LLLT Literature Watch for May 2010

34 new LLLT papers for your to review including LED nerve regeneration, post-mastectomy lymphedema, healing of mucous membrane pemphigoid, biceps muscle performance and LED attenuation of oxidative renal damage in Type I diabetic rats.

P.S. when did you last get trained?

  • How much LLLT is enough, how much is to much?
  • What are joules and J/cm2?
  • Do they matter ?
  • What is the difference between laser and LED?

Attend a THOR training to find out. Details here https://www.thorlaser.com/courses/

Low Level Laser Therapy in the Treatment of Mucous Membrane Pemphigoid: A Promising Procedure.

Yilmaz HG, Kusakci Seker B, Bayindir H, Tozum TF

Department of Periodontology, Faculty of Dentistry, Near East University, Mersin10, Turkey.

Background: Mucous membrane pemphigoid is a heterogeneous group of autoimmune, subepithelial blistering diseases. A combination of both topical and systemic steroid treatment is often used when managing patients with mucous membrane pemphigoid. The use of systemic steroids presents an increased risk of adverse side effects. Consequently, effective alternative modalities of therapy should be considered, such as application of low level laser therapy (LLLT). Methods: Patient suffering from mucous membrane pemphigoid who was successfully treated with the application of local corticosteroids and LLLT using an 810 nm diode laser was presented. The lesions were treated by LLLT over a period of 7 days using a continuous waveform for 40 seconds and an energy density of 5 J/cm(2). Results: Following treatment a significant improvement in tissue color and consistency was observed. The patient was followed every month for a period of 12 months, and the lesions healed uneventfully. Conclusions: The results reported in this case show that healing of mucous membrane pemphigoid can be achieved when LLLT is used as an adjunct to following local corticosteroid application.

J Periodontol 2010 May 3

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=20450370

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The short-term effects of low-level laser therapy in the management of breast-cancer-related lymphedema.

Dirican, A, Andacoglu, O, Johnson, R, McGuire, K, Mager, L, Soran, A

Department of Surgery, Division of Surgical Oncology, Magee-Womens Hospital University of Pittsburgh Medical Center, Pittsburgh, PA, USA.

BACKGROUND: Breast-cancer-related lymphedema (BCRL) is a chronic disease, and currently there is no definitive treatment for it. There are some therapeutic interventions targeted to decrease the limb swelling and the associated problems. Low-level laser therapy (LLLT) has been used in the treatment of post-mastectomy lymphedema since 2007 in the US. The aim of this study is to review our short-term experience with LLLT in the treatment of BCRL. METHOD: Seventeen BCRL patients referred to our lymphedema program between 2007 and 2009 were enrolled in this study. All patients had experienced at least one conventional treatment modality such as complex physical therapy, manual lymphatic drainage, and/or pneumatic pump therapy. LLLT was added to patients’ ongoing therapeutic regimen. All patients completed the full course of LLLT consisting of two cycles. The difference between sums of the circumferences of both affected and unaffected arms (DeltaC), pain score, scar mobility, and range of motion were measured before and after first and second cycles of LLLT sequentially. RESULTS: All patients were female with a median age of 51.8 (44-64) years. DeltaC decreased 54% (15-85%) and 73% (33-100%), after the first and second cycles of LLLT, respectively. Fourteen out of seventeen experienced decreased pain with motion by an average of 40% (0-85%) and 62.7% (0-100%) after the first and second cycle of LLLT, respectively. Three patients had no improvement in pain after LLLT. Scar mobility increased in 13 (76.4%) and shoulder range of motion improved in 14 (82.3%) patients after LLLT. One patient developed cellulitis during LLLT. CONCLUSION: Patients with BCRL received additional benefits from LLLT when used in conjunction with standard lymphedema treatment. These benefits include reduction in limb circumference, pain, increase in range of motion and scar mobility. Additionally, two cycles of LLLT were found to be superior to one in this study.

Support Care Cancer 2010 May 6

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=20445997

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[Cytological evaluation of laser therapy influence upon skin reparation]

Evidence on the studying of the effectiveness the low intensive laser radiation influence as complex treatment of patient with maxillofacial phlegmons with using of the cytological method were presented. Results of the laser therapeutist were in acceleration of the inflammation stage. The neutrophil granulocytes and macrophages settled down in wound earlier then in the control. This led to acceleration of the wound healing.

Stomatologiia (Mosk) 2010 89(1) 33-6

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=20436407

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Effects of Low-Level Laser Therapy (LLLT) in the Development of Exercise-Induced Skeletal Muscle Fatigue and Changes in Biochemical Markers Related to Post-Exercise Recovery.

Leal Junior EC, Lopes-Martins RA, Frigo L, De Marchi T, Rossi RP, de Godoi V, Tomazoni SS, da Silva DP, Basso M, Filho PL, de Valls Corsetti F, Iversen VV, Bjordal JM

STUDY DESIGN: Randomized crossover double-blinded placebo-controlled trial. OBJECTIVE: To investigate if low level laser therapy (LLLT) can affect biceps muscle performance, fatigue development, and biochemical markers of post-exercise recovery. BACKGROUND: Cell and animal studies have suggested that LLLT can reduce oxidative stress and inflammatory responses in muscle tissue. But it remains uncertain whether these findings can translate into humans in sport and exercise situations. METHODS: Nine healthy male volleyball players participated in the study. They received either active LLLT (cluster probe with 5 laser diodes, l=810 nm, 200 mW power output, 30 seconds of irradiation, applied in 2 locations over the biceps of the non-dominant arm, 60 J of total energy) or placebo LLLT using an identical cluster probe. The intervention or placebo were applied 3 minutes before the performance of exercise. All subjects performed voluntary elbow flexion repetitions with a workload of 75% of their maximal voluntary contraction force (MVC) until exhaustion. RESULTS: Active LLLT increased the number of repetitions by 14.5% (mean of 39.56, SD +/- 4.33 versus 34.56 +/- 5.64, p=0.037) and the elapsed time before exhaustion by 8.0% (p=0.034), when compared to the placebo treatment. The biochemical markers also indicated that recovery may be positively affected by LLLT as indicated by post-exercise blood lactate levels (p<0.01), Creatine Kinase (CK) activity (p=0.017), and C-Reactive Protein (CRP) levels (p=0.047) showing a faster recovery with LLLT application prior to the exercise. CONCLUSION: We conclude that pre-exercise irradiation of the biceps with an LLLT dose of 6 J per application location, applied in 2 locations, increased endurance for repeated elbow flexion against resistance, and decreased post-exercise levels of blood lactate, CK, and CRP. LEVEL OF EVIDENCE: Therapy, Level 1a. J Orthop Sports Phys Ther, Epub 12 April 2010. doi:10.2519/jospt.2010.3294.

J Orthop Sports Phys Ther 2010 Apr 12

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=20436237

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Clinical and microbiologic follow-up evaluations after non-surgical periodontal treatment with erbium:YAG laser and scaling and root planing.

Lopes BM, Theodoro LH, Melo RF, Thompson GM, Marcantonio RA

Department of Periodontology, Araraquara Dental School, UNESP-Sao Paulo State University, Araraquara, Sao Paulo, Brazil.

BACKGROUND: This study compared erbium-doped: yttrium, aluminum, and garnet (Er:YAG) laser irradiation (100 mJ/pulse; 10 Hz; 12.9 J/cm(2)) with or without conventional scaling and root planing (SRP) to SRP only for treatment of periodontal pockets. METHODS: Nineteen patients with pockets from 5 to 9 mm were included. In a split-mouth design, each site was allocated to a treatment group: 1) SRPL, SRP and laser; 2) L, laser; 3) SRP, SRP only; and 4) C, no treatment. Clinical parameters of probing depth (PD), gingival recession, and clinical attachment level (CAL) were evaluated at baseline and 1, 3, 6, and 12 months after treatment. Visible plaque index, gingival bleeding index (GI), bleeding on probing (BOP), and subgingival plaque samples were also measured 12 days postoperatively, in addition to the above mentioned months. Intergroup and intragroup statistical analyses were performed (P <0.05). RESULTS: GI decreased for SRPL and increased for L, SRP, and C (P <0.05) 12 days postoperatively and decreased for SRPL and SRP (P <0.05) 3, 6, and 12 months after baseline; BOP and PD decreased for all treated groups (P <0.01) 3, 6, and 12 months after treatment. CAL gain was significant for SRPL, L, and SRP (P <0.05) 3, 6, and 12 months postoperatively. SRPL and L presented a significant reduction in the percentage of sites with bacteria 6 and 12 months after treatment (P <0.05). CONCLUSION: Non-surgical periodontal treatment with Er:YAG laser may be an alternative treatment for reduction and control of the proliferation of microorganisms in persistent periodontitis.

J Periodontol 2010 May 81(5) 682-91

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=20429647

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[Effect of the photosensitizers pheophorbid a and protoporphyrin IX on skin wound healing by the action of low-intensity laser irradiation]

The effect of photosensitizer with subsequent He-Ne (632.8 nm; 3 mW/cm2) laser irradiation on experimental skin wound healing has been studied. Pheophorbid a and protoporphyrin IX were used as photosensitizers. It was found that the application of the photosensitizer and subsequent laser irradiation, first, decreased the amount and the functional activity of leukocyte in wound excudate and, second, inhibited the SOD-activity, compared to that of the control group. Moreover, pheophorbide a and protoporphyrin practically did not affect the total healing period but decreased the length of the inflammation stage. It was supposed that these effects are related to the generation of reactive oxygen species during irradiation.

Biofizika 2010 Mar-Apr 55(2) 350-5

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=20429292

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The evolution of transcranial laser therapy for acute ischemic stroke, including a pooled analysis of NEST-1 and NEST-2.

Stemer AB, Huisa BN, Zivin JA

University of California, San Diego Medical Center, Medical Office North, 3rd floor, Suite 3, 200 West Arbor Drive #8466, San Diego, CA 92103-8466, USA.

Intravenous tissue plasminogen activator is the only proven therapy for acute ischemic stroke. Not enough patients are eligible for treatment and additional new therapies are needed. Recently, laser technology has been applied to acute ischemic stroke. This noninvasive technique uses near-infrared wavelengths applied to the scalp within 24 h of symptom onset. The mechanism is incompletely understood but may involve increased mitochondrial adenosine triphosphate production. Animal models demonstrated safety and efficacy warranting randomized controlled trials in humans. NEST-1 (phase 2) and NEST-2 (phase 3) confirmed the safety of transcranial laser therapy, although efficacy was not found in NEST-2. Pooled analysis of NEST-1 and NEST-2 revealed a significantly improved success rate in patients treated with laser therapy. Further phase 3 testing is planned and may create a new paradigm for the treatment of acute ischemic stroke.

Curr Cardiol Rep 2010 Jan 12(1) 29-33

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=20425181

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Conservative Management of Lumbar Disc Herniation With Associated Radiculopathy: A Systematic Review.

Hahne, AJ, Ford, JJ, McMeeken, JM

From the *Musculoskeletal Research Centre, School of Physiotherapy, LA Trobe University, Bundoora, Australia; and daggerFaculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Australia.

STUDY DESIGN.: A systematic review of randomized controlled trials. OBJECTIVE.: To determine the efficacy and adverse effects of conservative treatments for people who have lumbar disc herniation with associated radiculopathy (LDHR). SUMMARY OF BACKGROUND DATA.: Although conservative management is commonly used for people who have LDHR, the efficacy and adverse effects of conservative treatments for this condition are unclear. METHODS.: We searched 10 computer databases for trials published in English between 1971 and 2008. Trials focusing on people with referred leg symptoms and radiologic confirmation of a lumbar disc herniation were included if at least 1 group received a conservative and noninjection treatment. RESULTS.: Eighteen trials involving 1671 participants were included. Seven (39%) trials were considered of high quality. Meta-analysis on 2 high-quality trials revealed that advice is less effective than microdiscectomy surgery at short-term follow-up, but equally effective at long-term follow-up. Individual high-quality trials provided moderate evidence that stabilization exercises are more effective than no treatment, that manipulation is more effective than sham manipulation for people with acute symptoms and an intact anulus, and that no difference exists among traction, laser, and ultrasound. One trial showed some additional benefit from adding mechanical traction to medication and electrotherapy methods. Adverse events were associated with traction (pain, anxiety, lower limb weakness, and fainting) and ibuprofen (gastrointestinal events). CONCLUSION.: Advice is less effective than microdiscectomy in the short term but equally effective in the long term for people who have LDHR. Moderate evidence favors stabilization exercises over no treatment, manipulation over sham manipulation, and the addition of mechanical traction to medication and electrotherapy. There was no difference among traction, laser, and ultrasound. Adverse events were associated with traction and ibuprofen. Additional high-quality trials would allow firmer conclusions regarding adverse effects and efficacy.

Spine (Phila Pa 1976) 2010 Apr 23

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=20421859

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Light distribution in intravascular low level laser therapy applying mathematical simulation: a comparative study.

Li X, Cheng G, Huang N, Wang L, Liu F, Gu Y

Department of Laser Medicine, Chinese PLA General Hospital, Beijing 100853, China.

Intravascular low level laser therapy (ILLLT) has been applied in the treatment of many diseases for about twenty years. However, much fundamental work has not been done on its dosimetry. The study was designed to compare the difference of light distribution during ILLLT between using flat end fiber and optical fiber coupled with cylindrical light diffuser. Light distribution of He-Ne laser was processed by Monte Carlo model. The laser output was 5 mW. The diameter of both optical fibers was 400 microm. Four tissue optical parameters were chosen for simulation. The results showed that optical parameters of blood are important to determine the distribution of laser energy. The highest power density could increase to over 5000 mW/cm2 using flat end fiber. And the laser energy was absorbed by the blood cells in very small area before the tip of flat end fiber. But when using optical fiber coupled with cylindrical light diffuser, the highest power density was about 100 mW/cm2. More volume of blood cells could be irradiated by laser light. In summary, optical fiber coupled with cylindrical light diffuser is superior to flat end fiber at the aspect of increasing the volume of irradiated blood and decreasing unwanted damage to blood cells during intravascular low level laser therapy.

J Xray Sci Technol 2010 Jan 1 18(1) 47-55

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=20421704

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Is low-level laser therapy effective in acute or chronic low back pain?

Ay S, Dogan SK, Evcik D

Department of Physical Rehabilitation and Medicine, Ufuk University School of Medicine, Ankara, Turkey, saimeay@yahoo.com.

The purpose of this study was to compare the effectiveness of low-level laser therapy (LLLT) on pain and functional capacity in patients with acute and chronic low back pain caused by lumbar disk herniation (LDH). LLLT has been used to treat acute and chronic pain of musculoskeletal system disorders. This study is a randomized, double-blind, placebo-controlled study. Forty patients with acute (26 females/14 males) and 40 patients with chronic (20 females/20 males) low back pain caused by LDH were included in the study. Patients were randomly allocated into four groups. Group 1 (acute LDH, n = 20) received hot-pack + laser therapy; group 2 (chronic LDH, n = 20) received hot-pack + laser therapy; group 3 (acute LDH, n = 20) received hot-pack + placebo laser therapy, and group 4 (chronic LDH, n = 20) received hot-pack + placebo laser therapy, for 15 sessions during 3 weeks. Assessment parameters included pain, patients’ global assessment, physician’s global assessment, and functional capacity. Pain was evaluated by visual analog scale (VAS) and Likert scale. Patients’ and physician’s global assessment were also measured with VAS. Modified Schober test and flexion and lateral flexion measures were used in the evaluation of range of motion (ROM) of lumbar spine. Roland Disability Questionnaire (RDQ) and Modified Oswestry Disability Questionnaire (MODQ) were used in the functional evaluation. Measurements were done before and after 3 weeks of treatment. After the treatment, there were statistically significant improvements in pain severity, patients’ and physician’s global assessment, ROM, RDQ scores, and MODQ scores in all groups (p < 0.05). However, no significant differences were detected between four treatment groups with respect to all outcome parameters (p > 0.05). There were no differences between laser and placebo laser treatments on pain severity and functional capacity in patients with acute and chronic low back pain caused by LDH.

Clin Rheumatol 2010 Apr 23

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=20414695

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[Effects of low-level helium-neon laser on induced wound healing in rats]

Busnardo VL, Biondo-Simoes ML

Pontificia Universidade Catolica do Parana, Curitiba, PR, Brasil. vivianelucci@up.edu.br

OBJECTIVE: To evaluate the effects of low-level helium-neon (HeNe) laser on cutaneous wound healing in rats. METHODS: Sixty Wistar rats were divided into control group and experimental group. A sutured longitudinal, dorsal-medial incision was made, with simple separate stitches. The experimental group was irradiated daily in three areas of the wound with HeNe laser (5mW maximum continuous power, 632.8 nm wavelength, 4 J/cm(2) energy density and 0.015 cm(2) laser beam area) for 36 seconds. The areas were evaluated on the third, seventh and fourteenth days postoperative. Histological sections were stained with hematoxylin-eosin to determine the type of inflammatory reaction according to the protocol by Vizzotto et al. (2003)* and with Picrosirius to identify types I and III collagen and the collagen maturation index (CMI). Immunohistochemical detection was employed with anti-CD45-LCA to recognize the inflammatory cells. RESULTS: Both groups had the same inflammatory pattern. The experimental group had fewer inflammatory cells at the three evaluation times (p<0.001) with faster reduction in the number of leukocytes. The experimental group had greater total collagen density on the third day (p=0.001), with more type III collagen (p=0.001) and more type I collagen (p=0.001). There was no significant difference in the CMI. CONCLUSION: Low-level laser irradiation does not change the quality of the inflammatory response, but it does reduce its intensity; it increases collagen deposition in the early stages of the healing process and does not interfere with collagen maturation.

Rev Bras Fisioter 2010 Feb 14(1) 45-51

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=20414561

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[The use of electrothermal and phototherapeutic methods for the treatment of fibromyalgia syndrome: a systematic review]

Ricci NA, Dias CN, Driusso P

Departamento de Fisioterapia, Universidade Federal de Sao Carlos, Sao Carlos, SP, Brasil. natalia_ricci@hotmail.com

OBJECTIVE: To systematically investigate the scientific evidence relating to electrothermal and phototherapeutic methods for the treatment of fibromyalgia syndrome (FMS). METHODS: The search for reports on interventions using electrothermal and phototherapy for FMS was carried out in the Pubmed, Medline, Lilacs, Scielo, ISI Web of Knowledge, PEDro and Cochrane Collaboration databases. Randomized controlled clinical trials published over the past 10 years in English, Portuguese and Spanish were selected. The methodological quality of the studies was assessed using the Jadad scale. The analysis on the study results was done by means of critical review of the content. RESULTS: Seven studies were reviewed in full, and these identified interventions using laser (n=4), transcutaneous electrical nerve stimulation (TENS; n=1), interferential current (IFC) alone (n=1) and IFC combined with ultrasound (US; n=1). Only two studies showed good methodological quality according to the Jadad scale. Most of the studies (n=6) used the criteria of the American College of Rheumatology for the clinical diagnosis of FMS. Pain was the most frequently evaluated FMS symptom. The intervention methods and their duration varied widely, and there was no mention of the parameters used in the electrothermal and phototherapeutic methods. Pain levels reduced significantly in all of the studies. CONCLUSION: There are still limitations on the generalization of the results, adverse reactions and doses of the FMS treatment. Further studies are needed to establish the effectiveness of electrothermal and phototherapy in treating FMS.

Rev Bras Fisioter 2010 Feb 14(1) 1-9

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=20414555

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Mechanism of high-power NIR laser bacteria inactivation.

Hibst R, Graser R, Udart M, Stock K

Institut fur Lasertechnologien in der Medizin und Messtechnik an der Universitat Ulm, Helmholtzstrasse 12, 89081 Ulm, Germany.

Lasers are used in dentistry for a variety of indications. One of these is the disinfection of root canals or the sterilization of residual caries. Many studies have demonstrated the capacity to kill bacteria for lasers but the fundamental mechanism of the laser effect remains quite unclear. With our experiments we wanted to determine whether high-power NIR laser bacterial killing is caused by the light itself (photochemical effect) or by a photothermal process. In order to differentiate between mechanisms we heated bacteria suspensions of a nonpathogenic strain of E. coli by a water bath and by a diode laser (940 nm) with the same temporal temperature course. Furthermore, bacteria suspensions were irradiated while the temperature was fixed by ice water. Killing of bacteria was measured via fluorescence labelling. Comparison of killing rates between laser and water-based heating shows no significant differences. The most important parameter is the maximum temperature. Laser irradiation of bacteria at low temperatures does not result in killing. Our experiments show that at least for E. coli bacteria inactivation by high-power laser irradiation is solely based on a thermal process. ((c) 2010 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim).

J Biophotonics 2010 Apr 21

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=20411570

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In Vivo Low-level Light Therapy Increases Cytochrome Oxidase in Skeletal Muscle.

Hayworth, CR, Rojas, JC, Padilla, E, Holmes, GM, Sheridan, EC, Gonzalez-Lima, F

Departments of Psychology, Pharmacology and Toxicology, Institute for Neuroscience, University of Texas at Austin, Austin, TX.

Abstract Low-level light therapy (LLLT) increases survival of cultured cells, improves behavioral recovery from neurodegeneration and speeds wound healing. These beneficial effects are thought to be mediated by upregulation of mitochondrial proteins, especially the respiratory enzyme cytochrome oxidase. However, the effects of in vivo LLLT on cytochrome oxidase in intact skeletal muscle have not been previously investigated. We used a sensitive method for enzyme histochemistry of cytochrome oxidase to examine the rat temporalis muscle 24 h after in vivo LLLT. The findings showed for the first time that in vivo LLLT induced a dose- and fiber type-dependent increase in cytochrome oxidase in muscle fibers. LLLT was particularly effective at enhancing the aerobic capacity of intermediate and red fibers. The findings suggest that LLLT may enhance the oxidative energy metabolic capacity of different types of muscle fibers, and that LLLT may be used to enhance the aerobic potential of skeletal muscle.

Photochem Photobiol 2010 Apr 16

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=20408982

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Effect of HeNe Laser Irradiation on Extracellular Matrix Deposition and Expression of Cytokines and Chemokines in Paracoccidioidomycotic Lesions.

Nagib PR, Gameiro J, da Costa TA, Di Gangi R, da Silva Ribeiro J, Paulino LC, Verinaud L

Institute of Tropical Pathology and Public Health, Federal University of Goias-UFG, Goiania, Goias, Brazil.

Abstract Paracoccidioidomycosis is the most prevalent human mycosis in Latin America. Cutaneous lesions are extremely painful and sensitive, and current treatment with antifungal drugs is lengthy and may cause side effects to patients. In this perspective, the helium-neon (HeNe) laser emerges as a novel therapy form due to its ability to heal wounds without changing cell function. In this work, we evaluate the effects of HeNe laser irradiation on extracellular matrix deposition and expression of cytokines and chemokines in cutaneous lesions caused by experimental infection of Balb/c mice. Our results showed decreased levels of pro-inflammatory interleukin (IL)-17 and tumor necrosis factor-alpha, and of anti-inflammatory IL-10 cytokines in lesions exposed to HeNe laser irradiation. Chemokines CCL3 and CXCL10 showed decreased levels in laser-treated lesions, but no significant difference was observed in relation to CCL5 expression. We also detected decreased density of fibronectin and laminin in HeNe laser-treated lesions. Data presented herein support the validity of our previous results suggesting positive effects of HeNe laser in accelerating wound healing in this experimental model. We believe that HeNe laser is a new nonharmful strategy that may be used as adjuvant and/or alternative therapy for improving treatment of paracoccidioidomycotic lesions.

Photochem Photobiol 2010 Apr 16

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=20408980

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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 (470nm) 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 10min by LED at 470nm or 630nm with an intensity of 50mW/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 2010 Apr 16

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=20400080

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A short-term evaluation of Nd:YAG laser as an adjunct to scaling and root planing in treatment of periodontal inflammation.

Qadri, T, Poddani, P, Javed, F, Tuner, J, Gustafsson, A

Division of Periodontology, Department of Dental Medicine, Karolinska Institutet, Huddinge, Sweden.

