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LLLT Research Abstracts

A systematic review with procedural assessments and meta-analysis of low level laser therapy in lateral elbow tendinopathy (tennis elbow).

Bjordal JM, Lopes-Martins RA, Joensen J, Couppe C, Ljunggren AE, Stergioulas A, Johnson MI

Institute of Physiotherapy, Faculty of Health and Social Sciences, Bergen University College, Moellendalsvn, 6, 5009 Bergen, Norway. jmb@hib.no

BACKGROUND: Recent reviews have indicated that low level level laser therapy (LLLT) is ineffective in lateral elbow tendinopathy (LET) without assessing validity of treatment procedures and doses or the influence of prior steroid injections.

METHODS: Systematic review with meta-analysis, with primary outcome measures of pain relief and/or global improvement and subgroup analyses of methodological quality, wavelengths and treatment procedures.

RESULTS: 18 randomised placebo-controlled trials (RCTs) were identified with 13 RCTs (730 patients) meeting the criteria for meta-analysis. 12 RCTs satisfied half or more of the methodological criteria. Publication bias was detected by Egger's graphical test, which showed a negative direction of bias. Ten of the trials included patients with poor prognosis caused by failed steroid injections or other treatment failures, or long symptom duration or severe baseline pain. The weighted mean difference (WMD) for pain relief was 10.2 mm [95% CI: 3.0 to 17.5] and the RR for global improvement was 1.36 [1.16 to 1.60]. Trials which targeted acupuncture points reported negative results, as did trials with wavelengths 820, 830 and 1064 nm. In a subgroup of five trials with 904 nm lasers and one trial with 632 nm wavelength where the lateral elbow tendon insertions were directly irradiated, WMD for pain relief was 17.2 mm [95% CI: 8.5 to 25.9] and 14.0 mm [95% CI: 7.4 to 20.6] respectively, while RR for global pain improvement was only reported for 904 nm at 1.53 [95% CI: 1.28 to 1.83]. LLLT doses in this subgroup ranged between 0.5 and 7.2 Joules. Secondary outcome measures of painfree grip strength, pain pressure threshold, sick leave and follow-up data from 3 to 8 weeks after the end of treatment, showed consistently significant results in favour of the same LLLT subgroup (p < 0.02). No serious side-effects were reported.

CONCLUSION: LLLT administered with optimal doses of 904 nm and possibly 632 nm wavelengths directly to the lateral elbow tendon insertions, seem to offer short-term pain relief and less disability in LET, both alone and in conjunction with an exercise regimen. This finding contradicts the conclusions of previous reviews which failed to assess treatment procedures, wavelengths and optimal doses.

BMC Musculoskelet Disord 2008 9 75


Electrophysiologic Effects of a Therapeutic Laser on Myofascial Trigger Spots of Rabbit Skeletal Muscles.

Chen KH, Hong CZ, Kuo FC, Hsu HC, Hsieh YL

From the Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital, Chiayi, Taiwan (K-HC, H-CH); College of Medicine, Chang Gung University, Taoyuan, Taiwan (K-HC, H-CH); and Department of Physical Therapy, HungKuang University, Taichung, Taiwan (C-ZH, F-CK); and the Department of Physical Therapy, Graduate Institute of Rehabilitation Science, China Medical University, Taichung, Taiwan (Y-LH).

OBJECTIVE:: To better understand the mechanisms of therapeutic lasers for treating human myofascial trigger points, we designed a blinded controlled study of the effects of a therapeutic laser on the prevalence of endplate noise (EPN) recorded from the myofascial trigger spot (MTrS) of rabbit skeletal muscle.

DESIGN:: In eight rabbits, one MTrS in each biceps femoris muscle was irradiated with a 660-nm, continuous-wave, gallium-aluminum-arsenate (GaAlAs) laser, at 9 J/cm. The contralateral side of muscle was treated with a sham laser. Each rabbit received six treatments. The immediate and cumulative effects were assessed by the prevalence of EPN with electromyographic (EMG) recordings after the first and last treatments.

RESULTS:: Compared with pretreatment values, the percentages of EPN prevalence in the experimental side after the first and last treatments were significantly reduced (P < 0.01 for both). The change in EPN prevalence in the experimental side was significantly greater than in the control side immediately after the first and last treatments (P < 0.05). However, no significant differences were noted between the first and last treatments (P > 0.05).

CONCLUSIONS:: In our study, immediate and cumulative effects of a GaAlAs laser applied on MTrS were demonstrated on the basis of the assessment of EPN prevalence. It seems that laser irradiation may inhibit the irritability of an MTrS in rabbit skeletal muscle. This effect may be a possible mechanism for myofascial pain relief with laser therapy.

Am J Phys Med Rehabil 2008 Jul 9 


Effect of laser phototherapy on the release of fibroblast growth factors by human gingival fibroblasts.

Damante CA, De Micheli G, Miyagi SP, Feist IS, Marques MM

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

The effects of laser phototherapy on the release of growth factors by human gingival fibroblasts were studied in vitro. Cells from a primary culture were irradiated twice (6 h interval), with continuous diode laser [gallium-aluminum-arsenium (GaAlAs), 780 nm, or indium-gallium-aluminum-phosphide (InGaAlP),_660 nm] in punctual 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). Positive [10% fetal bovine serum (FBS)] and negative (1%FBS) controls were not irradiated. Production of keratinocyte growth factor (KGF) and basic fibroblast growth factor (bFGF) was quantified by enzyme-linked immunosorbent assay (ELISA). The data were statistically compared by analysis of variance (ANOVA) followed by Tukey's test (P
Lasers Med Sci 2008 Jul 4 


Low-level laser therapy improves vision in patients with age-related macular degeneration.

Ivandic BT, Ivandic T

University of Heidelberg, Otto-Meyerhof Centre, Heidelberg.

Germany Abstract Objective: The objective of this study of a case series was to examine the effects of low-level laser therapy (LLLT) in patients with age-related macular degeneration (AMD).

Background Data: AMD affects a large proportion of the elderly population; current therapeutic options for AMD are limited, however. Patients and Methods: In total, 203 patients (90 men and 113 women; mean age 63.4 +/- 5.3 y) with beginning (dry) or advanced (wet) forms of AMD (n = 348 eyes) were included in the study. One hundred ninety-three patients (mean age 64.6 +/- 4.3 y; n = 328 eyes) with cataracts (n = 182 eyes) or without cataracts (n = 146 eyes) were treated using LLLT four times (twice per week). A semiconductor laser diode (780 nm, 7.5 mW, 292 Hz, continuous emission) was used for transconjunctival irradiation of the macula for 40 sec (0.3 J/cm(2)) resulting in a total dose of 1.2 J/cm(2). Ten patients (n = 20 eyes) with AMD received mock treatment and served as controls. Visual acuity was measured at each visit. Data were analyzed retrospectively using a t-test.

Results: LLLT significantly improved visual acuity (p < 0.00001 versus baseline) in 162/182 (95%) of eyes with cataracts and 142/146 (97%) of eyes without cataracts. The prevalence of metamorphopsia, scotoma, and dyschromatopsia was reduced. In patients with wet AMD, edema and bleeding improved. The improved vision was maintained for 3-36 mo after treatment. Visual acuity in the control group remained unchanged. No adverse effects were observed in those undergoing therapy.

Conclusion: In patients with AMD, LLLT significantly improved visual acuity without adverse side effects and may thus help to prevent loss of vision.

Photomed Laser Surg 2008 Jun 26(3) 241-5


Influence of laser photobiomodulation upon connective tissue remodeling during wound healing.

Medrado AP, Soares AP, Santos ET, Reis SR, Andrade ZA

Laboratory of Experimental Pathology, Oswaldo Cruz Foundation, Rua Waldemar Falcao, 121, Salvador, Bahia 40.296-710, Brazil.

The modulation of collagen fibers during experimental skin wound healing was studied in 112 Wistar rats submitted to laser photobiomodulation treatment. A standardized 8mm-diameter wound was made on the dorsal skin of all animals. In half of them, 0.2ml of a silica suspension was injected along the border of the wound in order to enhance collagen deposition and facilitate observation. The others received saline as vehicle. The treatment was carried out by means of laser rays from an aluminum-gallium arsenide diode semiconductor with 9mW applied every other day (total dose=4J/cm(2)) on the borders of the wound. Tissue sections obtained from four experimental groups representing sham-irradiated animals, laser, silica and the association of both, were studied after 3, 7, 10, 15, 20, 30 and 60 days from the laser application. The wounded skin area was surgically removed and submitted to histological, immunohistochemical, ultrastructural, and immunofluorescent studies. Besides the degree and arrangement of collagen fibers and of their isotypes, the degree of edema, the presence of several cell types especially pericytes and myofibroblasts, were described and measured. The observation of Sirius-red stained slides under polarized microscopy revealed to be of great help during the morphological analysis of the collagen tissue dynamic changes. It was demonstrated that laser application was responsible for edema regression and a diminution in the number of inflammatory cells (p<0.05). An evident increase in the number of actin-positive cells was observed in the laser-treated wounds. Collagen deposition was less than expected in silica-treated wounds, and laser treatment contributed to its better differentiation and modulation in all irradiated groups. Thus, laser photobiomodulation was able to induce several modifications during the cutaneous healing process, especially in favoring newly-formed collagen fibers to be better organized and compactedly disposed.

J Photochem Photobiol B 2008 Jul 3 


Influence of low-level laser therapy on biomaterial osseointegration: a mini-review.

Obradovic RR, Kesic LG, Pesevska S

Department of Oral Medicine and Periodontology, Dental Clinic, Faculty of Medicine, University of Nis, Bul. Nikole Tesle 45/19, 18000, Nis, Serbia, dr.rada@yahoo.com.

The aim of this paper is to provide an overview of the available literature on low-level laser therapy (LLLT) and its influence on bone repair and the osseointegration of biomaterials. Extensive studies of alveolar bone repair, a common problem in periodontal therapy, have been conduced worldwide. The utility of LLLT in biomaterial osseointegration is still unanswered, due to lack of literature and poorly understood mechanisms. It is still difficult for one to compare studies about the action of LLLT on the osseointegration of biomaterials because the experimental models and duration of treatments are very distinct. However, it could be concluded that LLLT may offer advantages in terms of periodontal and bone functional recovery and biomaterial osseointegration.

Lasers Med Sci 2008 Jun 20 


Low-Intensity Laser Irradiation Improves the Mitochondrial Dysfunction of C2C12 Induced by Electrical Stimulation.

Xu X, Zhao X, Liu TC, Pan H

Laboratory of Laser Sports Medicine, College of Sports Sciences, South China Normal University, Guangzhou, China.

Abstract Objective: We investigated the effects of electrical stimulation and low-intensity laser (LIL) energy on the mitochondrial function of cultured C2C12 myotubes in order to find a dosage that could be used to improve the function of mitochondria, and then rehabilitate exercise-induced damage and fatigue.

Background Data: Many other studies in the past demonstrated that LIL had a cytoprotective effect, and a recent study also found that LIL could reduce muscular fatigue during tetanic contractions in rats.

Methods: Cultured C2C12 myotubes were subjected to electrical stimulation or/and LIL irradiation at various intensities. Reactive oxygen species (ROS) were detected with a fluorescent probe (DCFH-DA) and mitochondrial function was assessed with an MTT assay.

Results: The results showed that electrical stimulation at 20 ms, 5 Hz, and 45 V for 75 min can induce mitochondrial dysfunction in cultured C2C12 myotubes. Electrical stimulation-induced mitochondrial dysfunction was improved, but degeneration occurred with LIL at doses of 0.33-8.22 and 11.22-14.16 J/cm(2), respectively, and these changes were markedly increased with LIL at 0.33 and 1.34 J/cm(2), respectively.

Conclusions: We conclude that treatment of myotubes with the proper dosage of LIL irradiation significantly diminished production of ROS and restored mitochondrial function, and this may provide a foundation for the use of photobiomodulation to treat exercise-induced mitochondrial dysfunction or skeletal muscular fatigue.

Photomed Laser Surg 2008 Jun 26(3) 197-202


Low-power laser irradiation activates Src tyrosine kinase through reactive oxygen species-mediated signaling pathway.

Zhang J, Xing D, Gao X

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

Low-power laser therapy in medicine is widespread but the mechanisms are not fully understood. It has been suggested that low-power laser irradiation (LPLI) could induce photochemical reaction and activate several intracellular signaling pathways. Reactive oxygen species (ROS) are considered to be the key secondary messengers produced by LPLI. Here, we studied the signaling pathway mediated by ROS upon the stimulation of LPLI. Src tyrosine kinases are well-known targets of ROS and can be activated by oxidative events. Using a Src reporter based on fluorescence resonance energy transfer (FRET) and confocal laser scanning microscope, we visualized the dynamic Src activation in Hela cells immediately after LPLI. Moreover, Src activation by LPLI was in a dose-dependent manner. The increase of Src phosphorylation at Tyr416 was detected by Western blotting. In the presence of vitamin C, catalase alone, or the combination of catalase and superoxide dismutase (SOD), the activation of Src by LPLI is significantly abolished. In contrast, Go6983 loading, a PKC inhibitor, did not affect this response. Treatment of Hela cells with exogenous H(2)O(2) also resulted in a concentration-dependent activation of Src. These results demonstrated that it was ROS that mediated Src activation by LPLI. Cellular viability assay revealed that laser irradiation of low doses (
J Cell Physiol 2008 Jul 9


Effects of Low-Level Laser Therapy and Eccentric Exercises in the Treatment of Recreational Athletes With Chronic Achilles Tendinopathy.

Stergioulas A, Stergioula M, Aarskog R, Lopes-Martins RA, Bjordal JM

Peloponnese University, Sparta, Laconia, Greece.

BACKGROUND: Eccentric exercises (EEs) are recommended for the treatment of Achilles tendinopathy, but the clinical effect from EE has a slow onset. HYPOTHESIS: The addition of low-level laser therapy (LLLT) to EE may cause more rapid clinical improvement.

STUDY DESIGN: Randomized controlled trial; Level of evidence, 1.

METHODS: A total of 52 recreational athletes with chronic Achilles tendinopathy symptoms were randomized to groups receiving either EE + LLLT or EE + placebo LLLT over 8 weeks in a blinded manner. Low-level laser therapy (lambda = 820 nm) was administered in 12 sessions by irradiating 6 points along the Achilles tendon with a power density of 60 mW/cm(2) and a total dose of 5.4 J per session.

RESULTS: The results of the intention-to-treat analysis for the primary outcome, pain intensity during physical activity on the 100-mm visual analog scale, were significantly lower in the LLLT group than in the placebo LLLT group, with 53.6 mm versus 71.5 mm (P = .0003) at 4 weeks, 37.3 mm versus 62.8 mm (P = .0002) at 8 weeks, and 33.0 mm versus 53.0 mm (P = .007) at 12 weeks after randomization. Secondary outcomes of morning stiffness, active dorsiflexion, palpation tenderness, and crepitation showed the same pattern in favor of the LLLT group.

CONCLUSION: Low-level laser therapy, with the parameters used in this study, accelerates clinical recovery from chronic Achilles tendinopathy when added to an EE regimen. For the LLLT group, the results at 4 weeks were similar to the placebo LLLT group results after 12 weeks.

Am J Sports Med 2008 Feb 13


Low-power laser in the prevention of induced oral mucositis in bone marrow transplantation patients: a randomized trial.

Antunes HS, de Azevedo AM, da Silva Bouzas LF, Adao CA, Pinheiro CT, Mayhe R, Pinheiro LH, Azevedo R, D'Aiuto de Matos V, Rodrigues PC, Small IA, Zangaro RA, Ferreira CG.

Section of Dentistry, Instituto Nacional de Cancer (INCA), Rio de Janeiro. Brazil

We investigated the clinical effects of low-power laser therapy (LPLT) on prevention and reduction of severity of conditioning-induced oral mucositis (OM) for hematopoietic stem cell transplantation (HSCT). We randomized 38 patients who underwent autologous (AT) or allogeneic (AL) HSCT. A diode InGaAlP was used, emitting light at 660 nm, 50 mW, and 4 J/cm2, measured at the fiberoptic end with 0.196 cm2 of section area. The evaluation of OM was done using the Oral Mucositis Assessment Scale (OMAS) and the World Health Organization (WHO) scale. In the LPLT group, 94.7% of patients had an OM grade (WHO) lower than or equal to grade 2, including 63.2% with grade 0 and 1, whereas in the controls group, 31.5% of patients had an OM grade lower than or equal to grade 2 (P < .001). Remarkably, the hazard ratio (HR) for grades 2, 3, and 4 OM was 0.41 (range, 0.22-0.75; P = .002) and for grades 3 and 4 it was 0.07 (range, 0.11-0.53; P < .001). Using OMAS by the calculation of ulcerous area, 5.3% of the laser group presented with ulcers of 9.1 cm2 to 18 cm2, whereas 73.6% of the control group presented with ulcers from 9.1 cm2 to 18 cm2 (P = .003). Our results indicate that the use of upfront LPLT in patients who have undergone HSCT is a powerful instrument in reducing the incidence of OM and is now standard in our center.

