Journal of Lasers in Medical Sciences

Introduction: Carpal tunnel syndrome (CTS) is the most common type of peripheral entrapment neuropathy that occurs in the wrist area in a space called the carpal tunnel. Low-level laser therapy (LLLT) and ultrasound are among the most common methods of physical modalities for treating CTS; the effectiveness of these two methods and superiority of one over the other is not agreed among experts.

Methods: In present systematic review and meta-analysis study, the most important databases including PubMed, Cochrane Library, Scopus, Centre for Reviews and Dissemination, Science Direct, Trip Medical Database, and Google Scholar were searched using appropriate keywords and specific strategies without time limitation to collect data. The collected data was analyzed using meta-analytic method and random effects model. The heterogeneity among studies was examined using I². The data was analyzed using Review Manager Software.

Results: From among 108 related studies, 49 cases were entered in the first stage. After the final examination, 6 studies were selected for meta-analysis. The total number of patients in these six studies was 403; 204 subjects were in the LLLT group and 199 subjects were in the ultrasound group. The results of meta-analyses showed that there was no significant difference between these two therapeutic methods in terms of pain relief, symptom severity scale (SSS), functional status scale (FSS), motor latency, sensory latency, handgrip strength, and motor amplitude.

Conclusion: Based on meta-analyses, there was no significant difference between two LLLT and ultrasound methods; in other words, they had similar effectiveness in improving the condition of patients with CTS. However, the authors believed that arriving at conclusions in this area requires high-quality and large size studies.

Introduction: Different molecular approaches have contributed to find various response of skin to external and internal tensions such as laser irradiation and many important mediators of skin disease have been identified through these approaches. However different essential signals of skin biomarker pathways and proteins partially detected or completely unknown. In the present study impact of proteomics in the evaluation of laser therapy of skin is investigated.

Methods: Keywords of “Proteomics”, Laser therapy”, “Skin”, and “Skin disease” searched in Google Scholar, Scopus and PubMed search engines. After screening, 53 documents were included in the study.

Results: Global assessments revealed that different proteins in different signaling pathways of skin metabolism in terms of health or illness after laser therapy are expressed differentially. Results indicated that application of proteomics is a useful method to promote the results of laser interventions.

Conclusion: This kind of researches deals with practical proteomics of skin and could supply an essential skip to understand skin diseases to develop more suitable therapeutic achievements in laser application.

Introduction: The purpose of this study is to investigate the effect of a low-power laser on the proliferation, migration, differentiation of different types of mesenchymal stem cells (MSCs) in different studies.

Methods: The relevant articles that were published from 2004 to 2019 were collected from the sources of PubMed, Scopus, and only the articles specifically examining the effect of a low-power laser on the proliferation, differentiation, and migration of the MSCs were investigated.

Results: After reviewing the literature, only 42 articles were found relevant. Generally, most of the studies demonstrated that different laser parameters increased the proliferation, migration, and differentiation of the MSCs, except the results of two studies which were contradictory. In fact, changing the parameters of a low-power laser would affect the results. On the other hand, the source of the stem cells was reported as a key factor. In addition, the combination of lasers with other therapeutic approaches was found to be more effective.

Conclusion: The different parameters of lasers has been found to be effective in the proliferation, differentiation, and migration of the MSCs and in general, a low-power laser has a positive effect on the MSCs, helping to improve different disease models.

There are several types of surgeries which use lasers in the operating room. Surgeons use lasers in general surgery or surgical specialties to cut, coagulate, and remove tissue. In modern medicine, the application of laser therapy is an attractive subject due to its minimal invasive effect. Today lasers are widely used in the treatment and diagnosis of many diseases such as various cancers, lithotripsy, ophthalmology, as well as dermatology and beauty procedures. Depending on the type of lasers, the wavelength and the delivery system, most lasers have replaced conventional surgical instruments for better wound healing results. Over time, by using many different tools and devices, new lasers have been created; as a result, they are used in a wide range of medical special cases. In this review, laser applications in surgery and its beneficial effects compared to previous surgeries with the aim of providing appropriate therapeutic and non-invasive solutions with minimal side effects after surgery are investigated.

