Review Article

Use alone or in Combination of Red and Infrared Laser in Skin Wounds

Fernando José Camello de Lima, Fabiano Timbó Barbosa, Célio Fernando de Sousa-Rodrigues

Journal of Lasers in Medical Sciences, Vol. 5 No. 2 (2014), 16 March 2014, Page 51-57

A systematic review was conducted covering the action of red laser, infrared and combination of both, with emphasis on cutaneous wound therapy, showing the different settings on parameters such as fluency, power, energy density, time of application, frequency mode and even the type of low-power lasers and their wavelengths. It was observed that in general, the lasers brings good clinical and histological results mainly, but there is not a protocol that defines a dosage of use that has predictability of therapeutic success in repairing these wounds.

Biological Effects of Low Level Laser Therapy

Shirin Farivar, Talieh Malekshahabi, Reza Shiari

Journal of Lasers in Medical Sciences, Vol. 5 No. 2 (2014), 16 March 2014, Page 58-62

The use of low level laser to reduce pain, inflammation and edema, to promote wound, deeper tissues and nerves healing, and to prevent tissue damage has been known for almost forty years since the invention of lasers. This review will cover some of the proposed cellular mechanisms responsible for the effect of visible light on mammalian cells, including cytochrome c oxidase (with absorption peaks in the Near Infrared (NIR)). Mitochondria are thought to be a likely site for the initial effects of light, leading to increased ATP production, modulation of reactive oxygen species, and induction of transcription factors. These effects in turn lead to increased cell proliferation and migration (particularly by fibroblasts).

Original Article

Low-Level Laser Therapy Attenuates the Myeloperoxidase Activity and Inflammatory Mediator Generation in Lung Inflammation Induced By Gut Ischemia and Reperfusion: A Dose-Response Study

Flávia Mafra- de- Lima, Flávio Aimbire, Humberto Miranda, Rodolfo de Paula Vieira, Ana Paula Ligeiro de Oiveira, Regiane Albertini

Journal of Lasers in Medical Sciences, Vol. 5 No. 2 (2014), 16 March 2014, Page 63-70

Introduction: Intestinal ischemia and reperfusion (i-I/R) is an insult associated with acute respiratory distress syndrome (ARDS). Herein we evaluate the dose-response effect of low-level laser therapy (LLLT) on lung inflammation induced by i-I/R.

Methods: Mice were subjected to mesenteric artery occlusion (45 min) and killed after clamp release and intestinal reperfusion (2h). Increasing doses (1, 3, 5 and 7,5 J/cm2) of laser irradiation (660 nm) was carried out on the mice skin over the upper bronchus for 5 min after initiating reperfusion. Neutrophils activation was determined by myeloperoxidase (MPO) activity. The mRNA expression and protein concentration of inflammatory mediators IL-1β, IL-6, TNF and IL-10 in lung were measured by RT-PCR and ELISA, respectively.

Results: With exception of 1J/cm2, LLLT reduced MPO activity as well as IL-1β levels in the lungs from inflamed mice. LLLT was also markedly effective in reducing both IL-6 and TNF expression and levels in the lungs from mice submitted to i-I/R in all laser doses studied. Otherwise, LLLT significantly increased the protein levels of IL-10 in inflamed mice by i-I/R; however only in the dose of 1J/cm2.

Conclusion: We conclude that the LLLT is able to control the neutrophils activation and pro-inflammatory cytokines release into the lungs in a model of i-I/R in mice.

Low Level Laser Effect in Treatment of Patients with Intractable Tinnitus Due To Sensorineural Hearing Loss

Abbas Mirvakili, Amirhoushang Mehrparvar, Mehrdad Mostaghaci, Abolfazl Mollasadeghi, Masud Mirvakili, Mohammadhosein Baradaranfar, Mohammadhosein Dadgarnia, Mohammadhosein Davari

Journal of Lasers in Medical Sciences, Vol. 5 No. 2 (2014), 16 March 2014, Page 71-74

Introduction: Tinnitus is defined as a perception of sound without an external acoustic stimulus. Due to large number of causes and limited knowledge of its pathophysiology, tinnitus still remains an obscure symptom.