Blood. 2007 Mar 1;109(5):2250-5. Epub 2006 Oct 19.


The use of low energy photon therapy (LEPT) in venous leg ulcers: a double-blind, placebo-controlled study.

Gupta AK, Filonenko N, Salansky N, Sauder DN

Department of Medicine, University of Toronto, Ontario, Canada

BACKGROUND: Venous ulcers are estimated to be present in 0.2 to 0.4% of the population. Although new therapies have significant promise, nonhealing ulcers still represent a significant problem.

OBJECTIVE: To evaluate the efficacy of low energy photon therapy (LEPT) in the treatment of venous leg ulcers.

METHODS: A placebo-controlled, double-blind study using low energy photon therapy was performed in nine patients with 12 venous ulcers. Treatment was given three times a week for 10 weeks, using two monochromatic optical sources. One source provided a wavelength (lambda) of 660 nm (red) while the second source delivered a wavelength of 880 nm (infrared). Two optical probes were used, one consisted of an array of 22 monochromatic sources, operating at a wavelength of 660 nm and covering an area 6 x 10 cm2. The second probe had seven infrared sources, operating at a wavelength of 880 nm and covering an area of 4 cm2. The above configuration of optical probes was selected to cover the majority of the ulcer area being treated. The patients who were randomized to placebo treatment received sham therapy from an identical-appearing light source from the same delivery system.

RESULTS: Nine patients with 12 venous ulcers were randomized to receive LEPT or placebo therapy. At the conclusion of the study, the percentage of the initial ulcer area remaining unhealed in the LEPT and placebo groups was 24.4% and 84.7%, respectively (P = 0.0008). The decrease in ulcer area (compared to baseline) observed in the LEPT and placebo groups was 193.0 mm2 and 14.7 mm2, respectively (P = 0.0002). One patient dropped out of the study, complaining of lack of treatment efficacy; he was found to be randomized to the placebo group. There were no adverse effects.

CONCLUSION: In this placebo-controlled, double-blind study LEPT was an effective modality for the treatment of venous leg ulcers.

Dermatol Surg. 1998 Dec;24(12):1383-6

The Impact of low power laser in the treatment of conditioning-induced oral mucositis: a report of 11 clinical cases and their review.

Antunes HS, Ferreira EM, de Matos VD, Pinheiro CT, Ferreira CG

Serviso de Pesquisa Clinica, Instituto Nacional de Cancer, Rua Andre Cavalcante, Rio de Janeiro, Brasil. hspindola@inca.gov.br

We have investigated the clinical effects of low power laser therapy (LPLT) on the treatment of conditioning-induced oral mucositis (OM) in patients submitted to hematopoietic stem cell transplantation (HSCT). The evaluation of OM was done using the Oral Mucositis Assessment Scale (OMAS) and World Health Organization (WHO) scale. In the context of a randomized placebo-controlled trial with 38 patients for the evaluation of preventive LPLT, eleven individuals were submitted to allogeneic (AL) HSCT and developed oral mucositis grade 4 (WHO) or a total area of OM of 12 cm (OMAS) and due to that were treated with LPLT with the purpose of symptom relief. The irradiation used was a diode InGaAlP, emitting light at 660 nm, 50 mW and 8 J/cm(2) measured at the end of fiber optic with 0.196 cm(2) of section area during the treatment. The tip of the laser device touched the oral mucosa and patients recovered on average 6 days (3-12 days) from the beginning of the laser application. Our results have indicated that the use of LPLT in HSCT patients is a powerful instrument in the treatment of overt OM and is now a standard procedure in this group of patients in our hospital.

Med Oral Patol Oral Cir Bucal 2008 Mar 13(3) E189-92


Clinical Effect of CO(2) Laser in Reducing Pain in Orthodontics.

Fujiyama K, Deguchi T, Murakami T, Fujii A, Kushima K, Takano-Yamamoto T

Objective: To test the hypothesis that there is no difference in the pain associated with orthodontic force application after the application of local CO(2) laser irradiation to the teeth involved.

Materials and Methods: Separation modules were placed at the distal contacts of the maxillary first molars in 90 patients in this single-blinded study. In 60 of these patients (42 females and 18 males; mean age = 19.22 years) this was immediately followed by laser therapy. The other 30 patients (18 females and 12 males; mean age = 18.8 years) did not receive active laser irradiation. Patients were then instructed to rate their levels of pain on a visual analog scale over time, and the amount of tooth movement was analyzed.

Results: Significant pain reductions were observed with laser treatment from immediately after insertion of separators through day 4, but no differences from the nonirradiated control side were noted thereafter. No significant difference was noted in the amount of tooth movement between the irradiated and nonirradiated group.

Conclusions: The hypothesis was rejected. The results suggest that local CO(2) laser irradiation will reduce pain associated with orthodontic force application without interfering with the tooth movement.

Angle Orthod 2008 Mar 78(2) 299-303


Nd:YAG laser biostimulation in the treatment of bisphosphonate-associated osteonecrosis of the jaw: clinical experience in 28 cases.

Vescovi P, Merigo E, Manfredi M, Meleti M, Fornaini C, Bonanini M, Rocca JP, Nammour S

Unit of Oral Pathology and Medicine, Section of Dentistry, Department of ENT/Dental/Ophthalmological and Cervico-Facial Sciences, University of Parma, Parma, Italy. paolo.vescovi@unipr.it

OBJECTIVE: To research an efficient treatment for the management of bisphosphonate-associated osteonecrosis.

BACKGROUND DATA: Necrosis of the jawbone has recently been described in association with systemic bisphosphonate therapy with drugs including zoledronic acid, pamidronate, and alendronate. The extent and clinical characteristics of bisphosphonate-associated osteonecrosis (BON) of the jaw are extremely variable, and range from the presence of fistulae in the oral mucosa or orofacial tissues, to large exposed areas of necrotic bone within the oral cavity. Clinical signs and symptoms commonly reported include pain, swelling, the presence of pus, loose teeth, ill-fitting dentures, and paresthesias of the inferior alveolar nerve when the necrosis affects the mandible. Fractures have also been reported. The treatment of BON of the jaw is still controversial since no therapy has proven to be efficacious as shown by the literature on the subject.

MATERIALS AND METHODS: In this study we report results achieved with 28 patients affected by BON of the jaw, who received treatment with the Nd:YAG laser alone or in combination with conventional medical or surgical treatment. Clinical variables such as severity of symptoms, presence of pus, and closure of mucosal flaps before and after therapy were evaluated to establish the effectiveness of laser irradiation. The 28 patients with BON were subdivided into four groups: eight patients were treated with medical therapy only (antibiotics with or without antimycotics and/or antiseptic rinses), six patients were treated with medical and surgical therapy (necrotic bone removal and bone curettage), six patients were treated with medical therapy associated with laser biostimulation, and eight patients were treated with medical therapy associated with both surgical therapy and laser biostimulation.

RESULTS: Of the 14 patients who underwent laser biostimulation, nine reported complete clinical success (no pain, symptoms of infection, or exposed bone or draining fistulas), and three improved their symptomatology only, with a follow-up of between 4 and 7 mo.

CONCLUSIONS: While the results reported in this study are not conclusive, they indicate that laser therapy has potential to improve management of BON.

Photomed Laser Surg 2008 Feb 26(1) 37-46


Effect of lower-level laser therapy on rabbit tibial fracture.

Liu  X, Lyon  R, Meier  HT, Thometz  J, Haworth  ST

Musculoskeletal Functional Assessment Center, Medical College of Wisconsin, Milwaukee, Wisconsin.

Objective: The purpose of the study was to demonstrate the biological effects of low-level laser therapy (LLLT) on tibial fractures using radiographic, histological, and bone density examinations.

Methods: Fourteen New Zealand white rabbits with surgically induced mid-tibial osteotomies were included in the study. Seven were assigned to a group receiving LLLT (LLLT-A) and the remaining seven served as a sham-treated control group (LLLT-C). A low-energy laser apparatus with a wavelength of 830 nm, and a sham laser (a similar design without laser diodes) were used for the study. Continuous outflow irradiation with a total energy density of 40 J/cm(2) and a power level of 200 mW/cm(2) was directly delivered to the skin for 50 seconds at four points along the tibial fracture site. Treatment commenced immediately postsurgery and continued once daily for 4 weeks.

Results: Radiographic findings revealed no statistically significant fracture callus thickness difference between the LLLT-A and LLLT-C groups (p > 0.05). However, the fractures in the LLLT-A group showed less callus thickness than those in LLLT-C group 3 weeks after treatment. The average tibial volume was 14.5 mL in the LLLT-A group, and 11.25 mL in the LLLT-C group. The average contralateral normal tibial volume was 7.1 mL. Microscopic changes at 4 weeks revealed an average grade of 5.5 and 5.0 for the LLLT-A group and the LLLT-C group, respectively. The bone mineral density (BMD) as ascertained using a grey scale (graded from 0 to 256) showed darker coloration in the LLLT-A group (138) than in the LLLT-C group (125).

Conclusion: The study suggests that LLLT may accelerate the process of fracture repair or cause increases in callus volume and BMD, especially in the early stages of absorbing the hematoma and bone remodeling. Further study is necessary to quantify these findings.

Photomed Laser Surg 2007 Dec 25(6) 487-94


Anti-inflammatory effects of low-level laser therapy (LLLT) with two different red wavelengths (660nm and 684nm) in carrageenan-induced rat paw edema.

Albertini R, Villaverde AB, Aimbire F, Salgado MA, Bjordal JM, Alves LP, Munin E, Costa MS

Instituto de Pesquisa & Desenvolvimento - IP&D, Universidade do Vale do Paraiba - UNIVAP, Av. Shishima Hifumi, 2911, CEP: 12244-000 Sao Jose dos Campos, SP. Brazil

It has been suggested that low-level laser therapy (LLLT) can modulate inflammatory processes. The aim of this experiment was to investigate what effects red laser irradiation with two different wavelengths (660nm and 684nm) on carrageenan-induced rat paw edema and histology. Thirty two male Wistar rats were randomly divided into four groups. One group received a sterile saline injection, while inflammation was induced by a sub-plantar injection of carrageenan (1mg/paw) in the three other groups. After 1h, LLLT was administered to the paw in two of the carrageenan-injected groups. Continuous wave 660nm and 684nm red lasers respectively with mean optical outputs of 30mW and doses of 7.5J/cm(2) were used. The 660nm and 684nm laser groups developed significantly (p<0.01) less edema (0.58ml [SE+/-0.17] ml and 0.76ml [SE+/-0.10] respectively) than the control group (1.67ml [SE+/-0.19]) at 4h after injections. Similarly, both laser groups showed a significantly lower number of inflammatory cells in the muscular and conjunctive sub-plantar tissues than the control group. We conclude that both 660nm and 684nm red wavelengths of LLLT are effective in reducing edema formation and inflammatory cell migration when a dose of 7.5J/cm(2) is used.

J Photochem Photobiol B 2007 Nov 12 89(1) 50-5


Transcranial near-infrared light therapy improves motor function following embolic strokes in rabbits: An extended therapeutic window study using continuous and pulse frequency delivery modes.

Lapchak, PA Salgado, KF Chao, CH Zivin, JA

University of California San Diego, Department of Neuroscience, MTF 316, 9500 Gilman Drive, La Jolla, CA 92093-0624, USA; Veterans Administration San Diego Healthcare System, 3350 La Jolla Village Drive, Room 6197, San Diego, CA 92161, USA; Veterans Medical Research Foundation, 3350 La Jolla Village Drive, San Diego, CA 92161 USA

Photon or near-infrared light therapy (NILT) may be an effective neuroprotective method to reduce behavioral dysfunction following an acute ischemic stroke. We evaluated the effects of continuous wave (CW) or pulse wave (P) NILT administered transcranially either 6 or 12 h following embolization, on behavioral outcome. For the studies, we used the rabbit small clot embolic stroke model (RSCEM) using three different treatment regimens: 1) CW power density of 7.5 mW/cm(2); 2) P1 using a frequency of 300 mus pulse at 1 kHz or 3) P2 using a frequency of 2 ms pulse at 100 Hz. Behavioral analysis was conducted 48 h after embolization, allowing for the determination of the effective stroke dose (P(50)) or clot amount (mg) that produces neurological deficits in 50% of the rabbits. Using the RSCEM, a treatment is considered beneficial if it significantly increases the P(50) compared with the control group. Quantal dose-response analysis showed that the control group P(50) value was 1.01+/-0.25 mg (n=31). NILT initiated 6 h following embolization resulted in the following P(50) values: (CW) 2.06+/-0.59 mg (n=29, P=0.099); (P1) 1.89+/-0.29 mg (n=25, P=0.0248) and (P2) 1.92+/-0.15 mg (n=33, P=0.0024). NILT started 12 h following embolization resulted in the following P(50) values: (CW) 2.89+/-1.76 mg (n=29, P=0.279); (P1) 2.40+/-0.99 mg (n=24, P=0.134). At the 6-h post-embolization treatment time, there was a statistically significant increase in P(50) values compared with control for both pulse P1 and P2 modes, but not the CW mode. At the 12-h post-embolization treatment time, neither the CW nor the P1 regimens resulted in statistically significant effect, although there was a trend for an improvement. The results show that P mode NILT can result in significant clinical improvement when administered 6 h following embolic strokes in rabbits and should be considered for clinical development.

Neuroscience 2007 Jul 12 


Reciprocity of exposure time and irradiance on energy density during photoradiation on wound healing in a murine pressure ulcer model.

Lanzafame, RJ Stadler, I Kurtz, AF Connelly, R Timothy, PA Sr Brondon, P Olson, D

Laser Center, Rochester General Hospital, Rochester, New York, USA. ray.lanzafame@viahealth.org

BACKGROUND: Energy density and exposure time reciprocity is assumed and routinely used in low-level light therapy (LLLT) regimens. This study examined dose reciprocity effects on wound healing.

METHODS: Pressure ulcers were created on seven groups of C57/BL mice (n = 18). Photoradiation was administered (18 days; 5 J/cm(2)/day @ 670 nm) using a custom LED apparatus and treatment matrix varying both intensity and exposure. Control animals were treated similarly, without photoradiation. Ulcer staging was performed using a standardized scale. Changes in stage, wound area and wound closure rates were measured. Histology was performed.

RESULTS: Photostimulatory effects at day 7 occurred with parameters of 125 seconds @ 40 mW x 1/day; 625 seconds @ 8 mWx1/day; 62.5 seconds @ 40 mWx2/day; and 312.5 seconds @ 8 mWx2/day; and at day 18 using 625 seconds @ 8 mW and 312.5 seconds @ 8 mWx2/day. Statistically significant increases in wound closure rates occurred using 625 seconds @ 8 mW; 62.5 seconds @ 40 mWx2/day; and 312.5 seconds @ 8 mWx2/day treatments. Mean ulcer grade scores were similar to controls.

CONCLUSIONS: Varying irradiance and exposure time to achieve a specified energy density affects phototherapy outcomes in this model. Variation of exposure time and irradiance may account for conflicting results in the literature. Further studies of these effects are warranted.

Lasers Surg Med 2007 Jul 39(6) 534-42


Low-level laser therapy for zymosan-induced arthritis in rats: Importance of illumination time.

Castano, AP Dai, T Yaroslavsky, I Cohen, R Apruzzese, WA Smotrich, MH Hamblin, MR

Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, Massachusetts 02114, USA.

BACKGROUND: It has been proposed for many years that low-level laser (or light) therapy (LLLT) can ameliorate the pain, swelling, and inflammation associated with various forms of arthritis. Light is thought to be absorbed by mitochondrial chromophores leading to an increase in adenosine triphosphate (ATP), reactive oxygen species and/or cyclic AMP production and consequent gene transcription via activation of transcription factors. However, despite many reports about the positive effects of LLLT in arthritis and in medicine in general, its use remains controversial. For all indications (including arthritis) the optimum optical parameters have been difficult to establish and so far are unknown.