Introduction: Mechanism of Laser therapy and also its safety are two important features of application of different types of laser in medicine. Aim of this study is investigating the critical affected genes after treatment of squamous cell carcinoma patients.

Methods: Gene expression profiles of 4 squamous cell carcinoma patients that are treated via chemoradiotherapy plus laser relative to the 3 similar patients without laser exposure from Gene Expression Omnibus (GEO) are downloaded and are screen to find critical genes via network analysis. STRING database, Cytoscape software, and Clue GO plug in of Cytoscape software are used.  

Results: The genes; HSX70 and NCC27 as neighbors and HSPA1B, CLIC1, RAB13, PPIF, and LCE3D were determined as hub genes. Over-expression of LCE3D was interpreted as side effect of laser therapy. Apoptosis and cell cycle were the dominant biological processes that regulated by the HSP molecules in laser treated patients.

Conclusion: Laser was effected the main biological processes and simultaneously issued side effects.

Objective: This case series describes successful management grade 3 burn ulcers in 10 diabetic patients using Autologous Fibroblast Transplantation along with Low-Level Laser Therapy.

Background: Low Level Laser Therapy (LLLT) has been used as an effective therapeutic modality since the mid sixties. Although there are several clinical studies using LLLT in wound healing especially diabetic, pressure and venous ulcers, but there are rare reports of using this technique in burn ulcers. In this study for the first time we used LLLT along with antilogous fibroblast skin transplantation to treat grade 3 burn ulcers in diabetic patients.

Materials and Methods: Ten diabetic patients with grade 3 burn ulcer, candidate for skin graft surgery entered the study. 1 Cm² was biopsied using punch. Fibroblasts were extracted and cultured in-vitro. Patients were treated using LLLT in 3-4 weeks that took time that fibroblast cultures become ready to use. Laser irradiation was done using red red light, 650 nm, 150 mW, 1 J/ cm²  for the bed of the ulcer and infra red light 808 nm, 200 mW, 6 J/ cm² for the margins every other day for 10 sessions. Then a thin layer of fibroblast suspension was applied to the base of ulcer using sterile sampler and its surface was covered by Vaseline gauze.

Result: All patients healed completely in 10-12 weeks. No adverse effects were reported.

Conclusion: We conclude that this method can be used as an effective method for treating large wounds especially in complicated patients including diabetics.

Introduction: Cross-contamination between dental office and prosthetic laboratories is of utmost importance. The dental prosthesis could harbor tones of microorganisms harmful to health staff. It has been estimated that more than 60% of the prostheses delivered to clinics from laboratories or vice versa are contaminated with pathogenic microorganisms. Several disinfection methods and chemicals have been proposed for sanitizing prostheses. Cold plasma, or nonthermal plasma, has been introduced as a new method in medical equipment disinfection. The current study aimed to compare the antimicrobial effect of cold plasma and the routinely used alcohol-based impression disinfectant ASEPTOPRINT® on disinfecting dentures.

Methods: In this experimental study, 30 maxillary complete dentures were used as the microbial source. Dentures were randomly divided into 3 groups: (1) cold plasma treatment for 30 seconds, (2) cold plasma for 60 seconds, (3) ASEPTOPRINT® spray. Microbial culturing was taken before and after disinfection in each group on both Blood Agar plates and Soborou Dextrose Agar (SDA) plates. After 48 hours incubation at 37°C, the number of colonies was counted using a digital colony counter and differences between the groups were analyzed.

Results: A significant reduction in microbial colonies was observed after using all disinfection methods. ASEPTOPRINT® spray showed more antimicrobial effects comparing to cold plasma.

Conclusion: The antimicrobial effect of ASEPTOPRINT® spray solution is more than cold plasma application on both microbial and fungal microorganisms. The time of plasma application was not accompanied by any significant differences in the results.