Methods: This was a cross-sectional study on 120 patients with tinnitus and sensorineural hearing loss who were randomly divided into two groups; one group received low-level laser and the second group used the same instrument but off, for 20 sessions of 20 minutes. A tinnitus handicap inventory (THI) and Visual Analog Scale (VAS) were used to evaluate the severity of patients' symptoms. Severity and frequency of tinnitus were also determined using Audiometric tests.

Results: The average age of the 120 patients in the two groups of study were not statistically significantly different. The mean difference of severity of tinnitus between the two groups was statistically significant at the end of the study and 3 month after completion of treatment. The VAS and THI mean differences after the treatment were statistically significant between the two groups but not statistically significant after 3 months of completion the study.

Conclusion: Low level laser radiation is effective for short-term treatment of Tinnitus caused by sensorineural hearing loss and its impact may be reduced over the time.

One Possible Mechanism of Pulsed Dye Laser Treatment on Infantile Hemangioma: Induction of Endothelial Apoptosis and Serum vascular endothelial growth factor (VEGF) Level Changes

Yongqian Cao, Fagang Wang, Qingwei Jia, Rongjian Xu, Wei Dang, Qing Chen, Li Lin, Yibing Wang

Journal of Lasers in Medical Sciences, Vol. 5 No. 2 (2014), 16 March 2014, Page 75-81

Introduction: Pulsed dye laser (PDL) is an important treatment for superficial infantile hemangioma, but few studies report on its cellular mechanism. The aim of this study was to evaluate alterations of serum vascular endothelial growth factor (VEGF) level in infantile hemangioma (IH) patients after laser treatment and effects of PDL irradiation on human umbilical vein endothelial cells (HUVECs) in vitro, as well as to explore the biomolecular mechanisms and ultrastructure changes of the PDL effect.

Methods: 74 children with infant hemangioma including 45 patients in proliferating phase, 18 patients in involuting phase, 11 patients in involuted phase and 10 healthy children were engaged in this study. The plasma VEGF levels of children were measured with the enzyme-linked immunosorbent assay (ELISA). 24 hours after, HUVECs cultured in vitro were irradiated with PDL, cell apoptosis, mRNA levels of VEGF, and changes of ultrastructure were evaluated using flow cytometry, real-time reverse transcriptase polymerase chain reaction (RT-PCR), and transmission electron microscopy, respectively.

Results: The serum VEGF concentrations in children with proliferating hemangiomas were significantly higher than in patients with involuting / involved hemangiomas and healthy patients. After receiving 3 laser treatments, the plasma VEGF levels of IH patients in proliferating hemangiomas decreased significantly. PDL irradiation could down-regulate VEGF mRNA expression of HUVECs, and increase cell apoptosis rate.

Conclusion: The present study demonstrates that PDL irradiation imparts apoptosis induction effects on HUVECs in vitro. Furthermore, our results suggest that vascular endothelial growth factor may be of particular importance in pathophysiology and PDL treatment of hemangiomas, also serum VEGF levels may be used as an aid in the follow up of IH. This provides valuable evidence of the PDL effect on infantile hemangioma.

The Effect of Antimicrobial Photodynamic Therapy with Radachlorin® on Staphylococcus Aureus and Escherichia Coli: An in Vitro Study

Reza Fekrazad, Hadi Zare, Sara Mohammadi Sepahvand, Parisa Morsali

Journal of Lasers in Medical Sciences, Vol. 5 No. 2 (2014), 16 March 2014, Page 82-85

Introduction: The aim of this study is the evaluation of the effect of Antimicrobial Photodynamic Therapy with Radachlorin on Staphylococcus aureus and Escherichia coli.

New windows are open in the antimicrobial field so-call Photodynamic therapy that incorporates a nonpoisonous photosensitizer (PS) with innocuous special wavelength photons to excite the PS.