METHODS: We tested LLLT on rats that had zymosan injected into their knee joints to induce inflammatory arthritis. We compared illumination regimens consisting of a high and low fluence (3 and 30 J/cm(2)), delivered at high and low irradiance (5 and 50 mW/cm(2)) using 810-nm laser light daily for 5 days, with the positive control of conventional corticosteroid (dexamethasone) therapy.

RESULTS: Illumination with 810-nm laser was highly effective (almost as good as dexamethasone) at reducing swelling and a longer illumination time (10 or 100 minutes compared to 1 minute) was more important in determining effectiveness than either the total fluence delivered or the irradiance. LLLT induced reduction of joint swelling correlated with reduction in the inflammatory marker serum prostaglandin E2 (PGE2).

CONCLUSION: LLLT with 810-nm laser is highly effective in treating inflammatory arthritis in this model. Longer illumination times were more effective than short times regardless of total fluence or irradiance. These data will be of value in designing clinical trials of LLLT for various arthritides.

Lasers Surg Med 2007 Jul 39(6) 543-50


Ga-As (808 nm) Laser Irradiation Enhances ATP Production in Human Neuronal Cells in Culture.

Oron, U Ilic, S De Taboada, L Streeter, J

Photothera Inc., Carlsbad, California. USA

Objective: The aim of the present study was to investigate whether Ga-As laser irradiation can enhance adenosine triphosphate (ATP) production in normal human neural progenitor (NHNP) cells in culture.

Methods: NHNP were grown in tissue culture and were treated by Ga-As laser (808 nm, 50 mW/cm(2), 0.05 J/cm(2)), and ATP was determined at 10 min after laser application.

Results: The quantity of ATP in laser-treated cells was 7513 +/- 970 units, which was significantly higher (p < 0.05) than the non-treated cells, which comprised 3808 +/- 539 ATP units.

Conclusion: Laser application to NHNP cells significantly increases ATP production in these cells. These findings may explain the beneficial effects of low-level laser therapy (LLLT) in stroked rats. Tissue culture of NHNP cells might offer a good model to study the mechanisms associated with promotion of ATP production in the nervous system by LLLT.

Photomed Laser Surg 2007 Jun 25(3) 180-2


Low-Level Laser Therapy Applied Transcranially to Mice following Traumatic Brain Injury Significantly Reduces Long-term Neurological Deficits.

Oron A, Oron U, Streeter J, Taboada LD, Alexandrovich A, Trembovler V, Shohami E.

Department of Orthopedics, Assaf Harofeh Medical Center, Zerifin, Israel.

Low-level laser therapy (LLLT) has been evaluated in this study as a potential therapy for traumatic brain injury (TBI). LLLT has been found to modulate various biological processes. Following TBI in mice, we assessed the hypothesis that LLLT might have a beneficial effect on their neurobehavioral and histological outcome. TBI was induced by a weight-drop device, and motor function was assessed 1 h post-trauma using a neurological severity score (NSS). Mice were then divided into three groups of eight mice each: one control group that received a sham LLLT procedure and was not irradiated; and two groups that received LLLT at two different doses (10 and 20 mW/cm(2) ) transcranially. An 808-nm Ga-As diode laser was employed transcranially 4 h post-trauma to illuminate the entire cortex of the brain. Motor function was assessed up to 4 weeks, and lesion volume was measured. There were no significant changes in NSS at 24 and 48 h between the laser-treated and non-treated mice. Yet, from 5 days and up to 28 days, the NSS of the laser-treated mice were significantly lower (p < 0.05) than the traumatized control mice that were not treated with the laser. The lesion volume of the laser treated mice was significantly lower (1.4%) than the non-treated group (12.1%). Our data suggest that a non-invasive transcranial application of LLLT given 4 h following TBI provides a significant long-term functional neurological benefit. Further confirmatory trials are warranted.

J Neurotrauma. 2007 Apr;24(4):651-6.


Laser biostimulation in end-stage multivessel coronary artery disease - a preliminary observational study.

Zycinski P, Krzeminska-Pakula M, Peszynski-Drews C, Kierus A, Trzos E, Rechcinski T, Figiel L, Kurpesa M, Plewka M, Chrzanowski L, Drozdz J.

II Katedra i Klinika Kardiologii Uniwersytetu Medycznego, ul. Kniaziewicza 1/5, Lodz Poland

Background: Low-energy laser radiation through its direct influence on tissue repair processes without heating effect may have vital importance in the therapy of patients with advanced coronary artery disease (CAD).

Aim: The introductory assessment of the effects of laser biostimulation applied to patients with advanced multivessel CAD.

Methods: 39 patients with advanced CAD were assigned (mean age 64.8+/-9.6, male gender 64%, CCS class 2.5+/-0.5, EF=46+/-11%, 69% with a history of acute myocardial infarction), to undergo two sessions of irradiation of low-energy laser light on skin in the chest area from helium-neon B1 lasers. The time of irradiation was 15 minutes while operations were performed 6 days a week for one month. Before including the patients in the experimental group a full clinical evaluation, basic biochemical tests, ECG, 24h Holter recordings, 6-minute walk test, treadmill test using Bruce protocol and full echocardiographic examination were performed. After the first and second period of laser therapy with a one-month break between them analogical parameters with the initial examination were measured.

Results: No side effects associated with the laser biostimulation or performed clinical tests were noted. Lower CCS class (2.5+/-0.5 --> 2.2+/-0.4 --> 2.0+/-0.4, p<0.001), higher exercise capacity (5.1+/-2.2 --> 5.8+/-2.2 --> 6.6+/-2.5 [METS], p=0.023), longer exercise time (257+/-126 --> 286+/-127 --> 325+/-156 [s], p=0.06), less frequent angina symptoms during the treadmill test (65% --> 44% --> 38%, p=0.02), longer distance of 6-minute walk test (341+/-93 --> 405+/-113 --> 450+/-109 [m], p <0.001), lower systolic blood pressure values (SP 130+/-14 --> 125+/-12 --> 124+/-14 [mmHg], p=0.05) and trend towards less frequent 1 mm ST depression lasting 1 min during Holter recordings were noted.

Conclusions: An improvement of functional capacity and less frequent angina symptoms during exercise tests without a significant change in the left ventricular function were observed. Laser biostimulation in short-term observation was a very safe method. These encouraging results should be confirmed in a larger, placebo-controlled study

Kardiol Pol. 2007 Jan;65(1):13-21

Low-level laser irradiation (LLLI) promotes proliferation of mesenchymal and cardiac stem cells in culture.

Tuby H, Maltz L, Oron U.

Department of Zoology, The George S. Wise Faculty of Life Sciences, Tel-Aviv University, Tel-Aviv 69978, Israel.

BACKGROUND AND OBJECTIVES: Low-level laser irradiation (LLLI) was found to promote the proliferation of various types of cells in vitro. Stem cells in general are of significance for implantation in regenerative medicine. The aim of the present study was to investigate the effect of LLLI on the proliferation of mesenchymal stem cells (MSCs) and cardiac stem cells (CSCs). STUDY DESIGN/MATERIALS AND METHODS: Isolation of MSCs and CSCs was performed. The cells were cultured and laser irradiation was applied at energy densities of 1 and 3 J/cm(2). RESULTS: The number of MSCs and CSCs up to 2 and 4 weeks respectively, post-LLLI demonstrated a significant increase in the laser-treated cultures as compared to the control. CONCLUSION: The present study clearly demonstrates the ability of LLLI to promote proliferation of MSCs and CSCs in vitro. These results may have an important impact on regenerative medicine.

Lasers Surg Med. 2007 Apr 24;39(4):373-378 [Epub ahead of print]


A systematic review of the effectiveness of physical therapy interventions for temporomandibular disorders.

McNeely ML, Armijo Olivo S, Magee DJ.

Department of Physical Therapy, 2-50 Corbett Hall, University of Alberta, Edmonton, Alberta, Canada T6G 2G4 Canada

BACKGROUND AND PURPOSE: The purpose of this qualitative systematic review was to assess the evidence concerning the effectiveness of physical therapy interventions in the management of temporomandibular disorders.

METHODS: A literature search of published and unpublished articles resulted in the retrieval of 36 potential articles.

RESULTS: Twelve studies met all selection criteria for inclusion in the review: 4 studies addressed the use of therapeutic exercise interventions, 2 studies examined the use of acupuncture, and 6 studies examined electrophysical modalities. Two studies provided evidence in support of postural exercises to reduce pain and to improve function and oral opening. One study provided evidence for the use of manual therapy in combination with active exercises to reduce pain and to improve oral opening. One study provided evidence in support of acupuncture to reduce pain when compared with no treatment; however, in another study no significant differences in pain outcomes were found between acupuncture and sham acupuncture. Significant improvements in oral opening were found with muscular awareness relaxation therapy, biofeedback training, and low-level laser therapy treatment.

DISCUSSION AND CONCLUSION: Most of the studies included in this review were of very poor methodological quality; therefore, the findings should be interpreted with caution.

Phys Ther. 2006 May;86(5):710-25.

Low level laser therapy for osteoarthritis and rheumatoid arthritis: a metaanalysis.

Brosseau L, Welch V, Wells G, Tugwell P, de Bie R, Gam A, Harman K, Shea B, Morin M.

Physiotherapy Program, School of Rehabilitation Sciences, Faculty of Health Sciences, University of Ottawa, Ontario, Canada

OBJECTIVE: Osteoarthritis (OA) and rheumatoid arthritis (RA) affect a large proportion of the population. Low level laser therapy (LLLT) was introduced as an alternative noninvasive treatment for RA and OA about 10 years ago, but its effectiveness is still controversial. We assessed the effectiveness of LLLT in the treatment of RA and OA.

METHODS: A systematic review was conducted, following an a priori protocol, according to the methods recommended by the Cochrane Collaboration. Trials were identified by a literature search of Medline, Embase, and the Cochrane Controlled Trials Register. Only randomized controlled trials of LLLT for the treatment of patients with a clinical diagnosis of RA or OA were eligible. Thirteen trials were included, with 212 patients randomized to laser and 174 patients to placebo laser, and 68 patients received active laser on one hand and placebo on the opposite hand. Treatment duration ranged from 4 to 10 weeks. Followup was reported by only 2 trials for up to 3 months.

RESULTS: In patients with RA, relative to a separate control group, LLLT reduced pain by 70% relative to placebo and reduced morning stiffness by 27.5 min (95% CI -52.0 to -2.9), and increased tip to palm flexibility by 1.3 cm (95% CI -1.7 to -0.8). Other outcomes such as functional assessment, range of motion, and local swelling were not different between groups. There were no significant differences between subgroups based on LLLT dosage, wavelength, site of application, or treatment length. In RA, relative to a control group using the opposite hand, there was no difference between control and treatment hand, but all hands were improved in terms of pain relief and disease activity. For OA, a total of 197 patients were randomized. Pain was assessed by 3 trials. The pooled estimate (random effects) showed no effect on pain (standardized mean difference -0.2, 95% CI -1.0 to +0.6), but there was statistically significant heterogeneity (p > 0.05). Other outcomes of joint tenderness, joint mobility, and strength were not significant.

CONCLUSION: LLLT should be considered for short term relief of pain and morning stiffness in RA, particularly since it has few side effects. For OA, the results are conflicting in different studies and may depend on the method of application and other features of the LLLT. Clinicians and researchers should consistently report the characteristics of the LLLT device and the application techniques. New trials on LLLT should make use of standardized, validated outcomes. Despite some positive findings, this metaanalysis lacked data on how effectiveness of LLLT is affected by 4 factors: wavelength, treatment duration of LLLT, dosage, and site of application over nerves instead of joints. There is a need to investigate the effects of these factors on effectiveness of LLLT for RA and OA in randomized controlled clinical trials.

J Rheumatol. 2000 Aug;27(8):1961-9.

Elementary Processes in Cells after Light Absorption Do Not Depend on the Degree of Polarization: Implications for the Mechanisms of Laser Phototherapy.

Karu TI, Pyatibrat LV, Moskvin SV, Andreev S, Letokhov VS

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

ABSTRACT Objective: The objective of this work was to evaluate the importance of the degree of light polarization in stimulation of cellular metabolism.

Background Data: Although the possible role of polarization's effects on the mechanisms of laser phototherapy is sometimes discussed in the literature, there are still no clear answers.

Material and Methods: A model system (HeLa cell suspension) was used in which the lengths of light scattering (l(sc)) and absorption (l(a)) were much larger than the thickness of the irradiated layer (L = 3 mm). The cell suspension (1 x 10(6) cells/cm(3)) was irradiated with a diode laser (lambda = 637 nm, D = 65.7 J/m(2), tau = 10 sec, I = 6.57 W/m(2)). The polarization degree (99.4%, 60.9%, and 34.2%) of the beam was changed by means of optical fibers of different lengths. The irradiated suspension was incubated at 37 degrees C for 30 min, and the attached cells were counted afterwards.

Results: The cell fraction stimulated to adhere by red light at 637 nm was nearly the same in all three experimental groups (58.1% +/- 2.5%, 57.6% +/- 3.5%, and 62.5% +/- 3.2% for degree of beam polarization of 99.4%, 66.9%, and 34.2%, respectively). There was no statistically significant difference in these results (p <0.8, <0.6, and <0.7, respectively). At the same time, all three groups had statistically significant differences (p < 0.01) in adherence from the sham-irradiated control group (39.1% +/- 2.2%).

Conclusion: The biological effect (stimulation of cell attachment) of light with lambda = 637 nm on cells in our model system was pronounced, but did not depend on the degree of light polarization. Elementary processes in cells (light absorption and photochemistry) do not appear to depend on the degree of light polarization.

Photomed Laser Surg 2008 Feb 28 


Improved wound healing by low-level laser irradiation after gingivectomy operations: a controlled clinical pilot study.

Ozcelik O, Cenk Haytac M, Kunin A, Seydaoglu G

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

AIM: Low-level laser therapy (LLLT) may induce morphological, molecular and cellular processes, which are involved in wound healing. The aim of this split-mouth controlled clinical trial was to assess the effects of LLLT on healing of gingiva after gingivectomy and gingivoplasty.

MATERIAL AND METHODS: Twenty patients with inflammatory gingival hyperplasias on their symmetrical teeth were included in this study. After gingivectomy and gingivoplasty, a diode laser (588 nm) was randomly applied to one side of the operation area for 7 days. The surgical areas were disclosed by a solution (Mira-2-tones) to visualize the areas in which the epithelium is absent. Comparison of the surface areas on the LLLT-applied sites and controls were made with an image-analysing software.

RESULTS: Despite the prolonged time needed for application, patients have tolerated LLLT well. While there were no statistically significant differences between the stained surface areas of the LLLT applied and the control sites immediately after the surgery, LLLT-applied sites had significantly lower stained areas compared with the controls on the post-operative third, seventh and 15th day (p<0.001 for each).

CONCLUSIONS: Within the limitations of this study, the results indicated that LLLT may enhance epithelization and improve wound healing after gingivectomy and gingivoplasty operations.

J Clin Periodontol 2008 Mar 35(3) 250-4


Effect of the CO2 laser combined with fluoridated products on the inhibition of enamel demineralization.

Steiner-Oliveira C, Rodrigues LK, Lima EB, Nobre-dos-Santos M

Piracicaba School of Dentistry at the State University of Campinas in Piracicaba, SP, Brazil.

AIM: This in vitro study evaluated the combined effects of a 10.6 microm CO2 laser, fluoridated dentifrice, and mouthrinse on the reduction of lesion progression in carious human enamel.

METHODS AND MATERIALS: Slabs of previously demineralized dental enamel were assigned to nine groups, either treated with/without a CO2 laser, with/without fluoridated dentifrice, and with/without fluoridated mouthrinse. After a pH-cycling regime, fluoride concentrations were determined in the demin- and remineralizing solutions. A qualitative polarized light analysis was performed on enamel, and enamel mineral loss was determined by cross-sectional microhardness testing.

RESULTS: All treatments were able to decrease mineral loss, and the inhibition of demineralization progression ranged from 48% to 60%.

CONCLUSION: The 10.6 microm CO2 laser irradiation alone or combined with fluoridated products reduced demineralization progression in enamel. However, there was no significant additional demineralization inhibitory effect with the use of the combined laser-fluoride treatments.

CLINICAL SIGNIFICANCE: CO2 lasers have proven to be efficient in reducing subsurface enamel demineralization. Its association with a high frequent fluoride therapy may enhance this protective effect.

J Contemp Dent Pract 2008 9(2) 113-21


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

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

Department of Public Health Sciences, John A. Burns School of Medicine, University of Hawaii at Manoa, Honolulu, HI 96822, USA. ehurwitz@aii.edu

STUDY DESIGN: Best evidence synthesis.