Introduction: Exposure to the artificial light at night (LAN) effect human health and causes several functional modification in body. Obesity, diabetes, and hormonal changes are reported after LAN in humans. Aim of this study is highlighting critical features of gene expression changes in liver of rats which are received autonomic nervous system.

Methods: Up-regulated proteins of irradiated MDA-MB-231 breast cancer cells by a single and fractioned 10 Gray (Gy) 137Cs γ-radiation were analyzed by ptotein-protein interaction (PPI) network analysis by Cytoscape software via STRING database. The network were analyzed by using Network analyzer to characterized the central genes. Action map was mapped for the queried genes and the added neighbors. via CluePedia-STRING ACTIONS-v10.5- 20.11.2017.

Results: The 14 differentially expressed proteins (DEPs) plus 10 neighbors were interacted to construct a network. Among the 14 queried DEPs FN1, CSPG4, LRP1, GSN, RTN4, and CTSD were highlighted as a complex set in analysis.  Analysis revealed that SRC as an added neighbor were activated by the critical DEPs. Activation of the other oncogene as like AKT1 also were determined.

Conclusion: The results indicate that the inhibition of SRC activity or the inhibition of its activators is a useful function of breast cancer RT.

Background: A pivotal issue to achieve success in the treatment of the root canal is root canal disinfection. One of the most important bacteria that infect root canal is enterococcus faecalis. This study seeks to examine the effectiveness of three methods for disinfecting the root canal: photodynamic therapy, modified triple antibiotic paste (MTAP) and calcium hydroxide.

Method and material: 62 single-rooted extracted anterior teeth were collectected.After cleaning and disinfection, crowns were cut at the CEJ point. The root canals were shaped to the working length up to file F3 protaper (F1, F2, F3). EDTA 17% and sodium hypochlorite 2.5% were used for 5 minutes to wash and remove the smear layer, and then the apical foramen was sealed using composite. After that, the teeth were sterilized in an autoclave at 121° C for 15 minutes. Then 10 samples were taken randomly as the negative control. The remaining samples were immersed and cultivated in a suspension containing enterococcus faecalis for 21 days. Then samples were divided into 5 groups: two positive control groups, one group treated with the antibiotic paste with the concentration of 1mg/ml, one group treated with calcium hydroxide, and one group treated with photodynamic therapy. Then, to collect the biofilm, the protaper file F4 was used. After that, the microbial suspension was provided and counting the colonies to compare the groups was carried out.

Results: The findings indicated that the amount of CFU/mg of MTAP samples, including clindamycin, metronidazole and ciprofloxacin in the concentration of 1mg/ml and photodynamic therapy and calcium hydroxide was lower than that in the control group. Antibiotic paste, cleansed the root canal up to 99.9%. Photodynamic therapy reduced the amount of CFU/mg to 98.8%, and calcium hydroxide reduced the amount of CFU/mg to 94.13%.

Introduction: Dental pulp cells, a unique source of ectomesenchymal pluripotent stem cells, are originated from the skull neural crest. They are considered as one ideal source of cells for the regenerative medicine applications. Cerebrospinal fluid (CSF), a transparent fluid found in the brain and spinal cord, is enriched with electrolytes, proteins, and growth factors such as EGF, bFGF, BDNF, GDNF, and neuropeptides and can be utilized as a trigger in order to induce the neural differentiation. On the other hand, photobiomodulation (PBM), with the ability to prevent cell apoptosis, can induce cell proliferation by means of increasing the ATP synthesis in mitochondria and facilitating the secretion of the growth factors. In this research, we first aimed to isolate and culture the dental pulp stem cells (DPSCs) and subsequently to investigate their potential for neural differentiation.

Methods: Human dental pulp stem cells (hDPSCs) were isolated from the pulp tissues using an outgrowth method and subsequently cultured. In order to access the cells’ differentiation potential, cells were firstly classified into four groups which were treated with CSF, gallium aluminum arsenide diode laser irradiation (808 nm; 30 mW power output) and a combination of both, while the fourth group was considered as the control. MTT assay was then used to examine the viability of cells following the treatments. After 4, 7, and 14 days the cell morphology in the treated groups was evaluated while RT-PCR was used in order to evaluate the Nestin and β-tubulinIII neural gene marker expressions.