Methods: Two strains of bacteria used in this study were Methicillin resistant Staphylococcus aureus (ATCC 33591; PTCC 1764) and Escherichia coli (ATCC 25922; PTCC1399). Concentrations of 0.2 ml of Radachlorin® were applied on 0.2 ml of bacterial suspensions and placed in a 48-well microtiter plate. The following groups were used: (I) L− PS− (no laser, no photosensitizer), (II) L−PS+ (treated only with PS), (III) L+ PS− (treated only with laser) and (IV) L+ PS+ (treated with laser and PS: photodynamic therapy group). Aliquots of bacterial suspensions were sensitized with Radachlorin® for 15 minutes in the dark at room temperature and then bacterial suspensions in group III and IV were irradiated with 210 mW (power density) and 12 J/cm2 (energy density) on continuous mode.

Results: This study showed that photodynamic therapy reduces 0.14 log 10 in E.Coli (group IV) and there were significant differences for group IV (P<0.01). Photodynamic therapy in S.Aureus showed 6.28 log 10 colony count reduction (group IV) and there were highly significant differences in Photodynamic therapy group (P<0.0001).

Conclusion: Radachlorin® have bactericidal effect on S.aureus (6.28 log 10) and bacteriostatic effect on E.coli (0.14 log 10).

Application of Low-Level Laser Therapy Following Coronary Artery Bypass Grafting (CABG) Surgery

Nooshafarin Kazemi Khoo, Kamran Babazadeh, Marjan Lajevardi, Fataneh Hashem Dabaghian, Ehsan Mostafavi

Journal of Lasers in Medical Sciences, Vol. 5 No. 2 (2014), 16 March 2014, Page 86-91

Introduction: An attack of acute myocardial infarction (MI) poses the threat of great damage to cardiac tissue. Operative therapeutic modalities such as coronary artery bypass grafting (CABG) may enhance myocardial perfusion in high-grade coronary vasculature occlusions. It has been shown previously that Low-Level Laser Therapy (LLLT) significantly reduces infarct size following induction of myocardial infarction in rats and dogs. The aim of this study was to investigate the effects of LLLT on cardiac tissue healing markers following grafting operations for coronary vessel occlusion.

Methods: Thirty-two cases having each two or three coronary vessel occlusions (2VD/3VD) underwent low-level laser therapy post-CABG, and 28 patients who did not undergo laser therapy were studied as a control group. Diode laser (810 nm, 500 mW) was used as LLLT protocol for 3 successive days post-CABG. Repeated measurements of blood cell count (CBC) and cardiac damage markers (CPK, CPK-MB, LDH) attained before CABG and during the 5 days of LLLT post-operatively, taken at one and 12 hours after daily laser irradiation.

Results: In a comparison of the mean levels of the control and laser group, the variables were statistically different on 5th day after intervention for WBC, Neutrophil and Lymphocyte counts and WBC and lymphocyte changes. A statistically significant difference was seen in changes of CPK, CPK-mb and LDH over time P<0.001.

Conclusion: It is concluded that low-level laser irradiation after CABG surgery could decrease cardiac cellular damage and help accelerate the repair of cardiac tissue post-operatively. This may lower post-operative disability as well as bed rest period in these patients.

Case Report

Posthaste Outgrow of Lip Pyogenic Granuloma after Diode Laser Removal

Mohammad Asnaashari, Jamile Bigom -Taheri, Maesoome Mehdipoor, Mahin Bakhshi, Saranaz Azari-Marhabi

Journal of Lasers in Medical Sciences, Vol. 5 No. 2 (2014), 16 March 2014, Page 92-95

Introduction: Pyogenic granuloma (PG) is one of the inflammatory hyperplasia seen in the oral cavity. It is a reactional response to minor trauma or chronic irritation and also might be related to hormonal changes. Rarely, PG occurs extragingivally.The most common treatment of PG is surgical excision but alternative approaches such as laser excision have also been proposed.

Case report: Herein, we present a case of lip pyogenic granuloma in a 15-year-old male whom had been under orthodontic treatment. The lesion was first excised with diode laser as a conservative method, but the lesion had immediately recurred and was excised with surgical blade as the traditional method. No recurrence or scarring was observed in 6 months follow-up.

Results and conclusion: Although the use of laser as modern medicine offers a new tool for treatment of oral lesions, scalpel (blade) surgical excision still seems to be the successful treatment of choice in minimizing the recurrence of lesion especially when exacerbating factors such as hormonal imbalances exist.