OBJECTIVE: To identify, critically appraise, and synthesize literature from 1980 through 2006 on noninvasive interventions for neck pain and its associated disorders.

SUMMARY OF BACKGROUND DATA: No comprehensive systematic literature reviews have been published on interventions for neck pain and its associated disorders in the past decade.

METHODS: We systematically searched Medline and screened for relevance literature published from 1980 through 2006 on the use, effectiveness, and safety of noninvasive interventions for neck pain and associated disorders. Consensus decisions were made about the scientific merit of each article; those judged to have adequate internal validity were included in our best evidence synthesis.

RESULTS: Of the 359 invasive and noninvasive intervention articles deemed relevant, 170 (47%) were accepted as scientifically admissible, and 139 of these related to noninvasive interventions (including health care utilization, costs, and safety). For whiplash-associated disorders, there is evidence that educational videos, mobilization, and exercises appear more beneficial than usual care or physical modalities. For other neck pain, the evidence suggests that manual and supervised exercise interventions, low-level laser therapy, and perhaps acupuncture are more effective than no treatment, sham, or alternative interventions; however, none of the active treatments was clearly superior to any other in either the short- or long-term. For both whiplash-associated disorders and other neck pain without radicular symptoms, interventions that focused on regaining function as soon as possible are relatively more effective than interventions that do not have such a focus.

CONCLUSION: Our best evidence synthesis suggests that therapies involving manual therapy and exercise are more effective than alternative strategies for patients with neck pain; this was also true of therapies which include educational interventions addressing self-efficacy. Future efforts should focus on the study of noninvasive interventions for patients with radicular symptoms and on the design and evaluation of neck pain prevention strategies.

Spine 2008 Feb 15 33(4 Suppl) S123-52


Laser therapy in the treatment of achilles tendinopathy: a pilot study.

Tumilty S, Munn J, Abbott JH, McDonough S, Hurley DA, Baxter GD

School of Physiotherapy, Centre for Physiotherapy Research, University of Otago, Dunedin, New Zealand

OBJECTIVE: To test the feasibility of a randomized controlled trial to assess the clinical effectiveness of low-level laser therapy (LLLT) when used in addition to eccentric exercise in the management of Achilles tendinopathy.

BACKGROUND DATA: LLLT has emerged as a possible treatment modality for tendon injuries. Over the past 20 years only three human studies have investigated LLLT for Achilles tendinopathy.

MATERIALS AND METHODS: Twenty patients were randomized into an active laser or placebo group; all patients, therapists, and investigators were blinded to allocation. All patients were given a 12-week eccentric exercise program and irradiated three times per week for 4 wk with either an active or placebo laser at standardized points over the affected tendons. Irradiation parameters in the active treatment group were: 810 nm, 100 mW, applied to six points on the tendon for 30 s, for a total dose of 3 J per point and 18 J per session. Outcome measures were the VISA-A questionnaire, pain, and isokinetic strength. Patients were measured before treatment and at 4 and 12 wk. Analysis of covariance was used to analyze data, using the effects of baseline measurements as a covariate.

RESULTS: Within groups, there were significant improvements (p < 0.05) at 4 and 12 wk for all outcome measures, except eccentric strength for the placebo group at 4 wk (p = 0.11). Based on the results of the current study, recruitment of 20 subjects per group would be required to perform an adequately powered study based on minimally important clinical differences in VISA-A scale.

CONCLUSION: This study has demonstrated the feasibility of undertaking a randomized controlled trial of LLLT for Achilles tendinopathy. Conclusions regarding effectiveness cannot be made due to the low statistical power of this pilot study.

Photomed Laser Surg 2008 Feb 26(1) 25-30


A randomized double-blind comparative study of Biolight light therapy following surgical extraction of impacted lower third molars.

Kashani H, Kanagaraja S, Kahnberg KE

Department of Oral & Maxillofacial Surgery, NAL Medical Center Hospital, Trollhattan, Sweden. hossein.kashani@vgregion.se

Monochromatic light has been used in many studies and indicated that phototherapy might be effective in the treatment of pain relief. The aim of this investigation was to evaluate the efficacy of monochromatic light phototherapy on patients who had undergone impacted third molar surgery. Sixty adult patients were included in the study. The patients were divided into 2 groups; the Biolight therapy group and the placebo therapy group. All the subjects received phototherapy 6 minutes preoperative and 10 minutes postoperative.They were examined 3 and 7 days after surgery to evaluate postoperative pain and wound healing. One patient was excluded from the study due to extraction of the third molar in maxilla. All the patients received a questionnaire to answer regarding pain and the number of pain killers consumed.The results from this study showed that Phototherapy using monochromatic light Biolight therapy had no significant differences compared to the placebo group.

Swed Dent J 2007 31(4) 165-70


Effect of combined laser acupuncture on knee osteoarthritis: a pilot study.

Shen  X, Zhao  L, Ding  G, Tan  M, Gao  J, Wang  L, Lao  L

Shanghai University of Traditional Chinese Medicine, 1200 Cailun Road, Shanghai, 201203. China

Our objective was to assess the efficacy and safety of combined 10.6 micron and 650 nm laser irradiation on patients with knee osteoarthritis (OA). Forty patients with OA were randomly allocated to an active laser group or to a placebo laser group (20 per group). They either received active or sham laser treatment at acupoint Dubi (ST 35) in a total of 12 sessions. There was significant difference between the two groups in the Western Ontario and McMaster Universities (WOMAC) osteoarthritis index pain score change from baseline after 2 weeks of treatment (P = 0.047). The pain reduction of the active laser treatment group was 49%, whereas that of the placebo control group was only 13%. However, due to the high patient drop-out rate, the 4-week assessment could not be analyzed. Combined laser treatment seems beneficial to patients with knee OA. However, due to the small sample size and the high drop-out rate of patients in the placebo group, a large sample-size clinical trial is warranted to determine further the therapeutic efficacy of the device.

Lasers Med Sci 2008 Jan 5 


Monochromatic phototherapy: effective treatment for grade II chronic pressure ulcers in elderly patients.

Dehlin  O, Elmstahl  S, Gottrup  F

Department of Community Medicine, Malmo University Hospital, 20502 Malmo Sweden

BACKGROUND AND AIMS: Monochromatic pulsating light may have effects on wound healing. In an earlier study of grade II ulcers, there was a tendency toward better healing in the phototherapy group (p=0.06). The present study on patients with grade II ulcers was performed to verify these findings. Data from this study were pooled with data from the earlier study.

METHODS: Ninety-four patients were offered participation in the new study and 76 patients were evaluated. They were pooled with 87 patients from the earlier study, bringing the total to 163. All patients were treated with monochromatic pulsating light or placebo over the ulcerated area, according to a specified program up to 12 weeks.

RESULTS: The mean normalized reduction in pressure ulcer size at week 12 was 0.79 for the phototherapy group and 0.50 for the placebo group (95% confidence interval 0.01-0.53; p=0.039). No serious side-effects were noted.

CONCLUSIONS: Monochromatic pulsating light accelerates healing in grade II pressure ulcers in elderly patients.

Aging Clin Exp Res 2007 Dec 19(6) 478-83


Neural substrates of awakening probed with optogenetic control of hypocretin neurons.

Adamantidis AR, Zhang F, Aravanis AM, Deisseroth K, de Lecea L

[1] Department of Psychiatry and Behavioral Sciences, Stanford University, 701B Welch Road, Palo Alto, California 94304, USA [2] These authors contributed equally to this work.

The neural underpinnings of sleep involve interactions between sleep-promoting areas such as the anterior hypothalamus, and arousal systems located in the posterior hypothalamus, the basal forebrain and the brainstem. Hypocretin (Hcrt, also known as orexin)-producing neurons in the lateral hypothalamus are important for arousal stability, and loss of Hcrt function has been linked to narcolepsy. However, it is unknown whether electrical activity arising from Hcrt neurons is sufficient to drive awakening from sleep states or is simply correlated with it. Here we directly probed the impact of Hcrt neuron activity on sleep state transitions with in vivo neural photostimulation, genetically targeting channelrhodopsin-2 to Hcrt cells and using an optical fibre to deliver light deep in the brain, directly into the lateral hypothalamus, of freely moving mice. We found that direct, selective, optogenetic photostimulation of Hcrt neurons increased the probability of transition to wakefulness from either slow wave sleep or rapid eye movement sleep. Notably, photostimulation using 5-30 Hz light pulse trains reduced latency to wakefulness, whereas 1 Hz trains did not. This study establishes a causal relationship between frequency-dependent activity of a genetically defined neural cell type and a specific mammalian behaviour central to clinical conditions and neurobehavioural physiology.

Nature 2007 Oct 17 


Excimer laser for psoriasis: a review of theories regarding enhanced efficacy over traditional UVB phototherapy.

Zakarian, K Nguyen, A Letsinger, J Koo, J

Department of Pediatrics, University of California, Irvine, CA, USA. kzakaria@uci.edu

BACKGROUND: Fiber-optically targeted ultraviolet B (UVB) therapy has been shown to clear plaques of psoriasis in a significantly fewer number of treatments and reduce overall cumulative UVB dose than traditional UVB phototherapy.

OBJECTIVE: This article reviews existing theories in the literature attempting to explain the superior efficacy of targeted UVB.

METHODS: Medline was used to perform a comprehensive review of the literature from 1965 to present. Only information from the English language journals are reported in this study.

RESULTS: The theories proposed to explain the higher efficacy of the excimer (XeCl) laser relative to traditional UVB include the ability to use higher intensities of ultraviolet (UV) light and a more efficient induction of T cell apoptosis.

CONCLUSION: The possible explanations for the superior efficacy of the excimer laser over traditional UVB therapy for psoriasis include: 1) a higher intensity UV light to plaques, which is more effective in clearing psoriasis; 2) penetration into the dermis where it may induce T cell apoptosis, potentially to a greater extent than the wavelength or given energy level predicts; and 3) the difference in the delivery of UVB light may result in cell death and skin immune system suppression more effectively than traditional UVB.

J Drugs Dermatol 2007 Aug 6(8) 794-8


Time-dependent responses of wounded human skin fibroblasts following phototherapy.

Hawkins, DH Abrahamse, H

Laser Research Group, Faculty of Health Sciences, University of Johannesburg, P.O. Box 17011, Doornfontein, Johannesburg 2028 South Africa

BACKGROUND AND OBJECTIVE: The penetration and distribution of laser light in target tissue is dependent on the wavelength of the light. One problem with most of the published data on laser irradiation is that most studies do not record the duration between the exposure and the evaluation. This study aimed to establish if the dose, wavelength or duration of effect (1h or 24h) influences the biological responses of irradiated fibroblasts.

MATERIALS AND METHODS: The study established cellular responses of normal and wounded human skin fibroblasts to helium-neon (632.8nm), diode (830nm) and Nd:YAG (1064nm) laser irradiation using one exposure of 5J/cm(2) or 16J/cm(2) on day 1 and again on day 4. Cellular responses to laser irradiation were evaluated by measuring changes in cell viability (ATP viability and caspase 3/7 activity) and cell proliferation (ALP enzyme activity and bFGF expression), 1h and 24h post irradiation.

RESULTS: Wounded cells exposed to 5J/cm(2) using 632.8nm showed an increase in ATP viability after 1h, a decrease in caspase 3/7 activity after 24h and an increase in cell proliferation after 24h. The results suggest that changes in parameters such as ATP viability should be observed directly after laser irradiation (1h) whereas other parameters such as caspase 3/7 activity, bFGF expression and ALP enzyme activity should be measured at least 24h after the final exposure.

CONCLUSION: This study confirms that the duration of effect should be included as one of the main laser parameters when reporting on the effects of laser irradiation. It is important to establish time-dependent responses as the results may provide an understanding of the cellular responses following laser irradiation.

J Photochem Photobiol B 2007 Jul 28 


The effect of mastectomy and radiotherapy for breast carcinoma on soft tissues of the shoulder and its joint mobility among Egyptian patients.

Saied, GM Kamel, RM Dessouki, NR

Department of General Surgery, Faculty of Medicine, Cairo University Egypt

Patients with post mastectomy soft tissue shoulder disorders usually benefit from various lines of physiotherapy treatment. However, the controversy about their efficacy persists. The aim of this work was to study and assess the efficacy of each, and to identify the best intervention. One hundred female patients with ipsilateral post mastectomy shoulder problems were enrolled in the study, from September 2003 until December 2004. They were followed up for 32 weeks. Mastectomy, both radical and conservative and axillary lymph node clearance, was the standard surgery applied for operable breast carcinoma in this series. Clinical examination was followed by testing for the shoulder complaint by measuring maximal protrusion at the inferior scapular angle, scapular stabilization and the lift-off tests. Approved physiotherapy modalities were then applied, viz: no treatment (randomly chosen 12 patients), passive and active motion therapy (14 patients), oral diclofenac sodium (19 patients), local triamcinilone injection (40 patients) and manually applied low intensity laser therapy (15 patients). Assessment was by determining overall success rate for each intervention modality. Intervention outcome was assessed at 8, 16, and 32 weeks as shown by physical examination using the healthy shoulder as a reference, and by measuring restricted mobility during passive lateral rotation and glenohumeral abduction. "Success rate" was determined separately for each group at the end of the intervention period. The applied surgery was followed by radiotherapy in 96%, chemotherapy in 24% and both in 11%. The presenting post mastectomy symptoms at the shoulder were pain (100%), shoulder weakness (88%), winging of the scapula (11%) and inability to perform everyday shoulder movements (23%). Evaluation was by overall improvement score. The results were: 14.3% for untreated patients, 43.3% for those treated by motion therapy, 42% for diclofenac therapy, 80.7% for local triamcinolone, and lastly 68% for low intensity laser therapy. All treatment regimens for shoulder disabilities in those patients gave little long-term advantage, local steroid injections were the most effective. Low level laser therapy may augment its effect. It is concluded that all treatment regimens provide little long-term advantage; however, trimcinilone local injections may be the most useful in terms of pain relief and improvement in shoulder movement.

Tanzan Health Res Bull 2007 May 9(2) 121-5


Low intensity laser application in temporomandibular disorders: a phase I double-blind study.

Mazzetto, MO Carrasco, TG Bidinelo, EF de Andrade Pizzo, RC Mazzetto, RG

Department of Restorative Dentistry, School of Dentistry of Ribeirao Preto, University of Sao Paulo (FORP-USP) Brazil

The purpose of this study was to evaluate the effectiveness of low intensity laser therapy (LILT) for the control of pain from temporomandibular disorder (TMD) in a random and double-blind research design. Forty-eight (48) patients presenting temporomandibular joint (TMJ) pain were divided into an experimental group (GI) and a placebo group (GII). The sample was submitted to the treatment with infrared laser (780 nm, 70 mW, 10 s, 89.7 J/cm2) applied in continuous mode on the affected temporomandibular region, at one point: inside the external auditive duct toward the retrodiskal region, twice a week, for four weeks. For the control group, two identical probes (one active and one that does not emit radiation) were used unknown by the clinician and the subjects. A tip planned for laser acupuncture was used and connected to the active point of the probe. The parameter evaluated was the intensity of pain after palpation of the condylar lateral pole, pre-auricular region and external auditive duct, according to the Visual Analogue Scale (VAS). Four evaluations were performed: Ev1 (before laser application), Ev2 (after 4th application), Ev3 (after 8th application) and Ev4 (30 days after the last application). Data were submitted to statistical analysis. The results showed a decrease in the pain level mainly for the active probe. Among the evaluations, the Ev3 exhibited lower sensitivity to palpation. In conclusion, the results show that low intensity laser is an effective therapy for the pain control of subjects with TMD.

Cranio 2007 Jul 25(3) 186-92


The analgesic effectiveness of laser therapy in patients with gonarthrosis: an evaluation.

Kujawa, J Talar, J Gworys, K Gworys, P Pieszynski, I Janiszewski, M

Background. Osteoarthrosis is a very common disease of the musculo-skeletal system. Laser therapy can be used to alleviate the pain associated with this syndrome, which markedly impinge the patients physical comfort and limit physical activity.

Material and methods. The research involved 32 patients (26 women and 6 men, average age 57.3 A+/-12.1 years) with pain complaints in one knee joint and radiologically confirmed degenerative changes. The control group consisted of 32 matched patients awaiting treatment. Laser biostimulation was applied with a semiconductor laser (400 mW, wave length 810 nm). Contact (point) irradiation was applied, with a surface energy density of 12.7 J/cm2. One series of 10 procedures was performed on one knee joint, 5 days a week. Pain intensity was evaluated with the Visual Analogue Scale (VAS) and a modified version of the Laitinen questionnaire.