Results: It was shown that PBM has the ability to elevate the proliferation of DPSCs. Also, the differentiated morphology was obvious in the CSF treated group, especially on day 14 with the formation of three-dimensional (3D) structures. The results of gene expression analysis showed that on the fourth day of post-treatment, Nestin, and β-tubulinIII gene expressions were reduced in all groups while a rising trend in their expression was observed subsequently on days 7 and 14.

Conclusion: In accordance with previous studies, including functional and protein base researches, it has been demonstrated that CSF has a direct role in neural induction. Although past works have been significant, none of them shows a 3D structure. In this article, we investigated the dual effect of PBM and CSF. Initial results confirmed the upregulation of neural-related transcription factors. The 3D organization of the formed tissue could imply the initiation of organogenesis which has not been reported before. In sum, the dual effect of CSF and PBM has been shown to have the potential for contributing to the initiation of neurogenesis and organogenesis

Introduction: The management of Peyronie’s disease (PD) has remained a therapeutic dilemma for physicians and there is no gold standard treatment. In this paper, we decided to investigate the beneficial effect of the intralesional administration of verapamil compared with the intralesional administration of verapamil plus a low-intensity laser (LIL).

Methods: Research was activated from May 2016 to May 2018 and a total of 38 men aged 18 years and older completed the investigation. The subjects were randomly divided into 2 groups. Group 1 was composed of 22 patients that were treated only by verapamil (5 mg) plus a sham laser weekly for 6 weeks, and group 2 consisted of 22 patients that received a laser, using the BTL – 6000 HIGH-INTENSITY LASER 12 W machine and the same protocol of intralesional verapamil injection. The visual analogue scale (VAS) was used to evaluate pain during an erection, penile ultrasonography was used to measure plaque size, the penile curvature angle degree was measured using the photographs taken during an erection, and the International Index of Erectile Function questionnaire was used to assess erectile function. The follow-up treatment lasted for nine months, with visits performed in the 3rd and 9th months.

Results: All study parameters decreased significantly after treatment in both arms, but the reduction in pain and penile curvature improvements in combination therapy revealed more significant changes in 3 months (p = .035, p=.032). Nevertheless, these improvements were not seen in the follow-up session after 9 months.

Conclusion: A laser appears to be safe treatment modality in carefully-selected patients with PD. It has moderate efficacy in the short term.

Introduction: Exposure to the artificial light at night (LAN) effect human health and causes several functional modification in body. Obesity, diabetes, and hormonal changes are reported after LAN in humans. Aim of this study is highlighting critical features of gene expression changes in liver of rats which are received autonomic nervous system.

Methods: Liver gene expression profiles of 5 male Wistar rats that were received a sympathetic plus parasympathetic hepatic denervation and 1 hour expose light at night (LAN) from Gene Expression Omnibus (GEO) are compared with controls. The significant differentially expressed genes (DEGs) are screened by protein-protein interaction (PPI) network analysis STRING database (an application of Cytoscape software). CuleGO and CleuDedia the two applications of Cytoscape software were used for more analysis. 

Results: Among 250 DEGs, 173 genes characterized genes with fold change more than 2 plus 100 added relevant genes were included in the PPI network. Analysis of the main connected component (MCC) led to introduce 15 hubs and 15 bottlenecks. CCT2, COPS7A, KAT2A, and ERCC1were determined as hub-bottlenecks. Among hubs and bottlenecks, DHX15, KAT2A, CCT2, HSP90AB1, CCNE1, DHX16, LSM2, WEE1, CWC27, BAZ1B, RAB22A, DNM2, and DHX30 were linked to the each other’s by various kinds of actions. CCT2 and KAT2A, the two hub-bottlenecks are included in the interacted genes in the action map. Four classes of biological terms including negative regulation of non-motile cilium assembly, negative regulation of transforming growth factor beta activation, alpha-tubulin acetylation, and histamine-induced gastric acid secration were identified as the critical involved biochemical pathways and biological processes.