Background: The aim of this split-mouth, single blind, randomized, controlled clinical trial was to compare the short-term outcome of combined scaling and root planing (SRP) and Neodymium Yttrium Aluminum Garnet (Nd:YAG) laser irradiation with SRP alone. Methods: Thirty patients were recruited. Mandibular left or right side was randomly assigned as the test- (SRP with laser treatment) and control-side (SRP alone). The water-cooled Nd:YAG laser was used at four Watt, 80 millijoule per pulse, 50 Hertz, and with a pulse width of 350 microseconds. At baseline, gingival crevicular fluid (GCF) samples were taken from the test and control sides and levels of matrix metalloproteinase (MMP)-8, Interleukin (IL)-1beta, -4, -6, and -8 were measured using standard techniques. Plaque index (PI), gingival index (GI) and probing pocket depth (PPD) were measured by calibrated examiners. Results: At the one week follow-up, PPD (P <0.001), PI (P <0.05) and GCF volume (P <0.001) showed significant improvement on the test-side compared to the control-side. At the three-month follow-up, PPD (P <0.01), PI (P <0.01), GI (P <0.001) and GCF volume (P <0.05) also showed significant improvement on the test-side compared to the control-side. At the one week follow up, the IL-1beta and MMP-8 levels were significantly reduced on the test-side compared to the control-side. The three-month follow-up confirmed that the improvements on the test-site had been sustained compared to the control site. Conclusions: In short-term, SRP in combination with a single application of a water cooled Nd:YAG laser significantly improves clinical signs associated with periodontal inflammation compared to treatment by SRP alone.

J Periodontol 2010 Apr 16

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=20397904

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Efficacy of Low-Level Laser Therapy for Body Contouring and Spot Fat Reduction.

Caruso-Davis MK, Guillot TS, Podichetty VK, Mashtalir N, Dhurandhar NV, Dubuisson O, Yu Y, Greenway FL

School of Human Ecology, Louisiana State University, Baton Rouge, LA, 70803, USA.

BACKGROUND: Low-level laser therapy (LLLT) is commonly used in medical applications, but scientific studies of its efficacy and the mechanism by which it causes loss of fat from fat cells for body contouring are lacking. This study examined the effectiveness and mechanism by which 635-680 nm LLLT acts as a non-invasive body contouring intervention method. METHODS: Forty healthy men and women ages 18-65 years with a BMI <30 kg/m(2) were randomized 1:1 to laser or control treatment. Subject’s waistlines were treated 30 min twice a week for 4 weeks. Standardized waist circumference measurements and photographs were taken before and after treatments 1, 3, and 8. Subjects were asked not to change their diet or exercise habits. In vitro assays were conducted to determine cell lysis, glycerol, and triglyceride release. RESULTS: Data were analyzed for those with body weight fluctuations within 1.5 kg during 4 weeks of the study. Each treatment gave a 0.4-0.5 cm loss in waist girth. Cumulative girth loss after 4 weeks was -2.15 cm (-0.78 +/- 2.82 vs. 1.35 +/- 2.64 cm for the control group, p < 0.05). A blinded evaluation of standardized pictures showed statistically significant cosmetic improvement after 4 weeks of laser treatment. In vitro studies suggested that laser treatment increases fat loss from adipocytes by release of triglycerides, without inducing lipolysis or cell lysis. CONCLUSIONS: LLLT achieved safe and significant girth loss sustained over repeated treatments and cumulative over 4 weeks of eight treatments. The girth loss from the waist gave clinically and statistically significant cosmetic improvement.

Obes Surg 2010 Apr 15

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=20393809

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Low-level laser therapy (LLLT) attenuates RhoA mRNA expression in the rat bronchi smooth muscle exposed to tumor necrosis factor-alpha.

de Lima FM, Bjordal JM, Albertini R, Santos FV, Aimbire F

Instituto de Pesquisa e Desenvolvimento, IP&D, Av. Shishima Hifumi, 2911, Sao Jose dos Campos, CEP: 12244-000, Sao Paulo, SP, Brazil.

Low-level laser therapy (LLLT) has been found to produce anti-inflammatory effects in a variety of disorders. Bronchial smooth muscle (BSM) hyperreactivity is associated with increased Ca(+2) sensitivity and increased RhoA mRNA expression. In the current study, we investigated if LLLT could reduce BSM contraction force and RhoA mRNA expression in tumor necrosis factor-alpha (TNF-alpha)-induced BSM hyperreactivity. In the study, 112 male Wistar rats were divided randomly into 16 groups, and BSM was harvested and suspended in TNF-alpha baths for 6 and 24 h, respectively. Irradiation with LLLT was performed with a wavelength of 660 nm for 42 s with a dose of 1.3 J/cm(2). This LLLT dose was administered once in the 6-h group and twice in the 24-h group. LLLT significantly decreased contraction force in BSM at 6 h (TNF-alpha + LLLT: 11.65 +/- 1.10 g/100 mg of tissue) (F = 3115) and at 24 h (TNF-alpha + LLLT: 14.15 +/- 1.1 g/100 mg of tissue) (F = 3245, p < 0.05) after TNF-alpha, respectively, when compared to vehicle-bathed groups (control). LLLT also significantly decreased the expression of RhoA mRNA in BSM segments at 6 h (1.22 +/- 0.20) (F = 2820, p < 0.05) and 24 h (2.13 +/- 0.20) (F = 3324, p < 0.05) when compared to BSM segments incubated with TNF-alpha without LLLT irradiation. We conclude that LLLT administered with this protocol, reduces RhoA mRNA expression and BSM contraction force in TNF-alpha-induced BSM hyperreactivity.

Lasers Med Sci 2010 Apr 15

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=20393772

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Mechanical evaluation of the influence of low-level laser therapy in secondary stability of implants in mice shinbones.

Maluf AP, Maluf RP, da Rocha Brito C, Franca FM, de Brito RB Jr

Sao Leopoldo Mandic Dental Research Institute, Campinas, SP, Brazil, alemaluf@terra.com.br.

The present work evaluates mechanically the bone-implant attachment submitted or not to low-level laser therapy, with wavelength of 795 nm, in a continuous way, with power of 120 mW. The implant was placed in one of the shinbones of 24 mice, randomly distributed into two groups. The experimental group was submitted to six laser applications, divided into four points previously established, two lateral and two longitudinal, six times 8 J/cm(2) with an interval of 2 days, totaling the dose of 48 J/cm(2). The control group did not receive laser therapy. The interval between applications was 48 h and the irradiations began immediately after the end of the implant surgeries. The two groups were killed on the 14th day and a bone block of the area was removed where the implant was inserted. A torque machine was used to measure the torque needed for loosening the implants. A statistically significant difference was observed between the two groups. The experimental group presented larger difficulty for breaking up the implant interface with the bone block than the control group. It can be concluded that with the animal model and the protocol of irradiation present in this study, the laser therapy demonstrated capacity to increase the attachment bone implant.

Lasers Med Sci 2010 Apr 15

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=20393769

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Development of compression-controlled low-level laser probe system: towards clinical application.

Yeo C, Son T, Park J, Lee YH, Kwon K, Nelson JS, Jung B

Department of Biomedical Engineering, Yonsei University, 234 Maeji-Ri, Heungup-Myeon, Wonju-Si, Gangwon-Do, 220-710, Korea.

Various physico-chemical tissue optical clearing (TOC) methods have been suggested to maximize photon density in tissue. In order to enhance photon density, a compression-controlled low-level laser probe (CCLLP) system was developed by utilizing the principle of mechanical tissue compression. Negative compression (NC) was applied to the laser probes built in various diameters and simultaneously the laser was irradiated into ex-vivo porcine skin samples. Laser photon density (LPD) was evaluated as a function of NC and probe diameter by analyzing 2D diffusion images of the laser exposures. The CCLLP system resulted in a concentrated laser beam profile, which means enhancement of the LPD. As indicators of LPD, the laser peak intensity increased and the full width at half maximum (FWHM) decreased as a function of NC. The peak intensity at -30 kPa increased 2.74, 3.22, and 3.64 fold at laser probe diameters of 20, 30, and 40 mm, respectively. In addition, sample temperature was measured with a thermal camera and increased 0.4 K at -30 kPa after 60 s of laser irradiation as a result of enhanced LPD. The CCLLP system effectively demonstrated enhancement of the LPD in tissue and potentially its clinical feasibility.

Lasers Med Sci 2010 Apr 15

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=20393768

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Seeing the Light – The Truth about Soft Tissue Lasers and Nonsurgical Periodontal Therapy.

Matthews DC

Although laser treatment has generated considerable interest among dentists and the public, there is no evidence that any laser system adds clinical value over and above scaling and root planing and conventional surgical treatment for periodontitis. Following a brief explanation of the mechanism behind soft tissue lasers, the evidence on the use of laser therapy in addition to traditional nonsurgical periodontal treatment in the management of periodontal diseases is reviewed.

J Can Dent Assoc 2010 Apr 76(2) 10702

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=20388312

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Mitochondrial mechanisms of photobiomodulation in context of new data about multiple roles of ATP.

Karu T

Photomed Laser Surg 2010 Apr 28(2) 159-60

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=20374017

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Use of laser technology in orthodontics: hard and soft tissue laser treatments.

Genovese, MD, Olivi, G

AIM: Modern technology has perfected a new instrument that has become almost indispensable in modern dentistry, in accordance with the philosophy of minimally invasive therapy: the laser. The aim of this work is to evaluate the effectiveness and efficacy of laser technology to solve mucogingival problems associated with orthodontic treatment. Some laser wavelengths work both on hard and soft tissues (2780 nm, 2940 nm), other lasers, such as the 810 nm diode, have a very good surgical and haemostatic action on soft tissues and an important analgesic and biostimulating effect that can help the healing of both TMJ painful symptoms as well as the pain following active orthodontic treatment. Several cases connected to orthodontic therapy are presented. MATERIALS AND METHODS: Different laser systems (diode laser at 810 nm; Er,Cr:YSGG laser at 2780 nm; Erbium:YAG laser at 2940 nm) were used, both for soft tissue surgery and enamel etching, and for biostimulating effect. These wavelengths were used with different parameters for each case, according to international current studies in view of minimally invasive therapy. RESULTS: The cases reported showed very quick and good healing of the laser treated tissues. These treatments, necessary for the orthodontic therapy or for its completion, become extremely simple, safe and rapid and the orthodontic specialist can perform them himself. CONCLUSION: The laser technique is very effective in many operative and surgical procedures during orthodontic therapy. Further studies are however necessary to set the treatment protocols in orthodontic biostimulation.

Eur J Paediatr Dent 2010 Mar 11(1) 44-8

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=20359282

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Oral mucositis. Review of literature.

Scardina, GA, Pisano, T, Messina, P

Department of Oral Sciences, University of Palermo, Italy. scardina@odonto.unipa.it

The standard treatment for malignant neoplasia of the cervicofacial area is surgery in association with radio- and/or chemotherapy. These therapies can cause local and systemic complications. Mucositis is the most common dose-correlated complication to the oral cavity. It is particularly difficult to treat in patients who are already physically and psychologically exhausted by the tumoral pathology. This study illustrates, through a review of the literature, the attack rate, the pathogenesis and the clinical course of the mucositis, as well as the correct dental approach and clinical-therapeutic management of these patients, with the aim of improving the quality of their lives.

N Y State Dent J 2010 Jan 76(1) 34-8

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=20359063

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Effect of near-infrared light-emitting diodes on nerve regeneration.

Ishiguro, M, Ikeda, K, Tomita, K

Department of Orthopaedic Surgery, Graduate School of Medicine, Kanazawa University, 13-1 Takara-machi, Kanazawa, Ishikawa, 920-8641, Japan.

BACKGROUND: Photobiomodulation by red to near-infrared light-emitting diodes (LEDs) has been reported to accelerate wound healing, attenuate degeneration of an injured optic nerve, and promote tissue growth. The purpose of this study was to investigate the effect of LEDs on nerve regeneration. A histological study as well as a measurement of antioxidation levels in the nerve regeneration chamber fluid was performed. METHODS: For the histological study, the bilateral sciatic nerves were transected, and the left proximal stump and the right distal stump were inserted into the opposite ends of a silicone chamber, leaving a 10-mm gap. Light from an LED device (660 nm, 7.5 mW/cm(2)) was irradiated for 1 h per day. At 3 weeks after surgery, regenerated tissue was fixed and examined by light microscopy. For the antioxidation assay of chamber fluid, the left sciatic nerve and a 2-mm piece of nerve from the proximal stump were transected and inserted into opposite sides of a silicone chamber leaving a 10-mm gap. LEDs were irradiated using the same parameters as those described in the histological study. At 1, 3, and 7 days after surgery, antioxidation of the chamber fluid was measured using an OXY absorbent test. RESULTS: Nerve regeneration was promoted in the LED group. Antioxidation of the chamber fluid significantly decreased from 3 days to 7 days in the control group. In the LED group, antioxidation levels did not decrease until 7 days. CONCLUSIONS: Chamber fluid is produced from nerve stumps after nerve injury. This fluid contains neurotrophic factors that may accelerate axonal growth. Red to near-infrared LEDs have been shown to promote mitochondrial oxidative metabolism. In this study, LED irradiation improved nerve regeneration and increased antioxidation levels in the chamber fluid. Therefore, we propose that antioxidation induced by LEDs may be conducive to nerve regeneration.

J Orthop Sci 2010 Mar 15(2) 233-9

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=20358337

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Effects of low-level light therapy on streptozotocin-induced diabetic kidney.

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

School of Public and Environmental Affairs, Indiana University, 1315 East Tenth Street, Bloomington, IN 47405, United States.

Hyperglycemia causes oxidative damage in tissues prone to complications in diabetes. Low-level light therapy (LLLT) in the red to near infrared range (630-1000nm) has been shown to accelerate diabetic wound healing. To test the hypothesis that LLLT would attenuate oxidative renal damage in Type I diabetic rats, male Wistar rats were made diabetic with streptozotocin (50mg/kg, ip), and then exposed to 670nm light at a dose of 9J/cm(2) once per day for 14weeks. The activity and expression of catalase and the activity of Na K-ATPase increased in kidneys of light-treated diabetic rats, whereas the activity and expression of glutathione peroxidase and the expression of Na K-ATPase were unchanged. LLLT lowered the values of serum BUN, serum creatinine, and BUN/creatinine ratio. In addition, LLLT augmented the activity and expression of cytochrome c oxidase, a primary photoacceptor molecule in the mitochondrial respiratory chain, and reduced the formation of the DNA adduct 8-hydroxy-2′-deoxyguanosine in kidney. LLLT improved renal function and antioxidant defense capabilities in the kidney of Type I diabetic rats. Thus, 670nm LLLT may be broadly applicable to the amelioration of renal complications induced by diabetes that disrupt antioxidant defense mechanisms.

J Photochem Photobiol B 2010 May 3 99(2) 105-10

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=20356759

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The influence of baseline characteristics on response to a laser acupuncture intervention: an exploratory analysis.

Glazov G

School of Primary, Aboriginal and Rural Health Care, University of Western Australia, 328 Stirling Hwy Claremont WA 6010, Australia. glazog01@student.uwa.edu.au

OBJECTIVES: In clinical practice it is known that subjects vary in their response to acupuncture, but there is little data on what predicts the outcome. The aim of this study was to identify such predictors. METHOD: A secondary analysis was performed on data from 100 participants in a trial of laser and sham laser acupuncture for chronic non-specific low back pain. Multiple regression analysis was used to identify which baseline characteristics predicted pain change in the immediate, short and intermediate term. An analysis of covariance was performed based on these results to re-examine the primary result of the trial. RESULTS: Strong predictors of poor response were receipt of disability support pension, headache, the regular use of analgesics or previous failed back surgery. Higher pain scores or exacerbation of pain at baseline predicted a greater proportionate pain relief after the intervention. Adjusted analysis suggested a clinically important effect of laser compared to sham (p<0.05), at short term follow-up only. CONCLUSION: The findings of this study suggest which characteristics of patients with chronic low back pain are more likely to respond to laser acupuncture treatment, but require replication in other studies. The findings may not apply in other acupuncture interventions and treatment of different conditions. They may also be used to set selection criteria for future studies, and to aid interpreting the effect of baseline imbalances on trial results.

Acupunct Med 2010 Mar 28(1) 6-11

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=20351369

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The effects of low-level diode laser treatment and dental pulp-capping materials on the proliferation of L-929 fibroblasts.

Ferriello V, Faria MR, Cavalcanti BN

Biodentistry Postgraduate Program, Ibirapuera University, Sao Paulo, Brazil.

Low-level laser therapy (LLLT) has been reported to improve tissue healing and might therefore be useful in dental pulp capping after trauma. We evaluated the effects of a low-level diode laser (lambda = 680 nm) and dental pulp-capping substances on cell proliferation. Calcium hydroxide and adhesive resin were applied as conditioned media to cultures. Half of the samples received irradiation with the diode laser at a fluence of 4 J/cm(2) for 60 s. Using a hemocytometer, cells were counted at 1, 3, 5, and 7 days, and the data were analyzed by ANOVA. All cultures exhibited continuous growth, except those treated with adhesive resin. As compared to the other two groups, cell proliferation was significantly lower in cultures treated with adhesive resin; it was also significantly lower in cultures treated with calcium hydroxide, as compared to the control group. When combined with dental pulp-capping materials, LLLT had no effect on L-929 cell proliferation.

J Oral Sci 2010 52(1) 33-8

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=20339230

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LPLI inhibits apoptosis upstream of Bax translocation via a GSK-3beta-inactivation mechanism.

Zhang L, Zhang Y, Xing D

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

Low-power laser irradiation (LPLI), a non-damage physical therapy, which has been used clinically for decades of years, is shown to promote cell proliferation and prevent apoptosis. However, the underlying mechanisms that LPLI prevents cell apoptosis remain undefined. In this study, based on real-time single-cell analysis, we demonstrated for the first time that LPLI inhibits staurosporine (STS)-induced cell apoptosis by inactivating the GSK-3beta/Bax pathway. LPLI could inhibit the activation of GSK-3beta, Bax, and caspase-3 induced by STS. In the searching for the mechanism, we found that, LPLI can activate Akt, which was consistence with our former research, even in the presence of STS. In this anti-apoptotic process, the interaction between Akt and GSK-3beta increased gradually, indicating Akt interacts with and inactivates GSK-3beta directly. Conversely, LPLI decreased the interaction between GSK-3beta and Bax, with the suppression of Bax translocation to mitochondria, suggesting LPLI inhibits Bax translocation through inactivating GSK-3beta. These results were further confirmed by the experiments of co-immunoprecipitation. Wortmannin, an inhibitor of phosphatidylinositol 3′-OH kinase (PI3K), potently suppressed the activation of Akt and subsequent anti-apoptotic processes induced by LPLI. Taken together, we conclude that LPLI protects against STS-induced apoptosis upstream of Bax translocation via the PI3K/Akt/GSK-3beta pathway. These findings raise the possibility of LPLI as a promising therapy for neuron-degeneration disease induced by GSK-3beta.

J Cell Physiol 2010 Jul 224(1) 218-28

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=20333643

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The light revival: does phototherapy promote wound healing? A review.

Whinfield AL, Aitkenhead I

Department of General Practice and Primary Care, Kings College London School of Medicine, 5 Lambeth Walk, London, UK. annewhin@googlemail.com

BACKGROUND: Throughout history, light has been recognised as a potential source of healing. The introduction of lasers made it possible to modify and control light for optimum therapeutic use. AIM: This paper reviews recent clinical trials that test phototherapy on human models in order to assess the value of phototherapy in routine wound care. METHOD: A literature search was undertaken using a variety of sources including online databases. RESULTS: The results of numerous in vitro and animal investigations suggest that phototherapy may stimulate cell activity and promote tissue repair. Reports of human clinical trials are relatively few. There is inconsistency of selected treatment parameters amongst studies testing the effect of phototherapy on wound healing. Clinical trials using human models do not provide sufficient evidence to establish the usefulness of phototherapy as an effective tool in wound care regimes. CONCLUSION: Further well designed research trials are required to determine the true value of phototherapy in routine wound care.

Foot (Edinb) 2009 Jun 19(2) 117-24

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=20307462

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Laser acupuncture for myofascial pain of the masticatory muscles. A controlled pilot study.

Katsoulis J, Ausfeld-Hafter B, Windecker-Getaz I, Katsoulis K, Blagojevic N, Mericske-Stern R

Department of Prosthodontics, School of Dental Medicine, University of Bern, Bern, Switzerland. joannis.katsoulis@zmk.unibe.ch

PURPOSE: The purpose of this investigation was to evaluate the effectiveness of laser acupuncture within the scope of a pilot study. METHODS: 108 adult patients were examined and of those eleven patients were included in the prospective pilot study. These patients took part voluntarily and were diagnosed with tendomyopathy of the masticatory musculature with maximum face and jaw pain on a visual analogous scale VAS > or = 30 in the last 14 days. Four patients wanted to be sure not to be assigned to the placebo group and were treated with the laser (group1, verum open, N = 4). The remaining seven were split by means of block randomisation into groups 2 (verum blind, N = 3) and 3 (placebo blind, N = 4). Two local points (ST 6, SI 18) and two distant points (SI 3, LI 4) on both sides of the body were stimulated (groups 1 and 2) or placebo-stimulated (group 3) with the LASERneedle machine for 15 minutes twice a week for three weeks (6 sessions). After three months a clinical follow-up was carried out, which included a standardised questionnaire as to the maximum pain intensity (VAS and verbal scale) and on the need for further treatment. A pain reduction (VAS) of about 50% was evaluated as a success. RESULTS: Pain decreased on average 40 VAS points for ten of eleven patients. The pain reduction on the VAS in group 1 (verum open) was more than 50% for all four patients, in group 3 (placebo blind) for three of four patients, and in group 2 (verum blind) all remained under 50%. The evaluation on the verbal scale showed a pain reduction from moderate to very strong pains initially, to moderate, light and no pain after three months for all three groups. DISCUSSION: The range of application of the laser was limited by the narrow inclusion criteria of the pilot study. The laser acupuncture (open and blinded) did not show a negative effect in any group. The pain reduction was strongest with the blinded patients of the placebo group. The worst performance was in the blinded group with laser acupuncture. CONCLUSION: Due to the low number of participants, no clear conclusion can be drawn. Laser needle acupuncture may be a treatment option for patients with an interest in a noninvasive, complementary therapy. But clarification and treatment planning on an individual basis must take place first.

Schweiz Monatsschr Zahnmed 2010 120(3) 213-25

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=20238281

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Laser biomodulation on L 929 cell culture.

Pires-Oliveira DA, Oliveira RF, Machado AH, Zangaro RA, Pacheco-Soares C

Universidade Camilo Castelo Branca, Unicastelo, Sao Paulo, Brazil.

OBJECTIVE: The aim of the present study was to analyze the effects of photobiomodulation using a 904-nm diode laser at two energy densities (6 J/cm(2) and 50 mJ/cm(2)) on L929 fibroblast cells. BACKGROUND: Low-power laser irradiation (LPLI) is a non-pharmacological resource that induces important in vitro photobiomodulation on cell cultures and tissues. METHODS: Irradiation was performed for three days at 24-h intervals. After each interval, the cells were stained with MitoTracker Orange and DioC6 dyes to assess the photobiomodulatory effects of irradiation on mitochondrial activity and changes in the endoplasmic reticulum. The MTT assay [3-(4.5-dimethylthiazol-2-yl)-2.5 diphenyltetrazolium bromide] was used to evaluate cell proliferation. RESULTS AND CONCLUSIONS: The fluorescence microscopy assessment of mitochondria and endoplasmic reticulum in cells irradiated with 6 J/cm(2) and 50 mJ/cm(2) demonstrated intense mitochondrial activity, which was confirmed by DioC6 staining. Reticular activity was observed stemming from increased protein synthesis. Photobiomodulation with 50 mJ/cm(2) was slightly higher than with 6 J/cm(2), as demonstrated by fluorescence microscopy results. Photobiomodulation was also time-dependent, with better results 72-h after irradiation.

Photomed Laser Surg 2010 Apr 28(2) 167-71

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=20232997

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Phototherapy: the challenge to accurately measure irradiance.

Vreman HJ

Indian Pediatr 2010 Feb 7 47(2) 127-8

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=20228426

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Effects of CO2 laser irradiation of the gingiva during tooth movement.

Seiryu, M, Deguchi, T, Fujiyama, K, Sakai, Y, Daimaruya, T, Takano-Yamamoto, T

Division of Orthodontics and Dentofacial Orthopedics, Tohoku University Graduate School of Dentistry, 4-1, Seiryomachi, Aoba-ku, Sendai, 980-8574, Japan.