Results. In 29 patients (91%) there was a statistically significant reduction in pain complaints in the affected knee measured by VAS. In 19 patients (59%) there was a statistically significant reduction in the frequency and intensity of pain complaints on the Laitinen questionnaire. The improvement in daily motor activity and the reduced use of antalgesic drugs were not statistically significant.

Conclusions. Laser biostimulation in patients with knee pain reduces symptoms on the VAS, and significantly reduces the intensity and frequency of pain as assessed by the Laitinen questionnaire. One series of laser treatments has no significant effect on motor activity and use of painkillers in patients with chronic knee pain due to osteoarthrosis.

Ortop Traumatol Rehabil 2004 Jun 30 6(3) 356-66


Comparison between 308-nm monochromatic excimer light and narrowband UVB phototherapy (311-313 nm) in the treatment of vitiligo - a multicentre controlled study.

Casacci, M Thomas, P Pacifico, A Bonnevalle, A Paro Vidolin, A Leone, G

Dermatology Clinic, Huriez Hospital, University of Lille 2, France.

Background Vitiligo is an acquired pigmentary disorder characterized by areas of depigmented skin resulting from loss of epidermal melanocytes. Recently, it has been shown that narrowband ultraviolet B (NB-UVB) phototherapy may be more effective than psoralen and ultraviolet A (PUVA) photochemotherapy in treating vitiligo, and that 308-nm monochromatic excimer light (MEL) may present some advantages as compared to NB-UVB for the treatment of vitiligo. Aim The aim of this study was to compare the effectiveness of NB-UVB phototherapy and 308-nm MEL in vitiligo patients. Methods The study was done in a randomized, investigator-blinded and half-side comparison design. Twenty-one subjects with symmetrical vitiligo lesions were enrolled in this study. Vitiligo lesions on one body side were treated twice weekly for 6 months with 308-nm MEL, while NB-UVB phototherapy was used to treat lesions on the opposite side. Results At the end of the study six lesions (37.5%) treated with 308-nm MEL and only one lesion (6%) treated with NB-UVB achieved an excellent repigmentation (score 4) while four lesions (25%) treated with 308-nm MEL and five lesions (31%) treated with NB-UVB showed a good repigmentation (score 3). Conclusions It appears that 308-nm MEL is more effective than NB-UVB in treating vitiligo lesions and it induces repigmentation more rapidly.

J Eur Acad Dermatol Venereol 2007 Aug 21(7) 956-63


Alteration of extracellular matrix modulators after nonablative laser therapy in skin rejuvenation.

Oh, J Kim, N Seo, S Kim, IH

Laboratory of Cellular Oncology, Korea University Ansan Hospital, Gojan 1-dong, Danwon gu, Ansan, Gyeonggi do 425-707 Korea

BACKGROUND: Nonablative laser therapy is widely practised for skin rejuvenation, which stimulates collagen production and dermal matrix remodelling. Matrix remodelling is primarily modulated by a coordinated action of matrix metalloproteinases (MMPs) and their inhibitors, but the effects of nonablative lasers on these matrix modulators are not fully investigated.

OBJECTIVES: To evaluate the changes in matrix modulators, such as MMP-1, MMP-2, MMP-3, MMP-9 and MT1-MMP, and their inhibitors (TIMP-1, TIMP-2 and RECK in particular), after nonablative laser treatments of human facial skin.

METHODS: Twenty-four adult volunteers received a series of four nonablative laser treatments separated by 3-week intervals on facial skin. Two-millimetre skin punch biopsies were obtained at baseline and 3 weeks after the last treatment.

RESULTS: Nonablative laser treatments led to a robust increase in two major dermal matrix components, type I collagen and tropoelastin. Among MMPs tested, levels of MMP-2 mRNA were statistically significantly increased, but the amount of active MMP-2 was rather reduced. More importantly, the expression level of RECK was significantly enhanced by laser treatments.

CONCLUSIONS: Clinical outcomes following nonablative laser treatments may result not only from increased biosynthesis but also from decreased degradation, via an induction of RECK expression, of matrix proteins.

Br J Dermatol 2007 Aug 157(2) 306-10


Polychromatic Light Similar to the Terrestrial Solar Spectrum Without its UV Component Stimulates DNA Synthesis in Human Peripheral Blood Lymphocytes in vivo and in vitro

Kira Samoilova,1 Natalya Zhevago,2 and R. Glen Calderhead3

1Institute of Cytology of Russian Academy of Sciences

2Institute of Cytology of Russian Academy of Sciences

3Japan Phototherapy Laboratory Russia, Japan

Immunosuppressive effects of the minor component of the terrestrial solar spectrum, UV radiation have been substantiated over the past years. This raises the question what influence the dominant part of the solar spectrum, visible and IR light, would have on the human immune system. In the present randomized, placebo-controlled double blind study a small area of the volunteers' body surface was irradiated with polychromatic light (480-3400 nm), simulating the significant part of the terrestial sunlight irradiance spectrum and its power density. An average 2.5-3-fold increase in the spontaneous and PHA-induced DNA synthesis in peripheral blood lymphocytes (Lym) was revealed at 0.5-24 h after irradiation at a therapeutic dose (12 J/cm2) of subjects with low preirradiation levels of both processes. The in vivo findings were echoed in parallel in vitro experiments, when blood drawn from the same subjects was directly irradiated (2.4 J/cm2), or when the irradiated blood was mixed 1:10 with non-irradiated autologous blood to model events in the circulation following transcutaneous blood photomodification. Our data suggest that exposure of the human body to polychromatic visible + IR light may photomodify blood in the dermal vasculature of the irradiated area to lead to an immediate transfer of the light-induced effects to Lym of the entire circulating blood, which can result in modulation of Lym functional state at the systemic level.

A Systematic Review of the Effectiveness of Physical Therapy Interventions for Temporomandibular Disorders.

McNeely ML, Armijo Olivo S, Magee DJ.

2-50 Corbett Hall, Department of Physical Therapy, University of Alberta, Edmonton, Alberta, Canada T6G 2G4. sla4@ualberta.ca. Canada

BACKGROUND AND PURPOSE: The purpose of this qualitative systematic review was to assess the evidence concerning the effectiveness of physical therapy interventions in the management of temporomandibular disorders.

METHODS: A literature search of published and unpublished articles resulted in the retrieval of 36 potential articles.

RESULTS: Twelve studies met all selection criteria for inclusion in the review: 4 studies addressed the use of therapeutic exercise interventions, 2 studies examined the use of acupuncture, and 6 studies examined electrophysical modalities. Two studies provided evidence in support of postural exercises to reduce pain and to improve function and oral opening. One study provided evidence for the use of manual therapy in combination with active exercises to reduce pain and to improve oral opening. One study provided evidence in support of acupuncture to reduce pain when compared with no treatment; however, in another study no significant differences in pain outcomes were found between acupuncture and sham acupuncture. Significant improvements in oral opening were found with muscular awareness relaxation therapy, biofeedback training, and low-level laser therapy treatment.

DISCUSSION AND CONCLUSION: Most of the studies included in this review were of very poor methodological quality; therefore, the findings should be interpreted with caution.

Retrospective Study of Adjunctive Diode Laser

Therapy for Pain Attenuation in 662 Patients:

Detailed Analysis by Questionnaire

SHIGEYUKI NAKAJI, M.D., Ph.D.,1  CHIYUKI SHIROTO, 2 MISAKO YODONO,2  TAKASHI UMEDA,1 QIANG LIU, 1 Department of Hygiene  Hirosaki University School of Medicine  Zaifu-cho 5, Hirosaki City  Aomori 036-8562 Japan

Objective: The aim of this study was to assess the long-term effects of low-level laser therapy (LLLT) through  a retrospective survey using questionnaires.

Background Data: The use of LLLT for chronic pain attenuation  has been reported in the international literature for over 20 years.

Methods: We used a series of diode laser  systems in which the most effective wavelength was consistently found to be 830nm with an output power in  continuous-wave of 60mW. Subjects were 1,087 patients treated by LLLT at the Shiroto Clinic from April  1992 to August 1995. Questionnaires were sent to subjects in September and October 1996.

Results: The reply  rate was 60.9%, comprising 662 questionnaires (265 males, 397 females, mean age of 53.4 years). The total efficacy rating (excellent plus good) immediately after LLLT was 46.8% in men and 47% in women. At the time  of the survey, this rose to 73.3% in men and 76.8% in women, with positive effects also recorded on psychosomatic factors such as well-being, physical energy, general fatigue, mental vigor, and emotional stability. LLLT  effects continued for 1Ð3 days. No statistically significant difference in efficacy was seen between males and females. LLLT as used in the study is therefore considered safe, effective, and side-effect-free, making it an ideal  adjunctive therapeutic modality for intractable chronic and other pain.
Conclusion: Infrared diode LLLT is  therefore considered safe, effective, and side-effect-free, making it an ideal adjunctive therapeutic modality  for intractable chronic pain.

Photomed Laser Surg. 2005 Feb;23(1):60-5.

Low-level laser therapy modulates cyclo-oxygenase-2 expression during bone repair in rats.

Matsumoto MA, Ferino RV, Monteleone GF, Ribeiro DA

Department of Oral Maxillofacial Surgery, School of Dentistry, University of the Sacred Heart (USC), Bauru, SP, Brazil.

The goal of this study was to analyze the role of cyclo-oxygenase-2 following bone repair in rats submitted to low-level laser therapy. A total of 48 rats underwent surgery to inflict bone defects in their tibias having been randomly distributed into two groups: negative control and laser exposed group, i.e., the animals were treated with low-level laser therapy by means of gallium arsenide laser at 16 J/cm(2). The animals were killed after 48 h, 7 days, 14 days, or 21 days. The tibias were removed for morphological, morphometric, and immunohistochemistry analysis for cyclo-oxygenase-2. Statistical significant differences (P < 0.05) were observed in the quality of bone repair and quantity of formed bone between groups 14 days after surgery in the laser exposed group. In the same way, cyclo-oxygenase-2 immunoreactivity was more intense in bone cells for intermediate periods evaluated in this group. Taken together, such results suggest that low-level laser therapy is able to improve bone repair in the tibia of rats after 14 days of surgery as a result of an up-regulation for cyclo-oxygenase-2 expression in bone cells.

Lasers Med Sci 2008 Feb 29 


Complex therapy of chronic bacterial prostatitis using matrix-urologist laser therapy

Kozdoba AS, Popov SV, Ivanchenko LP

A total of 49 patients with chronic bacterial prostatitis (CBP) were divided into two groups matched by age, the disease duration and severity of clinical symptoms. The study group consisted of 27 CBP patients who received antimicrobial therapy with sparfloxacine (fluoroquinolone of the third generation) and impact of vibromagnetolaser head of the VMLG-10 unit. The control group consisted of 22 CBP patients given antimicrobial therapy with sparfloxacine and 10 sessions of manual massage. Eradication of the bacteria was achieved in 25 (92%) patients of the study group and 19 (86.4%) patients of the control group. The treatment significantly attenuated the symptoms, normalized leukocyte count in the prostatic secretion, reduced size of the gland. Thus, application of the vibromagnetolaser head VMLG-10 of the laser therapy unit Matrix-urologist raises treatment efficacy in CBP patients.

Urologiia 2007 Sep-Oct (5) 51, 53-5


Infrared laser light further improves bone healing when associated with bone morphogenic proteins: an in vivo study in a rodent model.

Gerbi ME, Marques AM, Ramalho LM, Ponzi EA, Carvalho CM, Santos Rde C, Oliveira PC, Noia M, Pinheiro AL

School of Dentistry, Federal University of Pernambuco, Recife, PE, Salvador.

OBJECTIVE: This study assessed histologically the effect of laser photobiomodulation (LPBM) on the repair of surgical defects created in the femurs of Wistar rats treated or not treated with bone morphogenic proteins (BMPs) and organic bovine bone graft.

BACKGROUND DATA: This paper is part of an ongoing series of works in which biomaterials are used in association with LPBM. Several previous reports by our group have shown that the use of laser photobiomodulation improves the treatment of bone defects.

MATERIALS AND METHODS: Forty-eight adult male Wistar rats were divided into four randomized groups: group I (control, n = 12); group II (LPBM, n = 12); group III (BMPs + organic bovine bone graft, n = 12); and group IV (BMPs + organic bovine bone graft + LPBM, n = 12). The irradiated groups received seven irradiations every 48 h, beginning immediately after the surgical procedure. The laser therapy (lambda = 830 nm, 40 mW CW, varphi = 0.6 mm) consisted of 16 J/cm(2) per session divided equally over four points (4 J/cm(2) each) around the defect. The subjects were sacrificed after 15, 21, and 30 d, and the specimens were routinely embedded in wax, stained with hematoxylin and eosin and sirius red, and analyzed under light microscopy.

RESULTS: The results showed histological evidence of increased deposition of collagen fibers (at 15 and 21 d), as well as an increased amount of well-organized bone trabeculae at the end of the experimental period (30 d) in the irradiated animals versus the non-irradiated controls.

CONCLUSION: The use of LPBM with BMPs and organic bovine bone grafts increases the positive biomodulating effects of laser light.

Photomed Laser Surg 2008 Feb 26(1) 55-60


Cytokine mRNA expression is decreased in the subplantar muscle of rat paw subjected to carrageenan-induced inflammation after low-level laser therapy.

Albertini R, Villaverde AB, Aimbire F, Bjordal J, Brugnera A, Mittmann J, Silva JA, Costa M

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

OBJECTIVE: The objective of this work was to investigate the anti-inflammatory effects of low-level laser therapy, applied at different wavelengths (660 and 684 nm), on cytokine mRNA expression after carrageenan-induced acute inflammation in rat paw.

BACKGROUND DATA: Low-level laser therapy (LLLT) has been observed to reduce pain in inflammatory disorders. However, little is known about the mechanisms behind this effect or whether it is wavelength-specific.

MATERIALS AND METHODS: The test sample consisted of 32 rats divided into four groups: A(1) (control-saline), A(2) (carrageenan-only), A(3) (carrageenan + 660 nm laser therapy), and A(4) (carrageenan + 684 nm laser therapy). The animals from groups A(3) and A(4) were irradiated 1 h after induction of inflammation by carrageenan injection. Continuous-wave red lasers with wavelengths of 660 and 684 nm and dose of 7.5 J/cm(2) were used.

RESULTS: Both the 660 nm and 684 nm laser groups had 30%-40% lower mRNA expression for cytokines TNF-alpha, IL-1beta, and IL-6 in the paw muscle tissue than the carrageenan-only control group. Cytokine measurements were made 3 h after laser irradiation of the paw muscle, and all cytokine differences between the carrageenan-only control group and the LLLT groups were statistically significant (p < 0.001).

CONCLUSIONS: LLLT at the 660-nm and 684-nm wavelengths administered to inflamed rat paw tissue at a dose of 7.5 J/cm(2) reduce cytokine mRNA expression levels within 3 h in the laser-irradiated tissue.

Photomed Laser Surg 2008 Feb 26(1) 19-24


Efficacy of He-Ne Laser in the prevention and treatment of radiotherapy-induced oral mucositis in oral cancer patients.

Arora H, Pai KM, Maiya A, Vidyasagar MS, Rajeev A

Department of Oral Medicine and Radiology, Manipal College of Dental Sciences, Manipal, Karnatka, India. drarora@gmail.com

OBJECTIVE: The objective of this study was to evaluate the efficacy of low-level lasers for the prevention and treatment of radiotherapy-induced oral mucositis in oral cancer patients.

MATERIAL AND METHODS: Twenty-four hospitalized patients with oral cancer, scheduled to undergo radiotherapy at KMC, Manipal, were enrolled in the present study and assigned to laser (Group I)/control group (Group II). They were treated using He-Ne laser (lambda = 632.8nm, output = 10 mW and energy density = 1.8 J/cm(2)). Patients were subjected to treatment using laser scanner for 8 days and subsequently were treated using laser probe at 6 anatomic sites in the oral cavity for 5 minutes each. The patients were evaluated on each day of treatment for pain severity (NRS), functional impairment (FIS), and oral mucositis (RTOG) and were followed until the end of cancer treatment. Statistical analysis was done using SPSS version 10.

RESULTS: Laser therapy applied prophylactically during radiotherapy can reduce the severity of oral mucositis, severity of pain, and functional impairment.

Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2008 Feb 105(2) 180-6, 186.e1


Phototherapy promotes cell migration in the presence of hydroxyurea.

