, Xing D

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

Cell Signal 2011 Sep 14

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

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

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

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

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

Photochem Photobiol 2011 Sep 12

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

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Phototherapy and the peripheral nervous system.

Chow R

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

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

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

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=21895528

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

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

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

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=21950074

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

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

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

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

Lasers Med Sci 2011 Sep 27

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=21948400

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

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

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

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

Micron 2011 Aug 30

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=21924919

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

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

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

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

Lasers Med Sci 2011 Sep 4

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=21892789

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

Apuhan T, Terzi EH, Kukner A, Gok U

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

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

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

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=21890373

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

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

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

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

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

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=21879172

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