Patients often feel pain or discomfort in response to orthodontic force. It was hypothesized that CO(2) laser irradiation may reduce the early responses to nociceptive stimuli during tooth movement. The distribution of Fos-immunoreactive (Fos-IR) neurons in the medullary dorsal horn of rats was evaluated. Two hrs after tooth movement, Fos-IR neurons in the ipsilateral part of the medullary dorsal horn increased significantly. CO(2) laser irradiation to the gingiva just after tooth movement caused a significant decrease of Fos-IR neurons. PGP 9.5- and CGRP-positive nerve fibers were observed in the PDL of all study groups. The maximum temperature below the mucosa during CO(2) laser irradiation was less than 40 degrees C. It was suggested that CO(2) laser irradiation reduced the early responses to nociceptive stimuli during tooth movement and might not have adverse effects on periodontal tissue.

J Dent Res 2010 May 89(5) 537-42

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=20228277

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Posted in Research | on LLLT Literature Watch for May 2010

What makes THOR probes special (why we test LEDs)

Posted in Special Feature, Video of the Week | on What makes THOR probes special (why we test LEDs)

LLLT Literature Watch for January 2010

Some very interesting papers in this edition including a large back pain RCT of 546 patients, LLLT for major depression and anxiety from Harvard Medical School, Allergic Rhinitis  and another from Harvard on mechanism and dose.

Acute Low Back Pain with Radiculopathy: A Double-Blind, Randomized, Placebo-Controlled Study.

Konstantinovic LM, Kanjuh ZM, Milovanovic AN, Cutovic MR, Djurovic AG, Savic VG, Dragin AS, Milovanovic ND

1 Clinic for Rehabilitation, Medical School , Belgrade, Serbia.

Abstract Objective: The aim of this study was to investigate the clinical effects of low-level laser therapy (LLLT) in patients with acute low back pain (LBP) with radiculopathy. Background Data: Acute LBP with radiculopathy is associated with pain and disability and the important pathogenic role of inflammation. LLLT has shown significant anti-inflammatory effects in many studies. Materials and Methods: A randomized, double-blind, placebo-controlled trial was performed on 546 patients. Group A (182 patients) was treated with nimesulide 200 mg/day and additionally with active LLLT; group B (182 patients) was treated only with nimesulide; and group C (182 patients) was treated with nimesulide and placebo LLLT. LLLT was applied behind the involved spine segment using a stationary skin-contact method. Patients were treated 5 times weekly, for a total of 15 treatments, with the following parameters: wavelength 904 nm; frequency 5000 Hz; 100-mW average diode power; power density of 20 mW/cm(2) and dose of 3 J/cm(2); treatment time 150 sec at whole doses of 12 J/cm(2). The outcomes were pain intensity measured with a visual analog scale (VAS); lumbar movement, with a modified Schober test; pain disability, with Oswestry disability score; and quality of life, with a 12-item short-form health survey questionnaire (SF-12). Subjects were evaluated before and after treatment. Statistical analyses were done with SPSS 11.5. Results: Statistically significant differences were found in all outcomes measured (p < 0.001), but were larger in group A than in B (p < 0.0005) and C (p < 0.0005). The results in group C were better than in group B (p < 0.0005). Conclusions: The results of this study show better improvement in acute LBP treated with LLLT used as additional therapy.

Photomed Laser Surg 2009 Dec 9

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=20001318

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Psychological benefits 2 and 4 weeks after a single treatment with near infrared light to the forehead: a pilot study of 10 patients with major depression and anxiety.

Schiffer F, Johnston AL, Ravichandran C, Polcari A, Teicher MH, Webb RH, Hamblin MR

The Department of Psychiatry, Harvard Medical School and the Developmental Biopsychiatry Research Program, McLean Hospital, 115 Mill Street Belmont, MA 02478 USA. fschiffer@mclean.harvard.edu.

ABSTRACT: BACKGROUND: Many studies have reported beneficial effects from the application of near-infrared (NIR) light photobiomodulation (PBM) to the body, and one group has reported beneficial effects applying it to the brain in stroke patients. We have reported that the measurement of a patient’s left and right hemispheric emotional valence (HEV) may clarify data and guide lateralized treatments. We sought to test whether a NIR treatment could 1. improve the psychological status of patients, 2. show a relationship between immediate psychological improvements when HEV was taken into account, and 3. show an increase in frontal pole regional cerebral blood flow (rCBF), and 4. be applied without side effects. METHODS: We gave 10 patients, (5 M/5 F) with major depression, including 9 with anxiety, 7 with a past history of substance abuse (6 with an opiate abuse and 1 with an alcohol abuse history), and 3 with post traumatic stress disorder, a baseline standard diagnostic interview, a Hamilton Depression Rating Scale (HAM-D), a Hamilton Anxiety Rating Scale (HAM-A), and a Positive and Negative Affect Scale (PANAS). We then gave four 4-minute treatments in a random order: NIR to left forehead at F3, to right forehead at F4, and placebo treatments (light off) at the same sites. Immediately following each treatment we repeated the PANAS, and at 2-weeks and at 4-weeks post treatment we repeated all 3 rating scales. During all treatments we recorded total hemoglobin (cHb), as a measure of rCBF with a commercial NIR spectroscopy device over the left and the right frontal poles of the brain. RESULTS: At 2-weeks post treatment 6 of 10 patients had a remission (a score

Behav Brain Funct 2009 5 46

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=19995444

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Biphasic dose response in low level light therapy.

Huang YY, Chen AC, Carroll JD, Hamblin MR

Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, MA; Department of Dermatology, Harvard Medical School, Boston, MA; Aesthetic and Plastic Center of Guangxi Medical University, Nanning, P.R. China.

The use of low levels of visible or near infrared light for reducing pain, inflammation and edema, promoting healing of wounds, deeper tissues and nerves, and preventing cell death and tissue damage has been known for over forty years since the invention of lasers. Despite many reports of positive findings from experiments conducted in vitro, in animal models and in randomized controlled clinical trials, LLLT remains controversial in mainstream medicine. The biochemical mechanisms underlying the positive effects are incompletely understood, and the complexity of rationally choosing amongst a large number of illumination parameters such as wavelength, fluence, power density, pulse structure and treatment timing has led to the publication of a number of negative studies as well as many positive ones. A biphasic dose response has been frequently observed where low levels of light have a much better effect on stimulating and repairing tissues than higher levels of light. The so-called Arndt-Schulz curve is frequently used to describe this biphasic dose response. This review will cover the molecular and cellular mechanisms in LLLT, and describe some of our recent results in vitro and in vivo that provide scientific explanations for this biphasic dose response.

Dose Response 2009 7(4) 358-83

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=20011653

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Effect of LED Phototherapy of Three Distinct Wavelengths on Fibroblasts on Wound Healing: A Histological Study in a Rodent Model.

de Sousa AP, Santos JN, Dos Reis JA, Ramos TA, de Souza J, Cangussu MC, Pinheiro AL

1 Laser Center, School of Dentistry, Federal University of Bahia , Salvador, Bahia, Brazil.

Abstract Aim: The aim of the present investigation was to evaluate histologically fibroblastic proliferation on dorsal cutaneous wounds in a rodent model treated or not with light-emitting diodes (LEDs) of three wavelengths. Background: Fibroblasts secrete substances essential for wound healing. There are few reports of LED phototherapy on fibroblast proliferation, mainly in vivo. Animals and Methods: Following approval by the Animal Experimentation Committee of the School of Dentistry of the Federal University of Bahia, we obtained 16 young adult male Wistar rats weighing between 200 and 250 g. Under general anesthesia, one excisional wound was created on the dorsum of each animal; they were then randomly distributed into four groups of four animals each: G0, untreated control; G1, red LED (700 nm +/- 20 nm, 15 mW, 10 J/cm(2)); G2, green LED (530 nm +/- 20 nm, 8 mW, 10 J/cm(2)); and G3, blue LED (460 nm +/- 20 nm, 22 mW, 10 J/cm(2)). The irradiation started immediately after surgery and was repeated every other day for 7 days. Animals were killed 8 days after surgery. The specimens were removed, routinely processed to wax, cut, and stained with hematoxylin/eosin (HE). Fibroblasts were scored by measuring the percentage of these cells occupying the area corresponding to wound healing on stained sections. Results: The quantitative results showed that red LED (700 +/- 20 nm) and green LED (530 +/- 20 nm) showed a significant increase in fibroblast numbers (p < 0.01 and p = 0.02) when compared with the control group. Conclusion: The use of green and red LED light is effective in increasing fibroblastic proliferation on rodents.

Photomed Laser Surg 2009 Dec 9

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=20001321

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Effect of low-level laser therapy (GaAs 904 nm) in skeletal muscle fatigue and biochemical markers of muscle damage in rats.

Leal Junior EC, Lopes-Martins RA, de Almeida P, Ramos L, Iversen VV, Bjordal JM

Section for Physiotherapy Science, Department of Public Health and Primary Health Care, University of Bergen (UiB), Kalfarveien 31, 5020, Bergen, Norway, ernesto.leal.junior@gmail.com.

We wanted to test if pre-exercise muscle irradiation with 904 nm laser affects the development of fatigue, blood lactate levels and creatine kinase (CK) activity in a rat model with tetanic contractions. Thirty male Wistar rats were divided into five groups receiving either one of four different laser doses (0.1, 0.3, 1.0 and 3.0 J) or a no-treatment control group. Laser irradiation was performed immediately before the first contraction for treated groups. Electrical stimulation was used to induce six tetanic tibial anterior muscle contractions with 10 min intervals between them. Contractions were stopped when the muscle force fell to 50% of the peak value for each contraction; blood samples were taken before the first and immediately after the sixth contraction. The relative peak forces for the sixth contraction were significantly better (P < 0.05) in the two laser groups irradiated with highest doses [151.27% (SD +/- 18.82) for 1.0 J, 144.84% (SD +/- 34.47) for 3.0 J and 82.25% (SD +/- 11.69) for the control group]. Similar significant (P < 0.05) increases in mean performed work during the sixth contraction for the 1.0 and 3.0 J groups were also observed. Blood lactate levels were significantly lower (P < 0.05) than the control group in all irradiated groups. All irradiated groups except the 3.0 J group had significantly lower post-exercise CK activity than the control group. We conclude that pre-exercise irradiation with a laser dose of 1.0 J and 904 nm wavelength significantly delays muscle fatigue and decreases post-exercise blood lactate and CK in this rat model.

Eur J Appl Physiol 2009 Dec 19

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=20024577

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Endonasal phototherapy with Rhinolight for the treatment of allergic rhinitis.

Brehmer D

University of Witten/Herdecke, Faculty of Medicine, Friedrichstrasse 3/4, 37073 Goettingen, Germany. dr.d.brehmer@t-online.de

Allergic rhinitis, although not life threatening, significantly affects the quality of the patient’s daily life. The three major steps in the treatment of the condition are avoidance of allergens, treatment of symptoms (in particular, antihistaminics and topical nasal corticosteroids) and specific immunotherapy. Avoidance of the allergen is usually not possible and symptom relief is often limited, despite the availability of a number of pharmacological options. Specific immunotherapy demands a high level of cooperation on the part of the patient for at least 3 years. Endonasal phototherapy with the Rhinolight device (Rhinolight Ltd, Szeged, Hungary) for the treatment of immunoglobulin E-mediated allergic rhinitis is a new option that utilizes the immunosuppressive effects of UV radiation. The method directs a combination of UV-B (5%), UV-A (25%) and visible light (70%) into the nasal cavity, and its effectiveness has been demonstrated in one double-blind, placebo-controlled study. The results of additional studies have been presented at various medical conferences and in abstracts. Reports in the literature confirm that phototherapy is a well-established and successful treatment of atopic dermatitis and other skin diseases.

Expert Rev Med Devices 2010 Jan 7(1) 21-6

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=20021238

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Laser acupuncture does not improve menopausal symptoms.

O’Brien KA, Varigos E, Black C, Komesaroff PA

From the 1Victoria University Faculty of Health, Engineering, and Science, Melbourne, Australia; 2Monash University Department of Medicine, Alfred Hospital, Melbourne, Australia; 3Monash Surgical Private Hospital, Melbourne, Australia; and 4The Menopause and Midlife Women’s Clinic, The Oxford Clinic, Christchurch, New Zealand.

OBJECTIVE:: Acupuncture is commonly used to treat menopausal symptoms and other gynecological conditions. Laser acupuncture, more accurately named “laser acupoint stimulation,” has the advantages of being noninvasive, reproducible, and convenient. A few studies of conventional acupuncture have suggested a beneficial effect in treating menopausal symptoms. This study sought to investigate the effectiveness of laser acupoint stimulation in relieving symptoms associated with menopause. METHODS:: A double-blind, randomized, placebo-controlled study was conducted in 40 women experiencing active symptoms of menopause. Outcome variables were numbers of diurnal and nocturnal flushes and symptom score, determined using a previously validated scale. A laser acupoint stimulation device was altered to produce identical flashing lights whether or not the laser was operating to allow for a placebo (“laser off”) control. Participants received either active or placebo treatment on a fortnightly basis for 12 weeks. The acupoint selection in both groups was individualized to each participant, selected from a set of 10 acupoints. RESULTS:: There were no significant differences between the active and placebo treatment groups in numbers of diurnal or nocturnal flushes or in nonflushing symptom scores. CONCLUSIONS:: Laser acupoint stimulation chosen from a fixed set of acupoints is no more efficacious than manual stimulation with an inert laser probe in altering menopausal symptoms.

Menopause 2010 Jan 8

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=20065886

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Effects of low power laser irradiation on bone healing in animals: a meta-analysis.

Bashardoust Tajali S, Macdermid JC, Houghton P, Grewal R

ABSTRACT: Purpose: The meta-analysis was performed to identify animal research defining the effects of low power laser irradiation on biomechanical indicators of bone regeneration and the impact of dosage. Methods: We searched five electronic databases (MEDLINE, EMBASE, PubMed, CINAHL, and Cochrane Database of Randomised Clinical Trials) for studies in the area of laser and bone healing published from 1966 to October 2008. Included studies had to investigate fracture healing in any animal model, using any type of low power laser irradiation, and use at least one quantitative biomechanical measures of bone strength. There were 880 abstracts related to the laser irradiation and bone issues (healing, surgery and assessment). Five studies met our inclusion criteria and were critically appraised by two raters independently using a structured tool designed for rating the quality of animal research studies. After full text review, two articles were deemed ineligible for meta-analysis because of the type of injury method and biomechanical variables used, leaving three studies for meta-analysis. Maximum bone tolerance force before the point of bone fracture during the biomechanical test, 4 weeks after bone deficiency was our main biomechanical bone properties for the Meta analysis. Results: Studies indicate that low power laser irradiation can enhance biomechanical properties of bone during fracture healing in animal models. Maximum bone tolerance was statistically improved following low level laser irradiation (average random effect size 0.726, 95% CI 0.08 – 1.37, p 0.028). While conclusions are limited by the low number of studies, there is concordance across limited evidence that laser improves the strength of bone tissue during the healing process in animal models.

J Orthop Surg Res 2010 Jan 4 5(1) 1

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=20047683

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[Reaction on ‘Less need for insulin, a surprising effect of phototherapy in insulin-dependent diabetes mellitus’]

Meesters Y

Tijdschr Psychiatr 2009 51(12) 975-7

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=20047170

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Histological evaluation of the effect of low-level laser on distraction osteogenesis in rabbit mandibles.

Kreisner PE, Blaya D, Gaiao L, Maciel-Santos ME, Etges A, Santana-Filho M, de Oliveira MG

Av. Cel. Lucas de Oliveira, 1841/203, Petropolis CEP: 90460-001 – Porto Alegre, RS, Brazil, mogerhardt@yahoo.com.br.

Objectives: This study evaluated the action of low level laser therapy (LLLT) on the percentage of newly formed bone in rabbit mandibles that underwent distraction osteogenesis (DO). Study design: Ten rabbits underwent bone lengthening according to the following protocol: Latency – 3 days; Activation – 7 days 0.7 mm/d; and Consolidation – 10 days. The control group was composed of 4 rabbits. The experimental group, composed of 6 rabbits, received infrared GaAlAs LLLT (wavelength=830 nm, 40 mW) according to the following protocol: point dose of 10 J/cm(2) applied directly on the bone site that underwent DO during bone consolidation at 48-hour intervals. Results: The percentage of newly formed bone was greater in the LLLT group (57.89%) than in the control group (46.75%) (p=0.006). Conclusion: The results suggest that LLLT had a positive effect on the percentage of newly formed bone. Better-quality bone sites may allow early removal of the osteogenic distractors, thus shortening total treatment time.

Med Oral Patol Oral Cir Bucal 2009 Dec 29

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=20038884

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Conservative management of posterior interosseous neuropathy in an elite baseball pitcher’s return to play: a case report and review of the literature.

Robb A, Sajko S

Division of Graduate Studies, Sports Sciences, Canadian Memorial Chiropractic College. Tel: 416.482.2340. Email: arobb@cmcc.ca.

This report documents retrospectively a case of Posterior Interosseous Neuropathy (PIN) occurring in an elite baseball pitcher experiencing a deep ache in the radial aspect of the forearm and altered sensation in the dorsum of the hand on the throwing arm during his pitching motion. The initial clinical goal was to control for inflammation to the nerve and muscle with active rest, microcurrent therapy, low-level laser therapy, and cessation of throwing. Minimizing mechanosensitivity at the common extensor region of the right elbow and PIN, was achieved by employing the use of myofascial release and augmented soft tissue mobilization techniques. Neurodynamic mobilization technique was also administered to improve neural function. Implementation of a sport specific protocol for the purposes of maintaining throwing mechanics and overall conditioning was utilized. Successful resolution of symptomatology and return to pre-injury status was achieved in 5 weeks. A review of literature and an evidence-based discussion for the differential diagnoses, clinical examination, diagnosis, management and rehabilitation of PIN is presented.

J Can Chiropr Assoc 2009 Dec 53(4) 300-10

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=20037695

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The effects of helium-neon light therapy on healing of partial osteotomy of the tibia in streptozotocin induced diabetic rats.

Abdi S, Bayat M, Javadieh F, Mohsenifar Z, Rezaie F, Bayat M

Medical Faculty, Cellular and Molecular Biology Research Center, Department of Pathology, Ayatollah Taleghani Hospital, Shahid Beheshti University, M.C., Tehran, Iran.

OBJECTIVE: The effect of light therapy (LT) on surgically created partial osteotomy in streptozotocin (STZ)-induced diabetic rats was examined. BACKGROUND DATA: LT has been shown to enhance bone repair in healthy human and animal models. MATERIALS AND METHODS: Forty male rats were divided into groups 1 to 5. Diabetes was induced in rats of groups 1, 2, and 3 using an intraperitoneal injection of STZ. All diabetic rats were maintained for 30 days after STZ injection. Under general anesthesia and sterile conditions, a partial transversal standardized osteotomy was made in the mid-portion of the right tibia. The defects in groups 2, 3, and 5 were treated using a helium-neon (He-Ne) laser (632.8 nm, 10 mW, circular beam shape). Groups 1 and 4 were diabetic placebo and normal placebo groups, respectively. A dose of 369.4 J/cm2 for groups 2 and 5 and a dose of 66.8 J/cm2 for group 3 were applied three times a week. Six weeks after surgery, the right tibia was collected. The specimen was subjected to a three-point bending test. RESULTS: LT with 369.4 J/cm2 energy density resulted in significantly greater bending stiffness in group 5 (41.8+/-5.2) than in groups 1 (18.5+/-4.1), 2 (17.7+/-1.6), and 3 (11.5+/-4) (least significant difference (LSD) test, p<0.01, p<0.001, and p<0.001, respectively). LT with 369.4 J/cm2 energy density resulted in a significantly higher stress load in group 5 (10+/-0.4) than in groups 1 (4.9+/-1.5), 2 (5.7+/-0.52), and 3 (3.9+/-1.1) (LSD test, p<0.01, p<0.01, p<0.001, respectively). CONCLUSION: LT with a He-Ne laser in STZ-induced diabetic rats did not enhance bone repair of a partial transversal standardized osteotomy.

Photomed Laser Surg 2009 Dec 27(6) 907-12

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=20035603

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Choice of treatment modalities was not influenced by pain, severity or co-morbidity in patients with knee osteoarthritis.

Jamtvedt G, Dahm KT, Holm I, Odegaard-Jensen J, Flottorp S

Norwegian Knowledge Centre for the Health Services, Oslo, and Centre for Evidence-Based Practice, University College Bergen, Bergen, Norway.

Background and Purpose. Patients with knee osteoarthritis (OA) are commonly treated by physiotherapists in primary care. The physiotherapists use different treatment modalities. In a previous study, we identified variation in the use of transcutaneous electrical nerve stimulation (TENS), low level laser or acupuncture, massage and weight reduction advice for patients with knee OA. The purpose of this study was to examine factors that might explain variation in treatment modalities for patients with knee OA. Methods. Practising physiotherapists prospectively collected data for one patient with knee osteoarthritis each through 12 treatment sessions.We chose to examine factors that might explain variation in the choice of treatment modalities supported by high or moderate quality evidence, and modalities which were frequently used but which were not supported by evidence from systematic reviews. Experienced clinicians proposed factors that they thought might explain the variation in the choice of these specific treatments. We used these factors in explanatory analyses. Results. Using TENS, low level laser or acupuncture was significantly associated with having searched databases to help answer clinical questions in the last six months (odds ratio [OR] = 1.93, 95% confidence interval [CI] = 1.08-3.42). Not having Internet access at work and using more than four treatment modalities were significant determinants for giving massage (OR = 0.36, 95% CI = 0.19-0.68 and OR = 8.92, 95% CI = 4.37-18.21, respectively). Being a female therapist significantly increased the odds for providing weight reduction advice (OR = 3.60, 95% CI = 1.12-11.57). No patient characteristics, such as age, pain or co-morbidity, were significantly associated with variation in practice. Conclusions. Factors related to patient characteristics, such as pain severity and co-morbidity, did not seem to explain variation in treatment modalities for patients with knee OA. Variation was associated with the following factors: physiotherapists having Internet access at work, physiotherapists having searched databases for the last six months and the gender of the therapist. There is a need for more studies of determinants for physiotherapy practice. Copyright (c) 2009 John Wiley & Sons, Ltd.

Physiother Res Int 2009 Dec 23

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=20033888

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Low-level laser therapy as a non-invasive approach for body contouring: a randomized, controlled study.

Jackson RF, Dedo DD, Roche GC, Turok DI, Maloney RJ

River View Surgery Center, Marion, Indiana 46952, USA.

BACKGROUND AND OBJECTIVE: Transmission electron microscopic images have demonstrated the formation of transitory pores in adipocyte cell membranes followed by the collapse of adipose cells subsequent to laser irradiation of 635 nm. The objective is to evaluate the application of a 635 nm and 17.5 mW exit power per multiple diode laser for the application of non-invasive body contouring of the waist, hips, and thighs. STUDY DESIGN/PATIENTS AND METHODS: Double-blind, randomized, placebo-controlled trial of a 2-week non-invasive laser treatment conducted from May 2007 to June 2008 across multiple-private practice sites in the United States of America. Sixty-seven volunteers between the ages of 18-65 with a body mass index (BMI) between 25 and 30 kg/m(2) and who satisfied the set inclusion criteria participated. Eight of the 67 subjects did not have circumference measurements recorded at the 2-week post-procedure measurement point. Participants were randomly assigned to receive low-level laser treatments or a matching sham treatment three times per week for 2 weeks. Reduction in the total combined inches of circumference measurements of the waist, hip and bilateral thighs from baseline to the completion of the 2-week procedure administration phase was assessed. RESULTS: Participants in the treatment group demonstrated an overall reduction in total circumference across all three sites of -3.51 in. (P < 0.001) compared with control subjects who revealed a -0.684 reduction (P < 0.071745). Test group participants demonstrated a reduction of -0.98 in. (P < 0.0001) across the waist, -1.05 in. (P < 0.01) across the hip, and -0.85 in. (P < 0.01) and -0.65 in. (P < 0.01) across the right and left thighs from baseline to 2 weeks (end of treatment). At 2 weeks post-procedure, test group subjects demonstrated a gain of 0.31 total inches collectively across all three sites. CONCLUSION: These data suggest that low-level laser therapy can reduce overall circumference measurements of specifically treated regions.