Zungu IL, Mbene AB, Hawkins Evans DH, Houreld NN, Abrahamse H

Laser Research Group, Faculty of Health Sciences, University of Johannesburg, P.O. Box 17011, Doornfontein, Johannesburg, 2028, South Africa, habrahamse@uj.ac.za.

Phototherapy has been shown to cause an increase in cell proliferation and migration. This study focused on viability (trypan blue), proliferation [sodium 3'-(1-(phenylaminocarbonyl)-3,4-tetrazolium)-bis(4-methoxy-6-nitro)-benzen e sulphonic acid hydrate (XTT) and adenosine triphosphate (ATP)] and migration of WS1 cells following irradiation in the presence of hydroxyurea (HU), which is an inhibitor of proliferation. Wounded cells were irradiated on days 1 and 4 with a fluence of 5 J/cm(2) with a helium-neon (He-Ne) laser at 632.8 nm. After a repair time of 24 h, cellular responses were assessed. Wounded irradiated cells without HU showed an increase in cell viability and proliferation, which was confirmed by complete wound closure by day 4. Although wounded irradiated cells treated with 5 mM HU showed incomplete wound closure, these cells showed increased migration compared with that of control cells. This study showed that laser irradiation using an He-Ne laser with a fluence of 5 J/cm(2) stimulates cell viability. The HU results confirmed that laser irradiation promotes cell migration and proliferation.

Lasers Med Sci 2008 Jan 23 


Low level laser therapy modulates kinin receptors mRNA expression in the subplantar muscle of rat paw subjected to carrageenan-induced inflammation.

Bortone  F, Santos  HA, Albertini  R, Pesquero  JB, Costa  MS, Silva  JA Jr

Departamento de Ciencias da Reabilitacao, Centro Universitario Nove de Julho, UNINOVE. Rua Vergueiro, 235 Liberdade, CEP 01504001. Sao Paulo-SP Brazil

Low level laser therapy (LLLT) has been used clinically in order to treat inflammatory processes. In this work, we evaluated if LLLT alters kinin receptors mRNA expression in the carrageenan-induced rat paw edema. Experimental groups were designed as followed: A(1) (Control-saline), A(2) (Carrageenan-only), A(3) (Carrageenan+laser 660 nm) and A(4) (Carrageenan+laser 684 nm). Edema was measured by a plethysmometer. Subplantar tissue was collected for kinin receptors mRNA quantification by Real time-PCR. LLLT of both 660 and 684 nm wavelengths administrated 1 h after carrageenan injection was able to promote the reduction of edema produced by carrageenan. In the A(2) group, B1 receptor expression presented a significantly increase when compared to control group. Kinin B1 receptor mRNA expression significantly decreased after LLLT's 660 or 684 nm wavelength. Kinin B2 receptor mRNA expression also diminished after both laser irradiations. Our results suggest that expression of both kinin receptors is modulated by LLLT, possibly contributing to its anti-inflammatory effect.

Int Immunopharmacol 2008 Feb 8(2) 206-10


Effect of low-level laser therapy on skin fibroblasts of streptozotocin-diabetic rats.

Mirzaei  M, Bayat  M, Mosafa  N, Mohsenifar  Z, Piryaei  A, Farokhi  B, Rezaei  F, Sadeghi  Y, Rakhshan  M

Avicenna Hospital, Mazandran Medical University, Sari, Iran.

Objective: This study explored the effects of low-level laser therapy (LLLT) on cellular changes in cell culture and organ culture of skin from streptozotocin-diabetic (STZ-D) rats.

Background Data: Growth of skin and its fibroblasts are impaired in diabetes. Therefore the healing of skin wounds is impaired in diabetic patients. The positive effects of LLLT on complications of diabetes in patients and animal models have been shown.

Methods: Diabetes was induced in rats by streptozotocin 30 days after its injection. Two sets of skin samples were extracted from skin under sterile conditions. Fibroblasts that were extruded from the samples were proliferated in vitro, and another set of samples were cultured as organ culture. A 24-well culture medium containing Dulbecco's modified minimum essential medium was supplemented by 12% fetal bovine serum. There were five laser-treated and five sham-exposed groups. A helium-neon laser was used, and 0.9-4 J/cm(2) energy densities were applied four times to each organ culture and cell culture. The organ cultures were analyzed by light microscopy and transmission electron microscopy examinations. Cell proliferation was evaluated by dimethylthiazol-diphenyltetrazolium bromide (MTT) assay.

Results: Statistical analysis revealed that 4-J/cm(2) irradiation significantly increases the fibroblast numbers compared to the sham-exposed cultures (p = 0.046).

Conclusion: It is concluded that LLLT resulted in a significant increase of fibroblast proliferation of STZ-D rats in vitro.

Photomed Laser Surg 2007 Dec 25(6) 519-25


In chronic low back pain, low level laser therapy combined with exercise is more beneficial than exercise alone in the long term: a randomised trial.

Djavid, GE Mehrdad, R Ghasemi, M Hasan-Zadeh, H Sotoodeh-Manesh, A Pouryaghoub, G

Occupational Medicine, Tehran University of Medical Sciences, Tehran Iran

Question: Is low level laser therapy an effective adjuvant intervention for chronic low back pain?

Design: Randomised trial with concealed allocation, blinded assessors and intention-to-treat analysis.

Participants: Sixty-one patients who had low back pain for at least 12 weeks.

Intervention: One group received laser therapy alone, one received laser therapy and exercise, and the third group received placebo laser therapy and exercise. Laser therapy was performed twice a week for 6 weeks.

Outcome measures: Outcomes were pain severity measured using a 10-cm visual analogue scale, lumbar range of motion measured by the Schober Test and maximum active flexion, extension and lateral flexion, and disability measured with the Oswestry Disability Index on admission to the study, after 6 weeks of intervention, and after another 6 weeks of no intervention.

Results: There was no greater effect of laser therapy compared with exercise for any outcome, at either 6 or 12 weeks. There was also no greater effect of laser therapy plus exercise compared with exercise for any outcome at 6 weeks. However, in the laser therapy plus exercise group pain had reduced by 1.8 cm (95% CI 0.1 to 3.3, p = 0.03), lumbar range of movement increased by 0.9 cm (95% CI 0.2 to 1.8, p < 0.01) on the Schober Test and by 15 deg (95% CI 5 to 25, p < 0.01) of active flexion, and disability reduced by 9.4 points (95% CI 2.7 to 16.0, p = 0.03) more than in the exercise group at 12 weeks.

Conclusion: In chronic low back pain low level laser therapy combined with exercise is more beneficial than exercise alone in the long term.

Aust J Physiother 2007 53(3) 155-60


The use of light-emitting diodes to stimulate mitochondrial function and liver regeneration of partially hepatectomized rats.

Castro-E-Silva, T Castro-E-Silva, O Kurachi, C Ferreira, J Zucoloto, S Bagnato, VS

Instituto de Fisica de Sao Carlos, Universidade de Sao Paulo, Sao Carlos, SP Brasil

The biostimulating effect of laser radiation has been observed in many areas of Medicine. However, there are still several questions to be answered, among them the importance of light coherence in the stimulatory process. In the present study, we used light-emitting diodes (LED) to promote the stimulation of liver regeneration after partial hepatectomy in rats. Fourteen male Wistar rats weighing 200-250 g were submitted to partial hepatectomy (70%) followed by LED light irradiation (630 nm) of the remaining part of the liver at two doses, i.e., 10 (N = 7) and 140 (N = 7) J/cm(2). A group irradiated with laser, 590 nm (N = 7, 15 J/cm(2)) was performed for the study of proliferating cell nuclear antigen-labeling index. Data are reported as mean +/- SEM. Statistical comparisons of the groups were performed by analysis of variance for parametric measurements followed by the Bonferroni post-test, with the level of significance set at P < 0.05. Respiratory mitochondrial activity was increased in the irradiated groups (states 3 and 4; P < 0.05), with better results for the group exposed to the lower LED dose (10 J/cm(2)). The proliferating cell nuclear antigen-labeling index, by immunohistochemical staining, was similar for both LED-exposed groups (P > 0.05) and higher than for the control group (P < 0.05). The cell proliferation index obtained with LED and laser were similar (P > 0.05). In conclusion, the present results suggest that LED irradiation promotes biological stimulatory effects during the early stage of liver regeneration and that LED is as effective as laser light, independent of the coherence, divergence and cromaticity.

Braz J Med Biol Res 2007 Aug 40(8) 1065-9


Effects of Low Power Laser Irradiation on Intracellular Calcium and Histamine Release in RBL-2H3 Mast Cells.

Yang, WZ Chen, JY Yu, JT Zhou, LW

Surface Physics Laboratory (National Key Laboratory), Department of Physics, Fudan University, Shanghai China

Although laser irradiation has been reported to promote skin wound healing, the mechanism is still unclear. As mast cells are found to accumulate at the site of skin wounds we hypothesized that mast cells might be involved in the biological effects of laser irradiation. In this work the mast cells, RBL-2H3, were used in vitro to investigate the effects of laser irradiation on cellular responses. After laser irradiation, the amount of intracellular calcium ([Ca(2+)](i)) was increased, followed by histamine release, as measured by confocal fluorescence microscopy with Fluo-3/AM staining and a fluorescence spectrometer with o-phthalaldehyde staining, respectively. The histamine release was mediated by the increment of [Ca(2+)](i) from the influx of the extracellular buffer solution through the cation channel protein, transient receptor potential vanilloid 4 (TRPV4). The TRPV4 inhibitor, Ruthenium Red (RR) can effectively block such histamine release, indicating that TRPV4 was the key factor responding to laser irradiation. These induced responses of mast cells may provide an explanation for the biological effects of laser irradiation on promoting wound healing, as histamine is known to have multi-functions on accelerating wound healing.

Photochem Photobiol 2007 Jul-Aug 83(4) 979-84


The Efficacy of Linear Polarized Polychromatic Light on Burn Wound Healing: An Experimental Study on Rats.

Karadag CA, Birtane M, Aygit AC, Uzunca K, Doganay L.

Physical Medicine and Rehabilitation Department, Trakya University Medical Faculty, Edirne. Turkey

We aimed to investigate the questionable effect of linear polarized polychromatic light on burn wound healing in rats. Two deep second-degree burn wounds on the backside of each of 21 Sprague-Dawley rats were created with a standard burning procedure by applying a heated plaque. Burned regions located right dorsolaterally and classified as group I lesions were treated with linear polarized polychromatic light + open dressing + antibacterial pomade, whereas group II lesions were located left dorsolaterally and treated with only open dressing + antibacterial pomade. Macroscopic evaluation was performed for determination of the completed wound closure rate, measurement of burn wound area, and investigation of macroscopic edema, hyperemia, and epithelialization. Histopathological evaluation included monitoring of epithelialization, vascularization, origination of granulation tissue, inflammatory cell response, and total histopathological score on days 7, 14, and 21 after burn creation. Macroscopic evaluation revealed more obvious epithelialization in group I lesions between days 6 and 15. The number of completely closed wounds was higher in group I than in group II on days 16 and 21. The average area of burn wounds was lower from day 5, hyperemia was less on days 2 to 17, and edema was less from day 4 to day 13 in group I lesions. Histopathological evaluation revealed a higher rate of epithelialization on day 7 and higher vascularization occurrence on day 21 in group I lesions. Linear polarized polychromatic light seems to be effective in the treatment of burn wounds and in the promotion of healing. This may be related to linear polarized polychromatic light stimulation of epithelialization and vascularization.

J Burn Care Res. 2007 March/April;28(2):291-298.


Laser biostimulation of cartilage: in vitro evaluation.

Torricelli P, Giavaresi G, Fini M, Guzzardella GA, Morrone G, Carpi A, Giardino R.

Experimental Surgery Department, Istituto di Ricerca Codivilla-Putti, Bologna, Italy

An in vitro study was performed to evaluate the laser biostimulation effect on cartilage using a new gallium-aluminium-arsenic diode laser. Chondrocyte cultures were derived from rabbit and human cartilage. These cells were exposed to laser treatment for 5 days, using the following parameters: 300 joules, 1 watt, 100 (treatment A) or 300 (treatment B) hertz, pulsating emission for 10 minutes, under a sterile laminar flow. Control cultures (no treatment) received the same treatment with the laser device off. Cell viability was measured by MTT assay at the end of the laser treatment and then after 5 days. Neither rabbit nor human cultured chondrocytes showed any damage under a light microscope and immunostaining control following laser treatment. The MTT test results indicated a positive biostimulation effect on cell proliferation with respect to the control group. The increase in viability of irradiated chondrocytes was maintained for five days following the end of the laser treatment. The results obtained with the Ga-Al-As diode laser using the above tested parameters for in vitro biostimulation of cartilage tissues provide a basis for a rational approach to the experimental and clinical use of this device.

Biomed Pharmacother. 2001 Mar;55(2):117-20.

The influence of low-intensive laser therapy on the aggregation properties of thrombocytes in patients with peptic ulcer

Russia, Eastern Europe

The purpose of the study was to evaluate the influence of low-intensive laser therapy (LILT) on the aggregation properties of thrombocytes in patients with exacerbation of peptic ulcer (PU). The subjects, 111 patients aged 18 to 63, were divided into two groups: the main group (n = 81), and the control group (n = 30). In addition there were 15 healthy people who also underwent examination. Patients in the main group received complex treatment with untiulcer drugs and different methods of laser therapy: intravenous laser irradiation of blood, cutaneous irradiation, and a combination of both. The control group was treated with drugs only. The study found various changes in the aggregation properties of thrombocytes in patients with PU exacerbation, which consisted mostly in hyperaggregation. LILT had a normalizing effect on the aggregation properties of thrombocytes in patients of the main group.

Klin Med (Mosk), January 1, 2006; 84(2): 61-4.

Effectiveness of low-level laser therapy in temporomandibular joint disorders: a placebo-controlled study.

Fikackova, H Dostalova, T Navratil, L Klaschka, J

Institute of Biophysics and Informatics, 1st Medical Faculty., Department of Anatomy and Biomechanics, Faculties of Physical Education and Sports Czech Republic

Objective: Low-level laser therapy (LLLT) treatment for pain caused by temporomandibular joint disorders (TMD) was investigated in a controlled study comparing applied energy density, subgroups of TMD, and duration of disorders.

Background Data: Although LLLT is a physical therapy used in the treatment of musculoskeletal disorders, there is little evidence for its effectiveness in the treatment of TMD.

Methods: The study group of 61 patients was treated with 10 J/cm(2) or 15 J/cm(2), and the control group of 19 patients was treated with 0.1 J/cm(2). LLLT was performed by a GaAlAs diode laser with output of 400 mW emitting radiation wavelength of 830 nm in 10 sessions. The probe with aperture 0.2 cm(2) was placed over the painful muscle spots in the patients with myofascial pain. In patients with TMD arthralgia the probe was placed behind, in front of, and above the mandibular condyle, and into the meatus acusticus externus. Changes in pain were evaluated by self-administered questionnaire.

Results: Application of 10 J/cm(2) or 15 J/cm(2) was significantly more effective in reducing pain compared to placebo, but there were no significant differences between the energy densities used in the study group and between patients with myofascial pain and temporomandibular joint arthralgia. Results were marked in those with chronic pain. Conclusion: The results suggest that LLLT (application of 10 J/cm(2) and 15 J/cm(2)) can be considered as a useful method for the treatment of TMD-related pain, especially long lasting pain.

Photomed Laser Surg 2007 Aug 25(4) 297-303


Laser phototherapy effect on protein metabolism parameters of rat salivary glands.

Simoes A, Siqueira WL, Lamers ML, Santos MF, Eduardo CD, Nicolau J

Oral Biology Research Center, Faculty of Dentistry, University of Sao Paulo, Av. Prof. Lineu Prestes, 2227, Cidade Universitaria, Sao Paulo, SP, 05508-000, Brazil, lysimoes@usp.br.

The aim of this study was to evaluate the effects of infrared diode laser phototherapy (LP) on tissues of the submandibular gland (SMG) and parotid gland (PG). Wistar rats were randomly divided into experimental (A and B) and control (C) groups. A diode laser, 808 nm wavelength, in continuous wave mode, was applied to the PG, SMG and sublingual gland in the experimental groups on two consecutive days. The doses were 4 J/cm(2) and 8 J/cm(2), and total energy was 7 J and 14 J, respectively. The power output (500 mW) and power density (277 mW/cm(2)) were the same for both experimental groups. In order to visualize the area irradiated by the infrared laser, we used a red pilot beam (650 nm) with 3 mW maximum power for the experimental groups. For the control group, the red pilot beam was the only device used. The SMG and PG were removed after 1 week of the first irradiation. Total protein concentration, amylase, peroxidase, catalase and lactate dehydrogenase assays were performed, as well as histological analysis. Statistical tests revealed significant increase in the total protein concentration for groups A and B in the parotid glands (P < 0.05). Based on the results of this study, LP altered the total protein concentration in rats' parotid glands.