Conclusion: Several essential functions as like differentiation, cell cycle, ribosome assembly, and splicing are affected by LAN in rat liver with autonomic nervous system denervation.

Introduction:In sports medicine, laser application has been well-established for the recovery of muscles. The mechanisms by which benefits of this kind of therapy can be studied is molecular research approach. Protein-protein interaction network analysis as one of the important complementary studies of proteomics can accelerate this goal by the identification of novel contributing markers.

Methods:By the use of Cytoscape V3.7.1 and its applications, a network of differential expressed proteins (DEPs) from IR laser treatment samples were constructed and analyzed. Six hub-bottlenecks were determined, 4 of which were from differentially expressed proteins.

Results:ClueGO discovered 4 biological processes related to these hub-bottlenecks that their function could alter due to IR laser therapy.

Conclusion:In fact, by the expression changes of hub-bottlenecks including the up-regulation of HSP90s, one of the prominent biological processes in muscle recovery could be activated. This process is called nitric oxide synthase (NOS) activation that could be proposed as one of the underlying mechanisms of IR laser treatments in muscle recovery.

Introduction: The retrograde approach is a modification that makes the percutaneous cystolitholapaxy (PCCL) a more trendy method, especially in operating rooms with limited facilities. The transurethral approach for bladder calculi lithotripsy by a laser has become popular among urologists. In this study, we investigate the feasibility and safety of retrograde assisted access for PCCL in comparison with transurethral cystolithotripsy by the holmium-YAG laser (Ho:
YAG).

Methods: According to the type of intervention, the patients were stratified to two matched groups. In the retrograde-assisted percutaneous cystolitholapaxy (RPCCL) group, a Benique was conducted through the urethra into the bladder; palpating the suprapubic region, an about 1.5 cm incision was done over the tip, then an Amplatz sheath was placed over it, treading into the bladder; further cystolitholapaxy was done by a routine order. In transurethral Ho: YAG laser lithotripsy (TULL) via 200 μm fiber vaporize the stone.

Results: A total of 124 male patients with the mean age of 50.33 ± 9.64 years and the average stone burden of 3.35 ± 1.07 cm were included in the study. The most common cause of vesical calculi was spinal cord injury. Statistically significant differences were found in terms of the mean operation time in favor of the RPCCL group (P ≤ 0.05) and the mean hospital stay in favor of the TULL group (P ≤ 0.05). The stone-free rate (SFR) was 100% in both methods after a one month follow-up. None of the interventions changed to open surgery. There were not any major complications in both methods.

Conclusion: RPCCL is a safe and effective method in bladder stone treatment and is applicable in
medical centers without Ho: YAG equipment.

Introduction: Radiation Therapy (RT) as a common method for cancer treatment could conclude in some side effects. Molecular investigation is one of the approaches that could assist in decrypting the molecular mechanisms of this incident. For this aim, protein-protein interaction network analysis as a complementary study of proteome is applied to explore the RT effect on brain cancer effect after the early stage of exposure prior to skin lesion appears.

Methods: Cytoscape 3.7.2 and its plug-ins analyzed the network of DEPs in the treatment condition and the centrality and pathway enrichments were conducted by the use of NetworkAnalyzer and ClueGO+CluePedia.

Results:  A network of 15 DEPs indicated that six nodes are key players in the network stability and SERPINC1 and F5 are from the query proteins. Pathways of post-translational protein phosphorylation, Platelet degranulation, and Complement and coagulation cascades are the most highlighted ones for the central nodes that could be affected in radiation therapy.

Conclusion: The central proteins of the network of early stage treatments could have additional importance in the mechanisms of radiotherapy response prior to skin lesions. These candidates worth precise attention for this type of therapy after approving by validation studies.

Introduction: Intense Pulsed Light (IPL) is one of the effective methods used to treat the signs of facial aging. However, its efficacy in improving the appearance of periorbital wrinkles has always been evaluated in the context of whole-face rejuvenation and not studied in its own right. Therefore, in this study we sought to examine the effectiveness and side effects of IPL in periorbital skin rejuvenation.