Lasers Surg Med 2009 Dec 41(10) 799-809

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=20014253

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A multimodal approach to management of suspected neuropathic pain in a prairie falcon (Falco mexicanus).

Shaver SL, Robinson NG, Wright BD, Kratz GE, Johnston MS

Professional Veterinary Medicine Program, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, 300 W Drake Rd, Fort Collins, CO 80523-1678, USA.

An adult male prairie falcon (Falco mexicanus) was presented for evaluation and treatment of self-inflicted wounds along the right proximal patagium. The bird had started self-traumatizing approximately 1 month after fracturing the right metacarpus, although the fracture had stabilized, surface wounds had healed completely, and treatment with a nonsteroidal antiinflammatory drug had been administered. The bird was treated with gabapentin (11 mg/kg p.o. q12h), ketamine (0.5 mg/kg i.m. q24h), and low level laser therapy (LLLT) (<5 mW, 630-680 nm, 5-second application per site) for 3 weeks, but, despite initial improvement, new self-inflicted wounds appeared at the same site. Approximately 1.5 months later, a radial and medianoulnar nerve block was performed by using bupivacaine (2 mg/kg) and medetomidine (0.5 microg/kg). In addition, the dosing interval of ketamine was increased to q12h, and the dose of gabapentin was increased 7.5-fold. A higher energy and wavelength of LLLT (1040 mW, 830 nm, 2 J/cm2) was applied once to the injured region and fracture site, then the original LLLT protocol was applied once daily. After 2.5 months, the wounds healed completely and no further mutilation took place. Once deemed ready for release, the falcon was returned to the wild after 181 days in captivity. This is the first reported application of successful multimodal analgesia in a raptor with uncontrolled neuropathic pain.

J Avian Med Surg 2009 Sep 23(3) 209-13

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=19999765

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Laser Photobiomodulation of Wound Healing: A Review of Experimental Studies in Mouse and Rat Animal Models.

Peplow PV, Chung TY, Baxter GD

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

Abstract This investigation reviewed experimental studies of laser irradiation of wound healing in mice and rats published from 2003 to August 2008, respectively, to assess putative stimulatory effects of this treatment. Animal models, including rodents, attempt to reflect human wound healing and associated problems such as dehiscence, ischemia, ulceration, infection, and scarring. They have played a key role in furthering understanding of underlying mechanisms involved in impaired wound healing, and in testing new therapeutic strategies including laser irradiation. Original research papers investigating effects of laser or monochromatic light therapy on wound healing in mice and rats and published from January 2003 to August 2008 were retrieved from library sources, PubMed and Medline databases, reference lists from retrieved papers, and hand searches of relevant journals. Papers were selected for this review with regard to specific inclusion and exclusion criteria. Studies were critically reviewed in terms of study design, methodology, and appropriateness of laser irradiation parameters. The literature search identified eight studies in mice and 39 in rats. A variety of wound models were investigated, including acute-wound, impaired-healing, and chronic-wound models. Considerable variation was observed in research design, methodology, and irradiation parameters employed, limiting comparison of research findings between studies. Inadequate reporting of key experimental details, or errors in specification and/or calculation of key irradiation parameters was also found. Evidence from the studies reviewed suggested that use of red or infrared wavelength at a range of dosage parameters (median 4.2 Jcm(-2)) results in significant benefits in measured parameters of wound healing. Interestingly, coherence does not seem essential to the photobiomodulatory effects of ‘laser’ phototherapy. Studies reviewed consistently demonstrated the ability of laser or monochromatic light to photobiomodulate wound healing processes in experimental wounds in rats and mice, and strongly support the case for further controlled research in humans.

Photomed Laser Surg 2009 Dec 8

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=19995230

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Physiotherapy treatments for breast cancer-related lymphedema: a literature review.

Leal NF, Carrara HH, Vieira KF, Ferreira CH

Universidade de Sao Paulo, Brazil. nanda.taz@bol.com.br

Breast cancer is the second most frequent cancer among women. Surgery is part of the therapeutic process to prevent metastases, but it can also cause some complications, including lymphedema. Physiotherapy contributes to its treatment, using different techniques that have been developed over the years. This systematic literature review aims to present physiotherapy modalities applied for lymphedema therapy. The literature review was conducted using textbooks and Lilacs, Pubmed and Scielo databases, from 1951 to 2009. Physiotherapy resources used for lymphedema treatment include complex decongestive therapy (CDT), pneumatic compression (PC), high voltage electrical stimulation (HVES) and laser therapy. The analyzed literature shows that better results are obtained with combined techniques. CDT is the most used protocol, and its association with PC has demonstrated efficacy. The new techniques HVES and laser present satisfactory results.

Rev Lat Am Enfermagem 2009 Sep-Oct 17(5) 730-6

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=19967225

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Low level laser therapy does not modulate the outcomes of a highly bioactive glass-ceramic (Biosilicate((R))) on bone consolidation in rats.

Oliveira P, Ribeiro DA, Pipi EF, Driusso P, Parizotto NA, Renno AC

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

The main purpose of the present work was to evaluate if low level laser therapy (LLLT) can improve the effects of novel fully-crystallized glass-ceramic (Biosilicate((R))) on bone consolidation in tibial defects of rats. Forty male Wistar rats with tibial bone defects were used. Animals were divided into four groups: group bone defect control (CG); group bone defect filled with Biosilicate((R)) (BG); group bone defect filled with Biosilicate((R)), irradiated with LLLT, at 60 J cm(-2) (BG 60) and group bone defect filled with Biosilicate((R)), irradiated with LLLT, at 120 J cm(-2) (BG 120). A low-energy GaAlAs 830 nm, CW, 0.6 mm beam diameter, 100 W cm(-2), 60 and 120 J cm(-)(2) was used in this study. Laser irradiation was initiated immediately after the surgery procedure and it was performed every 48 h for 14 days. Fourteen days post-surgery, the three-point bending test revealed that the structural stiffness of the groups CG and BG was higher than the values of the groups BG60 and BG120. Morphometric analysis revealed no differences between the control group and the Biosilcate((R)) group. Interestingly, the groups treated with Biosilicate((R)) and laser (BG 60 and BG120) showed statistically significant lower values of newly formed bone in the area of the defect when compared to negative control (CG) and bone defect group filled with Biosilicate (CB). Our findings suggest that although Biosilicate((R)) exerts some osteogenic activity during bone repair, laser therapy is not able to modulate this process.

J Mater Sci Mater Med 2009 Nov 27

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=19943088

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The diagnosis and treatment of peripheral lymphedema.

Piller N, Carati C

Lymphology 2009 Sep 42(3) 146-7

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=19938271

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Laser as a therapy for dry mouth symptoms in a patient with Sjogren’s syndrome: a case report.

Simoes A, Platero MD, Campos L, Aranha AC, Eduardo Cde P, Nicolau J

Oral Biology Research Center, Department of Biomaterials and Oral Biochemistry, School of Dentistry, University of Sao Paulo, Sao Paulo, Brazil. lysimoes@usp.br

This clinical case study reports on dry mouth symptoms in a patient with Sjogren’s syndrome (SS) who was treated with laser phototherapy (LPT). A 60-year-old woman diagnosed with SS was referred to the laboratory for lasers in dentistry to treat her severe xerostomia. A diode laser (780 nm, 3.8 J/cm2, 15 mW) was used to irradiate the parotid, submandibular, and sublingual glands, three times per week, for a period of 8 months. The salivary flow rate and xerostomia symptoms were measured before, during, and after LPT. Dry mouth symptoms improved during LPT. After LPT, the parotid salivary gland pain and swelling were no longer present. Treatment with LPT was an effective method to improve the quality of life of this patient with SS.

Spec Care Dentist 2009 May-June 29(3) 134-7

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=19938253

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The effect of low-level laser irradiation (In-Ga-Al-AsP – 660 nm) on melanoma in vitro and in vivo.

Frigo L, Luppi JS, Favero GM, Maria DA, Penna SC, Bjordal JM, Bensadoun RJ, Lopes-Martins RA

Laboratory of Pharmacology and Phototherapy of Inflammation, Department of Pharmacology, Institute of Biomedical Sciences, University of Sao Paulo – Sao Paulo 05508-900 SP – Brasil. luciofrigo@uol.com.br

BACKGROUND: It has been speculated that the biostimulatory effect of Low Level Laser Therapy could cause undesirable enhancement of tumor growth in neoplastic diseases. The aim of the present study is to analyze the behavior of melanoma cells (B16F10) in vitro and the in vivo development of melanoma in mice after laser irradiation. METHODS: We performed a controlled in vitro study on B16F10 melanoma cells to investigate cell viability and cell cycle changes by the Tripan Blue, MTT and cell quest histogram tests at 24, 48 and 72 h post irradiation. The in vivo mouse model (male Balb C, n = 21) of melanoma was used to analyze tumor volume and histological characteristics. Laser irradiation was performed three times (once a day for three consecutive days) with a 660 nm 50 mW CW laser, beam spot size 2 mm(2), irradiance 2.5 W/cm(2) and irradiation times of 60s (dose 150 J/cm(2)) and 420s (dose 1050 J/cm(2)) respectively. RESULTS: There were no statistically significant differences between the in vitro groups, except for an increase in the hypodiploid melanoma cells (8.48 +/- 1.40% and 4.26 +/- 0.60%) at 72 h post-irradiation. This cancer-protective effect was not reproduced in the in vivo experiment where outcome measures for the 150 J/cm(2) dose group were not significantly different from controls. For the 1050 J/cm(2) dose group, there were significant increases in tumor volume, blood vessels and cell abnormalities compared to the other groups. CONCLUSION: LLLT Irradiation should be avoided over melanomas as the combination of high irradiance (2.5 W/cm(2)) and high dose (1050 J/cm(2)) significantly increases melanoma tumor growth in vivo.

BMC Cancer 2009 9 404

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=19930543

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The Effects of Low Level Laser Irradiation on Gingival Inflammation.

Pejcic A, Kojovic D, Kesic L, Obradovic R

Department of Periodontology and Oral Medicine, Medical Faculty, University of Nis , Nis, Serbia .

Abstract Objective: The goal of this study was to analyze the effects of low level laser irradiation treatment and conservative treatment on gingival inflammation. Background: It is widely accepted today that the primary etiological factor for the onset of periodontitis is dental plaque, although the exact mechanism of damage remains unknown. Inflammation is a basic response of periodontal tissue to damage and serves as a fast first line of defense against damage and infections. The treatment of gingivitis and periodontitis has gone through various stages: from the simplest, classical treatment methods, through improved radical interventions, to a new era marked by laser technology. Low level laser irradiation has an anti-inflammatory effect, both general and local. Materials and methods: The research was done on patients who had chronic periodontal disease (mild periodontitis) with expressed clinical symptoms of gingival inflammation. All patients in the study underwent conservative treatment. After conservative therapy, the patients from the experimental group were subjected to 10 low level laser treatment sessions. Both groups underwent regular follow-up visits 1, 3, and 6 months after treatment, which involved only clinical examination using plaque index (PI), gingival index (GI), and bleeding on probing index (BOP index). Results: A considerable decrease in all three indexes after the application of both therapies was noticed. The follow-up visits revealed the difference in index values. With laser therapy, the values of indexes decreased steadily, whereas with conservative therapy they increased up to a certain point, but did not reach the pre-therapy values. Conclusions: A general conclusion can be drawn that low level laser irradiation (semiconductor, 670 nm) can be used as a successful physical adjuvant method of treatment, which, together with traditional periodontal therapy, leads to better and longer-lasting therapeutic results.

Photomed Laser Surg 2009 Nov 22

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=19929224

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[Phototherapy for chronic pain treatment]

Ide Y

Department of Anesthesia, Toho University Sakura Medical Center Sakura 285-8741.

Three types of machines are used in the field of phototherapy for chronic pain. One type is an instrument for low reactive level laser therapy (LLLT), one is an instrument for linear polarized infrared light irradiation (SUPER LIZER), and the last one is an instrument for Xenon light irradiation (beta EXCEL Xe10). The available machines for LLLT all project laser by semiconductor. The newest machine (MEDILASER SOFT PULSE10) has peak power of 10 W and mean power of 1 W. This machine is as safe as 1 W machine and is effective twice as deep as the 1 W machine. The irradiation by low reactive level laser induces hyperpolarization, decreased resistance of neuronal membrane, and increased intra-cellular ATP concentrations. The effects of low reactive level laser might be induced by the activation of ATP-dependent K channel. The significant analgesic effects of 1 W and 10 W LLLT were reported with double blind test. The significant analgesic effects of linear polarized near infrared light irradiation with double blind test were also reported. The effects of low reactive level laser upon the sympathetic nerve system were thought to result from its normalization of the overloaded sympathetic nerve system.

Masui 2009 Nov 58(11) 1401-6

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=19928507

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[Diagnostic and therapeutic instruments for the pain clinic: introduction]

Hanaoka K

JR Tokyo General Hospital, Tokyo 151-8528.

Pain, a very unpleasant feeling often difficult to treat, is the most common complaint of patients visiting hospital. When a patient with pain visits our institution, first of all, we have to diagnose the pain including the grade of pain and stress associated with sympathetic-adrenal-medullary system. We then treat the pain of the patient using available devices. In the following special articles, functional magnetic imaging, device for measurement of salivary alpha-amylase and PainVisionTM for pain measurement are described as devices for diagnosis of pain. As devices for treatment of pain, epidural infuser pump, intrathecal infusion pump, spinal cord stimulation device and phototherapy device are also described. The mechanism and grade of intractable pain often confuse us to recognize pain. The devices, described in this special issue, are very useful for the evaluation and treatment of intractable pain. I feel happy if these articles greatly contribute to the treatment of patients with pain by pain clinicians.

Masui 2009 Nov 58(11) 1348-9

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=19928500

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Notalgia paresthesica successfully treated with narrow-band UVB: report of five cases.

Perez-Perez L, Allegue F, Fabeiro JM, Caeiro JL, Zulaica A

Department of Dermatology, Complejo Hospitalario Universitario de Vigo, Vigo, Spain.

Abstract Background Notalgia paresthesica is a disorder of unknown origin characterized by pruritus localized to the patients’ back. Local pain, burning or paresthesias have also been described. No definite treatments have been found for this disorder and most of those reported to date are anecdotal. Topical capsaicin is the option most widely used among dermatologists. Transcutaneous electrical nerve stimulation, gabapentin, oxcarbazepine and botulinum toxin have recently shown promising effects. UVB has been used for decades to treat different pruritic skin diseases, but its benefits in the management of NP have not been stated to date. Objectives To test the effects of UVB in notalgia paresthesica. Methods We used a course of UVB narrow band to treat five patients with notalgia paresthesica. The treatment was administered following a phototype protocol in a UV 7002 cabinet. Results We provide the results of a course of UVB narrow-band phototherapy in five patients. Phototherapy contributed substantially to improve pruritus in all of them. Conclusion Given the benefits achieved, we stress the interest of UVB narrow-band as a safe and well tolerated alternative treatment for notalgia paresthetica.

J Eur Acad Dermatol Venereol 2009 Nov 18

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=19925596

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Posted in Research | 2 Comments

Low-level laser irradiation promotes the recovery of atrophied gastrocnemius skeletal muscle in rats

Somehow this paper slipped through the net and missed my literature watch last year

Low-level laser irradiation promotes the recovery of atrophied gastrocnemius skeletal muscle in rats.

Nakano J, Kataoka, H, Sakamoto J, Origuchi T, Okita M, Yoshimura T

Unit of Physical Therapy and Occupational Therapy Sciences, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki 852-8052, Japan.

Low-level laser (LLL) irradiation promotes proliferation of muscle satellite cells, angiogenesis and expression of growth factors. Satellite cells, angiogenesis and growth factors play important roles in the regeneration of muscle. The objective of this study was to examine the effect of LLL irradiation on rat gastrocnemius muscle recovering from disuse muscle atrophy. Eight-week-old rats were subjected to hindlimb suspension for 2 weeks, after which they were released and recovered. During the recovery period, rats underwent daily LLL irradiation (Ga-Al-As laser; 830 nm; 60 mW; total, 180 s) to the right gastrocnemius muscle through the skin. The untreated left gastrocnemius muscle served as the control. In conjunction with LLL irradiation, 5-bromo-2-deoxyuridine (BrdU) was injected subcutaneously to label the nuclei of proliferating cells. After 2 weeks, myofibre diameters of irradiated muscle increased in comparison with those of untreated muscle, but did not recover back to normal levels. Additionally, in the superficial region of the irradiated muscle, the number of capillaries and fibroblast growth factor levels exhibited significant elevation relative to those of untreated muscle. In the deep region of irradiated muscle, BrdU-positive nuclei of satellite cells and/or myofibres increased significantly relative to those of the untreated muscle. The results of this study suggest that LLL irradiation can promote recovery from disuse muscle atrophy in association with proliferation of satellite cells and angiogenesis.

Exp Physiol 2009 Sep 94(9) 1005-15

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=19525315

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Posted in Research | on Low-level laser irradiation promotes the recovery of atrophied gastrocnemius skeletal muscle in rats

Roundup of the decade – a big thank you note

Wow, what a decade it has been for LLLT. Credibility is critical for acceptance by reimbursement and regulatory authorities as well as doctors and therapists. In the last ten years over 1,000 papers have been published that build on the work of the early pioneers. Highlights of this decade include: FDA clearance, publication in high impact factor journals such as Nature, Pain, PNAS, Spine, Muscle and Nerve, Stroke, Blood and, of course, The Lancet. Output from world renowned institutions including Harvard Medical School, NASA and the US Navy add further reassurance.

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Posted in Special Feature | 2 Comments

The next decade of LLLT – the barriers to mainstream adoption

Because LLLT modulates cellular oxidation and energy production it could potentially affect  a wide range of diseases, injuries or other dysfunctions in the body.

By the end of the next decade, it is possible  LLLT may be used in almost every department of every hospital (and every medicine cabinet of every home).

Given the amount of good quality research published over the last decade, why isn’t it part of mainstream medicine already?

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Posted in PBM/LLLT, Special Feature, THE FUTURE OF PBM/LLLT | on The next decade of LLLT – the barriers to mainstream adoption

62 new papers in the November 2009 LLLT literature watch

62 LLLT abstracts for you this month and of course we have to start with the Lancet paper on laser for neck pain. You can see a TV interview with the primary author Roberta Chow on the front page of our web site and an audio interview I did back in September is here.  There are as usual more papers showing how important dose and dose-rate-effects are. If you are unsure what W/cm2 are and how many you need then then it’s time you came on our “3 x 3 knowledge matrix” training course. There are trials on myofascial pain,lymphedema, plantar fasciitis, oral mucositis, psoriasis and more. read on

Efficacy of low-level laser therapy in the management of neck pain: a systematic review and meta-analysis of randomised placebo or active-treatment controlled trials.

Chow RT, Johnson MI, Lopes-Martins RA, Bjordal JM

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

BACKGROUND: Neck pain is a common and costly condition for which pharmacological management has limited evidence of efficacy and side-effects. Low-level laser therapy (LLLT) is a relatively uncommon, non-invasive treatment for neck pain, in which non-thermal laser irradiation is applied to sites of pain. We did a systematic review and meta-analysis of randomised controlled trials to assess the efficacy of LLLT in neck pain. METHODS: We searched computerised databases comparing efficacy of LLLT using any wavelength with placebo or with active control in acute or chronic neck pain. Effect size for the primary outcome, pain intensity, was defined as a pooled estimate of mean difference in change in mm on 100 mm visual analogue scale. FINDINGS: We identified 16 randomised controlled trials including a total of 820 patients. In acute neck pain, results of two trials showed a relative risk (RR) of 1.69 (95% CI 1.22-2.33) for pain improvement of LLLT versus placebo. Five trials of chronic neck pain reporting categorical data showed an RR for pain improvement of 4.05 (2.74-5.98) of LLLT. Patients in 11 trials reporting changes in visual analogue scale had pain intensity reduced by 19.86 mm (10.04-29.68). Seven trials provided follow-up data for 1-22 weeks after completion of treatment, with short-term pain relief persisting in the medium term with a reduction of 22.07 mm (17.42-26.72). Side-effects from LLLT were mild and not different from those of placebo. INTERPRETATION: We show that LLLT reduces pain immediately after treatment in acute neck pain and up to 22 weeks after completion of treatment in patients with chronic neck pain. FUNDING: None.

Lancet 2009 Nov 12

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=19913903

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Evaluation of low intensity laser therapy in myofascial pain syndrome.

Carrasco TG, Guerisoli LD, Guerisoli DM, Mazzetto MO

Faculty of Dentistry of Ribeirao Preto, University of Sao Paulo, Brazil.

Limited studies have demonstrated that low intensity laser therapy (LILT) may have a therapeutic effect on the treatment of myofascial pain syndrome (MPS). Sixty (60) patients with MPS and having one active trigger point in the anterior masseter and anterior temporal muscles were selected and assigned randomly to six groups (n=10): Groups I to Ill were treated with GaAIAS (780 nm) laser, applied in continuous mode and in a meticulous way, twice a week, for four weeks. Energy was set to 25 J/cm2, 60 J/cm2 and 105 J/cm2, respectively. Groups IV to VI were treated with placebo applications, simulating the same parameters as the treated groups. Pain scores were assessed just before, then immediately after the fourth application, immediately after the eighth application, at 15 days and one month following treatment. A significant pain reduction was observed over time (p<0.001). The analgesic effect of the LILT was similar to the placebo groups. Using the parameters described in this experiment, LILT was effective in reducing pain experienced by patients with myofascial pain syndrome. Thus, it was not possible to establish a treatment protocol. Analyzing the analgesic effect of LILT suggests it as a possible treatment of MPS and may help to establish a clinical protocol for this therapeutic modality.

Cranio 2009 Oct 27(4) 243-7

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=19891258

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Managing postmastectomy lymphedema with low-level laser therapy.

Lau RW, Cheing GL

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

OBJECTIVE: We aimed to investigate the effects of low-level laser therapy (LLLT) in managing postmastectomy lymphedema. BACKGROUND DATA: Postmastectomy lymphedema (PML) is a common complication of breast cancer treatment that causes various symptoms, functional impairment, or even psychosocial morbidity. A prospective, single-blinded, controlled clinical trial was conducted to examine the effectiveness of LLLT on managing PML. METHODS: Twenty-one women suffering from unilateral PML were randomly allocated to receive either 12 sessions of LLLT in 4 wk (the laser group) or no laser irradiation (the control group). Volumetry and tonometry were used to monitor arm volume and tissue resistance; the Disabilities of Arm, Shoulder, and Hand (DASH) questionnaire was used for measuring subjective symptoms. Outcome measures were assessed before and after the treatment period and at the 4 wk follow-up. RESULTS: Reduction in arm volume and increase in tissue softening was found in the laser group only. At the follow-up session, significant between-group differences (all p < 0.05) were found in arm volume and tissue resistance at the anterior torso and forearm region. The laser group had a 16% reduction in the arm volume at the end of the treatment period, that dropped to 28% in the follow-up. Moreover, the laser group demonstrated a cumulative increase from 15% to 33% in the tonometry readings over the forearm and anterior torso. The DASH score of the laser group showed progressive improvement over time. CONCLUSION: LLLT was effective in the management of PML, and the effects were maintained to the 4 wk follow-up.

Photomed Laser Surg 2009 Oct 27(5) 763-9

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=19878027

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Ultrasonographic evaluation of plantar fasciitis after low-level laser therapy: results of a double-blind, randomized, placebo-controlled trial.

Kiritsi O, Tsitas K, Malliaropoulos N, Mikroulis G

Prognosis, Diagnostic Center, Larnaca, Zaka 56, 56727, Thessaloniki, Greece, kirolga@hotmail.com.