Lasers Med Sci 2008 Feb 29 


Effectiveness of laser photobiomodulation at 660 or 780 nanometers on the repair of third-degree burns in diabetic rats.

Meireles GC, Santos JN, Chagas PO, Moura AP, Pinheiro AL

Laser Center, School of Dentistry, Department of Propedeutics and Integrated Clinics, Universidade Federal da Bahia, Salvador, Brazil.

OBJECTIVE: The aim of this investigation was to compare by light microscopy the effects of laser photobiomodulation (LPBM) at lambda = 660 nm and lambda = 780 nm on third-degree burns in diabetic Wistar rats. BACKGROUND DATA: Burns are severe injuries that result in fluid loss, tissue destruction, infection, and shock, that may result in death. Diabetes is a disease that reduces the body's ability to heal properly. LPBM has been suggested as an effective method of improving wound healing.

MATERIALS AND METHODS: A third-degree burn measuring 1.5 x 1.5 cm was created in the dorsum of each of 55 animals, and they were divided into three groups that were or were not treated with LPBM (lambda = 660 nm or lambda = 780 nm, 35 mW, varphi = 2 mm, 20 J/cm(2)). The treatments were started immediately post-burn at four points within the burned area (5 J/cm(2)) and were repeated at 24-hour intervals over 21 d. The animals were humanely killed after 3, 5, 7, 14, and 21 d by an overdose of intraperitoneal general anesthetic. The specimens were routinely cut and stained and analyzed by light microscopy.

RESULTS: We found that healing in the animals receiving 660-nm laser energy was more apparent at early stages, with positive effects on inflammation, the amount and quality of granulation tissue, fibroblast proliferation, and on collagen deposition and organization. Epithelialization and local microcirculation were also positively affected by the treatment.

CONCLUSION: The use of 780-nm laser energy was not as effective as 660-nm energy, but it had positive effects at early stages on the onset and development of inflammation. At the end of the experimental period the primary effect seen was on the amount and quality of the granulation tissue. The 660-nm laser at 20 J/cm(2), when used on a daily basis, was more effective than the 780-nm laser for improving the healing of third-degree burns in the diabetic rats beginning at the early stages post-burn.

Photomed Laser Surg 2008 Feb 26(1) 47-54


Effects of laser therapy on experimental wound healing using oxidized regenerated cellulose hemostat.

Soares LP, Oliveira MG, Pinheiro AL, Fronza BR, Maciel ME

Laser Center, Faculty of Dentistry, Federal University of Bahia (UFBA), Salvador, Brazil. liviaps@oi.com.br

OBJECTIVE: The aim of this paper was to evaluate if the healing of wound sites containing oxidized regenerated cellulose hemostat can be optimized by laser therapy.

BACKGROUND DATA: Topical hemostatic agents may be used to control bleeding in a variety of surgical sites. Hemostatic oxidized regenerated cellulose can cause strange body reactions and formation of granulomas.

MATERIALS AND METHODS: Thirty-six male Wistar rats averaging 6 wk of age, weighing 250 g each, were anesthetized had a standard 0.5-cm(2) block of oxidized regenerated cellulose (Surgicel) inserted into an incision on the back of the tongue. Postoperatively the animals were randomly divided into two groups of 18 animals each: one was irradiated and one was not irradiated (control). In the treatment group, transmucosal laser therapy was applied in one area (Ga-Al-As laser, 4 J/cm(2), lambda = 685 nm, 35 mW, varphi = 0.06 mm) and consisted of four sessions, with one session carried out every 48 h. The animals were killed at three different times: G1 (1 d), G2 (3 d), and G3 (7 d). Tissues were stained with hematoxylin and eosin and then analyzed.

RESULTS: It was observed that the treated group exhibited a greater reduction in edema and inflammatory infiltrate.

CONCLUSIONS: These results suggest that laser therapy at 685 nm could improve the healing process, even when the inflammatory process has been stimulated by oxidized regenerated cellulose hemostat.

Photomed Laser Surg 2008 Feb 26(1) 10-3


Comparison between the effect of low-level laser therapy and low-intensity pulsed ultrasonic irradiation in vitro.

De Oliveira RF, Oliveira DA, Monteiro W, Zangaro RA, Magini M, Soares CP

Laboratorio de Dinamica de Compartimento Celular, Instituto de Pesquisa e Desenvolvimento (IP&D), UNIVAP, Sao Jose dos Campos, Sao Paulo, Brazil.

OBJECTIVE: The objective of this study was to compare the effect of low-level laser therapy (LLLT) and low-intensity pulsed ultrasound (LIPUS) on fibroblast cell culture. Several methods, including ultrasound treatment and LLLT, are being used to facilitate tissue repair and healing processes.

MATERIALS AND METHODS: L929 fibroblast cell cultures were irradiated with low-level laser energy and LIPUS. Cultures irradiated with ultrasound were divided into five groups: group 1: control (did not receive irradiation); group 2: 0.2 W/cm(2) in pulsed mode at 10% (1:9 duty cycle); group 3: 0.6 W/cm(2) in pulsed mode at 10% (1:9 duty cycle); group 4: 0.2 W/cm(2) in pulsed mode at 20% (2:8 duty cycle); and group 5: 0.6 W/cm(2) in pulsed mode at 20% (2:8 duty cycle). Cultures irradiated with laser energy were divided into three groups: group 1: control (did not receive irradiation); group 2: 6 J/cm(2); and group 3: 50 mJ/cm(2). Each group was irradiated at 24-h intervals, with the following incubation periods post-irradiation: 24, 48, and 72 h; after each irradiation cycle the cultures were analyzed using MTT [3-(4.5-dimethylthiazol-2-yl)-2.5 diphenyltetrazolium bromide].

RESULTS: Analysis of results after LLLT and LIPUS demonstrated that the effect of laser therapy on fibroblast cell culture was greater than that of LIPUS (p < 0.05).

CONCLUSION: Results demonstrated that LLLT significantly increased fibroblastic activity more than LIPUS. Therefore, in the first and second phases of tissue repair, laser treatment may be more effective than ultrasound treatment.

Photomed Laser Surg 2008 Feb 26(1) 6-9


Effect of low-level laser therapy on mast cells in second-degree burns in rats.

Vasheghani MM, Bayat M, Rezaei F, Bayat A, Karimipour M

Paramedical Faculty, Shaheed Beheshti University, M.C., Tehran, Iran.

OBJECTIVE: This study sought to investigate whether low-level laser therapy (LLLT) with a helium-neon (He-Ne) laser would affect mast cell number and degranulation in second-degree burns in rats.

Background Data: LLLT has been recently applied to stimulate the wound healing process.

MATERIALS AND METHODS: Sixty-five rats were randomly allocated to one of five groups. A deep second-degree burn was inflicted on all rats except those in the control group. In the sham-exposed group burns remained untreated. In the two laser-treated groups, the burns were irradiated every day by LLLT, with energy densities of 1.2 and 2.4 J/cm(2). In the fifth group the burns were treated topically with 0.2% nitrofurazone cream every day. The unburned skin of the rats in the control group were used for baseline study. The effects on mast cell number and degranulation were assessed by counting the number of intact and degranulated mast cells in sections fixed in formalin and stained with toluidine blue.

RESULTS: On the seventh and 16th days post-burn, the type 1 mast cell count in the 2.4-J/cm(2) laser-treated group was significantly higher than that of the control group. On the 30th day, the total numbers of mast cells in the laser-treated groups were lower than those in the control and sham-exposed groups.

CONCLUSION: LLLT of deep second-degree cutaneous burns in rats significantly increased the number of intact mast cells during the inflammatory and proliferative phases of healing, and decreased the total number of mast cells during the remodeling phase.

Photomed Laser Surg 2008 Feb 26(1) 1-5


The short-term efficacy of laser, brace, and ultrasound treatment in lateral epicondylitis: a prospective, randomized, controlled trial.

Oken O, Kahraman Y, Ayhan F, Canpolat S, Yorgancioglu ZR, Oken OF

Ankara Education and Research Hospital, Department of Physical Medicine and Rehabilitation, Division of Hand Rehabilitation, Ankara, Turkey. okenoznur@yahoo.com

The aims of this study were to evaluate the effects of low-level laser therapy (LLLT) and to compare these with the effects of brace or ultrasound (US) treatment in tennis elbow. The study design used was a prospective and randomized, controlled, single-blind trial. Fifty-eight outpatients with lateral epicondylitis (9 men, 49 women) were included in the trial. The patients were divided into three groups: 1) brace group-brace plus exercise, 2) ultrasound group-US plus exercise, and 3) laser group-LLLT plus exercise. Patients in the brace group used a lateral counterforce brace for three weeks, US plus hot pack in the ultrasound group, and laser plus hot pack in the LLLT group. In addition, all patients were given progressive stretching and strengthening exercise programs. Grip strength and pain severity were evaluated with visual analog scale (VAS) at baseline, at the second week of treatment, and at the sixth week of treatment. VAS improved significantly in all groups after the treatment and in the ultrasound and laser groups at the sixth week (p<0.05). Grip strength of the affected hand increased only in the laser group after treatment, but was not changed at the sixth week. There were no significant differences between the groups on VAS and grip strength at baseline and at follow-up assessments. The results show that, in patients with lateral epicondylitis, a brace has a shorter beneficial effect than US and laser therapy in reducing pain, and that laser therapy is more effective than the brace and US treatment in improving grip strength.

J Hand Ther 2008 Jan-Mar 21(1) 63-7; quiz 68


Acquired perforating dermatosis associated with primary biliary cirrhosis and hashimoto thyroiditis.

Chiu, MW Haley, JC

Division of Dermatology, Department of Medicine, David Geffen School of Medicine at UCLA, Los Angeles, CA 90095 USA

Acquired perforating dermatosis (APD) is an uncommon skin eruption of unclear etiology that most often is associated with diabetes mellitus or chronic renal insufficiency. There are rare reports of APD in association with liver disease or thyroid disease. We report a case of APD in a patient with both primary biliary cirrhosis and Hashimoto thyroiditis in the absence of diabetes mellitus and chronic renal insufficiency. The patient had a partial response to narrowband UVB phototherapy.

Cutis 2007 Jun 79(6) 451-5


Red blood cell membrane as object of influence of physiotherapeutic factors

The authors presented in the article the survey of literature data and own observations on the influence of the most practiced therapeutic physical factors (electrical, ultrasound and light) on red blood cell membrane. Low intensive laser makes an impact on protein-lipid interactions in membranes of red blood cells, has antioxidant effect and improves the function of red blood cells. It proves the use of laser irradiation in the treatment of different diseases. Heat liberation and cavitation are the most important factors of ultrasound effect on red blood cell membrane. It was established by the method of the correlation spectroscopy that direct and alternating current at its 0.22 mA/cm density decreases the diameter of monomolecular protein globules of human serum albumin. This effect is seen increased under the augmentation of exposure time and current strength. Obtain results show direct effect of the electric current on albumin as well as protein component of blood cell membrane that may be of importance in molecular mechanisms of treatment effects of this physiotherapy factor. The effect of laser irradiation, ultrasound and electrical current depend on the intensity and the duration of the effect. Clarification of the effects of molecular mechanisms on red blood cell membrane may help to develop effective physiotherapeutic technologies to use in different areas of medicine.

Lik Sprava 2007 Jan-Mar (1-2) 3-9


Local phototherapy and pulse current in complex treatment of relapsing herpes simplex.

Tsiskarishvili  NV, Tsiskarishvili  NI, Tsiskarishvili  TsI

Tbilisi State Medical University, Department of dermatology and venereology. Georgia, Eastern Europe

The efficacy of the complex treatment of recurrent herpes simplex by means of photo-activated antivirus system in combination with the method of pulse current has been evaluated. 17-52 years old 36 patients with herpes simplex (20 female and 16 male) were under clinical observation. Diagnosis was determined on the basis of patients' complaints and clinical signature. Duration of illness was in the range of 5-37 years and the duration of exacerbations - 7-14 days. Patients were randomly divided into two representative groups (18 patients in each). Patients of the first group undergoing one-time local phototherapy. Patients of the second group were treated by pulse current exposure two-three times a week additionally. Total duration of each exposure was 30-40 minutes. It is concluded that the medical methods based on the application based on the energy may be considered as an alternative of pharmacological approach.

Georgian Med News 2007 Nov (152) 31-4


Complex therapy of irritative voiding disorders after transurethral resection of the prostate and adenomectomy

Rehabilitation therapy was performed in 5 groups (n=122) of patients operated for prostatic adenoma (TUR of the prostate, transvesical prostatectomy) and having postoperative marked irritative miction disorders. Group 1 received antibacterial therapy (AT); group 2-- AT+alpha-adrenoblockers; group 3-- AT+transrectal laser and magnetic physiotherapy; group 4-- AT+alpha-adrenoblockers+transrectal laser and magnetic physiotherapy; group 5-- AT+prostatotropic phytotherapy (gentos). The worst result was achieved in group 1, the best one--in groups 3 and 4. Thus, adjuvant physiotherapy inclusion in the complex of postoperative rehabilitation of patients operated for prostatic adenoma is justified as it improves treatment efficacy.

Urologiia 2007 Jul-Aug (4) 41-4


Light therapy and advanced wound care for a neuropathic plantar ulcer on a charcot foot.

Sutterfield R

Christian Hospital NE, St. Louis, Missouri 63136, USA. retta@fidnet.com

Light therapy is a relatively novel modality in wound care. I used a light-emitting diode (LED) and superluminous diode (SLD) to deliver low-intensity laser light as an adjunctive treatment to a patient with a chronic diabetic foot ulcer. Standard treatment of conservative sharp debridement, off-loading, bioburden management, and advanced dressings was delivered in a WOC clinic setting. This combination of therapies resulted in closure of the neuropathic plantar ulcer within 8 weeks.


Initial effects of low-level laser therapy on growth and differentiation of human osteoblast-like cells.

Stein E, Koehn J, Sutter W, Wendtlandt G, Wanschitz F, Thurnher D, Baghestanian M, Turhani D

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

Low-level laser therapy is a clinically well established tool for enhancement of wound healing. In vitro studies have also shown that low level laser therapy has a biostimulatory effect on cells of different origin. The aim of this in vitro study was to investigate the initial effect of low-level laser therapy on growth and differentiation of human osteoblast-like cells. SaOS-2 cells were irradiated with laser doses of 1 J/cm(2) and 2 J/cm(2) using a diode laser with 670 nm wave length and an output power of 400 mW. Untreated cells were used as controls. At 24 h, 48 h and 72 h post irradiation, cells were collected and assayed for viability of attached cells and alkaline phosphatase specific activity. In addition, mRNA expression levels of osteopontin and collagen type I were assessed using semi-quantitative RT-PCR. Over the observation period, cell viability, alkaline phosphatase activity and the expression of osteopontin and collagen type I mRNA were slightly enhanced in cells irradiated with 1 J/cm(2) compared with untreated control cells. Increasing the laser dose to 2 J/cm(2) reduced cell viability during the first 48 h and resulted in persistently lower alkaline phosphatase activity compared with the other two groups. The expression of osteopontin and collagen type I mRNA slightly decreased with time in untreated controls and cells irradiated with 1 J/cm(2), but their expression was increased by treatment with 2 J/cm(2) after 72 h. These results indicate that low-level laser therapy has a biostimulatory effect on human osteoblast-like cells during the first 72 h after irradiation. Further studies are needed to determine the potential of low-level laser therapy as new treatment concept in bone regeneration.

Wien Klin Wochenschr 2008 Feb 120(3-4) 112-117


Patients with tuberculosis associated with chronic non-specific lung diseases

Nikolaieva OD

159 patients have been observed to assess the efficiency of laseropuncture use in a complex treatment of patients with lung tuberculosis and chronic bronchitis. Disbalance in renal meridian (R), urinary bladder (V) and insufficiency of the energy in colon meridian (60.3%) were observed in patients with tuberculosis associated with chronic bronchitis. Medium deviations of electro-skin conductivity from the physiological gape in meridians of GI, IG, F, V, R in patients with tuberculosis associated with chronic bronchitis considerably differ from those data obtained from patients with only tuberculosis. Obtained data testify more severe disorders of energy balance in meridians of patients having except tuberculosis other associated diseases. Medium parameters of deviations from the physiological gape considerably decrease after the course of laseropuncture compared with those patients treated traditionally. Improve of the course of the chronic bronchitis was noted in patients who underwent laseropuncture.