Methods: In this uncontrolled, open-label clinical trial, 38 patients referred to the Behrooz professional skin clinic for signs of periorbital skin aging were recruited. Patients underwent three treatment sessions with IPL, at one-month intervals, and were evaluated for treatment side effects after each session. Six months after the final IPL session, patients were examined to assess the level of symptom improvement. Patients were photographed at each treatment session and at the six-month follow-up visit. Before and after patient images were evaluated by two dermatologists unaffiliated with the study to determine the extent of improvement in the appearance of wrinkles and skin texture.

Results: Six months post-treatment, excellent improvement was observed in 3 patients (9.1%), considerable improvement in 7 patients (21.2%), moderate improvement in 9 patients (27.3%), mild improvement in 9 patients (27.3%) and finally little or no improvement was observed in 5 patients (15.1%). Comparison of improvement scores based on Fitzpatrick skin phenotype did not show significant differences (p=0.674). 4 patients (12.1%) were dissatisfied with the treatment whilst 17 patients (51.5%) reported moderate to considerable satisfaction with IPL rejuvenation.

Conclusion: During whole face rejuvenation, IPL can be used to improve periorbital skin aging.

Introduction: Human melanoma is a type of invasive tumor that its treatments is challenging. To better understand the proton irradiation mechanisms as one of the widely applied therapy for this type of cancer, bioinformatics analysis of proteomics outcome could be beneficial.

Methods: Protein-protein interaction network analysis of differentially expressed proteins (DEPs) of melanoma BLM (BRO Lung Metastasis) cells in the treatment of 3 Gy dosage proton therapy is performed in this study via Cytoscape V.3.7.2. and its integrated plug-ins.

Results: A number of 18 DEPs were searched for network constructions and limited numbers of (query +neighbor proteins) were found central. The hub-bottlenecks or in the other words, central nodes were GAPDH, ACTB, ALB, AKT1, TP53, and EGFR. The fist mentioned proteins is from DEPs. Enrichment analysis of these elements identified as nitric-oxide synthase regulator activity and positive regulation of norepinephrine uptake that may be key in the mechanisms of proton therapy.

Conclusion: In conclusion, the identified central nodes (EGFR, TP53, ALB, AKT1, GAPDH, and ACTB) and the related biological terms consist with the nature of melanoma and also radiation effects. 

Introduction: Functional near-infrared spectroscopy (fNIRS) has been broadly applied for optical brain imaging. This method is hemodynamic-based functional brain imaging relying on the measurement of the neurovascular coupling to detect changes in cerebral neuronal activities. The extra-cerebral hemodynamic changes are important contaminating factors in fNIRS measurements. This error signal can be misinterpreted as cerebral activities during fNIRS studies. Recently, it was assumed that temporal changes in deoxygenated hemoglobin concentration [HHb] was hardly affected by superficial blood flow, and it was proposed that the activation maps could be determined from [HHb] at large source-detector separation.

Methods: In the current study, we measured the temporal changes in [HHb] using a continues-wave fNIRS device at large source-detector separation, while superficial blood flow was stimulated by infrared lasers. A mesh-based Monte Carlo code was applied to estimate fNIRS sensitivity to superficial hemodynamic changes in a realistic 3D MRI-based brain phantom.

Results: First, we simulated photon migration in a four-layered human-head slab model to calculate PPLs and fNIRS sensitivity. Then, the localization of the infrared laser inside a realistic brain model was studied using the Monte Carlo method. Finally, the changes in [HHb] over the prefrontal cortex of six adult males were measured by fNIRS at a source-detector separation of 3 cm. The results demonstrated that the relation between fNIRS sensitivity and an increase in S-D separation was nonlinear and a correlation between shallow and deep signals was observed.

Conclusion: The presented results demonstrated that the temporal changes in the superficial blood flow could strongly affect HHb measurement at large source-detector separation. Hence, the cerebral activity map extracted from the [HHb] signal was mainly contaminated by superficial blood flow.