The aim of this study was to investigate the effect of low-level laser therapy (LLLT) on plantar fasciitis documented by the ultrasonographic appearance of the aponeurosis and by patients’ pain scores. Thirty individuals with diagnosis of unilateral plantar fasciitis were enrolled in a randomized, double-blind, placebo-controlled trial, but 25 participants completed the therapeutic protocol. The contralateral asymptomatic fascia was used as control. After enrolment, symptomatic individuals were randomly assigned to receive LLLT, or identical placebo, for 6 weeks. Ultrasonography was performed at baseline and after completion of therapy. The subjective subcalcaneal pain was recorded at baseline and after treatment on a visual analogue scale (VAS). After LLLT, plantar fascia thickness in both groups showed significant change over the experimental period and there was a difference (before treatment and after treatment) in plantar fascia thickness between the two groups. However, plantar fascia thickness was insignificant (mean 3.627 +/- 0.977 mm) when compared with that in the placebo group (mean 4.380 +/- 1.0042 mm). Pain estimation on the visual analogue scale had improved significantly in all test situations (after night rest, daily activities) after LLLT when compared with that of the placebo group. (P = 0.006 and P = 0.01, respectively). Additionally, when the difference in pain scores was compared between the two groups, the change was statistically significant (after night rest P = 0.000; daily activities P = 0.001). In summary, while ultrasound imaging is able to depict the morphologic changes related to plantar fasciitis, 904 nm gallium-arsenide (GaAs) infrared laser may contribute to healing and pain reduction in plantar fasciitis.

Lasers Med Sci 2009 Oct 20

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=19841862

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Salivary Levels of TNF-alpha and IL-6 in Patients with Denture Stomatitis Before and After Laser Phototherapy.

Simunovic-Soskic M, Pezelj-Ribaric S, Brumini G, Glazar I, Grzic R, Miletic I

1 Department of Prosthodontics, School of Dentistry, Medical Faculty, University of Rijeka , Croatia .

Abstract Objective: The aim of this study was to monitor therapeutic response by determining the level of proinflammatory cytokines TNF-alpha and IL-6 in whole unstimulated saliva in patients with denture stomatitis (DS), before and after laser phototherapy (LPT). Background: DS is an inflammatory condition that occurs in subjects who wear dentures, and it is a common oral mucosal lesion. A potential noninvasive treatment for DS patients is LPT. Materials and Methods: A sample consisting of 40 consecutive subjects was selected on a voluntary basis from patients who presented for the diagnosis and treatment of DS at the Oral Medicine Unit of the Medical Faculty at the University of Rijeka. A clinical examination was performed according to the standard clinical criteria. Lesions described as palatal inflammation were diagnosed as Newton type II denture stomatitis. The patients were randomly assigned to either an experimental group (20 patients receiving real LPT) or a control group (20 patients receiving inactive/placebo laser treatment). In order to determine the salivary levels of TNF-alpha and IL-6, ELISA (Sigma Immunochemicals, St Louis, MO) was performed. Results: Following treatment with LPT for 4 wk, the levels of TNF-alpha and IL-6 decreased significantly (p < 0.001) and were significantly different from controls (p < 0.001). Conclusion: The results of this study suggest that LPT may be an efficacious choice of therapy.

Photomed Laser Surg 2009 Oct 1

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=19795993

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Use of therapeutic laser for prevention and treatment of oral mucositis.

Khouri VY, Stracieri AB, Rodrigues MC, Moraes DA, Pieroni F, Simoes BP, Voltarelli JC

University Hospital, University of Sao Paulo, Ribeirao Preto, SP, Brazil. vivikhouri@usp.br

Oral mucositis (OM) affects patients who are submitted to hematopoietic stem cell transplantation (HSCT) due to high doses of chemotherapy and/or radiotherapy. The purpose of this investigation was to perform a comparative study of the frequency and evolution of OM among patients subjected to therapeutic laser and to the conventional therapy (use of mouthwash called ‘Mucositis Formula’). The patients were subjected to a myeloablative conditioning regimen before the allogeneic HSCT. Twenty-two patients were selected and divided into 2 groups: group I was irradiated with InGaAlP laser (660 nm) and GaAlAs laser (780 nm), 25 mW potency, 6.3J/cm(2) dose, in 10-s irradiation time, followed to conventional treatment; group II was subjected only to the conventional treatment. Both World Health Organization (WHO) scale and the Oral Mucositis Assessment Scale (OMAS) were used to evaluate the results. Data were analyzed by the non-parametric Wilcoxon test, with p<0.05 considered as statistically significant. Group I presented a lower frequency of OM (p=0.02) and lower mean scores, according to WHO and OMAS scales (p<0.01 and p=0.01, respectively). In conclusion, laser reduced the frequency and severity of OM, suggesting that therapeutic laser can be used both as a new form of prevention and treatment of OM.

Braz Dent J 2009 20(3) 215-20

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=19784467

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Combination 830-nm and 633-nm Light-Emitting Diode Phototherapy Shows Promise in the Treatment of Recalcitrant Psoriasis: Preliminary Findings.

Ablon G

Ablon Skin Institute , Los Angeles, California .

Abstract Background and Objectives: Psoriasis is one of the major problems facing dermatologists worldwide. Planar arrays of light-emitting diodes (LEDs) have recently attracted attention in the treatment of difficult dermatological entities, 830 nm in near infrared (near-IR) and 633 nm in visible red. This study was designed to assess the efficacy of combination 830-nm and 633-nm LED phototherapy in the treatment of recalcitrant psoriasis. Subjects and Methods: Nine informed and consenting patients with psoriasis were enrolled in this preliminary study, (3 men, 6 women, mean age 34.3, skin types I to IV). All had chronic psoriasis, which in most cases had proved resistant to conventional treatments. They were treated sequentially with LED arrays delivering continuous-wave 830 nm (near-IR) and 633 nm (red) in two 20-min sessions over 4 or 5 weeks, with 48 h between sessions (830 nm, 60 J/cm(2); 633 nm, 126 J/cm(2)). Results: All patients completed their LED regimens (4 requiring 1 regimen, 5 requiring a second). Follow-up periods were from 3 to 8 months, except in two patients who were lost to follow-up. Clearance rates at the end of the follow-up period ranged from 60% to 100%. Satisfaction was universally very high. Conclusions: The antiinflammatory effects of LED energy at 830 nm and 633 nm have been well documented, as has their use in wound healing. LED phototherapy is easy to apply, pain free and side-effect free, and is well tolerated by patients of all skin types. The promising results of this preliminary study warrant a proper controlled double-blind study with a larger patient population.

Photomed Laser Surg 2009 Sep 21

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=19764893

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Photodynamic therapy for the treatment of recurrent herpes labialis: Preliminary results.

Sperandio FF, Marotti J, Aranha AC, Eduardo Cde P

This study sought to evaluate the clinical outcome of patients who had been diagnosed with recurrent herpes labialis (RHL) after treatment with photodynamic therapy (PDT) associated with low-level laser therapy (LLLT). PDT has shown great effectiveness for treating already-established RHL vesicles, compared to ordinary treatments involving antiviral compounds. Two patients with vesicles on their lips were treated with PDT, followed by irradiation with LLLT. Both patients reported pain relief immediately after the procedure; at a six-month follow-up, neither patient showed signs or symptoms that related to RHL.

Gen Dent 2009 Jul-Aug 57(4) 415-9

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=19903625

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Low-level laser therapy for pain caused by placement of the first orthodontic archwire: a randomized clinical trial.

Tortamano A, Lenzi DC, Haddad AC, Bottino MC, Dominguez GC, Vigorito JW

Department of Orthodontics, School of Dentistry, University of Sao Paulo, Sao Paulo, Brazil.

INTRODUCTION: The purpose of this study was to clinically evaluate the effect of low-level laser therapy (LLLT) as a method of reducing pain reported by patients after placement of their first orthodontic archwires. METHODS: The sample comprised 60 orthodontic patients (ages, 12-18 years; mean, 15.9 years). All patients had fixed orthodontic appliances placed in 1 dental arch (maxillary or mandibular), received the first archwire, and were then randomly assigned to the experimental (laser), placebo, or control group. This was a double-blind study. LLLT was started in the experimental group immediately after placement of the first archwire. Each tooth received a dose of 2.5 J per square centimeter on each side (buccal and lingual). The placebo group had the laser probe positioned into the mouth at the same areas overlying the dental root and could hear a sound every 10 seconds. The control group had no laser intervention. All patients received a survey to be filled out at home describing their pain during the next 7 days. RESULTS: The patients in the LLLT group had lower mean scores for oral pain and intensity of pain on the most painful day. Also, their pain ended sooner. LLLT did not affect the start of pain perception or alter the most painful day. There was no significant difference in pain symptomatology in the maxillary or mandibular arches in an evaluated parameter. CONCLUSIONS: Based on these findings, we concluded that LLLT efficiently controls pain caused by the first archwire.

Am J Orthod Dentofacial Orthop 2009 Nov 136(5) 662-7

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=19892282

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Investigation of the Effect of GaAs Laser Therapy on Lateral Epicondylitis.

Emanet SK, Altan LI, Yurtkuran M

Uludag University Medical Faculty , Ataturk Rehabilitation Center, Rheumatic Disease and Hydrotherapy Section, Bursa, Turkey .

Abstract Background and Objective: There are conflicting reports regarding the efficacy of low energy laser therapy in treatment of lateral epicondylitis (LE). Contradictory results are considered to be due to different joint treatment protocols regarding variables such as dose, duration, and frequency. The aim of this study was to investigate the efficacy of gallium-arsenide (GaAs) laser therapy, which was performed with the dose regimen recommended by the World Association for Laser Therapy, in relieving pain and improving functional activities in patients with LE. Patients and Methods: Forty-nine patients (50 elbows) evaluated in our outpatient clinic were included in the study. Elbows were randomized into two groups: laser (n = 25) and placebo laser (n = 25). Either laser or placebo laser therapy was applied to patients for 15 sessions (5 d per week for 3 weeks). Main outcome measures were visual analog scale, tenderness, Disability of the Arm Shoulder and Hand (DASH) questionnaire, the Patient-Related Lateral Epicondylitis Evaluation (PRTEE) test, pain-free grip strength, and the Nottingham Health Profile (NHP) questionnaire. Evaluations were performed before treatment, at the end of 3 weeks of treatment, and after the 12th week of treatment ended. Results: Upon post-treatment evaluation, a significant improvement in all parameters was observed for both groups (p < 0.05). No significant difference was found when the laser and placebo groups were compared. At the 12 week evaluation, a significant sustained improvement in all parameters was observed. On intergroup evaluation, a significant improvement was observed in favor of the active treatment group regarding pain with resisted extension of the wrist, tenderness with pressure, and for both the total and subgroup scores of the DASH questionnaire and PRTEE test, as well as for the pain subgroup of the NHP questionnaire (p < 0.05). Conclusion: Although low energy laser therapy had no advantage compared to placebo in patients with LE for the short term, a significant improvement, particularly in functional parameters, was achieved in the long term. Laser, which has relatively no side effects, might be included among long-term treatment options for LE.

Photomed Laser Surg 2009 Oct 30

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=19877824

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Therapeutic Effects of Low-Level Laser on Lateral Epicondylitis from Differential Interventions of Chinese-Western Medicine: Systematic Review.

Chang WD, Wu JH, Yang WJ, Jiang JA

1 Department of Rehabilitation Medicine, Da Chien General Hospital , Miaoli City, Taiwan .

Abstract Background: Low-level laser therapy (LLLT) is a conservative treatment for lateral epicondylitis (LE), but it is also an alternative intervention between the very different approaches of Chinese and Western medicine. Objective: The purpose of this study was to systematically review and meta-analyze the therapeutic effects of LLLT on LE. Methods: We searched several electronic databases, including Medline, PubMed, and CINAHL, and explored studies that were randomized controlled trials on the therapeutic effects of LLLT on LE from 1990 to February 2009. These studies were systematically reviewed for the difference in therapeutic effects among various LLLTs on acupuncture points and on tender and myofascial trigger points (MTrPs). The reviewed therapeutic effects included pain, grip strength, range of motion (ROM), and weight tests, and were compared by meta-analysis. Results: We selected ten articles, and in seven of them the irradiation was conducted on tender points or MTrPs in the experimental groups. In two other articles, the irradiation was conducted on acupuncture points, and the last one was conducted on both kinds of points. Only three articles provided sufficient data for meta-analysis. The results revealed that applying LLLT on tender points or MTrPs is an effective means to improve the effect size (ES) of pain release after treatment (pooled ES: 0.71, 95% CI: 0.82- approximately 0.60) and follow-up (pooled ES: 1.05, 95% CI: 1.16- approximately 0.94). LLLT application was also able to increase the grip force, ROM, and weight test (p < 0.05). Conclusions: We suggest that using LLLT on tender points or MTrPs of LE could effectively improve therapeutic effects.

Photomed Laser Surg 2009 Oct 30

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=19874256

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Analysis of Low-Level Laser Radiation Transmission in Occlusive Dressings.

de Jesus Guirro RR, de Oliveira Guirro EC, Martins CC, Nunes FR

1 Department of Biomechanics, Medicine and Rehabilitation of the Locomotor System, School of Medicine of Ribeirao Preto, University Sao Paulo , Brazil .

Abstract Objective: The purpose of this study is to analyze the power transmitted by low-level laser therapy (LLLT) into occlusive dressings using different wavelengths for the treatment of cutaneous lesions. Background Data: LLLT has been largely used to treat several cutaneous lesions commonly associated with occlusive dressings to accelerate the healing process. Materials and Methods: Radiation transmission was measured by a digital power analyzer connected to a laser emitter with wavelengths of 660, 830, and 904 nm and mean levels of 30, 30, 6.5 mW, respectively, previously calculated. Thirteen different occlusive dressings were analyzed and interposed between the laser emitter and the power analyzer sensor, with 15 measurements made for each dressing. Statistics were provided by the analysis of variance (ANOVA), followed by Student’s t-test (p < 0.05). Results: The power transmitted ranged between 98.6% and 0%, depending on the material and wavelength. The dressings tested were BioFill, Hydrofilm, Confeel Plus 3533, Confeel 3218, DuoDERM Extra Thin, Hydrocoll, Micropore Nexcare, CIEX tape, Emplasto Sabia, CombiDERM, Band-aid, Actisorb Plus, in addition to polyvinylchloride (PVC) film, and transmitted power higher than 40% of the incident power, independently from the wavelength indicated for the association with LLLT. Conclusion: The results showed that LLLT transmission depends on the occlusive dressing material and the wavelength irradiated.

Photomed Laser Surg 2009 Oct 9

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=19817516

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Sexual Functions and Depressive Symptoms after Photodynamic Therapy for Vulvar Lichen Sclerosus in Postmenopausal Women from the Upper Silesian Region of Poland.

Skrzypulec V, Olejek A, Drosdzol A, Nowosielski K, Kozak-Darmas I, Wloch S

Department of Women’s Disease Control and Prevention, School of Health Care, Medical University of Silesia, Katowice, Poland.

Introduction. Although lichen sclerosus (LS) may affect women’s physical functioning, mood, and quality of life, restricting their physical activities, sexual, and non-sexual contacts, there are limited data on the sexual functioning of women diagnosed with LS. Aims. The aim of the study was to evaluate the influence of photodynamic therapy for vulvar LS on sexual functions and depressive symptoms in postmenopausal women from the Upper Silesian Region of Poland. Methods. A total of 65 women aged 50-70 visiting an outpatient clinic for assessment of vulvar dermatoses were screened for the clinical trial. Finally, 37 women who met all the inclusion/exclusion criteria were included in the study. All the subjects were treated by topical laser therapy (photodynamic therapy). Sexual functions and depressive symptoms were assessed before and after the therapy using Female Sexual Function Index and Beck Depression Inventory, respectively. Main Outcome Measures. Sexual behaviors, sexual functions, and depressive symptoms in females after photodynamic therapy for vulvar LS. Results. The total FSFI score was significantly lower after the treatment of vulvar LS as compared with the baseline (median 24.6 vs. 15.9). However, the prevalence of clinically significant FSD was stable throughout the medical intervention except lubrication disorders (higher prevalence after the treatment: 40% vs. 68.57%). Although the scores of BDI at the baseline dropped significantly after the photodynamic therapy (median 12.0 and 9.0, respectively), there were no significant differences in the prevalence of depressive symptoms (48.65% vs. 45.94%). Conclusions. Topical laser therapy for vulvar LS has a good clinical outcome, especially in the context of no major negative effects on sexual functioning and the positive impact on the severity of depressive symptoms in postmenopausal women. However, patients should be informed about the possible lubrication disorders following the treatment.

J Sex Med 2009 Sep 29

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=19796058

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Use of 660-nm Diode Laser in the Prevention and Treatment of Human Oral Mucositis Induced by Radiotherapy and Chemotherapy.

Zanin T, Zanin F, Carvalhosa AA, de Souza Castro PH, Pacheco MT, Zanin IC, Junior AB

1 Photobiology and Lasertherapy Center, Vale do Paraiba University , Sao Jose dos Campos, SP, Brazil .

Abstract Objective: The aim of this multidisciplinary study was to evaluate quantitatively and qualitatively the effect of a 660-nm diode laser in the prevention and treatment of human oral mucositis (OM) in patients suffering from head and neck cancer who had undergone radiotherapy and chemotherapy. Background Data: OM is a severe oral lesion resulting from the toxic effects of treatment for cancer in the head and neck region. Low-level laser therapy is indicated to prevent and treat this oral complication and may be used alone or in association with conventional drug treatment, producing pain relief and wound repair. Methods: This study included 72 patients with head and neck cancer treated at the Cancer Hospital of Mato-Grosso, Brazil, and divided into a control group (C; n = 36) and a laser group (L; n = 36). Laser therapy was performed in combination with radiotherapy and chemotherapy twice a week using a diode laser (lambda = 660 nm, power = 30 mW, spot size = 2 mm, energy = 2 J per point). Results: Statistically significant differences were observed between the two groups. Patients in group L usually did not present with OM or pain, but all patients in group C presented with OM ranging from Level I to III associated with pain. This difference was significant from week 1 on, increased until week 4 and remained stable up to week 7. Conclusion: Laser therapy was effective in preventing and treating oral effects induced by radiotherapy and chemotherapy, thus improving the patient’s quality of life.

Photomed Laser Surg 2009 Sep 21

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=19764899

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Laser Therapy in the Tissue Repair Process: A Literature Review.

da Silva JP, da Silva MA, Almeida AP, Junior IL, Matos AP

1 Physiotherapy Department, Faculdade de Tecnologia e Ciencias , Vitoria da Conquista, Brazil .

Abstract Objective: Carry out a literature review on the use of laser therapy in the tissue repair process and address the different lasers and parameters used by the authors. Methods: A review was carried out of the literature from 1960 to 2008 in the Lilacs, Medline, and PubMed databases using the following key words: Laser Therapy, Wound Healing, and Tissue repair. Results: The most frequently used types of laser are helium neon (HeNe) lasers and diode lasers, including gallium-aluminum-arsenium (GaAlAs), arsenium-gallium (AsGa), and indium-gallium-aluminum-phosphide (InGaAlP) lasers. However, implementation of different protocols was found, with different materials and different activating wavelengths, thus making it difficult to compare results and choose the parameters of treatment. Conclusions: The majority of authors report that laser therapy speeds up the process of tissue repair, but further studies are suggested to determine the best parameters to be used.

Photomed Laser Surg 2009 Sep 21

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=19764898

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[Less need for insulin, a surprising effect of phototherapy in insulin-dependent diabetes mellitus]

Nieuwenhuis RF, Spooren PF, Tilanus JJ

opleiding tot psychiater verbonden aan deGGZ Breburg Groep en was werkzaam in het St. Elisabeth Ziekenhuis te Tilburg.

A 40-year-old woman with insulin-dependent diabetes mellitus was treated successfully with phototherapy for a seasonal affective disorder. Following sessions of phototherapy she developed hypoglycaemias and required less insulin. A review of the literature showed that melatonin has an inhibiting effect on insulin sensitivity. The melatonin secretion, which is suppressed by phototherapy, may cause an immediate decrease in the plasma glucose levels. This decrease may well be important for patients with insulin-resistant diabetes mellitus and seasonal affective disorder.

Tijdschr Psychiatr 2009 51(9) 693-7

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=19760569

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The Effect of Equal Daily Dose Achieved by Different Power Densities of Low-Level Laser Therapy at 635 and 670 nm on Wound Tensile Strength in Rats: A Short Report.

Vasilenko T, Slezak M, Kovac I, Bottkova Z, Jakubco J, Kostelnikova M, Tomori Z, Gal P

1 Department of Medical Biophysics, Pavol Jozef Safarik University , Kosice, Slovak Republic.

Abstract Objective: The aim of our study was to compare the effects of different power densities of LLLT at 635 and 670 nm achieving a daily dose of 5 J/cm(2) on wound tensile strength (TS) in rats. Background Data: Optimal parameters of low-level laser therapy (LLLT) are still unknown. Materials and Methods: Under general anesthesia, one full-thickness skin incision was performed on the back of each rat (n = 40) and immediately closed using an intradermal running suture. Rats were separated into five groups depending on treatment parameters: (1) sham irradiated control group (SIC); (2) 635 nm laser-treated group at 4 mW/cm(2) (L-635/4); (3) 635 nm laser-treated group at 15 mW/cm(2) (L-635/15); (4) 670 nm laser-treated group at 4 mW/cm(2) (L-670/4); and (5) 670 nm laser-treated group at 15 mW/cm(2) (L-670/15). The total daily dose was 5 J/cm(2). Seven days after surgery each wound was removed for wound TS measurement. Results: The lowest wound TS results were measured in the SIC rats (10.5 +/- 2.8 g/mm(2)). Higher wound TS results were measured in group L-670/15 (11.5 +/- 2.5 g/mm(2)) and group L-635/4 (11.7 +/- 4.3 g/mm(2)) rats, while significantly higher results were found in group L-670/4 (15.8 +/- 4.4 g/mm(2)) and group L-635/15 (15.9 +/- 4.8 g/mm(2)). The differences were significant between certain groups (p < 0.01: SIC vs. L-635/15, SIC vs. L-670/4; p < 0.05: L-635/4 vs. L-635/15, L-635/4 vs. L-670/4, L-635/15 vs. L-670/15, L-670/4 vs. L-670/15). Conclusion: Both red lasers significantly increased wound TS at selected parameters. Whereas the 635 nm laser significantly improved wound healing by using the higher power density, the 670 nm laser improved healing using a lower power density.

Photomed Laser Surg 2009 Sep 11

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=19743962

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Laser Photobiomodulation of Wound Healing in Diabetic and Non-Diabetic Mice: Effects in Splinted and Unsplinted Wounds.

Chung TY, Peplow PV, Baxter GD

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

Abstract Objective: The aim of this investigation was to compare the healing of laser-irradiated and non-irradiated wounds covered by an occlusive dressing in mice. Background data: Many previous studies of the effects of laser irradiation of experimental wounds in mice and rats did not cover the wounds so that healing occurred mainly by contraction. Healing of covered wounds is slower and mimics more closely wound healing in humans. Materials and Methods: Forty-seven diabetic and twenty non-diabetic mice were used. A single wound (5 mm diameter) was created on the left flank of each animal and covered by Tegaderm HP dressing (Day 1). Wounds were irradiated (660 nm) for 20 s using a lower power (18 mW) or higher power (80 mW) laser starting immediately post-wounding for seven consecutive days (0.36 or 1.6 J/day); untreated wounds served as controls. Animals were euthanized on Day 8, 10, or 14. Wound specimens were cut and stained using haematoxylin and eosin, and picrosirius red, and examined by microscopy. Results: Results confirmed that wound healing was impaired in diabetic mice. Analysis of the data demonstrated that Tegaderm HP dressing had retarded contraction (splinted the wounds) in a large proportion of diabetic mice and, to a lesser extent, in non-diabetic mice. Healing of splinted wounds was delayed compared to unsplinted wounds, but laser irradiation (1.6 J/day, 7 days) stimulated healing by re-epithelization and granulation tissue formation. Conclusion: These are the first findings of laser-mediated stimulation of healing in splinted wounds. Further studies are needed to assess the effects of different constellation sets of laser parameters in this wound model.

Photomed Laser Surg 2009 Nov 16

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=19916792

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Laser-aided circumferential supracrestal fiberotomy and low-level laser therapy effects on relapse of rotated teeth in beagles.

Kim SJ, Paek JH, Park KH, Kang SG, Park YG

a Assistant Professor, Department of Orthodontics, Oral Biology Research Institute, College of Dentistry, Kyung-Hee University, Seoul, Korea.