Lik Sprava 2007 Apr-May (3) 42-6


Rehabilitation in the first 48 hours after surgery.

Shumway R

Animal Medical Center, New York, New York 10021, USA. renee.shumway@amcny.org

Physical therapy is commonly used postoperatively in humans to decrease pain, inflammation and recovery time. The same goals can be achieved in our veterinary patients using similar modalities such as; cryotherapy, passive range of motion, massage, transcutaneous electrical stimulation and low-level light laser therapy. When used in the first 48 hours following surgery, the reduction in pain, increased mobility, and decreased inflammation will aid in early return to normal function. Applied appropriately these treatments have both immediate and long term benefits.

Clin Tech Small Anim Pract 2007 Nov 22(4) 166-70


Select modalities.

Canapp DA

Veterinary Orthopedic and Sports Medicine Group, Ellicott City, MD 21042, USA. dcanapp@vetsportsmedicine.com

Physical rehabilitation modalities such as therapeutic ultrasound (TU), transcutaneous electrical neuromuscular stimulation (TENS), neuromuscular electrical stimulation (NMES), cold or low-level laser therapy (LLLT), and pulsed magnetic field therapy (PMF) can all, when used properly, assist in treating orthopedic injuries, neurological conditions, and chronic conditions brought about by normal aging in our small animal companions. TU uses sound waves to produce both thermal and nonthermal effects that aid in tissue healing, repair, and function. TENS uses different frequencies of electrical current to decrease pain and inflammation. NMES also uses an electrical current to stimulate muscle contraction to assist in normal neuromuscular function in postorthopedic and neurological injuries. LLLT uses light energy to reduce pain, decrease inflammation, and stimulate healing at a cellular level. PMF uses magnetic field to stimulate normal cellular ion exchange and oxygen utilization and promote generalized healing of tissues. These modalities are discussed in detail covering mechanism of action, parameters, settings, and indications/contraindications of use in our small animals. Although these modalities are important in the physical rehabilitation of small animals, they need to be incorporated with a proper diagnosis, manual therapy, and home exercise program into a specific and individualized patient treatment protocol.

Clin Tech Small Anim Pract 2007 Nov 22(4) 160-5


Pulsed dye laser for the treatment of hypergranulation tissue with chronic ulcer in postsurgical defects.

Wang SQ, Goldberg LH

Department of Medicine, Dermatology Service, Memorial Sloan Kettering Cancer Center, New York, NY 07920, USA. wangs@mskcc.org

BACKGROUND AND OBJECTIVE: Hypergranulation tissue may complicate postoperative wounds, causing them to become chronic nonhealing ulcers. There is no reliably effective treatment. We report the use of the 595-nm pulsed-dye laser (PDL) for the treatment of wounds healing by second intention and complicated by hypergranulation tissue after Mohs micrographic surgery.

METHODS: In a retrospective case review, 9 patients with slow-healing or nonhealing postoperative wounds with hypergranulation tissue were treated with the 595-nm PDL. The majority of the wounds were located on the scalp, forehead, and temple.

RESULTS: All of the patients demonstrated dramatic improvement after one treatment. Most patients achieved complete or near complete re-epithelialization of the ulcers after 1 to 2 treatments. The PDL treatment required no local anesthesia, and there were no postlaser treatment complications reported.

CONCLUSIONS: The 595-nm PDL is an effective, safe, and reliable treatment to promote second intention healing in postsurgical wounds complicated by the formation of hypergranulation tissue.

J Drugs Dermatol 2007 Dec 6(12) 1191-4


Fiber-coupled light-emitting diode for localized photostimulation of neurons expressing channelrhodopsin-2.

Campagnola L, Wang H, Zylka MJ

Department of Cell and Molecular Physiology, 5109A NRB, CB #7545, 115 Mason Farm Road, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599-7545, United States.

Channelrhodopsin-2 (ChR2) is a blue-light-gated ion channel that can be used to stimulate genetically defined neurons reproducibly, rapidly and non-invasively. Existing approaches for delivering light to cells expressing ChR2 rely upon microscopes, lasers, arc lamps and shutters, all of which are relatively expensive and are not readily scalable for use on more than one brain region or animal at a time. In this paper, we describe an inexpensive method for delivering blue light locally and with millisecond precision to cells expressing ChR2. We accomplished this by coupling the light from a high-intensity blue light-emitting diode (LED; XLamp XR-E from CREE) into an optical fiber. When positioned in proximity to ChR2-expressing HEK293 cells, this fiber-coupled LED provided localized illumination of up to 32mW/mm(2) and generated ChR2 photocurrents as efficiently as wide-field mercury arc lamp illumination. This fiber-coupled LED was also used to photostimulate action potentials in ChR2-expressing dorsal root ganglia (DRG) sensory neurons. LED light power and pulse frequency were controlled with an inexpensive, custom-built amplifier circuit. This scalable fiber-coupled LED system can be used to deliver light independent of the microscope objective and could, in principle, deliver light in parallel to multiple brain regions or to multiple genetically engineered animals.

J Neurosci Methods 2008 Mar 30 169(1) 27-33


Fiber-coupled light-emitting diode for localized photostimulation of neurons expressing channelrhodopsin-2.

Campagnola  L, Wang  H, Zylka  MJ

Department of Cell and Molecular Physiology, 5109A NRB, CB #7545, 115 Mason Farm Road, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599-7545 USA

Channelrhodopsin-2 (ChR2) is a blue-light-gated ion channel that can be used to stimulate genetically defined neurons reproducibly, rapidly and non-invasively. Existing approaches for delivering light to cells expressing ChR2 rely upon microscopes, lasers, arc lamps and shutters, all of which are relatively expensive and are not readily scalable for use on more than one brain region or animal at a time. In this paper, we describe an inexpensive method for delivering blue light locally and with millisecond precision to cells expressing ChR2. We accomplished this by coupling the light from a high-intensity blue light-emitting diode (LED; XLamp XR-E from CREE) into an optical fiber. When positioned in proximity to ChR2-expressing HEK293 cells, this fiber-coupled LED provided localized illumination of up to 32mW/mm(2) and generated ChR2 photocurrents as efficiently as wide-field mercury arc lamp illumination. This fiber-coupled LED was also used to photostimulate action potentials in ChR2-expressing dorsal root ganglia (DRG) sensory neurons. LED light power and pulse frequency were controlled with an inexpensive, custom-built amplifier circuit. This scalable fiber-coupled LED system can be used to deliver light independent of the microscope objective and could, in principle, deliver light in parallel to multiple brain regions or to multiple genetically engineered animals.

J Neurosci Methods 2007 Nov 26 


Mechanistic study of apoptosis induced by high-fluence low-power laser irradiation using fluorescence imaging techniques.

Wu  S, Xing  D, Wang  F, Chen  T, Chen  WR

MOE Key Laboratory of Laser Life Science and Institute of Laser Life Science, Guangzhou 510631, China.

Low-power laser irradiation (LPLI) can cause cell proliferation, differentiation, or death; however, the cellular mechanisms of these effects of LPLI, at high or low fluences, are not well known. To investigate the mechanism of high-fluence LPLI-induced apoptosis, both human lung adenocarcinoma cells (ASTC-a-1) and African green monkey SV40-transformed kidney fibroblast cells (COS-7) were irradiated with a He-Ne laser for 10 min under a fluence of 120 Jcm(2) and 80 Jcm(2), respectively. The dynamics of reactive oxygen species (ROS) generation was determined by measuring changes in fluorescence resulting from oxidation of intracellular dichlorodihydrofluorescein diacetate (H(2)DCFDA) to (DCF). The changes of mitochondrial membrane potential, DeltaPsim, were studied by measuring the reduction of cellular fluorescence of Rhodamine 123 dyes using confocal laser scanning microscopy. The activation of caspase-3 in cells transfected by [SCAT3] reporters was observed using fluorescence resonance energy transfer (FRET) imaging. The activity of caspase-8 during high-fluence LPLI-induced apoptosis was studied by monitoring the cellular distribution of [Bid-CFP] reporters using fluorescence imaging. The following temporal sequence of cellular events was observed during apoptosis induced by high-fluence LPLI (120 Jcm(2), ASTC-a-1 cells): (1) immediate generation of mitochondrial ROS following laser irradiation, reaching a maximum level 60 min after irradiation; (2) onset of DeltaPsim decrease 15 min after laser irradiation, reaching a minimum level 50 min after irradiation; and (3) activation of caspase-3 between 30 min and 180 min after laser irradiation. Our results also show that the high-fluence LPLI does not activate caspase-8, indicating that the induced apoptosis was initiated directly from mitochondrial ROS generation and DeltaPsim decrease, independent of the caspase-8 activation.

J Biomed Opt 2007 Nov-Dec 12(6) 064015


Effectiveness of helium-neon laser irradiation on viability and cytotoxicity of diabetic-wounded fibroblast cells.

Houreld  NN, Abrahamse  H

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

Objective: This study investigated the effectiveness of helium-neon (He-Ne) laser irradiation at increasing intervals on diabetic-induced wounded human skin fibroblast cells (WS1) at a morphological, cellular, and molecular level.

Background Data: The controversies over light therapy can be explained by the differing exposure regimens and models used. No therapeutic window for dosimetry and mechanism of action has been determined at the level of individual cell types, particularly in diabetic cells in vitro.

Methods: WS1 cells were used to simulate an in vitro wounded diabetic model. The effect of the frequency of He-Ne irradiation (632.8 nm) at a fluence of 5 J/cm(2) was determined by analysis of cell morphology, viability, cytotoxicity, and DNA damage. Cells were irradiated using three different protocols: they were irradiated at 30 min only; irradiated twice, at 30 min and at 24 h; or irradiated twice, at 30 min and at 72 h post-wound induction.

Results: A single exposure to 5 J/cm(2) 30 min post-wound induction increased cellular damage. Irradiation of cells at 30 min and at 24 h post-wound induction decreased cellular viability, cytotoxicity, and DNA damage. However, complete wound closure as well as an increase in viability and a decrease in cytotoxicity and DNA damage occurs when cells were irradiated at 30 min and at 72 h post-wound induction.

Conclusions: Wounded diabetic WS1 cells irradiated to 5 J/cm(2) showed increased cellular repair when irradiated with adequate time between irradiations, allowing time for cellular response mechanisms to take effect. Therefore, the irradiation interval was shown to play an important role in wound healing in vitro and should be taken into account.

Photomed Laser Surg 2007 Dec 25(6) 474-81


Effect of Low-Level Laser Therapy on Inflammatory Reactions during Wound Healing: Comparison with Meloxicam.

Viegas  VN, Abreu  ME, Viezzer  C, Machado  DC, Filho  MS, Silva  DN, Pagnoncelli  RM

School of Dentistry, Laser Center, Pontificia Universidade Catolica do Rio Grande do Sul (PUCRS), Porto Alegre, RS, Brazil.

Objective: This study evaluated the action of low-level laser therapy (LLLT) on the modulation of inflammatory reactions during wound healing in comparison with meloxicam.

Background Data: LLLT has been recommended for the postoperative period because of its ability to speed healing of wounds. However, data in the literature are in disagreement about its anti-inflammatory action.

Methods: Standardized circular wounds were made on the backs of 64 Wistar rats. The animals were divided into four groups according to the selected postoperative therapy: group A-control; group B-administration of meloxicam; and groups C and D-irradiation with red (lambda = 685 nm) and infrared (lambda = 830 nm) laser energy, respectively. The animals were killed at 12, 36, and 72 h and 7 days after the procedure.

Results: Microscopic analysis revealed significant vascular activation of irradiated sites in the first 36 h. Only group B showed decreases in the intensity of polymorphonuclear infiltrates and edema. Group D showed a higher degree of organization and maturation of collagen fibers than the other groups at 72 h. The animals in group C showed the best healing pattern at 7 days. The anti-inflammatory action of meloxicam was confirmed by the results obtained in this research. The quantification of interleukin-1beta (IL-1beta) mRNA by real-time polymerase chain reaction (PCR) did not show any reduction in the inflammatory process in the irradiated groups when compared to the other groups.

Conclusions: LLLT improves the quality of histologic repair and is useful during wound healing. However, with the methods used in this study the laser energy did not minimize tissue inflammatory reactions.

Photomed Laser Surg 2007 Dec 25(6) 467-73


Complex treatment of venous trophic ulcers of the lower extremities

[No authors listed]

Under observation there were 189 patients with trophic ulcers of the lower extremities of venous genesis (CEAP VI class). In 78 patients conservative treatment was used with the low intensity laser radiation. Complex treatment consisted of preliminary preparing the ulcers and the following correction of the venous blood flow was used in 111 patients. 82 patients were treated by traditional methods disregarding the data of ultrasonic diagnosis. Laser therapy of ulcers by our original techniques and correction of the venous blood flow using new technologies and considering the data of duplex scanning was used in 29 patients, the best nearest and long-term results of the treatment being obtained in patients of this clinical group.

Vestn Khir Im I I Grek 2007 166(5) 24-7


Low intensity laser therapy is comparable to bromocriptine-evening primrose oil for the treatment of cyclical mastalgia in Egyptian females.

Saied  GM, Kamel  RM, Dessouki  N

Department of General Surgery, Faculty of Medicine, Cairo University, Egypt.

One of the successful treatments for cyclical mastalgia is bromocriptine evening primrose combination. A double blind study was applied on 80 patients with cyclical mastalgia. They were randomly divided into two groups (A and B). In group A, patients were treated by bromocriptine/evening primrose. To group B, LILT with specified dosimetry was applied, using a device that delivers He-Ne laser combined with 4 infra-red diode laser. Evaluation of treatment was both subjective (using VAS) and objective (studying the degree of drop in plasma cortisol level). The drop of plasma cortisol with treatment was studied using the student -t distribution. A good response was observed in the laser group in 82.5%, compared to 63.9% in the bromocriptine/evening primrose group. There was a significant deference before and after treatment in both groups (P<0.05). This difference was more for the drug treated group than for the laser treated group, but in the latter, it acted on a wider sector of patients. In conclusion, LILT is recommended as a new treatment modality for cyclical mastalgia.

Tanzan Health Res Bull 2007 Sep 9(3) 196-201


The effectiveness of PUVA treatment in severe psoriasis is significantly increased by additional UV 308-nm excimer laser sessions.

Trott  J, Gerber  W, Hammes  S, Ockenfels  HM

Department of Dermatology and Allergology, Klinikum Hanau, Leimenstrasse 20, 63450 Hanau, Germany. hautklinikum-hanau@ndh.net.

In most cases, patients with moderate to severe psoriasis are treated with narrow-band UVB phototherapy or with psoralen UVA (PUVA-) photochemotherapy. This UV-radiation is given to the whole skin, including unaffected skin. Normally, these two PUVA- and UVB-radiation procedures cannot be combined on account of the phototherapeutic side-effects on unaffected skin. The 308-nm excimer laser has been shown to be safe and effective in the treatment of localized mild-to-moderate plaque-type psoriasis whilst sparing healthy skin. Our aim was to compare the therapeutic response to PUVA plus up to 4 UVB308-nm radiations and PUVA monotherapy in patients with moderate-severe plaque-type psoriasis. 272 hospitalized adult patients were enrolled on this prospective random study. 256 patients completed the full course of treatment. PUVA treatment was given 4 times weekly to all patients. 123 patients received PUVA as a monotherapy. During the first two weeks, 149 patients were additionally treated up to four times with 308-nm excimer-derived UVB on the affected skin and treatment was evaluated for its efficacy, duration, number of times necessary for complete (CR) or partial remission (PASI reduction > 90 or > 50%, respectively), cumulative light dose, side effects of therapy and duration of remission after therapy. Statistically, there is no significant difference when comparing the efficacy of PUVA (CR 67.3%) and PUVA plus excimer (CR 63.6%). On average, patients treated by the combination method went into remission in half the treatment time (15 +/- 6 versus 27 +/- 7 days) and with half the cumulative UVA dose (22.9 +/- 5.8 versus 53.2 +/- 26.3), p < 0.05. In conclusion, skin heals considerably quicker when treated with a combination of photochemotherapy and a short course of UVB 308 nm laser treatment applied directly to the affected skin, resulting in a shorter hospital stay and quicker rehabilitation of patients with moderate-severe psoriasis.

Eur J Dermatol 2008 Jan 4 18(1) 55-60


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