ABSTRACT Objective: To investigate the effectiveness and periodontal side effects of laser circumferential supracrestal fiberotomy (CSF) and low-level laser therapy (LLLT) on orthodontically rotated teeth in beagles. Materials and Methods: Eighteen mandibular incisors from nine dogs were divided into three groups by treatment (n = 6/group): A, orthodontic couple force application only (control); B, laser CSF following orthodontic couple force application; and C, LLLT following orthodontic couple force application. Both mandibular lateral incisors were rotated for 4 weeks, and the relapse tendency was observed for 4 weeks more without any retainers. The amount of relapse, sulcus depth, and gingival recession were measured at weeks 4 and 8. One-way analysis of variance (ANOVA) and Scheffe’s post hoc test were used for data analysis. Tissue specimens were examined at week 8 under light microscopy after hematoxylin-eosin (H&E) and Masson’s trichrome staining. Results: The mean percentage of relapse was 41.29% in group A, 14.52% in group B, and 56.80% in group C (P < .001). Four weeks after laser CSF, the sulcus depth increased by 0.67 mm, but no gingival recession was observed. There was no significant difference between groups A and C in terms of sulcus depth and gingival recession. Conclusions: Laser CSF is an effective procedure to decrease relapse after tooth rotation, causing no apparent damage to the supporting periodontal structures, whereas LLLT on orthodontically rotated teeth without retainers appears to increase the relapse tendency.

Angle Orthod 2010 Mar 80(2) 385-90

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=19905867

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Effects of Chinese herbal medicine combined with He-Ne laser on lipoperoxide and superoxide dismutase in chloasma patients.

Wu YH, Li QL, Yang XW

Department of Chinese Medicine, Guangzhou Red Cross Hospital, Guangzhou 510220, China.

OBJECTIVE: To observe the effects of Chinese decoction and ligustrazin hydrochloride injection combined with He-Ne laser on lipoperoxide (LPO) and Superoxide dismutase (SOD) in patients with chloasma. METHODS: 90 cases of chloasma were randomly divided into the following two groups: a treatment group (of 54 cases) treated by a self-prepared prescription for toning the kidneys and relieving the depressed liver to remove blood stasis, ligustrazin hydrochloricde injection and He-Ne laser therapy, and a control group (of 36 cases) treated with oral administration of Vitamin E and Vitamin C plus external application of 20% Azelaic acid cream. RESULTS: The total effective rate in the treatment group was 79.6%, which was significantly higher than that of the control group (P < 0.05). After treatment, the LPO level in the treatment group was significantly lowered (P < 0.01), and the SOD level was significantly elevated (P < 0.05). CONCLUSION: The therapeutic methods adopted in the treatment group may show the action of antioxidation, providing good clinical effects for treating chloasma.

J Tradit Chin Med 2009 Sep 29(3) 163-6

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=19894376

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[Effect of infrared low-intensity laser therapy on orbital circulation in children with progressive short-handedness]

This work was designed to study effect of low-intensity infrared laser radiation (LIIRR) on orbital circulation in children with progressive progressive short-handedness. Parameters of the blood flow in the orbital artery, central retinal artery, and posterior ciliary artery were evaluated in a total of 88 patients at the age from 6 to 14 years. The study group (group 1) comprised 66 children with moderately severe progressive myopia (112 eyes), the control one (group 2) included 22 patients without visual disturbances (44 eyes). Patients of group 1 received physiotherapy for the treatment of significantly deteriorated hemodynamics in the orbital region. Indirect action of LIIRR on the orbital region promoted stabilization of short-handedness in 78.8% of the treated patients. It is concluded that the method described in this paper is clinically efficient and may be recommended for the prevention of progressive myopia in children.

Vopr Kurortol Fizioter Lech Fiz Kult 2009 Sep-Oct (5) 37-9

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=19886021

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Morphological analysis of second-intention wound healing in rats submitted to 16 J/cm 2 lambda 660-nm laser irradiation.

Gonzaga Ribeiro MA, Cavalcanti de Albuquerque RL, Santos Barreto AL, Moreno de Oliveira VG, Santos TB, Freitas Dantas CD

Laboratory of Morphology and Structural Biology, Science and Technology Institute, University Tiradentes, Aracaju/SE, Brazil.

BACKGROUND AND OBJECTIVES: Low-level laser therapy (LLLT) has been extensively applied to improve wound healing due to some biostimulatory properties presented by laser arrays apparently able to accelerate the cicatricial repair of soft tissue injuries. However, many controversial results have been reported in the literature, probably as a result of the wide sort of different protocols of photobiomodulation employed in those experiments. The goal of this study was to investigate the effect of a low-dose protocol of LLT on the intensity of the inflammatory response and the pattern of collagen fibers’ deposition during second-intention wound healing in rodents. MATERIALS AND METHODS: Standard-sized wounds were carried out in the back of 24 male rats. Half of them underwent LLLT treatment (16 J/cm 2 ) at 660 nm delivered for 7 days. Eight and 14 days after the wounds were performed, the repairing area was removed and stained in HE and Masson’s trichrome, and the inflammatory response, epithelization, and collagen fiber depositions were evaluated. RESULTS: We found that LLLT was able to slightly reduce the intensity of the inflammatory reaction as well as to enhance substantially the epithelization process at both 8 th and 14 th days. In addition, it also appeared to stimulate the deposition of collagen fibers at the final stages of wound healing. CONCLUSIONS: The LLLT protocol tested in this study resulted in some improvements in second-intention wound healing in rodents.

Indian J Dent Res 2009 Jul-Sep 20(3) 390

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=19884733

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Low-level laser therapy with pulsed infrared laser accelerates third-degree burn healing process in rats.

Ezzati A, Bayat M, Taheri S, Mohsenifar Z

Shahid Beheshti University, MC, Tehran, Iran.

This study investigated the influence of pulsed low-level laser therapy (LLLT) on the healing of a third-degree burn in a rat model. Two third-degree burns (distal and proximal) were made in the skin of 74 rats. Rats were divided into four groups. In group 1, the distal burn received LLLT with laser switched off; in groups 2 and 3, distal burns were treated with a 3,000 Hz-pulsed infrared diode laser with 2.3 and 11.7 J/cm(2) energy densities, respectively. In group 4, the distal burns were treated topically with 0.2% nitrofurazone. The proximal burn of all groups was considered a control burn. We assessed the response to treatment both microbiologically and macroscopically. The chi-square test showed that the incidence of Staphylococcus epidermidis, Lactobacillus, and diphtheria decreased significantly in laser-treated groups compared with other groups. Independent sample t-test showed that LLLT with 11.7 J/cm(2) energy density significantly increased wound-closure rate at 3 and 4 weeks after burning compared with their relevant control burns (p = 0.018 and p = 0.01, respectively). Pulsed LLLT with 11.7 J/cm(2)/890 nm of a third-degree burn in a rat model significantly increased wound-closure rate compared with control burns.

J Rehabil Res Dev 2009 46(4) 543-54

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=19882488

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Laser light may improve the symptoms of oral lesions of cicatricial pemphigoid: a case report.

Oliveira PC, Reis Junior JA, Lacerda JA, Silveira NT, Santos JM, Vitale MC, Pinheiro AL

Laser Center, School of Dentistry, Federal University of Bahia, Salvador, BA, Brazil.

OBJECTIVE: The aim of this work is to report the handling of a patient suffering from cicatricial pemphigoid (CP) treated with laser phototherapy (LPT) and systemic steroids. BACKGROUND DATA: CP is a group of rare chronic autoimmune blistering diseases that predominately affect the mucous membranes and occasionally the skin. The gingiva is most commonly involved, followed by the palate and the buccal mucosa. High-dosage systemic steroids are widely used for its treatment. LPT has been shown to improve wound healing and relieve pain. Its efficacy depends on the amount of energy delivered to the tissue, exposure time, and delivery method. MATERIALS AND METHODS: A white 47-y-old man with CP who used systemic steroids for the previous 5 y was examined at our clinic. Extra- and intraoral examination revealed classic signs of the condition. LPT (GaAlAs diode laser, 660 nm wavelength, 30 mW, continuous wave, diameter approximately 3 mm, 60 J/cm(2) per session) was used in association with the steroids. LPT was performed in a punctual contact manner every other day on the oral mucosa. Maintenance of the treatment was carried out weekly because interruption of the LPT resulted in the recurrence of the lesions. At the time that this report was written, the patient had been undergoing twice weekly treatments for 6 months without signs of lesion recurrence. CONCLUSION: Concomitant use of systemic steroids and LPT showed a positive effect on controlling oral CP lesions and on improving both oral health and the quality of life of the patient.

Photomed Laser Surg 2009 Oct 27(5) 825-8

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=19878031

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Effect of Low-Level Laser Therapy on Malondialdehyde Concentration in Random Cutaneous Flap Viability.

Prado R, Neves L, Marcolino A, Ribeiro T, Pinfildi C, Ferreira L, Thomazini J, Piccinato C

1 Department of Surgery and Anatomy, University of Sao Paulo-FMRP-USP , Ribeirao Preto, Brazil .

Abstract Objective: The aim of this study was to assess the effects of 830 nm and 670 nm laser on malondialdehyde (MDA) concentration in random skin-flap survival. Background Data: Low-level laser therapy (LLLT) has been reported to be successful in stimulating the formation of new blood vessels and activating superoxide-dismutase delivery, thus helping the inhibition of free-radical action and consequently reducing necrosis. Materials and Methods: Thirty Wistar rats were used and divided into three groups, with 10 rats in each one. A random skin flap was raised on the dorsum of each animal. Group 1 was the control group; group 2 received 830 nm laser radiation; and group 3 was submitted to 670 nm laser radiation. The animals underwent laser therapy with 36 J/cm(2) energy density immediately after surgery and on the 4 days subsequent to surgery. The application site of the laser radiation was 1 point, 2.5 cm from the flap’s cranial base. The percentage of the skin-flap necrosis area was calculated 7 days postoperative using the paper-template method, and a skin sample was collected immediately after as a way of determining the MDA concentration. Results: Statistically significant differences were found between the necrosis percentages, with higher values seen in group 1 compared with groups 2 and 3. Groups 2 and 3 did not present statistically significant differences (p > 0.05). Group 3 had a lower concentration of MDA values compared to the control group (p < 0.05). Conclusion: LLLT was effective in increasing the random skin-flap viability in rats, and the 670 nm laser was efficient in reducing the MDA concentration.

Photomed Laser Surg 2009 Oct 30

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=19877823

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Low-Level Laser Therapy for Implants Without Initial Stability.

Campanha BP, Gallina C, Geremia T, Loro RC, Valiati R, Hubler R, de Oliveira MG

1 School of Dentistry, Universidade Federal de Minas Gerais , Belo Horizonte, Brazil .

Abstract Objective: This study evaluated the effect of low-level infrared laser on removal torque values of implants with poor initial stability inserted in rabbit tibias. Background Data: It is important to analyze the effects of laser radiation on bone repair when low-quality bone and implants with poor initial stability are used. Materials and Methods: Thirty male white New Zealand rabbits (Oryctolagus Cuniculus) about 2 mo old and weighing 1.5-2.0 kg were used. Machined implants with poor initial stability were inserted in the tibia of each animal. Animals were randomly divided into two groups: laser irradiated and laser nonirradiated. Each group was further divided into three subgroups, according to the day the animals were killed: 15, 30, or 45 d. Torque values were measured with an axial digital torquemeter that applied counter-torque. The Student’s t-test was used to calculate means and standard deviations for the comparisons between laser and control groups. Results: A significant increase (p = 0.050) in removal torque values was found in the group of laser-irradiated implants at 15 and 30 d when compared with the control groups. At 45 d, no significant differences were found. Conclusion: In this study, low-level laser therapy promoted the osseointegration of implants with poor initial stability, particularly in the initial stages of bone healing.

Photomed Laser Surg 2009 Oct 27

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=19860572

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Effect of Biostimulation on Healing of Bone Defects in Diabetic Rats.

Akyol UK, Gungormus M

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

Abstract Background and Objective: The aim of this study was to investigate the effects of biostimulation on healing of bone defects in diabetic rats. Study Design/Material and Methods: Twenty-eight Wistar rats weighting 250 to 300 g were used for this study. Diabetes was chemically induced with streptozotocin, and 14 nondiabetic and 14 diabetic rats were included in the study. The distal epiphysis of the right and left femurs of the diabetic rats were perforated with a surgical bone drill. This surgical procedure was performed on the left femurs of normal rats too. The wound on the right side of each diabetic rat received laser stimulation. The left femur of each nondiabetic (normal) rat served as a control. The rats were assigned to three experimental groups: (1) normal bur (control group); (2) diabetic bur; (3) diabetic bur + biostimulation. Results: There was a significant difference among all groups in substantia spongiosa formation on day 10. According to the Mann-Whitney U test, there was a difference between Groups 1 and 2. A significant difference was noted between Groups 2 and 3 as well as between Groups 1 and 3 and between Groups 2 and 3 in union at 20 d of healing. Conclusions: Substantia spongiosa formation was slightly more evident in Groups 1 and 3 than in Group 2. Also, there was more union in Group 3 than in the other groups on day 20. As a result, it can be concluded that low-level laser therapy (808 nm laser at 10 J/cm(2)) can have a beneficial effect on spongiosa in diabetic bone repair when five treatments are administered with 2 d intervals between treatments.

Photomed Laser Surg 2009 Oct 27

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=19860570

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Validating a Nonacupoint Sham Control for Laser Treatment of Knee Osteoarthritis.

Zhao L, Shen X, Cheng K, Deng H, Ding G, Tan M, Lao L

1 Shanghai University of Traditional Chinese Medicine , Shanghai, China .

Abstract Objective: The goals of the present study were to evaluate the effect and safety of combined 10.6 mum and 650 nm laser acupuncture-moxibustion on patients with knee osteoarthritis (OA) and to validate a nonacupoint sham control for assessing the effect of point specificity on the treatment. Materials and Methods: A randomized, sham-controlled clinical trial was conducted in an outpatient clinical setting on patients with knee OA (n = 40). Laser irradiation was performed on acupoint Dubi (ST35) and a sham point three times a week for 4 wk. Outcome measurements were performed at baseline and at wk 2 and 4 using Western Ontario and McMaster Universities’ Osteoarthritis Index (WOMAC). Results: At the 2-wk assessment, i.e., after 6 treatments, improvement in the WOMAC pain score of the acupoint group was significantly greater than that of the control group (49.21% vs. 11.99%, respectively; p = 0.021). However, there were no significant differences between the two groups in the WOMAC physical function score (p = 0.129) or joint stiffness score (p = 0.705). No side effects were found during the trial. Conclusions: Combined 10.6-mum-650-nm laser acupuncture-moxibustion on acupoint ST35 is safe to use and was effective after 2-wk treatment, but not at the 4-wk assessment, in relieving knee OA pain compared to a nonacupoint sham control. A larger clinical trial to verify our findings is warranted.

Photomed Laser Surg 2009 Oct 27

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=19860569

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The Association of Low and High Laser Treatments on Self-Inflicted Lip Injury: A Case Report.

Santos MT, de Souza Merli LA, Guare RO, Ferreira MC

1 Universidade Cruzeiro do Sul , Sao Paulo, Brazil .

Objective: Report a clinical case of surgical lip lesion removal owing to self-injury in a 9-year-old male quadriplegic, spastic cerebral palsy (CP) patient using low and high lasers in association. Background: Various management methods for oral trauma have been suggested, depending on the severity, frequency, and cause of injury, including medication, behavioral techniques, and oral appliances or dental extractions. Methods: Initially, low-level laser therapy (LLLT) was used on the injured labial tissue measuring 2.2 cm externally and 3.4 cm in the internal mucosal, followed by surgical removal using a CO(2) laser. After 30 days, a significant reduction in injury to the oral tissues was observed, and the region presented normal color and good healing conditions. Conclusion: The association of different laser therapies to remove and heal a lip lesion owing to self-injurious behavior was effective and promoted improvement in the patient’s quality of life by establishing painless mastication.

Photomed Laser Surg 2009 Oct 27

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=19860566

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Healing of Surgical Wounds Made with lambda970-nm Diode Laser Associated or Not with Laser Phototherapy (lambda655 nm) or Polarized Light (lambda400-2000 nm).

Medeiros JL, Nicolau RA, Nicola EM, Dos Santos JN, Pinheiro AL

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

Abstract Objective: The aim of this study was to analyze the effect of two phototherapies, laser and polarized light, on diode laser (970lambda nm) wounds. Background Data: Lasers have been used in surgery, and some wavelengths may cause thermal damage to the tissue and affect healing. Several studies have shown that some wavelengths are effective in improving healing. Coherent and noncoherent light have been successfully used on the modulation of biological phenomena of several origins. Animals and Methods: Thirty-one Wistar rats were divided into 3 groups (GI to GIII). A 20-mm x 2-mm wound was created on the dorsum of each animal with a diode laser (Sirolaser, Sirona((R)), Bensheim, Germany). Group GI acted as control. On GII, laser light (lambda655 nm, 30 mW, phi approximately 3 mm, 12 J/cm(2)) was used and on GIII illumination with polarized light (lambda400-2000 nm, 40 mW, phi approximately 5.5 cm, 12 J/cm(2)) was used, every other day (GII) or daily (GIII) for 7 days. The animals were killed at 0, 7, and 14 days after surgery. Specimens were taken, routinely processed, stained and imunnomarked [HE (hematoxylin-eosin), sirius red, alpha-smooth muscle actin (SMA)], and underwent histological analysis. Results: GII showed better response at day 14 when re-epithelialization was in a more advanced stage. The number of myofibroblasts was significantly different over the healing time (7 to 14 days); this number was smaller than that observed on G1. On GIII at day 7, the number of myofibroblasts was significantly higher than for GII. At day 14, a more pronounced deposition of collagen matrix was also seen, and inflammation was discrete and more advanced for GIII. Conclusion: The results of the present study showed that the effect of the use of laser light was more evident at early stages of healing and that the use of polarized light improved the resolution of the inflammatory reaction, increased the deposition of collagen, increased the number of myofibroblasts, and quickened re-epithelialization during the experimental time.

Photomed Laser Surg 2009 Oct 26

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=19857050

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Effects of low-level laser therapy and orthodontic tooth movement on dental pulps in rats.

Abi-Ramia LB, Sasso Stuani A, Sasso Stuani A, Sasso Stuani MB, de Moraes Mendes A

Abstract Objectives: To describe the microscopic pulpal reactions resulting from orthodontically induced tooth movement associated with low-level laser therapy (LLLT) in rats. Materials and Methods: Forty-five young male Wistar rats were randomly assigned to three groups. In group I (n = 20), the maxillary right first molars were submitted to orthodontic movement with placement of a coil spring. In group II (n = 20), the teeth were submitted to orthodontic movement plus LLLT at 4 seconds per point (buccal, palatal, and mesial) with a GaAlAs diode laser source (830 nm, 100 mW, 18 J/cm(2)). Group III (n = 5) served as a control (no orthodontic movement or LLLT). Groups I and II were divided into four subgroups according to the time elapsed between the start of tooth movement and sacrifice (12 hours, 24 hours, 3 days, and 7 days). Results: Up until the 3-day period, the specimens in group I presented a thicker odontoblastic layer, no cell-free zone of Weil, pulp core with differentiated mesenchymal and defense cells, and a high concentration of blood vessels. In group II, at the 12- and 24-hour time points, the odontoblastic layer was disorganized and the cell-free zone of Weil was absent, presenting undifferentiated cells, intensive vascularization with congested capillaries, and scarce defense cells in the cell-rich zone. In groups I and II, pulpal responses to the stimuli were more intense in the area underneath the region of application of the force or force/laser. Conclusions: The orthodontic-induced tooth movement and LLLT association showed reversible hyperemia as a tissue response to the stimulus. LLLT leads to a faster repair of the pulpal tissue due to orthodontic movement.

Angle Orthod 2010 Jan 80(1) 116-22

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=19852650

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Effects of 660-nm gallium-aluminum-arsenide low-energy laser on nerve regeneration after acellular nerve allograft in rats.

Zhang LX, Tong XJ, Yuan XH, Sun XH, Jia H

Department of Rehabilitation Medicine, The First Affiliated Hospital, China Medical University, Shenyang, China.

Purpose: The purpose of this study was to explore and discuss the effects of 660-nm gallium-aluminum-arsenide low-energy laser (GaAlAs LEL) irradiation on neural regeneration after acellular nerve allograft repair of the sciatic nerve gap in rats. Methods: Eight male and female Sprague-Dawley rats were used as nerve donors, and 32 healthy Wistar rats were randomly divided into four groups: normal control group, acellular rat sciatic nerve (ARSN) group, laser group, and autograft group. Twelve weeks after surgery, nerve conduction velocity, restoration rate of tibialis anterior wet muscle weight, myelinated nerve number, and calcitonin gene-related peptide (CGRP) protein and mRNA expression of the spinal cord and muscle at the injury site were quantified and statistically analyzed. Results: Compared with the ARSN group, laser therapy significantly increased nerve conduction velocity, restoration rate of tibialis anterior wet muscle weight, myelinated nerve number, and CGRP protein and mRNA expression of the L(4) spinal cord at the injury site. Conclusions: These findings demonstrate that 660-nm GaAlAs LEL therapy upregulates CGRP protein and mRNA expression of the L(4) spinal cord at the injury site and increases the rate of regeneration and target reinnervation after acellular nerve allograft repair of the sciatic nerve gap in rats. Low-energy laser irradiation may be a useful, noninvasive adjunct for promoting nerve regeneration in surgically induced defects repaired with ARSN. Synapse 64:152-160, 2010. (c) 2009 Wiley-Liss, Inc.

Synapse 2009 Oct 22 64(2) 152-160

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=19852068

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Transcranial near infrared laser treatment (NILT) increases cortical adenosine-5′-triphosphate (ATP) content following embolic strokes in rabbits.

Lapchak PA, De Taboada L

University of California San Diego, Department of Neuroscience, 9500 Gilman Drive MTF316, La Jolla, CA 92093-0624, USA.

Transcranial near infrared laser therapy (NILT) improves behavioral outcome following embolic strokes in embolized rabbits and clinical rating scores in acute ischemic stroke (AIS) patients; however, the cellular mechanism(s) involved in NILT neuroprotection have not been elucidated. It has been proposed that mitochondrial energy production may underlie a response to NILT, but this has not been demonstrated using an in vivo embolic stroke model. Thus, we evaluated the effect of NILT on cortical ATP content using the rabbit small clot embolic stroke model (RSCEM), the model originally used to demonstrate NILT efficacy and initiate the NEST-1 clinical trial. Five minutes following embolization, rabbits were exposed to 2 min of NILT using an 808 nm laser source, which was driven to output either continuous wave (CW), or pulsed wave modes (PW). Three hours after embolization, the cerebral cortex was excised and processed for the measurement of ATP content using a standard luciferin-luciferase assay. NILT-treated rabbits were directly compared to sham-treated embolized rabbits and naive control rabbits. Embolization decreased cortical ATP content in ischemic cortex by 45% compared to naive rabbits, a decrease that was attenuated by CW NILT which resulted in a 41% increase in cortical ATP content compared to the sham embolized group (p>0.05). The absolute increase in ATP content was 22.5% compared to naive rabbits. Following PW NILT, which delivered 5 (PW1) and 35 (PW2) times more energy than CW, we measured a 157% (PW1 p=0.0032) and 221% (PW2 p=0.0001) increase in cortical ATP content, respectively, compared to the sham embolized group. That represented a 41% and 77% increase in ATP content compared to naive control rabbits. This is the first demonstration that embolization can decrease ATP content in rabbit cortex and that NILT significantly increases cortical ATP content in embolized rabbits, an effect that is correlated with cortical fluence and the mode of NILT delivery. The data provide new insight into the molecular mechanisms associated with clinical improvement following NILT.

Brain Res 2009 Oct 23

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=19837048

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Acupuncture for schizophrenia: a systematic review and meta-analysis.

Lee MS, Shin BC, Ronan P, Ernst E

Division of Standard Research, Korea Institute of Oriental Medicine, Daejeon 305-811, South Korea. drmslee@gmail.com

BACKGROUND: Acupuncture is one of the most popular types of complementary/alternative medicine. It is sometimes used as a treatment for schizophrenia. AIMS: The objective of this review is to assess systematically the clinical evidence for or against acupuncture as a treatment for schizophrenia. METHODS: We searched 20 databases from their inception to May 2009 without language restrictions. All randomised clinical trials (RCTs) of acupuncture, with or without electrical stimulation or moxibustion for patients with schizophrenia were considered for inclusion. RESULTS: Thirteen RCTs, all originating from China, met the inclusion criteria. One RCT reported significant effects of electroacupuncture (EA) plus drug therapy for improving auditory hallucunations and positive symptom compared with sham EA plus drug therapy. Four RCTs showed significant effects of acupuncture for response rate compared with antipsychotic drugs [n = 360, relative risk (RR): 1.18, 95% confidence interval (CI): 1.03-1.34, p = 0.01; heterogeneity: tau(2) = 0.00, chi(2) = 2.98, p = 0.39, I(2) = 0%]. Seven RCTs showed significant effects of acupuncture plus antipsychotic drug therapy for response rate compared with antipsychotic drug therapy (n = 457, RR: 1.15, 95% CI: 1.04-1.28, p = 0.008, heterogeneity: tau(2) = 0.00, chi(2) = 6.56, p = 0.36, I(2) = 9%). Two RCTs tested laser acupuncture against sham laser acupuncture. One RCT found beneficial effects of laser acupuncture on hallucination and the other RCT showed significant effects of laser acupuncture on response rate, Brief Psychiatric Rating Scale and clinical global index compared with sham laser. The methodological quality was generally poor and there was not a single high quality trial. CONCLUSION: These results provide limited evidence for the effectiveness of acupuncture in treating the symptoms of schizophrenia. However, the total number of RCTs, the total sample size and the methodological quality were too low to draw firm conclusions. As all studies originated from China, international studies are needed to test whether there is any effect.

Int J Clin Pract 2009 Nov 63(11) 1622-33

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=19832819

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Influence of the Use of Laser Phototherapy (lambda660 or 790 nm) on the Survival of Cutaneous Flaps on Diabetic Rats.

Santos NR, Dos Santos JN, Dos Reis JA, Oliveira PC, de Sousa AP, de Carvalho CM, Soares LG, Marques AM, Pinheiro AL

1 School of Dentistry, Federal University of Bahia , Salvador, Bahia, Brazil .

Abstract Objective: The aim of this study was to assess and compare the effects of laser phototherapy (LPT) on cutaneous flaps on diabetic rats. Background: Diabetes mellitus is characterized by high blood glucose levels. Its main complications are delayed wound healing, an impaired blood supply, and a decrease in collagen production. Cutaneous flaps are routinely used in several surgical procedures, and most failures are related to poor blood supply. LPT has been studied using several healing models. Animals and Methods: Twelve Wistar rats were randomized into three groups: group 1 (G1; diabetic animals without treatment), group 2 (G2; diabetic animals irradiated with lambda680 nm), and group 3 (G3; diabetic animals irradiated with lambda790 nm). Diabetes was induced with streptozotocin. A 2- x 8-cm cutaneous flap was raised on the dorsum of each animal, and a plastic sheet was introduced between the flap and the bed to cause poor blood supply. Nonirradiated animals acted as controls. The dose per session was 40 J/cm(2). Laser light was applied transcutaneously and fractioned on 16 contact points at the wound margins (16 x 2.5 J/cm(2)). Animal death occurred on day 8 after surgery. Specimens were taken, processed, cut, stained with eosin (HE) and sirius red, and underwent histological analysis. Results: It is shown that accute inflammation was mostly discrete for G3. Chronic inflammation was more evident for G2. Fibroblast number was higher for G3. Angiogenesis was more evident for G3. Necrosis was more evident for G2. Statistical analysis among all groups showed significant differences (p = 0.04) on the level of acute inflammation between G1 and G3, tissue necrosis between G1 and G2 (p = 0.03), chronic inflammation between (p = 0.04), fibroblastic proliferation between G2 and G3 (p = 0.05), and neovascularization between G2 and G3 (p = 0.04). Conclusion: LPT was effective in increasing angiogenesis as seen on irradiated subjects and was more pronounced when IR laser light was used.

Photomed Laser Surg 2009 Oct 15

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=19831497

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[Types of microcirculation and laser therapy in chronic pancreatitis]

The aim of the study was to evaluate effect of low-intensity laser therapy (LILT) on systemic circulation in patients with chronic pancreatitis (CP) in the phase of exacerbation. 65 patients aged 36-77 years were divided into study (n = 20) and control (n = 45) groups. In addition, 30 healthy subjects were examined. Patients of the study group received drug therapy combined with intravenous blood or skin laser irradiation. Controls were treated with medicinal preparations alone. CP was diagnosed based on characteristic pain syndrome, compromised secretory function of the pancreas, results of laboratory and instrumental analysis. Microcirculation was studied by laser Doppler flowmetry with a LAKK-02 apparatus (Lazma, Russia). CP patients had heterogeneous microcirculation with a significantly increased frequency of its pathologic types (spastic, hyperemic, spastic-congestive). Major characteristics of microcirculation were significantly different from those in healthy subjects. Combination of drug therapy and LILT substantially improved microcirculation regardless of its hemodynamic type.

Klin Med (Mosk) 2009 87(8) 56-61

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=19827533

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[Efficacy of photon therapy in combined postoperative treatment of children with congenital obstructive uropathy and secondary pyelonephritis]

Razin MP, Ignat’ev SV, Illek IaIu, Zaitseva GA, Sukhodoev AV

A total of 110 children aged from 5 to 15 years with different forms of congenital obstructive uropathy and secondary pyelonephritis received standard combined treatment (n = 71) or standard treatment combination with photon therapy 3 months after discharge from hospital. Postoperative combined treatment including photon therapy promoted uneventful course of the postoperative period, normalized immunological indices, achievement of persistent remission.

Urologiia 2009 Jul-Aug (4) 55-8

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=19824386

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Photostimulation of channelrhodopsin-2 expressing ventrolateral medullary neurons increases sympathetic nerve activity and blood pressure in rats.

Abbott SB, Stornetta RL, Socolovsky CS, West GH, Guyenet PG

University of Virginia, Macquarie University;

To explore the specific contribution of the C1 neurons to blood pressure (BP) control, we used an optogenetic approach to activate these cells in vivo. A lentivirus that expresses channelrhodopsin-2 (ChR2) under the control of the catecholaminergic neuron-preferring promoter PRSx8 was introduced into the rostral ventrolateral medulla (RVLM). After 2-3 weeks, ChR2 was largely confined to Phox2b-expressing neurons (89%). The ChR2-expressing neurons were non-GABAergic, non-glycinergic and predominantly catecholaminergic (~54%). Photostimulation of ChR2-transfected RVLM neurons (473 nm, 20Hz, 10 ms, ~9mW) increased BP (15 mmHg) and sympathetic nerve discharge (SND; 64 %). Light pulses at 0.2-0.5Hz evoked a large sympathetic nerve response (16 x baseline) followed by a silent period (1-2 s) during which another stimulus evoked a reduced response. Photostimulation activated most (75%) RVLM baroinhibited neurons sampled with 1/1 action potential entrainment to the light pulses and without accommodation during 20 Hz trains. RVLM neurons unaffected by either CO2 or BP were light-insensitive. Botzinger respiratory neurons were activated but their action potentials were not synchronized to the light pulses. Juxtacellular labeling of recorded neurons revealed that, of these three cell types, only the cardiovascular neurons expressed the transgene. In conclusion, ChR2 expression had no discernable effect on the putative vasomotor neurons at rest and was high enough to allow precise temporal control of their action potentials with light pulses. Photostimulation of RVLM neurons caused a sizable sympathoactivation and rise in blood pressure. These results provide the most direct evidence yet that the C1 neurons have a sympathoexcitatory function.

J Physiol 2009 Oct 12

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=19822543

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Biomodulative Effects of Visible and IR Laser Light on the Healing of Cutaneous Wounds of Nourished and Undernourished Wistar Rats.

Barbosa Pinheiro AL, Silva Meireles GC, Carvalho CM, Ramalho LM, Dos Santos JN

1 Laser Center, School of Dentistry, Federal University of Bahia , Salvador, BA, Brazil .

Abstract Aim: We evaluated histologically the differences in the healing of cutaneous wounds on nourished or undernourished rats following laser phototherapy (LPT) (20 or 40 J/cm(2)). Background: Wound healing occurs due to a competitive mechanism between the synthesis and lysis of collagen. Any factor that increases the lysis or reduces the synthesis of collagen may change the healing process. Nutritional deficiencies have a great effect on wound healing. Methods: Fifty nourished or undernourished Wistar rats had one standardized wound created on the dorsum and were divided into 10 subgroups: Control (standard diet); Control [Northeastern Brazilian basic diet (DBR)]; Standard diet + LPT (lambda635 nm; spatial average energy fluence (SAEF) 20 J/cm(2)); Standard diet + LPT (lambda635 nm; SAEF 40 J/cm(2)); Standard diet + LPT (lambda780 nm; SAEF 20 J/cm(2)); Standard diet + LPT (lambda780 nm; SAEF 40 J/cm(2)); DBR + LPT (lambda635 nm; SAEF 20 J/cm(2)); DBR + LPT (lambda635 nm; SAEF 40 J/cm(2)); DBR + LPT (lambda780 nm; SAEF 20 J/cm(2)); DBR + LPT (lambda780 nm; SAEF 40 J/cm(2)). The first application of the treatment was carried out immediately and repeated daily for seven days. The specimens were routinely processed to wax, cut, stained with H&E and Sirius Red stains, and analyzed using light microscopy. The analyses included re-epithelization, inflammatory infiltrate, and fibroblastic proliferation. Sirius Red stained slides were used to perform descriptive analyses of the collagen fibers. Results: The results showed that LPT with lambda635 wavelength was more effective for the treatment of undernourished subjects, treated with either LPT with lambda730 nm with SAEF of 20 J/cm(2) or lambda780 nm with SAEF of 40 J/cm(2). Conclusion: Nutritional status influenced the progression of the healing process as well as the quality of the healed tissue. In addition, the use of both wavelengths resulted in a positive biomodulatory effect on both nourished and undernourished subjects.

Photomed Laser Surg 2009 Oct 12

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=19821705

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Pain Threshold Improvement for Chronic Hyperacusis Patients in a Prospective Clinical Study.

Zazzio M

Audio Laser-Kliniken , Flygeln, Hovmantorp, Sweden .

Abstract Objective: The aim of this study was to investigate if laser therapy in combination with pulsed electromagnetic field therapy/repetitive transcranial magnetic stimulation (rTMS) and the control of reactive oxygen specimens (ROS) would lead to positive treatment results for hyperacusis patients. Background Data: Eight of the ten patients treated for tinnitus, who were also suffering from chronic hyperacusis, claimed their hyperacusis improved. Based upon that, a prospective, unblinded, uncontrolled clinical trial was planned and conducted. ROS and hyperacusis pain thresholds were measured. Materials and Methods: The patients were treated twice a week with a combination of therapeutic laser, rTMS, and the control and adjustment of ROS. A magnetic field of no more than 100 muT was oriented behind the outer ear, in the area of the mastoid bone. ROS were measured and controlled by administering different antioxidants. At every treatment session, 177-504 J of laser light of two different wavelengths was administered toward the inner ear via meatus acusticus. Results: The improvements were significantly better in the verum group than in a placebo group, where 40% of the patients were expected to have a positive treatment effect. The patients in the long-term follow-up group received significantly greater improvements than the patients in the short-term follow-up group. Conclusion: The treatment is effective in treating chronic hyperacusis.

Photomed Laser Surg 2009 Oct 12

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=19821704

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Evaluation of Low-Level Laser Therapy with a He-Ne Laser on the Healing of an Osteochondral Defect using a Biomechanical Test.

Javadieh F, Bayat M, Torkaman G

1 Medical Faculty, Shahid Beheshti University , M.C., Tehran, Iran .

Abstract Objective: The aim of the present study was to examine the influence of low-level laser therapy (LLLT) on the healing of an osteochondral defect in rabbits. Background data: Full-thickness defects of articular cartilage in the knee have a negligible capacity to heal spontaneously. Biostimulatory effects of LLLT on chondrocytes and articular cartilage were reported. Materials and Methods: An osteochondral defect with a 5-mm diameter was surgically induced in the right femoral patellar groove of forty-two adult male rabbits. They were divided into control and experimental groups. The experimental group received He-Ne laser treatment (632.8 nm, 10 mW, circular laser beam, with a surface area of 0.0314 cm(2)) of 148.4 J/cm(2) three times a week. The control group received placebo LLLT with the equipment switched off. Each group was divided into four subgroups: A, B, C, and D. The subgroups were sacrificed at 2, 4, 8, and 16 wk after surgery, respectively. The femur was removed and the defect was examined biomechanically by the in-situ indentation method. The instantaneous stiffness, maximum force, equilibrium load, and energy absorption were calculated. Results: The results of the experimental group were higher than those of the control group. Only one significant difference was observed between the control and experimental groups: the second part of the energy absorption of the experimental group (56.11 +/- 11.5) was significantly higher than that of the control group (18.9 +/- 4) (p = 0.015) 4 wk after surgery. Conclusion: LLLT with a He-Ne laser of an osteochondral defect in rabbits could not significantly accelerate the healing of the osteochondral defect from a biomechanical standpoint when compared with a control group.

Photomed Laser Surg 2009 Oct 12

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=19821703

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Effects of Low-Level Laser Therapy on Pain and Scar Formation after Inguinal Herniation Surgery: A Randomized Controlled Single-Blind Study.

de Paiva Carvalho RL, Alcantara PS, Kamamoto F, Cressoni MD, Casarotto RA

1 Postgraduate Program in Rehabilitation Sciences , University of Sao Paulo, Sao Paulo, Brazil .

Abstract Objective: The aim of this study was to investigate the efficacy of an infrared GaAlAs laser operating with a wavelength of 830 nm in the postsurgical scarring process after inguinal-hernia surgery. Background: Low-level laser therapy (LLLT) has been shown to be beneficial in the tissue-repair process, as previously demonstrated in tissue culture and animal experiments. However, there is lack of studies on the effects of LLLT on postsurgical scarring of incisions in humans using an infrared 830-nm GaAlAs laser. Method: Twenty-eight patients who underwent surgery for inguinal hernias were randomly divided into an experimental group (G1) and a control group (G2). G1 received LLLT, with the first application performed 24 h after surgery and then on days 3, 5, and 7. The incisions were irradiated with an 830-nm diode laser operating with a continuous power output of 40 mW, a spot-size aperture of 0.08 cm(2) for 26 s, energy per point of 1.04 J, and an energy density of 13 J/cm(2). Ten points per scar were irradiated. Six months after surgery, both groups were reevaluated using the Vancouver Scar Scale (VSS), the Visual Analog Scale, and measurement of the scar thickness. Results: G1 showed significantly better results in the VSS totals (2.14 +/- 1.51) compared with G2 (4.85 +/- 1.87); in the thickness measurements (0.11 cm) compared with G2 (0.19 cm); and in the malleability (0.14) compared with G2 (1.07). The pain score was also around 50% higher in G2. Conclusion: Infra-red LLLT (830 nm) applied after inguinal-hernia surgery was effective in preventing the formation of keloids. In addition, LLLT resulted in better scar appearance and quality 6 mo postsurgery.

Photomed Laser Surg 2009 Oct 12

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=19821701

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Green Tea and Red Light-A Powerful Duo in Skin Rejuvenation.

Sommer AP, Zhu D

Institute of Micro and Nanomaterials, University of Ulm , Ulm, Germany .

Abstract Objective: Juvenile skin has been the subject of intense research efforts since ancient times. This article reports on synergistic complementarities in the biological actions of green tea and red light, which inspired the design of a green tea-assisted facial rejuvenation program. Background Data: The approach is based on previous laboratory experiments providing insight into a mechanism by which visible light interacts with cells and their microenvironment. Methods: After 2 months of extreme oxidative stress, green tea-filled cotton pads were placed once per day for 20 minutes onto the skin before treatment with an array of light-emitting diodes (central wavelength 670 nm, dermal dose 4 J/cm(2)). Results: Rejuvenated skin, reduced wrinkle levels, and juvenile complexion, previously realized in 10 months of light treatment alone, were realized in 1 month. Conclusion: The accelerated skin rejuvenation based on the interplay of the physicochemical and biological effects of light with the reactive oxygen species scavenging capacity of green tea extends the action spectrum of phototherapy. The duo opens the gate to a multitude of possible biomedical light applications and cosmetic formulas, including reversal of topical deterioration related to excess reactive oxygen species, such as graying of hair.

Photomed Laser Surg 2009 Oct 9

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=19817517

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Effect of 830 nm Laser Phototherapy on Osteoblasts Grown In Vitro on Biosilicate((R)) Scaffolds.

Renno AC, McDonnell PA, Crovace MC, Zanotto ED, Laakso L

1 Department of Bioscience, Federal University of Sao Paulo , Santos, SP, Brazil .

Abstract Objective: The purpose of this study was (i) to develop a method for successfully seeding osteoblasts onto a glass-ceramic scaffold designed for use in clinical settings, and (ii) to determine whether the application of laser phototherapy at 830 nm would result in osteoblast proliferation on the glass-ceramic scaffold. Background: The use of bioscaffolds is considered a promising strategy for a number of clinical applications where tissue healing is sub-optimal. As in vitro osteoblast growth is a slow process, laser phototherapy could be used to stimulate osteoblast proliferation on bioscaffolds. Methods: A methodology was developed to seed an osteoblastic (MC3T3) cell line onto a novel glass-ceramic scaffold. Seeded scaffolds were irradiated with a single exposure of 830 nm laser at 10 J/cm(2) (at diode). Non-irradiated seeded scaffolds acted as negative controls. Cell proliferation was assessed seven days after irradiation. Results: Osteoblastic MC3T3 cells were successfully grown on discs composed of a glass-ceramic composite. Laser irradiation produced a 13% decrease in MC3T3 cell proliferation on glass-ceramic discs (mean +/- SD = 0.192 +/- 0.002) compared with control (non-irradiated) discs (mean +/-SD = 0.22 +/- 0.002). Conclusions: Despite successful seeding of bioscaffolds with osteoblasts, laser phototherapy resulted in a reduction in cell growth compared to non-irradiated controls. Future research combining laser phototherapy and glass-ceramic scaffolds should take into account possible interactions of the laser with matrix compounds.

Photomed Laser Surg 2009 Oct 9

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=19814702

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Laser Phototherapy as Topical Prophylaxis Against Radiation-Induced Xerostomia.

Simoes A, de Campos L, de Souza DN, de Matos JA, Freitas PM, Nicolau J

1 Department of Dental Materials, Division of Oral Biology, Faculdade de Odontologia, Universidade de Sao Paulo , Sao Paulo, SP, Brazil .

Abstract The common consequences of radiotherapy (RT) to the head and neck are oral mucositis, xerostomia, and severe pain. The aim of this study was to verify how laser phototherapy (LPT) used for oral mucositis could influence xerostomia symptoms and hyposalivation of patients undergiong RT. Patients were divided into two groups: 12 individuals receiving three laser irradiations per week (G1) and 10 patients receiving one laser irradiation per week (G2). A diode laser (660 nm, 6 J/cm(2), 0.24 J, 40 mW) was used until completely healing of the lesions or the end of the RT. At the first and last laser sessions, whole resting and stimulated saliva were collected, and questionnaires were administered. According to Wilcoxon and Student statistical test, xerostomia for G1 was lower than for G2 (p < 0.05), and salivary flow rate was no different before and after RT, except for stimulated collection of G2, which was lower (p < 0.05). Our results suggest that LPT can be beneficial as an auxiliary therapy for hypofunction of salivary glands.

Photomed Laser Surg 2009 Oct 9

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=19814701

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Methodological quality of systematic reviews analyzing the use of laser therapy in restorative dentistry.

Salmos J, Gerbi ME, Braz R, Andrade ES, Vasconcelos BC, Bessa-Nogueira RV

Center for Laser Therapy, Dental School, University of Pernambuco, Av. General Newton Cavalcanti, 1650, 54753-020, Camaragibe, Pernambuco, Brazil, janainasalmos@hotmail.com.

The purpose of this study was to identify systematic reviews (SRs) that compared laser with other dental restorative procedures and to evaluate their methodological quality. A search strategy was developed and implemented for MEDLINE, the Cochrane Library, LILACS, and the Brazilian Dentistry Bibliography (1966-2007). Inclusion criteria were: the article had to be an SR (+/- meta-analysis); primary focus was the use of laser in restorative dentistry; published in English, Spanish, Portuguese, Italian, German. Two investigators independently selected and evaluated the SRs. The overview quality assessment questionnaire (OQAQ) was used to evaluate methodological quality, and the results were averaged. There were 145 references identified, of which seven were SRs that met the inclusion criteria (kappa = 0.81). Of the SRs, 71.4% appraised lasers in dental caries diagnosis. The mean overall OQAQ score was 4.4 [95% confidence interval (CI) 2.4-6.5]. Of the SRs, 57.1% had major flaws, scoring

Lasers Med Sci 2009 Oct 8

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=19813047

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[Retinopathy of prematurity. Prevention, screening and treatment guidelines.]

Castro Conde JR, Echaniz Urcelay I, Botet Mussons F, Pallas Alonso CR, Narbona E, Sanchez Luna M

Hospital Universitario de Canarias, Universidad de La Laguna, Tenerife.

ROP screening is carried out at all the Spanish hospitals, but there is little agreement on the criteria used for its screening and other aspects related to its practice. Our aim is to report on recommendations for prevention, screening, treatment and follow-up of the retinopathy of prematurity in Spain. Prevention strategies and recommendations for screening, exploration and treatment of ROP, as well as of the organisation of the services to carry out it are reviewed. The most recent bibliography on the basis of the scientific evidence is considered, taking as reference, the guidelines published by the American Academy of Pediatrics (AAP) in 2006 and the recommendations updated in 2007 in the United Kingdom. The recommended prevention strategies are based on the best neonatal practice. The standards, as far as the screening is concerned, are established by birth weight (

An Pediatr (Barc) 2009 Oct 5

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=19811960

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The Effect of Laser Irradiation on Proliferation of Human Breast Carcinoma, Melanoma, and Immortalized Mammary Epithelial Cells.

Powell K, Low P, McDonnell PA, Laakso EL, Ralph SJ

1 School of Medical Science, Griffith University , Gold Coast, Queensland, Australia .

Abstract Objective: This study compared the effects of different doses (J/cm(2)) of laser phototherapy at wavelengths of either 780, 830, or 904 nm on human breast carcinoma, melanoma, and immortalized human mammary epithelial cell lines in vitro. In addition, we examined whether laser irradiation would malignantly transform the murine fibroblast NIH3T3 cell line. Background: Laser phototherapy is used in the clinical treatment of breast cancer-related lymphoedema, despite limited safety information. This study contributes to systematically developing guidelines for the safe use of laser in breast cancer-related lymphoedema. Methods: Human breast adenocarcinoma (MCF-7), human breast ductal carcinoma with melanomic genotypic traits (MDA-MB-435S), and immortalized human mammary epithelial (SVCT and Bre80hTERT) cell lines were irradiated with a single exposure of laser. MCF-7 cells were further irradiated with two and three exposures of each laser wavelength. Cell proliferation was assessed 24 h after irradiation. Results: Although certain doses of laser increased MCF-7 cell proliferation, multiple exposures had either no effect or showed negative dose response relationships. No sign of malignant transformation of cells by laser phototherapy was detected under the conditions applied here. Conclusion: Before a definitive conclusion can be made regarding the safety of laser for breast cancer-related lymphoedema, further in vivo research is required.

Photomed Laser Surg 2009 Oct 7

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=19811082

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KTP/532 YAG laser treatment for allergic rhinitis.

Yaniv E, Hadar T, Shvero J, Tamir R, Nageris B

Nose and Sinus Institute, Department of Otorhinolaryngology, Rabin Medical Center, Beilinson Campus, Petah Tiqwa and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel. docyaniv@yahoo.com

BACKGROUND: The purpose of this study was to investigate the efficacy of the KTP/532 YAG laser to reduce nasal congestion and discharge in patients with allergic rhinitis. METHODS: Forty-eight patients with symptoms of allergic rhinitis were treated with the KTP/532 laser. All had positive skin tests for common allergens. Treatments were provided on an ambulatory basis in one to three sessions under local anesthesia with lidocaine nose spray. Outcome was determined by daily symptom reports and regular endoscopy examination and interviews for 12 months. RESULTS: Treatment was very well tolerated. There were no major side effects. At examination after 1 year, nasal obstruction was improved in 69% and nasal discharge in 40% of cases. CONCLUSION: The KTP/532 YAG laser is effective for the treatment of nasal obstruction and discharge. Comparison with other techniques showed it to be the most effective in reducing nasal discharge. It can be done as an office procedure and does not damage the nasal mucous membrane. The KTP/532 YAG laser is effective as an additional treatment for patients refractory to medication.

Am J Rhinol Allergy 2009 Sep-Oct 23(5) 527-30

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=19807988

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The effects of 660 nm and 780 nm laser irradiation on viability of random skin flap in rats.

Cury V, Bossini PS, Fangel R, Crusca Jde S, Renno AC, Parizotto NA

Department of Physiotherapy, Federal University of Sao Carlos, Sao Carlos, SP, Brazil.

BACKGROUND AND OBJECTIVE: Some studies have shown that laser phototherapy is able to increase skin flap viability by decreasing the necrotic area and increasing neoangiogenesis. However, the mechanism by which laser acts on cells is not fully understood. The present study investigated the effects of two different laser wavelengths at 30 and 40 J/cm(2) on the viability of skin flap in rats. MATERIAL AND METHODS: Sixty male animals were used in this study. They were distributed into the following groups (n = 12 each group): control group, group irradiated with 660 nm at 30 J/cm(2); group irradiated with 780 nm, at 30 J/cm(2), group irradiated with 660 nm at 40 J/cm(2); and group irradiated with 780 nm at 40 J/cm(2). The skin flap was performed on the back of all animals studied, with a plastic sheet interposed between the flap and the donor site. Laser irradiation was done immediately after the surgery and on days 1, 2, 3, and 4 post-surgery. The percentage of the necrotic area of the flap was calculated at day 7 post-surgery. RESULTS: Control group showed a necrotic area of 62.83%. Interestingly, no statistically significant differences were found among the treated groups and the control group. CONCLUSION: This present study showed that 660 nm and 780 nm lasers at doses of 30 and 40 J/cm(2) were not effective for decreasing the necrotic area of the skin flaps in rats.

Photomed Laser Surg 2009 Oct 27(5) 721-4

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=19803711

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Effect of phototherapy with low intensity laser on local and systemic immunomodulation following focal brain damage in rat.

Moreira MS, Velasco IT, Ferreira LS, Ariga SK, Barbeiro DF, Meneguzzo DT, Abatepaulo F, Marques MM

LIM-51, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil.

Brain injury is responsible for significant morbidity and mortality in trauma patients, but controversy still exists over therapeutic management for these patients. The objective of this study was to analyze the effect of phototherapy with low intensity lasers on local and systemic immunomodulation following cryogenic brain injury. Laser phototherapy was applied (or not-controls) immediately after cryogenic brain injury performed in 51 adult male Wistar rats. The animals were irradiated twice (3 h interval), with continuous diode laser (gallium-aluminum-arsenide (GaAlAs), 780 nm, or indium-gallium-aluminum-phosphide (InGaAlP), 660 nm) in two points and contact mode, 40 mW, spot size 0.042 cm(2), 3 J/cm(2) and 5 J/cm(2) (3 s and 5 s, respectively). The experimental groups were: Control (non-irradiated), RL3 (visible red laser/ 3 J/cm(2)), RL5 (visible red laser/5 J/cm(2)), IRL3 (infrared laser/3 J/cm(2)), IRL5 (infrared laser/5 J/cm(2)). The production of interleukin-1IL-1beta (IL-1beta), interleukin6 (IL-6), interleukin-10 (IL-10), and tumor necrosis factor-alpha (TNF-alpha) was analyzed by enzyme immunoassay technique (ELISA) test in brain and blood samples. The IL-1beta concentration in brain of the control group was significantly reduced in 24 h (p<0.01). This reduction was also observed in the RL5 and IRL3 groups. The TNF-alpha and IL-6 concentrations increased significantly (p<0.01 and p<0.05, respectively) in the blood of all groups, except by the IRL3 group. The IL-6 levels in RL3 group were significantly smaller than in control group in both experimental times. IL-10 concentration was maintained stable in all groups in brain and blood. Under the conditions of this study, it is possible to conclude that the laser phototherapy can affect TNF-alpha, IL-1beta and IL-6 levels in the brain and in circulation in the first 24 h following cryogenic brain injury.

J Photochem Photobiol B 2009 Dec 2 97(3) 145-51

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=19800810

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Effects of 780-nm Low-level Laser Therapy with a Pulsed Gallium Aluminum Arsenide Laser on the Healing of a Surgically Induced Open Skin Wound of Rat.

Bayat M, Azari A, Golmohammadi MG

Physical Therapy Research Group, Academic Center for Education, Culture, and Research, Iran Medical Science Branch University , Vanak, Tehran, Iran .

Abstract Objective: The aim of the present investigation is to evaluate the effects of a 780-nm low-level laser on open skin wound healing. Background Data: Optimal parameters of low-level laser therapy (LLLT) for wound healing are discussed. Methods: One full-thickness skin wound was surgically induced in the dorsum skin of 30 rats. The rats were divided into two groups. Rats in the experimental group were daily treated with a gallium aluminum arsenide (GaAlAs) laser (2 J/cm(2), lambda = 780 nm, pulse frequency of 2336 Hz). Rats in the sham-exposed group received LLLT with switched off equipment. After 4, 7, and 15 days, wounds were checked by histological and biomechanical methods. Data were analyzed by the Mann-Whitney U-test. Results: Fibroblasts, endothelium of blood vessels, blood vessel sections, and maximum stress were significantly increased, whereas macrophages were significantly decreased, compared with those of the sham-exposed group. Conclusion: Pulsed LLLT with a 780-nm GaAlAs laser significantly accelerates the process of healing of surgically induced, full-thickness skin wounds in rat.

Photomed Laser Surg 2009 Oct 1

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=19795994

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Effect of Low-Level Laser Irradiation on Bisphosphonate-Induced Osteonecrosis of the Jaws: Preliminary Results of a Prospective Study.

Scoletta M, Arduino PG, Reggio L, Dalmasso P, Mozzati M

1 Oral Surgery Unit, Dentistry Section, Department of Clinical Physiopathology, University of Turin , Turin, Italy .

Abstract Objective: The aim of this study was to detail the clinical efficacy of low-level laser therapy (LLLT) for the management of bisphosphonate-induced osteonecrosis of the jaws (ONJ-BP). Background: ONJ-BP is the correct term, recently emerged, to describe a significant complication in a subset of patients receiving drugs such as zoledronic acid, pamidronate, and alendronate. No definitive standard of care has been set for ONJ-BP and no definitively agreed guidelines have been provided. There is currently no consensus on the correct approach to the issue. Materials and Methods: The investigators studied a prospective cohort of 20 patients affected by ONJ-BP, who received biostimulation with a pulsed diode laser (GaAs). Patients were exposed to a 904-nm infrared laser (50 kHz, 28.4 J/cm(2) energy density, 40% duty cycle, spot size 0.8 cm). Outcome variables were the size of lesions, edema, visual analogue score of pain, presence of pus, fistulas, and halitosis. Preoperative results were compared with the postoperative outcome and statistically evaluated. Results: Four weeks after LLLT, a statistically significant difference was observed for reported pain (p = 0.0001), clinical size (p = 0.0034), edema (p = 0.0005), and presence of pus and fistulas (p = 0.0078 and p = 0.03, respectively). Conclusion: This study suggests that LLLT would appear to be a promising modality of treatment for patients with ONJ-BP, providing that clinical efficacy is safe and well tolerated, especially by those patients who require conservative treatment. Of course, this needs to be addressed further in larger and randomly controlled studies in different clinical settings.

Photomed Laser Surg 2009 Oct 1

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=19795990

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Visible light induces no formation in sperm and endothelial cells.

Ankri R, Friedman H, Savion N, Kotev-Emeth S, Breitbart H, Lubart R

Department of Physics, Bar Ilan University, Ramat Gan 52900, Israel.

BACKGROUND: Visible light-based stimulation using low-intensity lasers, LEDs, and broadband visible light devices has been recently introduced for therapy of human tissues in the absence of exogenous photosensitizers. Nitric oxide (NO) formation might be a potential mechanism for photobiomodulation because it is synthesized in cells by nitric oxide synthase (NOS), which contains both flavin and heme groups that absorb visible light. NO synthesis may also result from increased reactive oxygen species (ROS), which are found in various cell cultures following visible light illumination. NO is mainly known for inducing blood vessel dilation by endothelial cells, and in sperm cells NO is considered as an important agent in acrosome reaction and capacitation process, which are essential for successful fertilization. PURPOSE: To study NO formation in endothelial and sperm cells following visible light irradiation. MATERIALS AND METHODS: Sperm and endothelial cells were illuminated with broadband visible light, 400-800 nm, 130 mW/cm(2), for 5 minutes. During illumination, the endothelial cells were incubated in PBS free of Ca(+2) and Mg(+2), and the sperm cells were incubated in NKM buffer, to induce “stress conditions.” NO production was quantified by using the Griess reagent which reacts with nitrite in the medium to yield an Azo compound which has an absorption band at 540 nm. RESULTS: Visible light illumination increased NO concentration both in sperm and endothelial cells. Blue light was more effective than red. Light-induced NO occurred only when endothelial cells were incubated in PBS free of Ca(+2) and Mg(+2), and in sperm cells, only when incubated in NKM. CONCLUSION: Light induces NO formation in endothelial and sperm cells. In endothelial cells, NO formation may explain previous results demonstrating enhanced wound healing and pain relief following illumination. In illuminated sperm cells, NO formation may account for the enhanced fertilization rate. Lasers Surg. Med. (c) 2009 Wiley-Liss, Inc.

Lasers Surg Med 2009 Sep 29

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=19790248

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Anti-Inflammatory Effect of Low-Level Laser and Light-Emitting Diode in Zymosan-Induced Arthritis.

de Morais NC, Barbosa AM, Vale ML, Villaverde AB, de Lima CJ, Cogo JC, Zamuner SR

1 Laboratory of Inflammation, Institute of Research and Development, University of Vale do Paraiba , Sao Jose dos Campos, Brazil .

Abstract Objective: The aim of this work was to investigate the effect of low-level laser therapy (LLLT) and light-emitting diode (LED) on formation of edema, increase in vascular permeability, and articular joint hyperalgesia in zymosan-induced arthritis. Background Data: It has been suggested that low-level laser and LED irradiation can modulate inflammatory processes. Material and Methods: Arthritis was induced in male Wistar rats (250-280 g) by intra-articular injection of zymosan (1 mg in 50 muL of a sterile saline solution) into one rear knee joint. Animals were irradiated immediately, 1 h, and 2 h after zymosan administration with a semiconductor laser (685 nm and 830 nm) and an LED at 628 nm, with the same dose (2.5 J/cm(2)) for laser and LED. In the positive control group, animals were injected with the anti-inflammatory drug dexamethasone 1 h prior to the zymosan administration. Edema was measured by the wet/dry weight difference of the articular tissue, the increase in vascular permeability was assessed by the extravasation of Evans blue dye, and joint hyperalgesia was measured using the rat knee-joint articular incapacitation test. Results: Irradiation with 685 nm and 830 nm laser wavelengths significantly inhibited edema formation, vascular permeability, and hyperalgesia. Laser irradiation, averaged over the two wavelengths, reduced the vascular permeability by 24%, edema formation by 23%, and articular incapacitation by 59%. Treatment with LED (628 nm), with the same fluence as the laser, had no effect in zymosan-induced arthritis. Conclusion: LLLT reduces inflammatory signs more effectively than LED irradiation with similar irradiation times (100 sec), average outputs (20 mW), and energy doses (2 J) in an animal model of zymosan-induced arthritis. The anti-inflammatory effects of LLLT appear to be a class effect, which is not wavelength specific in the red and infrared parts of the optical spectrum.

Photomed Laser Surg 2009 Sep 25

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=19780633

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[Comparison of non-invasive and invasive techniques in the treatment of patients with myofascial pain syndrome.]

Gul K, Onal SA

Department of Anesthesiology and Reanimation, Bingol State Hospital, Bingol, Turkey. kursadgul@yahoo.com

OBJECTIVES: We compared in this study the efficiency of non-invasive techniques including transcutaneous electrical nerve stimulation (TENS) and laser treatments with invasive techniques including lidocaine and botulinum toxin-A injection in patients with myofascial pain syndrome (MPS). METHODS: One hundred patients who admitted to Firat University Hospital Pain Department and who were diagnosed as MPS were included in the study. Patients were randomized into four groups of 25 patients each. Sixty sessions of TENS and 20 sessions of laser treatments were performed in the first and second groups, respectively. Lidocaine and botulinum toxin-A were injected in the third and fourth groups, respectively. 2 ml (20 mg) 1% lidocaine was injected in each patient twice a week for one month in Group III. 25 U (0.5 ml) of botulinum toxin-A was injected in each patient only once in Group IV. Pain was evaluated with visual analogue scale (VAS), palpable muscle spasm scoring (PMSS) and anesthesiometer at baseline, 15, 30 and 45 days. RESULTS: There were no statistically significant differences between the groups with respect to age, sex and education level. Pain control was statistically better in Group IV compared with the other groups with respect to VAS, PMSS and anesthesiometer scores. CONCLUSION: Botulinum toxin-A injection provided better pain control when compared to trigger point injection with lidocaine and non-invasive techniques including TENS and laser treatments.

Agri 2009 Jul 21(3) 104-12

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=19780001

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Effect of Low-Level Laser Therapy with Output Power of 30 mW and 60 mW in the Viability of a Random Skin Flap.

Costa MS, Pinfildi CE, Gomes HC, Liebano RE, Arias VE, Silveira TS, Ferreira LM

1 Division of Plastic Surgery, Federal University of Sao Paulo , Sao Paulo, SP, Brazil .

Abstract Objective: To assess the effects of low-level laser therapy (LLLT) with output power of 30 and 60 mW in the viability of a random skin flap in rats. Background Data: Output power values in LLLT are not well defined. Materials and Methods: Controlled, single-blind experimental study. Thirty-six animals were randomly distributed into three groups: sham group (SG), 30-mW output power (30G), and 60-mW output power (60G). In both treated groups, a fluency of 3 J/cm(2) was used. Two minutes after elevation of a random-pattern cranially based dorsal flap (4 x 10 cm), laser irradiation was applied and repeated on the first, second, third, and fourth postoperative days. Percentages of flap necrosis were calculated on the seventh postoperative day. Also, four fragments of each flap were collected to allow determination of the percentages of vascular density according to the bidimensional method of the morphometric analysis of blood vessels. Statistical analysis included the Wilcoxon test and Kruskal-Wallis variance analysis. A significance level of 5% was elected (p < 0.05). Results: Laser-treated animals presented significantly less necrosis than the sham group (SG, 53%; 30G, 24%; p < 0.05) (60G, 25%; p < 0.05). Also, laser-treated animals presented significantly more vascular density than the sham group (SG, 37%; 30G, 57%; p < 0.05) (60G, 59%; p < 0.05). Conclusion: LLLT (660 nm) with 30-mW and 60-mW output power was efficient in the increase of skin flap viability, but there was no difference between them.

Photomed Laser Surg 2009 Sep 21

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=19764895

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Low-Level Laser Irradiation (InGaAlP-660 nm) Increases Fibroblast Cell Proliferation and Reduces Cell Death in a Dose-Dependent Manner.

Frigo L, Favero GM, Campos Lima HJ, Maria DA, Bjordal JM, Joensen J, Iversen VV, Marcos RL, Parizzoto NA, Lopes-Martins RA

1 Biological Sciences and Health Center, Cruzeiro do Sul University , Sao Paulo, Brazil .

Abstract Background and Objective: Impaired cell metabolism and increased cell death in fibroblast cells are physiological features of chronic tendinopathy. Although several studies have shown that low-level laser therapy (LLLT) at certain parameters has a biostimulatory effect on fibroblast cells, it remains uncertain if LLLT effects depend on the physiological state. Study Design/Material and Methods: High-metabolic immortal cell culture and primary human keloid fibroblast cell culture were used in this study. Trypan blue exclusion and the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) test were used to determine cell viability and proliferation. Propidium iodide stain was used for cell-cycle analysis by flow cytometry. Laser irradiation was performed daily on three consecutive days with a GaAlAs 660-nm laser (mean output: 50 mW, spot size 2 mm(2), power density =2.5 W/cm(2)) and a typical LLLT dose and a high LLLT dose (irradiation times: 60 or 420 s; fluences:150 or 1050 J/cm(2); energy delivered: 3 or 21 J). Results: Primary fibroblast cell culture from human keloids irradiated with 3 J showed significant proliferation by the trypan blue exclusion test (p < 0.05), whereas the 3T3 cell culture showed no difference using this method. Propidium iodide staining flow cytometry data showed a significant decrease in the percentage of cells being in proliferative phases of the cell cycle (S/g(2)/M) when irradiated with 21 J in both cell types (hypodiploid cells increased). Conclusions: Our data support the hypothesis that the physiological state of the cells affects the LLLT results, and that high-metabolic rate and short- cell-cycle 3T3 cells are not responsive to LLLT. In conclusion, LLLT with a dose of 3 J reduced cell death significantly, but did not stimulate cell cycle. A LLLT dose of 21 J had negative effects on the cells, as it increased cell death and inhibited cell proliferation.

Photomed Laser Surg 2009 Sep 21

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=19764894

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[Effect of electroacupuncture on epileptic EEG and intracellular Ca2+ content in the hippocampus in epilepsy rats]

Yang F, Xu GL, Yang YQ, Shen DK, Feng PZ, Wang P, Liu XG

Shanghai Institute of Acu-moxibustion and Meridians, Shanghai 200030, China. saildoctor@126.com

OBJECTIVE: To study the underlying mechanism of electroacupuncture (EA) in relieving epilepsy in pentylenetetrazole (PTZ)-induced epilepsy rats. METHODS: Twenty SD rats were randomly divided into normal control, model, EA, Nimodipine groups, with 5 cases in each. Epilepsy model was established by intraperitoneal injection of PTZ (32.0 mg/kg), once daily for 28 days. EA (100 Hz, 0.6 mA) was applied to “Baihui” (GV 20) and “Dazhui” (GV 14), once daily for 7 days. For Nimodipine group, the rats were given with nimodipine (0.25 mg/kg, i.p.), once daily for 7 days. Electroencephalogram (EEG) was recorded and the fluorescence intensity of Ca2+ of the hippocampus tissue sections was detected by laser scanning confocal microscope (LSCM) after incubation in artificial cerebrospinal fluid containing Flou-3/AM (10 micromol/L) and pluronic F-127 (5 microl). RESULTS: Compared with model group, the latencies of epileptic EEG seizure prolonged obviously (P < 0.05), and epileptic EEG seizure frequencies decreased significantly (P < 0.05) in EA and Nimodipine groups. The fluorescence intensity of intracellular Ca2+ in hippocampus tissue in model group was obviously higher than that in control group (P < 0.01). In comparison to model group, Ca2+ levels in EA and Nimodipine groups lowered considerably (P < 0.05, P < 0.01). No significant differences were found between EA and Nimodipine groups in the aforementioned 3 indexes (P > 0.05). CONCLUSION: EA has an obvious anti-epileptic effect, which may be closely related to its effect in downregulating the increased hippocampal Ca2+ level in PTZ-kindled epilepsy rats.

Zhen Ci Yan Jiu 2009 Jun 34(3) 163-6

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=19761108

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Biophoton Detection and Low-Intensity Light Therapy: A Potential Clinical Partnership.

Tafur J, Van Wijk EP, Wijk RV, Mills PJ

1 Department of Psychiatry, Behavioral Medicine Laboratory, University of California at San Diego , San Diego, CA.

Abstract Low-intensity light therapy (LILT) is showing promise in the treatment of a wide variety of medical conditions. Concurrently, our knowledge of LILT mechanisms continues to expand. We are now aware of LILT’s potential to induce cellular effects through, for example, accelerated ATP production and the mitigation of oxidative stress. In clinical use, however, it is often difficult to predict patient response to LILT. It appears that cellular reduction/oxidation (redox) state may play a central role in determining sensitivity to LILT and may help explain variability in patient responsiveness. In LILT, conditions associated with elevated reactive oxygen species (ROS) production, e.g. diabetic hyperglycemia, demonstrate increased sensitivity to LILT. Consequently, assessment of tissue redox conditions in vivo may prove helpful in identifying responsive tissues. A noninvasive redox measure may be useful in advancing investigation in LILT and may one day be helpful in better identifying responsive patients. The detection of biophotons, the production of which is associated with cellular redox state and the generation of ROS, represents just such an opportunity. In this review, we will present the case for pursuing further investigation into the potential clinical partnership between biophoton detection and LILT.

Photomed Laser Surg 2009 Sep 15

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=19754267

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The Effect of Low-Level Laser Therapy on Healing of Skin Incisions Made Using a Diode Laser in Diabetic Rats.

Akyol U, Gungormus M

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

Abstract Background and Objective: To investigate the effect of low-level laser therapy (LLLT) on healing of skin incisions made using a diode laser in diabetic rats. Material and Methods: Eighteen diabetic Wistar rats were used for this study. One incision was performed on the left side of the dorsum using a diode laser, and the other two incisions were made with a scalpel and diode laser on the right side of each rat. The wound on the left side of each rat received laser stimulation (10 J/cm(2)). The rats were assigned to three experimental groups. Group 1, scalpel (n = 18); Group 2, diode (n = 18); Group 3, diode + biostimulation (n = 18). Results: Reepithelialization was fastest in Group 2 than Group 1 at day 10. The difference between Groups 1 and 3 was also statistically significant in reepithelialization at day 10. There was a significant difference between Groups 1 and 2 and between Groups 2 and 3 in inflammation at day 10. There was no difference between any of the groups in inflammation and reepithelialization at day 20. Conclusions: Scalpel incisions heal more slowly than diode and diode + biostimulation incisions in diabetic rats. We can suggest that diode + biostimulation may produce the least amount of tissue injury, with the fastest resolution of inflammatory response in diabetic rats. Diode laser incision (4 W) with 10-J/cm(2) LLLT seems to have a beneficial effect on skin incisions in diabetic rats.

Photomed Laser Surg 2009 Sep 15

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=19754259

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Effects of Laser Photobiomodulation on Cutaneous Wounds Treated with Mitomycin C: A Histomorphometric and Histological Study in a Rodent Model.

Santos NR, Dos Santos JN, Sobrinho JB, Ramalho LM, Carvalho CM, Soares LG, Pinheiro AL

1 Laser Center, School of Dentistry, Federal University of Bahia (UFBA) , Salvador, Brazil .

Abstract Aim: The aim of the present study was to assess histologically the effect of Laser Photobiomodulation (LPBM) on skin wounds treated with Mitomycin C (MMC). Background Data: Wound healing occurs because of a competitive mechanism between the synthesis and lyses of collagen. Therefore, any factor that increases the lyses or reduces the synthesis of collagen may result in changes in the healing process. MMC is an antineoplastic drug that inhibits fibroblast proliferation, collagen synthesis, and neoangiogenesis. LPBM has been shown to stimulate wound healing, increasing the production of collagen, fibroblastic proliferation, and angiogenesis. Materials and Methods: Forty-eight Wistar rats were randomly distributed into 4 main groups (n = 12): G1 – control (G1a – 7 d and G1b – 14 d); G2 – MMC (G2a – 7 d and G2b – 14 d); G3 – MMC + lambda660 nm laser (G3a – 7 d and G3b – 14 d); and G4 – MMC + lambda790 nm laser (G4a – 7 d and G4b – 14 d). Under general anesthesia, one excisional wound was created on the dorsum of each animal. Two ml of MMC solution was applied to the wound 4 h after surgery for 5 min. LPBM was performed on groups G3 (lambda690 nm; 20 J/cm(2); 30 mW; Phi = 2 mm) and G4 (lambda790 nm; 20 J/cm(2); 40 mW; Phi = 2 mm), starting immediately after the application of the MMC and repeated every other day during the experimental period. Laser light was applied transcutaneously at 4 equidistant points on the wound margin (4 x 5 J/cm(2), 20 J/cm(2)/session). The specimens were routinely cut and processed to wax. The slides were stained with HE and Sirius red. Computerized hystomorphometry was performed. Results: LPBM resulted in reduced inflammation and an increase in both fibroblast proliferation and collagen deposition. Conclusion: The use of LPBM improves wound healing in subjects treated with MMC.

Photomed Laser Surg 2009 Sep 11

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=19747035

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